Signal intensity at unenhanced T1-weighted magnetic resonance in the globus pallidus and dentate nucleus after serial administrations of a macrocyclic gadolinium-based contrast agent in children

Pediatr Radiol. 2017 Sep;47(10):1345-1352. doi: 10.1007/s00247-017-3874-1. Epub 2017 May 19.


Background: Few studies have been conducted on the relations between T1-weighted signal intensity changes in the pediatric brain following gadolinium-based contrast agent (GBCA) exposure.

Objective: The purpose of this study is to investigate the effect of multiple administrations of a macrocyclic GBCA on signal intensity in the globus pallidus and dentate nucleus of the pediatric brain on unenhanced T1-weighted MR images.

Materials and methods: This retrospective study included 50 patients, mean age: 8 years (standard deviation: 4.8 years), with normal renal function exposed to ≥6 administrations of the same macrocyclic GBCA (gadoterate meglumine) and a control group of 59 age-matched GBCA-naïve patients. The globus pallidus-to-thalamus signal intensity ratio and dentate nucleus-to-pons signal intensity ratio were calculated from unenhanced T1-weighted images for both patients and controls. A mixed linear model was used to evaluate the effects on signal intensity ratios of the number of GBCA administrations, the time interval between administrations, age, radiotherapy and chemotherapy. T-test analyses were performed to compare signal intensity ratio differences between successive administrations and baseline MR signal intensity ratios in patients compared to controls. P-values were considered significant if <0.05.

Results: A significant effect of the number of GBCA administrations on relative signal intensities globus pallidus-to-thalamus (F[8]=3.09; P=0.002) and dentate nucleus-to-pons (F[8]=2.36; P=0.021) was found. The relative signal intensities were higher at last MR examination than at baseline (P<0.001).

Conclusion: Quantitative analysis evaluation of globus pallidus:thalamus and dentate nucleus:pons of the pediatric brain demonstrated an increase after serial administrations of macrocyclic GBCA. Further research is necessary to fully understand GBCA pharmacokinetic in children.

Keywords: Brain; Deposit; Gadolinium; MRI; Pediatric.

MeSH terms

  • Cerebellar Nuclei / diagnostic imaging*
  • Child
  • Contrast Media / administration & dosage*
  • Female
  • Globus Pallidus / diagnostic imaging*
  • Humans
  • Magnetic Resonance Imaging / methods*
  • Male
  • Meglumine / administration & dosage*
  • Organometallic Compounds / administration & dosage*
  • Retrospective Studies


  • Contrast Media
  • Organometallic Compounds
  • Meglumine
  • gadoterate meglumine