Intrathecal Contrast-Enhanced Magnetic Resonance Imaging-Related Brain Signal Changes: Residual Gadolinium Deposition?

Invest Radiol. 2017 Apr;52(4):195-197. doi: 10.1097/RLI.0000000000000327.


Objectives: There have been recent studies evaluating brain magnetic resonance imaging changes in patients with normal renal function, after intravenous administration of gadolinium-based contrast agents (GBCAs). Their findings were supported by histological evidence as well and brought a new vision concerning what needs to be learned to provide better patient care. In this report, we aim to present brain magnetic resonance imaging changes after intrathecal administration of a linear ionic agent (gadopentetate dimeglumine).

Materials and methods: We evaluated hyperintensities in the deep nuclei of the brain in 6 patients with normal renal function after intrathecal administration of a linear ionic GBCA, without other confounding intravenous GBCA administrations. For visual analysis, T1 signal hyperintensity of the globus pallidus (GP), putamen, pons, and dentate nucleus (DN) were scored on a 4-point scale. For quantitative analysis, using the unenhanced T1-weighted images oval regions of interests were placed within the DN, central pons, GP, and thalamus on different image slice positions.

Results: On visual analysis, 5 patients had T1 signal hyperintensity of the DN and GP, whereas the DN/pons signal intensity and the GP/thalamus signal intensity were found to be increased in all 6.

Conclusions: This observation not only adds to our fund of knowledge concerning biodistribution and pharmacokinetics of those agents, but also raises the question of a possible association with the glymphatic pathway.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Brain / diagnostic imaging*
  • Brain / drug effects
  • Brain / pathology*
  • Contrast Media / pharmacokinetics*
  • Gadolinium DTPA / pharmacokinetics*
  • Humans
  • Image Enhancement / methods*
  • Magnetic Resonance Imaging / methods*
  • Male
  • Middle Aged
  • Retrospective Studies
  • Young Adult


  • Contrast Media
  • Gadolinium DTPA