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Непосредственное клиническое сравнение визуализационных возможностей комплексов диэтилентриаминпентауксусной кислоты с Mn(II) и Gd(III) при магнитно-резонансной томографии глиальных и менингеальных опухолей мозга.

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Direct Comparison of Contrast Enhancement with Mn(II)-DTPA and GD(III)-DTPA in MR-imaging of Intra- and Extraaxial Brain Tumors

Paramagnetic properties of the Gd(III) complexes with DTPA, EDTA, BOPTA and chemically close to these molecules are well known as highly suitable for MRI contrast-enhanced studies. Nevertheless the potential toxicity of free Gadolinium and also the high risks for Gd complexes stimulates the employment of paramagnetic ions different from Gd for the development of new clinical contrast agents. The Mn(II) relaxometric parameters are essentially close to that ones of Gd, whereas the Mn is among biologic microelements, crucially below Gd in all aspects of toxicity. Hencefore we developed the synthesis of and tested preclinically and clnically the Mn(II)-diethylenetriaminpentaacetic (DTPA) complex as possible paramagnetic contrast agent for the routine MRI studies. The 0.5 M Mn-DTPA solution as agent for paramagnetic enhancement was compared directly with Gadopentetate in 12 patients with CNS tumors, in whom the diagnosis of non-differentieted glioma or multiform glioblastoma (n = 7), or meningioma (n = 5) was established from MRI and CT and verified later from histological data. The doses were equivalent, as low as 0.2 ml of 0.5 M solution per 1 kg of body weight. The contrast enhancement was quantified using enhancement index (IE) as ratio of signal intensity (SI) of T1-weighted images acquired after injection of paramagnetic agent to the SI of non-contrast enhanced images. IE = (SI of T1-wMRIMn-DTPA) / (SI of T1-wMRIInitial). The relaxivity R1 was for the Mn-DTPA slightly over the value of Gadopentetate, in particular 4.21 ± 0.03 mmol–1*s–1 and 3.93 ± 0.02 mmol–1*s–1, respectively. The osmolarities were: 1947 ± 12 и 1955 ± 15 mOsm / ( H2O), at 37°С, for Mn-DTPA and Gadopentetate, respectively. The dimensions of tumors estimated using both agents correlated closely and highly significant (r = 0.97, p 0.0002). The visual images of both images were essentially the same. The values of IE in glial tumors for MnDTPA and Gadopentetate were, respectively, 1.51 ± 0.27 and 1.5

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