title: Hyperintense Dentate Nuclei on T1-Weighted MRI: Relation to Repeat Gadolinium Administration.
abstract: OBJECTIVE
  A hyperintense appearance of the dentate nucleus on T1-weighted MR images has been related to various clinical conditions, but the etiology remains indeterminate. We aimed to investigate the possible associations between a hyperintense appearance of the dentate nucleus on T1-weighted MR images in patients exposed to radiation and factors including, but not limited to, the cumulative number of contrast-enhanced MR images, amount of gadolinium administration, dosage of ionizing radiation, and patient demographics.
  
  
  METHODS
  The medical records of 706 consecutive patients who were treated with brain irradiation at The Johns Hopkins Medical Institutions between 1995 and 2010 were blindly reviewed by 2 readers.
  
  
  RESULTS
  One hundred eighty-four subjects were included for dentate nuclei analysis. Among the 184 subjects who cumulatively underwent 2677 MR imaging studies following intravenous gadolinium administration, 103 patients had hyperintense dentate nuclei on precontrast T1-weighted MR images. The average number of gadolinium-enhanced MR imaging studies performed in the group with normal dentate nuclei was significantly lower than that of the group with hyperintense dentate nuclei. The average follow-up time was 62.5 months. No significant difference was observed between hyperintense and normal dentate nuclei groups in terms of exposed radiation dose, serum creatinine and calcium/phosphate levels, patient demographics, history of chemotherapy, and strength of the scanner. No dentate nuclei abnormalities were found on the corresponding CT scans of patients with hyperintense dentate nuclei (n = 44). No dentate nuclei abnormalities were found in 53 healthy volunteers.
  
  
  CONCLUSIONS
  Repeat performance of gadolinium-enhanced studies likely contributes to a long-standing hyperintense appearance of dentate nuclei on precontrast T1-weighted-MR images.
authors: From the Division of Neuroradiology (M.E.A., E.Z., S.M., D.M.Y.), The Russell H. Morgan Department of Radiology and Radiological Science emin.adin@gmail.com.
authors: M E
authors: ME
authors: Adin
authors: Department of Radiation Oncology and Radiation Molecular Sciences (L.K.).
authors: L
authors: L
authors: Kleinberg
authors: Johns Hopkins Bloomberg School of Public Health (D.V.), The Johns Hopkins Medical Institutions, Baltimore, Maryland.
authors: D
authors: D
authors: Vaidya
authors: From the Division of Neuroradiology (M.E.A., E.Z., S.M., D.M.Y.), The Russell H. Morgan Department of Radiology and Radiological Science.
authors: E
authors: E
authors: Zan
authors: From the Division of Neuroradiology (M.E.A., E.Z., S.M., D.M.Y.), The Russell H. Morgan Department of Radiology and Radiological Science.
authors: S
authors: http://orcid.org/0000-0002-3689-7273
authors: S
authors: Mirbagheri
authors: From the Division of Neuroradiology (M.E.A., E.Z., S.M., D.M.Y.), The Russell H. Morgan Department of Radiology and Radiological Science.
authors: D M
authors: http://orcid.org/0000-0002-1222-6643
authors: DM
authors: Yousem
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002529:Cerebellar Nuclei / Q000473:pathology*; D002648:Child; D002675:Child, Preschool; D003287:Contrast Media / Q000008:administration & dosage*; D016371:Cranial Irradiation; D005260:Female; D005682:Gadolinium / Q000008:administration & dosage*; D006801:Humans; D007089:Image Enhancement; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011829:Radiation Dosage; D055815:Young Adult
chemical_list: D003287:Contrast Media; D005682:Gadolinium