评估钆增强MR成像在急性儿科癫痫发作评估中的实用性和频率尚不清楚。本研究的目的是评估基于钆的对比剂在用于评估急性儿科癫痫发作的MR成像中的实用性。我们选择了2016年10月1日至2021年9月30日期间前来急诊部门和/或住院部的连续儿科首次发作癫痫患儿，并进行脑部MR成像评估癫痫症状的患者。记录了临床和成像数据，包括患者的年龄、性别、静脉注射钆的使用情况以及可获得的癫痫的潜在原因。共鉴定了1884名符合条件的患者。其中，524名（28%）患者在脑部MR成像中发现了潜在的癫痫致病性损害，而1153名（61%）患者的研究结果正常，207名（11%）患者显示出非特异性信号变化。癫痫致病性损害可以细分为以下几类：神经发育性病变142例（27%）；颅内出血（创伤性或胚胎基质）89例（17%）；缺血/缺氧性病变62例（12%）；海马硬化44例（8%）；肿瘤性病变38例（7%）；免疫/感染性病变20例（4%）；后天痣病19例（4%）；血管异常17例（3%）；代谢性病变3例（<1%）；其他90例（17%）。其中874名（46%）患者接受了静脉注射钆。其中，只有48例（5%）被回顾性认为需要静脉注射钆：48例中的15例（31%）被细分为免疫/感染性病变，而33例（69%）为肿瘤性病变。其中1010名进行首次非对比剂研究的患者中，有15例（1.5%）需要使用静脉对比剂进行重复MR成像以进一步评估结果。大多数情况下，在急性儿科癫痫发作患者的成像中，钆对比剂的附加好处有限。© 2023美国神经放射学杂志。

The frequency and utility of gadolinium in evaluation of acute pediatric seizure presentation is not well known. The purpose of this study was to assess the utility of gadolinium-based contrast agents in MR imaging performed for the evaluation of acute pediatric seizure presentation.We identified consecutive pediatric patients with new-onset seizures from October 1, 2016, to September 30, 2021, who presented to the emergency department and/or were admitted to the inpatient unit and had an MR imaging of the brain for the evaluation of seizures. The clinical and imaging data were recorded, including the patient's age and sex, the use of IV gadolinium, and the underlying cause of epilepsy when available.A total of 1884 patients were identified for inclusion. Five hundred twenty-four (28%) patients had potential epileptogenic findings on brain MR imaging, while 1153 (61%) patients had studies with normal findings and 207 (11%) patients had nonspecific signal changes. Epileptogenic findings were subclassified as the following: neurodevelopmental lesions, 142 (27%); intracranial hemorrhage (traumatic or germinal matrix), 89 (17%); ischemic/hypoxic, 62 (12%); hippocampal sclerosis, 44 (8%); neoplastic, 38 (7%); immune/infectious, 20 (4%); phakomatoses, 19 (4%); vascular anomalies, 17 (3%); metabolic, 3 (<1%); and other, 90 (17%). Eight hundred seventy-four (46%) patients received IV gadolinium. Of those, only 48 (5%) cases were retrospectively deemed to have necessitated the use of IV gadolinium: Fifteen of 48 (31%) cases were subclassified as immune/infectious, while 33 (69%) were neoplastic. Of the 1010 patients with an initial noncontrast study, 15 (1.5%) required repeat MR imaging with IV contrast to further evaluate the findings.Gadolinium contrast is of limited additive benefit in the imaging of patients with an acute onset of pediatric seizures in most instances.© 2023 by American Journal of Neuroradiology.