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Ref: Buch K,et al.
JNeurosurg2018 Aug 10:1-6doi: 10.3171/2018.3.JNS1866The clinical use of the contrast agent is gradually being questionedrecent lysis literature has reported that mrI contrast agents containing radon can accumulate in the brain in substanceThe results suggest a rethinking of the use of intravenous contrast agents in MRI imagingIn particular, it is worrying that patients with forecourt neuroblastoma, who are followed once or twice a year, may have accumulated radon in the bodyCurrently, MRI brain brain imaging images, such as CISS, FIESTA, or 3D DRIVE, provide a high spatial lysing fluid-weighted sequence that facilitates the observation of nerve tissue in the hearing canal in the tibiaMrMRI imaging studies have confirmed the high sensitivity of MRI brain pool imaging sequences to detect vestibular neuroblastomas (range s2-20mm)Comparisons of non-enhanced MRI tests with traditional contrast-enhanced MRI tests using contrasting contrasts with contrasting precursor-enhanced MRI tests in patients with frontcourt neuroblastoma, such as Karen Buch of the Neuroimaging Department at Massachusetts General Hospital in the United States compared the differences between non-enhanced brain tumor sequences (CISS, FIESTA, or 3D DRIVE)The results were published online in The August 2018 issue of J Neurosurgthe study included 251 patients with vestibular neuroblastoma between January 2000 and January 2016; The researchers compared the size of the forecourt neuroblastoma detected on two different images, the detection rate of different components in the lesions, and the rate of accidental detection of potential lesionsComparing tumor size, it was found that the tumor size shown by the brain pool imaging sequence was an average of 15.07 to 8.66 mm, and the enhanced T1 sequence showed 15.08 to 8.71, with no significant difference between the two (p.99) (Table 1) Figure 1 MRI two imaging methods compare the size of vestibular neuroblastoma with the components of the lesions assessed the internal composition of the lesions, the authors found that the regular T2-weighted image showed that 45 patients (18%) had cystic components in the tumor (size range 2-19mm), the MRI brain pool contrast sequence could detect 39 of them (86.7%), and the enhanced MRI-T1 sequence could identify only 11 of them Five patients showed high signals of intratumor bleeding on T1-weighted images, while both MRI brain pool imaging sequences and enhanced MRI-T1 sequences failed to recognize bleeding components carefully reviewed 80 cases (32%) of MRI flat-sweep images and found other potential lesions other than tumors (Figure 2), while enhanced MRI failed to identify lesions in MRI flat-sweep images Figure 2 Clinical significance scoring stratification summarizes the detection rate of accidental detection of lesions concluded that enhanced MRI examination was no better than non-enhanced MRI imaging of brain pool contrast sequences when evaluating the size of vestibular neuroblastoma and the sacoric or bleeding components inside the lesions The latter is sufficient to accurately describe the size of the vestibular neuroblastoma and the signal characteristics in the lesions Therefore, it is recommended that the follow-up of patients with vestibular neuroblastoma can be used with a non-enhanced MRI examination method that contains a brain pool contrast sequence, thus avoiding the contrast agent that needs to be given for long-term routine follow-up (
li Lei, of the Tenth People's Hospital affiliated with Tongji University, Ofsusong , Fudan University Affiliated with Huashan Hospital, the editor-in-chief of "Foreign Information" and Professor Chen Jicheng of The of Fudan University)