Lumbar discography using gadolinium in patients with iodine contrast allergy followed by postdiscography computed tomography scan.
METHODS
A series of four case reports are presented. OBJECTIVE The case reports document completion of lumbar discography with gadolinium contrast followed by successful computed tomography scanning of intradiscal gadolinium.


BACKGROUND
Lumbar discography using gadolinium in cases of iodinated contrast allergy with magnetic resonance imaging used to visualize intradiscal gadolinium after the procedure has been described. To the authors' knowledge, there are no reports of gadolinium discography followed by computed tomography scanning of intradiscal gadolinium.


METHODS
The reported cases involved a chart review, performance of discography with gadolinium under fluoroscopic guidance, and postdiscography computed tomography scanning of the discs injected during the procedure.


RESULTS
Gadolinium was visible under fluoroscopy in all four cases. It was visualized on postdiscography computed tomography scans performed both early and late after the procedure. Normal discs retained gadolinium for a longer period than discs with annular disruption.


CONCLUSIONS
Gadolinium discography is a safe, viable alternative to conventional discography in the setting of a patient with iodinated contrast allergy. Postdiscography computed tomography scans adequately visualize intradiscal gadolinium in a more timely and cost-effective manner than magnetic resonance imaging.
Falco
Frank J E
FJ
to Frank J. E. Falco, MD, MidAtlantic Spine, 139 East Chestnut Hill Road, Newark, DE 19713, USA. Cssm01@aol.com.
Moran
James G
JG
D000328:Adult; D000707:Anaphylaxis / Q000209:etiology / Q000517:prevention & control; D003287:Contrast Media / Q000008:administration & dosage* / Q000009:adverse effects; D004342:Drug Hypersensitivity / Q000150:complications; D005260:Female; D005471:Fluoroscopy; D005682:Gadolinium / Q000008:administration & dosage; D006801:Humans; D007278:Injections, Spinal; D007403:Intervertebral Disc / Q000000981:diagnostic imaging / Q000378:metabolism; D007405:Intervertebral Disc Displacement / Q000000981:diagnostic imaging* / Q000503:physiopathology; D017613:Iodine Compounds / Q000009:adverse effects; D007902:Length of Stay; D008161:Lumbosacral Region; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D013997:Time Factors; D014057:Tomography, X-Ray Computed
D003287:Contrast Media; D017613:Iodine Compounds; D005682:Gadolinium