24 ⇓– 26 Ramalho et al 24 evaluated the signal intensity of the DN and GP in patients who received either gadodiamide, a linear nonionic GBCA, or gadobenate dimeglumine, a linear ionic contrast agent.
20 ⇓ ⇓– 23 There is, however, discrepancy in the literature concerning the linear agent gadobenate dimeglumine.
12 ⇓ ⇓ ⇓ ⇓ ⇓ ⇓– 19 The general consensus is that linear, but not macrocyclic, GBCAs are associated with the development of hyperintense signal in the GP and DN on unenhanced T1-weighted images as demonstrated by most of these studies, though controversial findings remain.
Subsequently, several studies evaluated various GBCAs and their association with gadolinium retention in both the adult 4 ⇓ ⇓ ⇓ ⇓ ⇓ ⇓– 11 and pediatric populations. At postmortem examination, the cause of this high T1-weighted signal intensity in the GP and DN was shown to be retained gadolinium. In 2014, Kanda et al 1 first reported the development of progressively increasing signal intensity in the globus pallidus (GP) and dentate nucleus (DN) on unenhanced T1-weighted imaging in patients who had undergone multiple contrast MRIs with the administration of gadopentetate dimeglumine or gadodiamide. Because gadolinium is an extremely toxic substance, chelating agents are designed to prevent release of gadolinium in the body before renal excretion. All GBCAs are composed of gadolinium and a chelating agent. Gadolinium-based contrast agents (GBCAs) are extensively used in evaluating both central nervous system and non-CNS pathologies with MR imaging and provide critical diagnostic and treatment-guiding information. ABBREVIATIONS: DN dentate nucleus GBCA gadolinium-based contrast agent GP globus pallidus MCP middle cerebellar peduncle TH thalamus
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