MR Lumbar Discography with Intradiscal Gadolinium in Patients with Severe Anaphylactoid Reaction to Iodinated Contrast Material

Abstract

Discography using intradiscal administration of gadolinium followed by MRI provides a method of obtaining a clinically pertinent study in a subset of patients who likely would not be offered the procedure, secondary to severe anaphylactoid reactions to iodinated contrast materials.

Visualization of Spinal Injection Procedures Using Gadolinium Contrast

“…Gadolinium is not commonly used in the performance of spinal injection procedures but has been previously reported for use in lumbar discography. 3,10 This case series demonstrates the usefulness of gadolinium in the visualization of a variety of spinal injection procedures under fluoroscopy. All of the spinal injections were performed successfully with gadolinium, which effectively localized needle placement for the injection of target structures.…”

MR-guided discography using an open 1 Tesla MRI system

“…The patient responded with typical memory pain to the discography-generated provocation in L4/5 and was selected for surgical treatment at this level entiation of intervertebral disc structures, nerve structures and the dural space [10,11]. Also, with MR discography adverse events due to allergic reactions associated with iodinated contrast agents can be avoided [10,22]. Although, the diagnostic validity has been verified [10,23], discography in a closed bore MR system is time consuming and rarely used in clinical routine.…”

Lumbar Discography Using Gadolinium in Patients With Iodine Contrast Allergy Followed by Postdiscography Computed Tomography Scan

“…Others have successfully injected gadolinium into the intervertebral disc during discography for the purpose of visualizing anular disruption in patients who are allergic to iodinated contrast agents, or who wished to limit their exposure to radiation. 7 Slipman et al 14 reported results of gadolinium discography of 58 discs in 14 patients. All the discs studied with intradiscal gadolinium were adequately visualized on postdiscography MRI, and there were no allergic reactions among the study subjects.…”