RT Journal Article
SR Electronic
T1 Time to Resolution of Inadvertent Subdural Contrast Injection during a Myelogram: When Can the Study Be Reattempted?
JF American Journal of Neuroradiology
JO Am. J. Neuroradiol.
FD American Society of Neuroradiology
SP 1958
OP 1962
DO 10.3174/ajnr.A6725
VO 41
IS 10
A1 D.P. Shlapak
A1 D.K. Kim
A1 F.E. Diehn
A1 J.C Benson
A1 V.T. Lehman
A1 G.B. Liebo
A1 J.M. Morris
A1 P.P. Morris
A1 J.T. Verdoorn
A1 C.M. Carr
YR 2020
UL http://www.ajnr.org/content/41/10/1958.abstract
AB BACKGROUND AND PURPOSE: Inadvertent subdural contrast injections can occur during any myelogram. Currently, there are no guidelines defining when residual subdural iodinated contrast will be cleared and no longer interfere with subsequent procedure and imaging. We investigated the time to resolution of subdural contrast using a 2-day lateral decubitus digital subtraction myelogram and associated CT myelogram data in patients undergoing evaluation for spontaneous intracranial hypotension.MATERIALS AND METHODS: Retrospective review of 63 patients with lateral decubitus digital subtraction myelograms from September 4, 2018, to October 1, 2019, was performed. Patients with 2-day lateral decubitus digital subtraction myelograms on 2 consecutive days, with or without a same-day CT myelogram on day 1 and with a same-day CT myelogram on day 2, were included. Patients with next-day CT covering at least the abdomen and pelvis after either-day injection were also included. In cases of subdural injection, next-day CT scans were evaluated for residual subdural contrast.RESULTS: Of 49 included patients, 5 had subdural injection on day 1, with the second-day CT myelogram available for review. One of these 5 patients had subdural injections on 2 different days and subsequently had chest/abdomen/pelvis CTA a day after the second subdural injection. In all 6 cases of subdural injections, there was complete resolution of subdural contrast on the next-day CT, with the shortest time to resolution of approximately 20.5 hours (range, 20.5–28.5 hours).CONCLUSIONS: Our study suggests that resolution of inadvertently injected subdural contrast occurs within 1 day, and the myelogram can be reattempted as early as the next day.CTMCT myelogrameGFRestimated glomerular filtration rateLDDSMlateral decubitus digital subtraction myelogram