Abstract:
BACKGROUND:Gadolinium leakage in ocular structures (GLOS) was recently observed in fluid-attenuated inversion recovery (FLAIR) images obtained the day after an initial gadolinium injection in stroke patients. The specificity of GLOS to stroke and its mechanisms remain unclear. OBJECTIVE:We investigated the factors associated with GLOS in a cohort of patients presenting with acute neurological deficits. MATERIALS AND METHODS:This retrospective study included consecutive patients admitted to our stroke unit for acute neurological deficit between July 2017 and August 2018 who underwent baseline brain magnetic resonance imaging with the injection of a macrocyclic gadolinium agent and another scan without injection within 72 hours. The patients were separated into a stroke group and a stroke mimic group based on diffusion-weighted images. Gadolinium leakage in ocular structures was defined as a bright signal in the vitreous in follow-up FLAIR compared with baseline FLAIR (pregadolinium). Clinical data were collected together with imaging features from the baseline scans, including the volume of the infarct and of hypoperfusion if applicable, white matter hyperintensities, the number of lacunes, and the number of microbleeds, which were combined to yield a small vessel disease (SVD) score. We compared the prevalence of GLOS in both groups using the χ2 test. In the entire cohort, univariate and multivariate regression models were used to test the associations between GLOS and the collected data. RESULTS:Among the 467 patients included in the study, GLOS was observed in similar proportions in the stroke group (32.2%, 136/422) and the stroke mimic group (28.9%, 13/45; mean difference, 3.3%; 95% confidence interval, -10.9 to 17.6; P = 0.65). In univariate analysis, GLOS was associated with older age, increased prevalence of vascular risk factors, brain imaging features of SVD (white matter hyperintensities, lacunes, microbleeds), as well as with impairment of renal function and increased dose of gadolinium. No associations were found with factors related to stroke, such as its volume, acute treatment, or rate of recanalization. Multivariate analyses showed that aging (P < 0.001), diabetes (P = 0.010), severe renal failure (P = 0.004), and increased dose of gadolinium (P < 0.001) were independent contributors to GLOS. CONCLUSIONS:Gadolinium leakage in ocular structures, which occurs more commonly at higher concentrations of gadolinium, is not specific to stroke and may represent increased permeability of the blood-retinal barrier associated with age- and vascular risk factor-related SVD.
journal_name
Invest Radioljournal_title
Investigative radiologyauthors
Galmiche C,Moal B,Marnat G,Sagnier S,Schweitzer C,Dousset V,Sibon I,Tourdias Tdoi
10.1097/RLI.0000000000000757subject
Has Abstractpub_date
2021-01-19 00:00:00eissn
0020-9996issn
1536-0210pii
00004424-900000000-98734pub_type
杂志文章abstract:BACKGROUND:Nephrogenic systemic fibrosis (NSF) has been related to the use of gadolinium-based contrast agents (GBCAs) in patients undergoing dialysis. The Prospective Fibrose Nephrogénique Systémique study, a French prospective study supported by the French drug regulatory agency (Agence Nationale de Sécurité du Médic...
journal_title:Investigative radiology
pub_type: 临床试验,杂志文章
doi:10.1097/RLI.0000000000000000
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abstract::A technique to measure absolute arterial blood flow in ml/min has been developed utilizing software programs with high-speed digital recording for the off-line analysis of intra-arterial injections of contrast medium. Measurements of pulsatile flow in a phantom for a physical flow model showed that calculations with t...
journal_title:Investigative radiology
pub_type: 杂志文章
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abstract:RATIONALE AND OBJECTIVES:The purpose of the study was to evaluate the effect of articular fluid distention on patellar position at different degrees of knee angulation. METHODS:Patellar position in 10 cadaveric knee specimens was determined with 30, 100, and 200 mm Hg joint distention at 45, 20, and 5 degrees of knee ...
journal_title:Investigative radiology
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journal_title:Investigative radiology
pub_type: 杂志文章
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pub_type: 杂志文章
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journal_title:Investigative radiology
pub_type: 杂志文章
doi:10.1097/00004424-199402000-00017
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journal_title:Investigative radiology
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journal_title:Investigative radiology
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pub_type: 杂志文章
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更新日期:2012-08-01 00:00:00
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abstract:RATIONALE AND OBJECTIVES:Paclitaxel added to angiographic contrast medium (CM) has been shown to inhibit restenosis in the porcine coronary overstretch model. This study determined early local tissue concentrations after the administration of different paclitaxel doses and preparations. MATERIALS AND METHODS:Fifteen p...
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journal_title:Investigative radiology
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journal_title:Investigative radiology
pub_type: 杂志文章
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更新日期:1994-04-01 00:00:00
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journal_title:Investigative radiology
pub_type: 杂志文章
doi:10.1097/00004424-200205000-00002
更新日期:2002-05-01 00:00:00