Gd-DTPA-enhanced MR imaging in pediatric patients after brain tumor resection

A prospective study was conducted in 15 pediatric patients who had undergone resection of intracranial tumors. The object of the study was to determine the safety and efficacy of magnetic resonance (MR) imaging performed after the administration of gadolinium diethylenetriamine-pentaacetic acid (Gd-DTPA) in evaluating residual or recurrent tumor. Precontrast T1-weighted, intermediate, and T2-weighted images were obtained at a field strength of 1.5 T. Gd-DTPA was then injected intravenously in a dose of 0.1 mmol per kilogram of body weight. T1-weighted images were obtained within 5 minutes after the injection, intermediate and T2-weighted images were obtained 10 minutes after the injection, and T1-weighted images were obtained approximately 20 minutes after the injection. None of the patients experienced allergic reactions or other side effects. Physical examination findings and laboratory values were unchanged after the Gd-DTPA-enhanced examination. In six patients, contrast-enhanced images depicted tumor not suspected on nonenhanced images. In four other patients, enhanced images provided better definition of the tumor core. The images of one patient with a brain stem tumor showed no evidence of enhancement. Pre- and postcontrast images of three previously treated patients showed no evidence of tumor. Gd-DTPA appears to be a safe and effective contrast agent for MR imaging and provides a more accurate method of imaging in the follow-up of brain tumors in pediatric patients.