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(Stroke. 2002;33:1799.)
© 2002 American Heart Association, Inc.

Original Contributions

Effect of Intravenous Gadolinium-DTPA on Diffusion-Weighted Images

Evaluation of Normal Brain and Infarcts

Kei Yamada, MD, PhD; Hiroshi Kubota, MS; Osamu Kizu, MD, PhD; Hisao Nakamura, MD; Hirotoshi Ito, MD; Sachiko Yuen, MD; Osamu Tanaka, MD; Takao Kubota, MD; Masahiro Makino, MD, PhD; Marc Van Cauteren, PhD Tsunehiko Nishimura, MD, PhD

From the Departments of Radiology (K.Y., H.K., O.K., H.N., H.I., S.Y., O.T., T.K., T.N.) and Neurology (M.M.), Kyoto Prefectural University of Medicine, Kyoto, and Philips Medical Systems Asia Pacific, Tokyo (M. v C.), Japan.

Reprint requests to Kei Yamada, Department of Radiology, Kyoto Prefectural University of Medicine, Kajii-cyo, Kawaramachi Hirokoji Sagaru, Kamigyo-ku, Kyoto City, Kyoto, Japan 602-8566. E-mail kyamada{at}koto.kpu-m.ac.jp

Background and Purpose— Diffusion-weighted imaging (DWI) is usually done before administration of intravenous contrast agents. Repetition of DWI is occasionally necessary after administration, but the effects of contrast material on DWI and apparent diffusion coefficient (ADC) values have not yet been fully examined. The present study assesses whether administration of gadolinium-based contrast material significantly affects DWI and ADC values.

Methods— We examined DWI data from 39 patients (mean age, 67.9 years; range, 34 to 87 years) who were evaluated with a stroke protocol at our institute. All patients were scanned at the acute or subacute stages of infarct from 3 hours to 5 days after symptom onset. We obtained DWI images using single-shot echo-planar imaging with a b value of 1000 s/mm². Patients were injected with 0.1 mmol gadopentetate dimeglumine per 1 kg body weight. We examined the signal-to-noise ratio of the normal brain and the infarct and evaluated the contrast-to-noise ratio of each lesion. In addition, we compared the ADC values calculated from the DWI images before and after administration of contrast. The statistical significance of differences between precontrast and postcontrast administration was determined by use of a paired t test.

Results— The signal-to-noise and contrast-to-noise ratios of the DW images were not significantly different before and after administration of contrast agent. The ADC values were slightly lower after administration of contrast agent for both normal brain (P=0.0011) and infarcts (P=0.038). The estimated differences in the ADC values were 1.3% and 3.5% for normal brain and infarcts, respectively.

Conclusions— The lack of a significant difference between the signal-to-noise and contrast-to-noise ratios of DW images before and after administration of contrast agent indicates the feasibility of postcontrast DWI.

Key Words: brain injuries • gadolinium DTPA • infarcts • magnetic resonance imaging • perfusion

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