La radiologia medica

, Volume 123, Issue 6, pp 469–473 | Cite as

Dentate nucleus T1 hyperintensity: is it always gadolinium all that glitters?

  • Luca PasquiniEmail author
  • Maria Camilla Rossi Espagnet
  • Antonio Napolitano
  • Daniela Longo
  • Alice Bertaina
  • Emiliano Visconti
  • Paolo Tomà


In the last few years, several scientific papers and reports have demonstrated magnetic resonance (MR) signal intensity (SI) changes on pre-contrast T1-weighted images following multiple gadolinium-based contrast agents (GBCA) administrations, particularly following the exposure to linear GBCAs. Pathological animal and human post-mortem studies have confirmed the relationship between this radiological finding and the presence of gadolinium accumulation in vulnerable brain regions in patients with normal renal function. In this short communication, we report the case of a 15-year-old patient affected by b-cell acute lymphoblastic leukemia (bALL) who developed a hyperintense signal in the dentate nuclei following multiple administrations of a macrocyclic GBCA. The purpose of this report is to discuss possible differential diagnoses of this radiological finding with special focus on the differentiation between iron or manganese accumulation, post-irradiation changes and GBCA-related Gd deposition, highlighting the importance of the acquisition of accurate clinical data to improve our scientific knowledge.


GBCA Gadolinium Dentate Nucleus MRI Macrocyclic 


Compliance with ethical standards

Conflict of interest

Author L.P declares that he has no conflict of interest. Author M.C.R.E. declares that she has no conflict of interest. Author A.N. declares that he has no conflict of interest. Author D.L. declares that she has no conflict of interest. Author A.B. declares that she has no conflict of interest. Author E.V. declares that he has no conflict of interest. Author P.T. declares that he has no conflict of interest.

Ethical approval

This article does not contain any studies with animals performed by any of the authors. Due to the typology of the report, the ethical approval was considered unnecessary.

Informed consent

Informed consent was obtained from all individual participants (or next of kin) included in the study.


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Copyright information

© Italian Society of Medical Radiology 2018

Authors and Affiliations

  1. 1.Neuroradiology Unit, Imaging DepartmentBambino Gesù Children’s HospitalRomeItaly
  2. 2.NESMOS Department, Radiology UnitSant’Andrea Hospital, La Sapienza University of RomeRomeItaly
  3. 3.Enterprise Risk Management, Medical Physics DepartmentIRCCS, Bambino Gesù Children’s HospitalRomeItaly
  4. 4.Department of Hematology and OncologyBambino Gesù Children’s HospitalRomeItaly
  5. 5.Neuroradiology UnitM. Bufalini HospitalCesenaItaly
  6. 6.Imaging DepartmentBambino Gesù Children’s HospitalRomeItaly

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