Gadopentetate dimeglumine-enhanced MR of the brain: clinical utility and safety in patients younger than two years of age

• Published in: American journal of neuroradiology Vol. 15; no. 6; pp. 1001 - 1008
• Main Authors: Eldevik, OP, Brunberg, JA
• Format: Journal Article Conference Proceeding
• Language: English
• Published: Oak Brook, IL Am Soc Neuroradiology 01.06.1994; American Society of Neuroradiology
• Subjects: Biological and medical sciences; Brain Diseases - diagnosis; Child, Preschool; Clinical Trial; Contrast Media; Contrast media. Radiopharmaceuticals; Drug Combinations; Gadolinium - adverse effects; Gadolinium DTPA; Humans; Infant; Infant, Newborn; Magnetic Resonance Imaging; Medical sciences; Meglumine - adverse effects; Organometallic Compounds - adverse effects; Pentetic Acid - adverse effects; Pentetic Acid - analogs & derivatives; Pharmacology. Drug treatments; Prospective Studies; Human; Central nervous system; Paramagnetic contrast agent; Exploration; Infant; Nuclear magnetic resonance imaging; Contrast media; Brain (vertebrata)
• ISSN: 0195-6108; 1936-959X

To evaluate the clinical utility and safety of gadopentetate dimeglumine as a contrast agent for MR of the brain in patients younger than 2 years of age. In 125 consecutive patients younger than 2 years of age, MR images obtained before and after gadopentetate dimeglumine administration (0.1 mmol/kg) were independently and prospectively evaluated. After interpreting the unenhanced T1- and T2-weighted images, we rated the utility of contrast administration in each patient as not helpful, helpful, or essential for formulation of the radiologic diagnosis. Ratings were categorized both on the basis of the referring clinical diagnoses and on the basis of a radiologic diagnosis that was established from the clinical history and from the findings on the precontrast and postcontrast T1- and T2-weighted images. Patients' vital signs were recorded, and general medical status was observed for 120 minutes after gadopentetate dimeglumine administration. In no case did gadopentetate dimeglumine permit detection of lesions when precontrast T1- and T2-weighted images were normal. In only 4 of 125 patients were postcontrast images considered essential for establishing the radiologic diagnosis. Abnormal contrast enhancement was radiologically helpful in 20 of 125 patients. Lack of enhancement was considered helpful in 22 of 125 patients. No adverse clinical events or clinically important trends in vital signs were observed after contrast administration. The indiscriminate use of contrast agents in the MR imaging of patients younger than 2 years of age is not warranted. Appropriate decisions regarding the use of gadopentetate dimeglumine can be based on the findings in unenhanced T1- and T2-weighted images and on the referring clinical diagnosis.