Abstract
BACKGROUND AND PURPOSE: To report the brain imaging features on magnetic resonance imaging (MRI) in inadvertent intrathecal gadolinium administration. METHODS: A 67-year-old female with gadolinium encephalopathy from inadvertent high dose intrathecal gadolinium administration during an epidural steroid injection was studied with multisequence 3T MRI. RESULTS: T1-weighted imaging shows pseudo-T2 appearance with diffusion of gadolinium into the brain parenchyma, olivary bodies, and membranous labyrinth. Nulling of cerebrospinal fluid (CSF) signal is absent on fluid attenuation recovery (FLAIR). Susceptibility-weighted imaging (SWI) demonstrates features similar to subarachnoid hemorrhage. CT may demonstrate a pseudo-cerebral edema pattern given the high attenuation characteristics of gadolinium. CONCLUSION: Intrathecal gadolinium demonstrates characteristic imaging features on MRI of the brain and may mimic subarachnoid hemorrhage on susceptibility-weighted imaging. Identifying high dose gadolinium within the CSF spaces on MRI is essential to avoid diagnostic and therapeutic errors.
Original language | English (US) |
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Pages (from-to) | 136-139 |
Number of pages | 4 |
Journal | Journal of Neuroimaging |
Volume | 25 |
Issue number | 1 |
DOIs | |
State | Published - Jan 1 2015 |
All Science Journal Classification (ASJC) codes
- Radiology Nuclear Medicine and imaging
- Clinical Neurology