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This is a retrospective analysis of 59 patients who received only gadobutrol and 60 patients who received only linear gadolinium-based contrast agents. Linear gadolinium-based contrast agents included gadoversetamide, gadobenatedimeglumine, and gadodiamide. T1 signal intensity in the globus pallidus, dentate nucleus, and pons was measured on the precontrast portions of patients' first and seventh brain MRIs. The dentate nucleus/pons signal ratio increased in the linear gadolinium-based contrast agent group while no significant increase was seen in the gadobutrol group. The authors conclude that successive doses of gadobutrol do not result in T1 shortening compared with changes seen in linear gadolinium-based contrast agents.

The authors reviewed clinical charts and images of patients 18 years of age or younger with ≥4 gadobenatedimeglumine–enhanced MRIs for 6 years. Seventy-six children (60 unconfounded by treatment, 16 with radiochemotherapy) met the selection criteria. T1 signal intensity ratios for the dentate to pons and globus pallidus to thalamus were calculated and correlated with number of injections, time interval, and therapy. Among the 60 children without radiochemotherapy, only 2 had elevated T1 signal intensity ratios. Twelve of the 16 children with radiochemotherapy showed elevated signal intensity ratios. Statistical analysis demonstrated a significant signal intensity ratio change for the number of injections. Compared with published adult series, children show a similar pattern of T1 hyperintense signal changes of the dentate and globus pallidus after multiple gadobenatedimeglumine injections. The T1 signal changes in children are accelerated by radiochemotherapy.