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Contrast Agents
Colin J. McCarthy, MB, BCh, BAO, MRCSI, FFR (RCSI); Lubdha M. Shah, MD
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KEY FACTS

  • Terminology

    • Imaging Anatomy

      • Anatomy Imaging Issues

        • Clinical Implications

          TERMINOLOGY

          • Definitions

            • Contrast agents are used for accurate localization of needle position, and spread of contrast agents aids in delineation of pertinent anatomy
            • For thermal-based pain management procedures, dilute contrast can also be used to assist with hydrodissection

          IMAGING ANATOMY

          • General Anatomic Considerations

            • Critical Anatomic Structures

              • Anatomic Relationships

                ANATOMY IMAGING ISSUES

                • Imaging Approaches

                  • Imaging Protocols

                    • Imaging Pitfalls

                      PATHOLOGY IMAGING ISSUES

                      • Key Concepts

                        • Imaging Approaches

                          CLINICAL IMPLICATIONS

                          • Clinical Importance

                            Selected References

                            1. Popescu A et al: Fact finders for patient safety: are gadolinium-based contrast media safe alternatives to iodinated contrast agents for the safe performance of spinal injection procedures? Pain Med. 19(10):2089-90, 2018
                            2. Kranz PG et al: Inadvertent intrafacet injection during lumbar interlaminar epidural steroid injection: a comparison of CT fluoroscopic and conventional fluoroscopic guidance. AJNR Am J Neuroradiol. 38(2):398-402, 2017
                            3. Shim E et al: Fluoroscopically guided epidural injections of the cervical and lumbar spine. Radiographics. 37(2):537-61, 2017
                            4. MacMahon PJ et al: Spine injectables: what is the safest cocktail? AJR Am J Roentgenol. 207(3):526-33, 2016
                            5. Palmer WE: Spinal injections for pain management. Radiology. 281(3):669-88, 2016
                            6. Mathis JM et al: Pharmaceuticals used in image-guided spine interventions. Neuroimaging Clin N Am. 20(2):215-22, 2010
                            7. Weil L et al: Fluoroscopic analysis of lumbar epidural contrast spread after lumbar interlaminar injection. Arch Phys Med Rehabil. 89(3):413-6, 2008
                            8. Safriel Y et al: Gadolinium use in spine procedures for patients with allergy to iodinated contrast--experience of 127 procedures. AJNR Am J Neuroradiol. 27(6):1194-7, 2006
                            9. Evron S et al: Identification of the epidural space: loss of resistance with air, lidocaine, or the combination of air and lidocaine. Anesth Analg. 99(1):245-50, 2004
                            10. Mathis JM. Materials used in image-guided spine interventions. In Mathis JM et al: Imaged-Guided Spine Interventions. New York: Springer. 27-36, 2004
                            Related Anatomy
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                            Related Differential Diagnoses
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                            References
                            Tables

                            Tables

                            KEY FACTS

                            • Terminology

                              • Imaging Anatomy

                                • Anatomy Imaging Issues

                                  • Clinical Implications

                                    TERMINOLOGY

                                    • Definitions

                                      • Contrast agents are used for accurate localization of needle position, and spread of contrast agents aids in delineation of pertinent anatomy
                                      • For thermal-based pain management procedures, dilute contrast can also be used to assist with hydrodissection

                                    IMAGING ANATOMY

                                    • General Anatomic Considerations

                                      • Critical Anatomic Structures

                                        • Anatomic Relationships

                                          ANATOMY IMAGING ISSUES

                                          • Imaging Approaches

                                            • Imaging Protocols

                                              • Imaging Pitfalls

                                                PATHOLOGY IMAGING ISSUES

                                                • Key Concepts

                                                  • Imaging Approaches

                                                    CLINICAL IMPLICATIONS

                                                    • Clinical Importance

                                                      Selected References

                                                      1. Popescu A et al: Fact finders for patient safety: are gadolinium-based contrast media safe alternatives to iodinated contrast agents for the safe performance of spinal injection procedures? Pain Med. 19(10):2089-90, 2018
                                                      2. Kranz PG et al: Inadvertent intrafacet injection during lumbar interlaminar epidural steroid injection: a comparison of CT fluoroscopic and conventional fluoroscopic guidance. AJNR Am J Neuroradiol. 38(2):398-402, 2017
                                                      3. Shim E et al: Fluoroscopically guided epidural injections of the cervical and lumbar spine. Radiographics. 37(2):537-61, 2017
                                                      4. MacMahon PJ et al: Spine injectables: what is the safest cocktail? AJR Am J Roentgenol. 207(3):526-33, 2016
                                                      5. Palmer WE: Spinal injections for pain management. Radiology. 281(3):669-88, 2016
                                                      6. Mathis JM et al: Pharmaceuticals used in image-guided spine interventions. Neuroimaging Clin N Am. 20(2):215-22, 2010
                                                      7. Weil L et al: Fluoroscopic analysis of lumbar epidural contrast spread after lumbar interlaminar injection. Arch Phys Med Rehabil. 89(3):413-6, 2008
                                                      8. Safriel Y et al: Gadolinium use in spine procedures for patients with allergy to iodinated contrast--experience of 127 procedures. AJNR Am J Neuroradiol. 27(6):1194-7, 2006
                                                      9. Evron S et al: Identification of the epidural space: loss of resistance with air, lidocaine, or the combination of air and lidocaine. Anesth Analg. 99(1):245-50, 2004
                                                      10. Mathis JM. Materials used in image-guided spine interventions. In Mathis JM et al: Imaged-Guided Spine Interventions. New York: Springer. 27-36, 2004