• Journal of neurosurgery · Mar 2004

    Case Reports

    Gadolinium leakage into the surgical bed mimicking residual enhancement following spinal cord surgery. Case report.

    • Matthew Walker, Saquib Khawar, Ali Shaibani, Sireen Reddy, Aruna Ganju, and Manu Gupta.
    • Department of Radiology, Feinberg School of Medicine of Northwestern University, Chicago, Illinois, USA. mwalker@radiology.northwestern.edu
    • J. Neurosurg. 2004 Mar 1; 100 (3 Suppl Spine): 291-4.

    AbstractIntramedullary spinal cord surgery can disrupt the blood-spinal cord barrier and cause intravascular contents to leak into the surgical cavity. Immediate postoperative Gd-enhanced magnetic resonance (MR) imaging can demonstrate leakage of contrast into the surgical bed and complicate the assessment of whether a residual enhancing tumor is present. The authors report a case in which the preoperative lesion was nonenhancing and not expected to enhance on postoperative imaging. A Gd-enhanced MR imaging study obtained less than 24 hours after surgery revealed that the intramedullary surgical cavity was filled with contrast material. Because of the time course and the lesion's preoperative appearance, this "enhancement" was known to be caused by the leakage of medium into the resection cavity rather than of pathological soft-tissue enhancement.

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