Related Experiment Videos
Gd-DTPA-enhanced cranial MR imaging in children: initial clinical experience and recommendations for its use
1Department of Radiology, Bowman Gray School of Medicine, Winston-Salem, NC 27103.
Insights
Gadolinium diethylenetriamine pentaacetic acid (Gd-DTPA) is safe for pediatric cranial MRI but not routinely recommended. Its use is most beneficial for suspected tumors or inflammatory conditions.
Area of Science:
- Pediatric Radiology
- Neuroimaging
- Magnetic Resonance Imaging
Background:
- Gadolinium-based contrast agents (GBCAs) are frequently used in MRI.
- Assessing the safety and utility of GBCAs in pediatric populations is crucial for diagnostic imaging.
- Gadolinium diethylenetriamine pentaacetic acid (Gd-DTPA) is a commonly used GBCA.
Purpose of the Study:
- To evaluate the utility and safety of Gd-DTPA for routine cranial MRI in children.
- To determine the diagnostic yield of Gd-DTPA in pediatric neuroimaging.
- To identify specific pediatric patient groups that benefit most from Gd-DTPA administration.
Main Methods:
- Prospective administration of Gd-DTPA to 65 pediatric patients (1 day to 18 years).
- Acquisition of precontrast T1- and T2-weighted, and postcontrast T1-weighted MRI scans.
- Analysis of contrast enhancement patterns and their impact on lesion characterization.
Main Results:
- No complications or significant adverse reactions were observed with Gd-DTPA administration.
- Contrast enhancement was noted in 14 lesions across seven patients, with pre-existing abnormalities.
- Gd-DTPA was extremely helpful in characterizing 4 primary tumors and moderately helpful for 4 other lesions.
- Absence of enhancement aided in clarifying abnormalities in 4 additional patients.
Conclusions:
- Gd-DTPA can be safely administered to pediatric patients for cranial MRI.
- Routine administration of Gd-DTPA in all pediatric cranial MRI examinations is not supported by this study.
- The highest diagnostic value of Gd-DTPA is observed in children with suspected neoplasms, inflammatory diseases, or those needing further characterization of precontrast lesions.
Abstract:
Gd-DTPA was administered prospectively to 65 consecutive children (ages 1 day to 18 years, mean 9.6 years) to document its utility and safety for routine cranial MR imaging. Precontrast T1- and T2-weighted scans and postcontrast T1-weighted scans were obtained. No complications or significant adverse reactions were encountered. Contrast enhancement was seen in 14 lesions from seven patients, but each of these patients had some abnormality also present on precontrast images. Contrast enhancement was thought to be extremely helpful in characterizing four primary tumors and moderately helpful in characterizing four other lesions. Absence of contrast enhancement was helpful in clarifying the nature of abnormalities seen in an additional four patients. Gd-DTPA may be used safely in children, but this study does not support its routine administration. The highest incremental diagnostic yield from its use will likely be among patients with suspected neoplasms or inflammatory diseases and among those requiring further characterization of lesions seen on precontrast scans.