Research Article
Gadoliniumlu MRG tetkikleri ve girişimsel nöroradyolojik uygulamaların subaraknoid mesafeye kontrast madde sızıntısına etkisi
Abstract
Amaç: Gadoliniumlu ve iyotlu kontrast maddelerin çeşitli patolojilerde subaraknoid mesafeye (SAM) geçtiği, hemorajiyi taklit ettiği ve nörotoksiteye yol açtığı bilinmektedir. Bu çalışmada gadoliniumlu MRG tetkikleri ve karotid arter stentleme (KAS) işlemlerinin kontrast maddenin SAM'a geçisine etkisi değerlendirilmektedir.
Gereç ve yöntemler: Bu çalışma Mayıs 2009-Mayıs 2011 tarihleri arasında karotis darlığı nedeniyle TRICKS MRA ve sonrasında KAS işlemi yapılan 10 (7 erkek ve 3 kadın) hastayı kapsamaktadır. Hastaların yaşı 52-84 (ort 73.40±8.75) aralığındaydı. Stent yerleştirme işlemi öncesi 8 hastaya, stent işlemi sonrası ise tüm hastalara difüzyon MRG ve FLAIR sekansını içeren MRG yapıldı.
Bulgular: KAS işlemi sonrası 1.5-3 saat aralığında alınan kontrol FLAIR sekansında 4 hastada SAM'a kontrast madde geçisi saptandı. TRICKS MRA ve KAS işlemi arasındaki süre ve iskemik lezyon varlığı ile SAM'a kontrast madde geçisi arasında anlamlı ilişki saptandı (sırasıyla p=0.011, p=0.005).
Sonuç: Gadolinium ve iyotlu kontrast maddelerin kullanıldığı kontrastlı MRG tetkikleri ve 24 saat içinde yapılan KAS işlemine bağlı SAM'a gadolinium geçişi görülebilir. Bu nedenle gadolinium içeren MRG tetkikleri sonrasında daha güvenli olabileceği nedeniyle iyotlu kontrast madde içeren tetkikler veya işlemlerin en azından 2 gün sonra yapılmasını önermekteyiz.
Keywords
karotid arter stentleme iyotlu kontrast maddeler manyetik rezonans anjiografi subaraknoidal mesafe gadolinium
References
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Year 2016,
Volume: 6 Issue: 4, 283 - 290, 22.12.2016
Abstract
References
- 1) Ong E.M, Yeh I.B. High signal in the cerebrospinal fluid following prior gadolinium administration in a patient with renal impairment. Singapore Med J 2007; 48(11):e296–8.
- 2) Bozzao A, Floris R, Fasoli F, et al. Cerebrospinal fluid changes after intravenous injection of gadolinium chelate: assessment by FLAIR MR imaging. Eur Radiol 2003; 13(3):592–7.
- 3) Morris J.M, Miller G.M. Increased signal in the subarachnoid space on fluid-attenuated inversion recovery imaging associated with the clearance dynamics of gadolinium chelate: a potential diagnostic pitfall. Am J Neuroradiol 2007; 28(10):1964–7.
- 4) Dechambre SD, Duprez T, Grandin CB, et al. High signal in cerebrospinal fluid mimicking subarachnoid hemorrhage on FLAIR following acute stroke and intravenous contrast medium. Neuroradiology 2000; 42(8):608–11.
- 5) Gürer B, Yılmaz RE, Kahveci R, et al. Non-ionic contrast media neurotoxicity mimicking intracerebral hematoma. Acta Neurochir 2011; 153:419–420.
- 6) Sawaya RA, Hammoud R, Arnaout S, et al. Contrast-induced encephalopathy following coronary angioplasty with iohexol. South Med J 2007; 100(10):1054–5.
- 7) Leong S, Fanning NF. Persistent neurological deficit from iodinated contrast encephalopathy following intracranial aneurysm coiling. A case report and review of the literature. Interv Neuroradiol 2012; 18(1):33–41.
- 8) Mamourian AC, Hoopes PJ, Lewis LD. Visualization of intravenously administered contrast material in the CSF on fluid-attenuated inversion-recovery MR images: an in vitro and animal-model investigation. Am J Neuroradiol 2000; 21:105–111
- 9) Kanamalla US, Boyko OB. Gadolinium diffusion into orbital vitreous and aqueous humor, perivascular space, and ventricles in patients with chronic renal disease. AJR Am J Roentgenol 2002; 179:1350–52.
- 10) Ogami R, Nakahara T, Hamasaki O, Araki H, Kurisu K. Cerebrospinal fluid enhancement on fluid attenuated inversion recovery images after carotid artery stenting with neuroprotective balloon occlusions: hemodynamic instability and blood-brain barrier disruption. Cardiovasc Intervent Radiol 2011; 34(5):936–41.
- 11) Ray DE, Cavanagh JB, Nolan CC, et al. Neurotoxic effects of gadopentetate dimeglumine: behavioral disturbance and morphology after intracerebroventricular injection in rats. AJNR Am J Neuroradiol 1996; 17(2):365–73.
- 12) Park KW, Im SB, Kim BT, et al. Neurotoxic manifestations of an overdose intrathecal injection of gadopentetate dimeglumine. J Korean Med Sci 2010; 25(3):505–8.
- 13) Arlt S, Cepek L, Rustenbeck HH, et al. Gadolinium encephalopathy due to accidental intrathecal administration of gadopentetate dimeglumine. J Neurol 2007; 254(6):810–2.
There are 13 citations in total.
Details
| Subjects | Health Care Administration |
|---|---|
| Journal Section | Original Research |
| Authors | |
| Publication Date | December 22, 2016 |
| Acceptance Date | March 17, 2016 |
| Published in Issue | Year 2016 Volume: 6 Issue: 4 |