Do we need gadolinium-based contrast medium for brain magnetic resonance imaging in children?

  • Dennis Dünger
  • Matthias Krause
  • Daniel Gräfe
  • Andreas Merkenschlager
  • Christian Roth
  • Ina Sorge
Original Article

Abstract

Background

Brain imaging is the most common examination in pediatric magnetic resonance imaging (MRI), often combined with the use of a gadolinium-based contrast medium. The application of gadolinium-based contrast medium poses some risk. There is limited evidence of the benefits of contrast medium in pediatric brain imaging.

Objective

To assess the diagnostic gain of contrast-enhanced sequences in brain MRI when the unenhanced sequences are normal.

Materials and methods

We retrospectively assessed 6,683 brain MR examinations using contrast medium in children younger than 16 years in the pediatric radiology department of the University Hospital Leipzig to determine whether contrast-enhanced sequences delivered additional, clinically relevant information to pre-contrast sequences. All examinations were executed using a 1.5-T or a 3-T system.

Results

In 8 of 3,003 (95% confidence interval 0.12–0.52%) unenhanced normal brain examinations, a relevant additional finding was detected when contrast medium was administered. Contrast enhancement led to a change in diagnosis in only one of these cases.

Conclusion

Children with a normal pre-contrast brain MRI rarely benefit from contrast medium application. Comparing these results to the risks and disadvantages of a routine gadolinium application, there is substantiated numerical evidence for avoiding routine administration of gadolinium in a pre-contrast normal MRI examination.

Keywords

Brain Children Contrast medium Diagnostic value Gadolinium Magnetic resonance imaging 

Notes

Compliance with ethical standards

Conflicts of interest

None

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Copyright information

© Springer-Verlag GmbH Germany 2017

Authors and Affiliations

  1. 1.Department of Paediatric RadiologyUniversity LeipzigLeipzigGermany
  2. 2.Department of Neurosurgery/Paediatric NeurosurgeryUniversity LeipzigLeipzigGermany
  3. 3.Department of Woman and Child Health, Hospital for Children & Adolescents, University LeipzigLeipzigGermany

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