Do we need gadolinium-based contrast medium for brain magnetic resonance imaging in children?

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Preparation and In Vitro Characterization of Dendrimer-based Contrast Agents for Magnetic Resonance Imaging
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Preparation and In Vitro Characterization of Dendrimer-based Contrast Agents for Magnetic Resonance Imaging

Published on: December 4, 2016

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Dennis Dünger1, Matthias Krause2, Daniel Gräfe1

  • 1Department of Paediatric Radiology, University Leipzig, Liebigstrasse 20a, 04103, Leipzig, Germany.

Pediatric Radiology
|April 7, 2018
PubMed

Insights

Gadolinium contrast medium rarely benefits pediatric brain MRI when initial scans are normal. Routine use in these cases is not supported by evidence, suggesting it should be avoided.

Area of Science:

  • Pediatric Radiology
  • Neuroradiology
  • Medical Imaging

Background:

  • Pediatric brain magnetic resonance imaging (MRI) is common, often using gadolinium-based contrast agents.
  • Gadolinium contrast administration carries potential risks.
  • Evidence for contrast medium benefits in pediatric brain MRI is limited.

Purpose of the Study:

  • To evaluate the diagnostic value of contrast-enhanced MRI sequences in pediatric brain imaging when unenhanced sequences are normal.
  • To determine if contrast administration provides clinically relevant additional information in normal pediatric brain MRIs.

Main Methods:

  • Retrospective analysis of 6,683 pediatric brain MRI examinations (children <16 years) at University Hospital Leipzig.
  • Comparison of findings between pre-contrast and contrast-enhanced sequences.
  • Utilized 1.5-T or 3-T MRI systems.

Main Results:

  • Only 8 out of 3,003 (0.27%) normal unenhanced brain MRIs showed a relevant additional finding after contrast administration.
  • Contrast enhancement altered the diagnosis in only one case.
  • The diagnostic gain from contrast was minimal in normal pediatric brain MRIs.

Conclusions:

  • Contrast-enhanced MRI provides minimal additional benefit for pediatric brain imaging when initial unenhanced scans are normal.
  • The risks associated with gadolinium contrast administration outweigh the limited benefits in these specific cases.
  • Routine use of gadolinium contrast in pre-contrast normal pediatric brain MRI examinations should be reconsidered and likely avoided.
Abstract

Keywords:
BrainChildrenContrast mediumDiagnostic valueGadoliniumMagnetic resonance imaging

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