title: Complex imaging features of accidental cerebral intraventricular gadolinium administration.
abstract: Gadolinium diethylenetriamine pentaacetic acid (Gd-DTPA) is a contrast agent commonly used for enhancing MRI. In this paper, the authors report on 2 cases of postoperative inadvertent administration of Gd-DTPA directly into a ventriculostomy tubing side port that was mistaken for intravenous tubing. Both cases demonstrated a low signal on MRI throughout the ventricular system and dependent portions of the subarachnoid spaces, which was originally believed to be CSF with areas of T1 shortening in the nondependent portions of the subarachnoid spaces, and misinterpreted as basal leptomeningeal enhancement and meningitis. The authors propose that the appearance of profound T1 hypointensity within the ventricles and diffuse susceptibility artifact along the ependyma is pathognomonic of intraventricular Gd-DTPA and should be recognized.
authors.affiliation: Department of Radiology, University of California, Los Angeles, California 90095, USA. nnayak@mednet.ucla.edu
authors.forename: Nita B
authors.initials: NB
authors.lastname: Nayak
authors.forename: Jimmy C
authors.initials: JC
authors.lastname: Huang
authors.forename: Gasser M
authors.initials: GM
authors.lastname: Hathout
authors.forename: Wisam
authors.initials: W
authors.lastname: Shaba
authors.forename: Suzie M
authors.initials: SM
authors.lastname: El-Saden
mesh_terms: D001932:Brain Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D002552:Cerebral Ventricles / Q000473:pathology*; D014695:Cerebral Ventriculography; D005260:Female; D019786:Gadolinium DTPA / Q000008:administration & dosage* / Q000009:adverse effects*; D006801:Humans; D007276:Injections, Intraventricular / Q000009:adverse effects; D008279:Magnetic Resonance Imaging; D008297:Male; D019300:Medical Errors / Q000009:adverse effects*; D008579:Meningioma / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D008581:Meningitis / Q000139:chemically induced* / Q000000981:diagnostic imaging / Q000473:pathology; D008875:Middle Aged; D020258:Neurotoxicity Syndromes / Q000000981:diagnostic imaging / Q000209:etiology* / Q000473:pathology; D013346:Subarachnoid Space / Q000000981:diagnostic imaging / Q000473:pathology; D014057:Tomography, X-Ray Computed
chemical_list: D019786:Gadolinium DTPA