Conditions of iodine contrast transfer from lumbosacral CSF to blood

Abstract 

Purpose: To determine conditions which influence transfer of iopamidol from lumbosacral cerebrospinal fluid (CSF) to blood. Methods: Iopamidol transfer was measured in 32 patients over 180 min after radiculography and compared with patient variables. Results: Iopamidol transfer began early in 12 patients, more slowly in 13 patients, and was not detected during sample period in 7 patients. Transfer of sequential samples correlated highly with each other (r>0.8). Transfer was more pronounced in patients with prominent nerve root sleeves on radiculogram (p=0.006, t test), and correlated inversely with body weight (r=−0.4258), and with albumin CSF/serum quotient (r=−0.4702). Conclusion: Early iopamidol transfer probably indicates transfer through spinal arachnoid villi and granulations with CSF bulk flow. Prominent nerve root sleeves may facilitate access to transfer sites. No transfer during sample period suggests no such spinal transfer, possibly due to sparse access to or presence of spinal transfer sites. Inverse correlation of transfer with body weight may reflect influence of body weight on retroperitoneal venous pressure, which regulates outflow of CSF and of compounds dissolved in it. Awareness of wide interindividual transfer variation and steady intraindividual transfer may help to specify dosage and effect expectation of intrathecal drug therapy.

Keywords:  Lumbosacral radiculography, Iopamidol transfer, Spinal nerve root sleeves, Body weight