Delayed magnetic resonance imaging with GdD-DTPA differentiates subdural hygroma and subdural effusion.

Abstract

BACKGROUND:

Posttraumatic subdural fluid collection is not a single clinical entity but can be divided into subdural hygroma and subdural effusion. Appropriate treatment requires preoperative differentiation. Delayed magnetic resonance (MR) imaging with intravenous administration of gadolinium-diethylenetriaminepenta-acetic acid (Gd-DTPA) was used to differentiate subdural hygroma and subdural effusion.

METHODS:

Timed arterial blood specimens were taken after intravenous Gd administration in patients with posttraumatic subdural fluid collections (five subdural hygromas and 13 subdural effusions). Delayed MR imaging was performed 1 hour after administration of Gd-DTPA. Gd-DTPA concentrations in the subdural fluid and blood specimens were measured by ion coupled plasma emission spectrometry. Dynamic biologic modeling was used to calculate the transfer rate constant for Gd-DTPA influx into these subdural fluid collections.

RESULTS:

The Gd concentrations in subdural hygromas and subdural effusions were 16 +/- 6 and 79 +/- 12 nmol/mL, respectively. The transfer rate constants for subdural hygromas and subdural effusions were 4.8 +/- 2.1 and 20.6 +/- 2.1 (x10(-4))min(-1), respectively. These values were significantly higher in subdural effusions than in subdural hygromas (p < 0.01). Delayed MR imaging with Gd showed significantly higher mean enhancement of 77.1 +/- 14.2% for subdural effusions compared to 4.6 +/- 3.1% for subdural hygromas (p < 0.01).

CONCLUSIONS:

Delayed MR imaging with Gd can differentiate subdural hygroma and subdural effusion.

• Authors: K Mori, M Maeda
• Journal: Surgical neurology (Surg Neurol) Vol. 53 Issue 4 Pg. 303-10; discussion 310-1 (Apr 2000) ISSN: 0090-3019 [Print] United States
• PMID: 10825512 (Publication Type: Journal Article)

Chemical References

• Contrast Media
• Gadolinium DTPA

Topics

• Aged
• Aged, 80 and over
• Brain Injuries (complications)
• Brain Neoplasms (diagnosis, etiology, surgery)
• Cerebral Ventriculography (methods)
• Cerebrospinal Fluid Shunts (methods)
• Contrast Media
• Diagnosis, Differential
• Female
• Gadolinium DTPA (administration & dosage)
• Humans
• Injections, Intravenous
• Lymphangioma, Cystic (diagnosis, etiology, surgery)
• Magnetic Resonance Imaging
• Male
• Middle Aged
• Preoperative Care
• Subdural Effusion (cerebrospinal fluid, surgery)
• Subdural Space (diagnostic imaging, pathology)
• Therapeutic Irrigation (methods)
• Time Factors
• Tomography, X-Ray Computed