Gadolinium-DTPA enhanced magnetic resonance imaging in human head injury.
We used low field magnetic resonance imaging and Gadolinium-DTPA to study 10 recently head injured patients. On the pre-contrast images we identified 36 abnormalities in 9 of the 10 patients. After contrast enhancement was seen in 9 of these lesions in 3 patients imaged 5-6 days after injury. Altered blood brain barrier permeability to gadolinium was not seen in 6 patients studied within 4 days of trauma. We did not identify any lesions with gadolinium that were not present on the pre-contrast images. We do not think that the routine use of contrast in head injury is justified since clinically important lesions will be present on routine sequences. However the use of gadolinium may provide information about the nature and timing of the underlying pathophysiological changes. In human head injury cytotoxic oedema occurs early and vasogenic oedema does not occur until 5-6 days after injury.
Lang
D A
DA
Institute of Neurological Sciences, Southern General Hospital, Glasgow, U.K.
Hadley
D M
DM
Teasdale
G M
GM
Macpherson
P
P
Teasdale
E
E
D000328:Adult; D003287:Contrast Media; D006259:Craniocerebral Trauma / Q000175:diagnosis* / Q000000981:diagnostic imaging; D005069:Evaluation Studies as Topic; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D007089:Image Enhancement; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009942:Organometallic Compounds; D004369:Pentetic Acid; D014057:Tomography, X-Ray Computed
D003287:Contrast Media; D009942:Organometallic Compounds; D004369:Pentetic Acid; D019786:Gadolinium DTPA