Radiology & Radiation Therapy

Correspondence:

Received: January 01, 1970 | Published: ,

Citation: DOI:

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Objectives

Presenting imaging characteristics in various diagnostic methods of Lipiodol. Figure 1 Compare characteristics of Lipiodol with the different contrast media of current use. Mention the differential diagnoses of the images of Lipiodol remains.

Figure 1 Imaging characteristics in various diagnostic methods of Lipiodol in the turkish sea.

Keywords

Keywords: CT scan, front skull x-ray, bone window, leptomeningeal reaction, water-soluble products

Methods and materials

We present the case of 72years old female patient with chronic headache and hypothyroidism. Derived from another institution carrying a front skull x-ray and brain CT scan with parenchyma and bone window, presenting a dense image in the sella turca. MRI is performed.

Results

The Lipiodol (France) and the Pantopaque (USA) are means of iodinated high density oily contrasts that were used until the 1980s for myelographic studies. After the procedure was finished, it was about vacuuming the the used contrast, but usually it was not possible to retrieve it all. Reabsorption of this product is very slow, approximately 1cc per year, so that its residues scattered in the subarachnoid space can be seen years later by leptomeningeal reaction. The current use of water-soluble products seeks to avoid these effects. CT scans shows droplets of higher density than calcium, distributed in the subarachnoid spaces, producing a "SPRAY effect".They are often confused with calcifications and / or metal artifacts. To differentiate them, when there is doubt, adjusting the window to bone density will show that Lipiodol drops maintain a greater density than the bone structures. Brain MRI shows hyperintense focal image in T1 and T2 sequence of 4mm compatible with myelographic contrast rests (oil) in the right lateral sector, associated with hypointense halo in upper sector (calcification).

Conclusion

This diagnostic possibility must be considered in adult patients (not in young people and children since the contrasts currently used are water soluble) and differentiate them from other possible diagnoses, by their location and the antecedent of myelography by means of a directed interrogation. The cause of their refractory headaches could be interpreted as a possible sequel arachnoiditis.