J Korean Soc Radiol.  2017 Nov;77(5):348-351. 10.3348/jksr.2017.77.5.348.

Retention of Gadolinium in Cerebrospinal Fluid and Decreased Renal Function: A Case Report

Affiliations
  • 1Department of Radiology, Busan Paik Hospital, Inje University, Busan, Korea. youngjin726@hanmail.net

Abstract

A gadolinium-based contrast is the preferred agent when differentiating acute neurological diseases. Since the renal route is the main pathway for excretion of gadolinium chelates, prolonged extracellular distribution of gadolinium has previously been reported in dialysis-dependent patients. Hence, gadolinium-based contrast agents are used cautiously in patients with known renal disease. Retention of gadolinium manifests as increased fluid-attenuated inversion recovery (FLAIR) signal intensity in the subarachnoid space, leading to diagnostic errors. Here, we describe a patient who presented to our emergency room with an acute cerebral infarction. Enhanced brain magnetic resonance imaging performed 2 days later revealed high signal intensity in the cerebrospinal fluid spaces on follow-up FLAIR images.

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