Samardzic Dejan, Thamburaj Krishnamoorthy
Department of Radiology, Penn State Milton S Hershey Medical Center, Penn State College of Medicine, Hershey, PA, 17033.
J Neuroimaging. 2015 Jan-Feb;25(1):136-9. doi: 10.1111/jon.12067. Epub 2013 Nov 19.
To report the brain imaging features on magnetic resonance imaging (MRI) in inadvertent intrathecal gadolinium administration.
A 67-year-old female with gadolinium encephalopathy from inadvertent high dose intrathecal gadolinium administration during an epidural steroid injection was studied with multisequence 3T MRI.
T1-weighted imaging shows pseudo-T2 appearance with diffusion of gadolinium into the brain parenchyma, olivary bodies, and membranous labyrinth. Nulling of cerebrospinal fluid (CSF) signal is absent on fluid attenuation recovery (FLAIR). Susceptibility-weighted imaging (SWI) demonstrates features similar to subarachnoid hemorrhage. CT may demonstrate a pseudo-cerebral edema pattern given the high attenuation characteristics of gadolinium.
Intrathecal gadolinium demonstrates characteristic imaging features on MRI of the brain and may mimic subarachnoid hemorrhage on susceptibility-weighted imaging. Identifying high dose gadolinium within the CSF spaces on MRI is essential to avoid diagnostic and therapeutic errors.
报告意外鞘内注射钆对比剂后的脑磁共振成像（MRI）特征。
对一名67岁女性进行研究，该患者在硬膜外类固醇注射期间意外鞘内高剂量注射钆对比剂后出现钆脑病，采用多序列3T MRI检查。
T1加权成像显示钆对比剂扩散至脑实质、橄榄体和膜迷路，呈现伪T2表现。液体衰减反转恢复序列（FLAIR）上脑脊液（CSF）信号未被抑制。磁敏感加权成像（SWI）显示出与蛛网膜下腔出血相似的特征。鉴于钆对比剂的高衰减特性，CT可能显示伪脑水肿模式。
鞘内注射钆对比剂在脑部MRI上表现出特征性影像特征，在磁敏感加权成像上可能类似蛛网膜下腔出血。在MRI上识别CSF间隙内的高剂量钆对比剂对于避免诊断和治疗错误至关重要。
