Conditions of iodine contrast transfer from lumbosacral CSF to blood.
OBJECTIVE
To determine conditions which influence transfer of iopamidol from lumbosacral cerebrospinal fluid (CSF) to blood.


METHODS
Iopamidol transfer was measured in 32 patients over 180 min after radiculography and compared with patient variables.


RESULTS
Iopamidol transfer began early in 12 patients, more slowly in 13 patients, and was not detected during sample period in 7 patients. Transfer of sequential samples correlated highly with each other (r>0.8). Transfer was more pronounced in patients with prominent nerve root sleeves on radiculogram (p=0.006, t test), and correlated inversely with body weight (r=-0.4258), and with albumin CSF/serum quotient (r=-0.4702).


CONCLUSIONS
Early iopamidol transfer probably indicates transfer through spinal arachnoid villi and granulations with CSF bulk flow. Prominent nerve root sleeves may facilitate access to transfer sites. No transfer during sample period suggests no such spinal transfer, possibly due to sparse access to or presence of spinal transfer sites. Inverse correlation of transfer with body weight may reflect influence of body weight on retroperitoneal venous pressure, which regulates outflow of CSF and of compounds dissolved in it. Awareness of wide interindividual transfer variation and steady intraindividual transfer may help to specify dosage and effect expectation of intrathecal drug therapy.
Seyfert
Sepp
S
Department of Neurology, University Hospital Benjamin Franklin, Free University of Berlin, D-12200 Berlin, Germany. seyfert@medizin.fu-berlin.de
Koch
Hans Christian
HC
Kunzmann
Volker
V
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001692:Biological Transport; D003287:Contrast Media / Q000493:pharmacokinetics*; D005260:Female; D006801:Humans; D007479:Iopamidol / Q000097:blood / Q000134:cerebrospinal fluid / Q000493:pharmacokinetics*; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D011843:Radiculopathy / Q000000981:diagnostic imaging*; D011859:Radiography; D012447:Sacrum / Q000000981:diagnostic imaging
D003287:Contrast Media; D007479:Iopamidol