Investigation On Detection Of Brain Metastases With Single Dose Via Double Dose Gadobutrol

Nowdays brain metastases have a higher incidence, and tumor metastasis is oneof the important biological characteristics. Tumor prognosis of brain metastasis isvery poor, if not treated, patients will die in a short term. Only with a correcttreatment plan and effective treatment, can the life survival and quality of patients beimproved effectively. The number, size and boundary of brain metastasis play animportant role in choosing treatment options, while MRI is the best diagnostic methodto diagnose brain metastases, improving MRI diagnosis of brain metastasis tumorsensitivity also have great clinical value. The purpose of this study is to investigatethe application value of the single or double doses of gadobutrol enhancing thediagnosis of brain metastases. Foreign and domestic scholars have studyed the clinicalvalue with large doses of MRI contrast agent, but the most scholars used a tripleddose and most choosed T1WI and FLAIR sequence. This study selected a double doseof gadobutrol to enhance basic sequence CUBET1WI as the breaking point for theresearch.This study collected a total of23patients,(10males,13females)who werehighly suspected with brain metastases through the check of MRI scan and enhancedMRI,from March2012to January2013at the First Hospital of Jilin University. Allpatients were injected the same contrast agent gadobutrol injection from the BayerHealthCare. The first injection was0.1mmol/kg,10min later the second injection0.1mmol/kg, and then achieved a cumulative dose of0.2mmol/kg. The injection speedis1.0ml/s. Before injection scanning sagittal T1FLAIR and sagittal CUBET1WI, afterthe first injection and the secnod injection immediately scanning sagittal CUBET1WI,but scanning sagittal T1FLAIR only after scanning sagittal CUBET1WI in the secondinjection. Analysing the value of the brain metastases’ display and diagnosis undersingle or double gadobutrol, all data were used SPSS20.0to process and analysis, andonly P <0.05was considered statistically significant. From the haplotypes enhanced CUBET1WI, double enhanced CUBET1WI anddouble enhanced T1FLAIR sequence images,23patients were found with162lesions. The analysis of the data showed that double enhanced CUBE--T1WIsequence images were better than haplotypes enhanced CUBET1WI in enhancing thecontour, the range, and the degree (Wilcoxon signed rank test, P <0.01), and hadstatistical significance.Compareing the double enhanced CUBET1WI sequenceimages with the haplotypes enhanced CUBET1WI on enhancing content (Wilcoxonsigned rank and test, P>0.05), it had no statisti--cal significance. Double enhancedCUBET1WI sequence images were better than double enhanced T1FLAIR inenhancing the contour and the degree (Wilcoxon signed rank and test, P <0.01),and itwas statistically significant. Double enhanced CUBET1WI image sequence werebetter than double enhanced T1FLAIR sequences in enhancing the contour and therange (Wilcoxon signed rank and test, P>0.05), and it was not statistically significant.The CR values of tumor/background (white matter, gray matter and cerebrospinalfluid) on the double enhanced CUBET1WI sequences were higher than haplotypesenhanced CUBET1WI (t test, P <0.01). The CNR values of tumor/whitematter(Wilcoxon signed rank and test, P <0.01), The CNR values of tumor/cerebrospinal fluid (t test, P <0.01) on the double enhanced CUBET1WI sequenceswere higher than haplotypes enhanced CUBET1WI. Comparison of gray matter andthe CNR values of tumor/gray matter between haplotypes enhanced CUBET1WI andthe double enhanced CUBET1WI sequence images,(Wilcoxon signed rank and test,P>0.05), the difference was not statistically significant. Comparison of the CR valuesof tumor/white matter (t test, P <0.01), the CR values of tumor/cerebrospinal fluid(Wilcoxon signed-rank test, P <0.05) between double enhanced CUBET1WIsequence images and double enhanced T1FLAIR, the difference was statisticallysignificant. Comparison of the CNR value of tumor/background (white matter, graymatter)(Wilcoxon signed-rank test, P <0.05)and the CNR value of tumor/cerebrospinal fluid(t test, P <0.05) between double enhanced CUBET1WI sequenceimages and double enhanced T1FLAIR, the difference was statistically significant.Double enhanced CUBET1WI were higher than double enhanced T1FLAIR in thecomparison gray and white matter (Wilcoxon signed rank and test, P <0.01). Thecomparison of the enhancing percentage between double enhanced CUBET1WI andthe double enhanced T1FLAIR (t test, P>0.05), the difference was not statisticallysignificant. Through the analysis of experimental data, we can draw the followingconclusions. First, double dose enhanced images have no significant advantage in thedetection rate of brain metastases over single dose.Second, double dose enhancedimages are significantly better than single dose in enhancing the contour, the rangeand the degree. Double dose enhancements have no obvious advantage over a singledose in enhancing the content display.Third, double dose enhanced CUBET1WIsequence images are significantly better than double dose enhanced T1FLAIRsequence images in enhancing the profile and the degree, while no obviousadvantages in enhancing content and range. Forth,the CR and CNR values of thetumor/background (white matter, cerebrospinal fluid)on double dose enhancedimages are higher than that in single dose enhanced images. Comparison the CNRvalues of the tumor/gray matter between single and double dose enhanced images,P>0.05, the difference is not significant. Fifth,comparison on the CR and CNR valuesof the tumor/background (white matter, cerebrospinal fluid) between double doseenhanced CUBET1WI and double dose enhanced T1FLAIR, P <0.01,the differenceis significant. While the comparison on the CR values of the tumor/gray matterbetween double dose enhanced CUBET1WI and double dose enhanced T1FLAIR,P>0.05, the difference is not statistically significant.From various aspects of the results in the brain metastases images, the doubledose enhanced images in clinical applications are superiorer than the single doseenhanced images,even though the detection rate of brain metastases between thedouble dose and the single dose has no significant difference. However, the doubledose has obvious advantages on brain metastases display and normal tissue contrast.Therefore, the double dose enhancement has the application value in clinicaldiagnosis, but whether it can replace a single dose enhancement should be combinedwith factors (such as economic,patients and so on) to carry out further researches.Among the double booster dose, to enhance basic sequence selecting the CUBET1WIenhancement is superior to choose TIFLAIR. As a new sequence, CUBE whether canapply in enhanced MRI needs to be confirmed in further studies.