Intrathecal gadolinium-enhanced MR myelography and cisternography: a pilot study in human patients.
OBJECTIVE
This study was designed to evaluate the safety, MR imaging characteristics, and clinical response to intrathecal gadopentetate dimeglumine (gadolinium) administration in human patients.


METHODS
Eleven adult patients were included in this prospective study. Via lumbar puncture, a single dose of either 0.2 ml, 0.5 ml, or 1.0 ml of gadolinium (500 mmol/l) mixed with 5 ml of previously removed CSF was slowly injected into the lumbar subarachnoid space. Immediate and delayed MR imaging were subsequently carried out using a 1.0-T magnet.


RESULTS
No patient manifested gross behavioral changes, neurologic alterations, or seizure activity. The intrathecal gadolinium-enhanced MR myelography revealed disk herniation (n = 4), posttraumatic spinal stenosis (n = 3), postsurgical noncommunicating cyst (n = 1), myelitis (n = 1), intradural extramedullary mass formation (n = 1), and intradural vascular malformation (n = 1).


CONCLUSIONS
This pilot study shows the relative safety and feasibility of low-dose intrathecal gadolinium administration. The potential clinical applications include the evaluation of obstructions and communications of the subarachnoid space, spontaneous or traumatic CSF leaks, and CSF dynamics. Additional animal and human studies must be performed to further evaluate the long-term safety and to prove the clinical applications of this procedure in a larger number of subjects.
Zeng
Q
Q
Department of Radiology, General Coal Hospital, Beijing, People's Republic of China.
Xiong
L
L
Jinkins
J R
JR
Fan
Z
Z
Liu
Z
Z
D000328:Adult; D001927:Brain Diseases / Q000175:diagnosis*; D003287:Contrast Media / Q000008:administration & dosage*; D005240:Feasibility Studies; D005260:Female; D019786:Gadolinium DTPA / Q000008:administration & dosage*; D006801:Humans; D007278:Injections, Spinal; D007405:Intervertebral Disc Displacement / Q000175:diagnosis; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D010865:Pilot Projects; D011446:Prospective Studies; D012449:Safety; D013122:Spinal Diseases / Q000175:diagnosis*; D013129:Spinal Puncture; D013130:Spinal Stenosis / Q000175:diagnosis
D003287:Contrast Media; D019786:Gadolinium DTPA