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Persistence of Gadolinium in CSF: A Diagnostic Pitfall in Patients with End-stage Renal Disease

Ansaar T. Raia and Jeffery P. Hogga

a From the Department of Radiology, West Virginia University, 2278 HSCS, Morgantown, WV 26506–9235.



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  		FIG 1. Sagittal (A) 500/8/1 (TR/TE/excitation) and axial (B) 566/12/1 precontrast T1-weighted and axial FLAIR (C) 10002/97.5/1 images of the brain demonstrate normal signal intensity of the CSF with normal contrast enhancement between the CSF and adjacent brain.

Sagittal (D) 500/8/1 and axial (E) 566/12/1 precontrast T1-weighted images 10 days later, demonstrate increased signal intensity within the subarachnoid space, manifested by an isointense appearance of the sulci as compared with the adjacent brain. Additionally, there is increased signal intensity within the ocular globes on the axial image. The axial FLAIR (F) 10002/97.5/1 image demonstrates diffuse significant increased signal intensity within the subarachnoid space and the ventricles. A–F were filmed at the same values for window and level, and were performed on the same scanner.



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  		FIG 2. Sagittal (A) 516/12/2 and axial (B) 686/11.6/2 precontrast T1-weighted images of the spine demonstrate diffuse increased signal intensity within the subarachnoid space. Sagittal precontrast T1-weighted (C) 550/12/2 image of the lumbar spine performed 2 weeks later shows resolution of the previously seen increased signal intensity and a normal signal within the CSF. A–C were filmed at the same values for window and level, and were performed on the same scanner





Copyright © 2009 by the American Society of Neuroradiology. Print ISSN: 0195-6108 Online ISSN: 1936-959X