Persistence of gadolinium in CSF: a diagnostic pitfall in patients with end-stage renal disease.
Two dialysis-dependent patients with end-stage renal disease underwent brain and spine MR imaging a few days after having undergone gadolinium-enhanced imaging studies. Increased signal intensity in the subarachnoid space on T1-weighted and fluid-attenuated inversion recovery images was noted. Excretion of gadolinium into the CSF was proven in one case by mass spectrometry. Dialysis-dependent patients with end-stage renal disease and neurologic abnormalities often undergo contrast-enhanced MR imaging. Recognition that these patients may show increased signal intensity in the subarachnoid space because of gadolinium excretion into CSF may prevent diagnostic errors.
Rai
A T
AT
Department of Radiology, West Virginia University, 2278 HSCS, Morgantown, WV 26506-9235, USA.
Hogg
J P
JP
D000368:Aged; D001812:Blood-Brain Barrier / Q000502:physiology; D001921:Brain / Q000473:pathology*; D002552:Cerebral Ventricles / Q000473:pathology; D003287:Contrast Media / Q000493:pharmacokinetics*; D003937:Diagnosis, Differential; D005260:Female; D005682:Gadolinium / Q000493:pharmacokinetics*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000134:cerebrospinal fluid*; D007677:Kidney Function Tests; D008159:Lumbar Vertebrae / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008657:Metabolic Clearance Rate / Q000502:physiology; D010531:Peritoneal Dialysis, Continuous Ambulatory; D006435:Renal Dialysis; D013346:Subarachnoid Space / Q000473:pathology
D003287:Contrast Media; D005682:Gadolinium