MR Lumbar Discography with Intradiscal Gadolinium in Patients with Severe Anaphylactoid Reaction to Iodinated Contrast Material

Objective. Describe our experience using discography with intradiscal gadolinium and MR lumbar discography in patients with a history of severe anaphylactoid reaction to iodinated radiocontrast agents. Design. Observational study of 14 patients. Methods. From 1997 to 1999, 14 patients were referred for lumbar discography with intradiscal gadolinium followed by MRI. Patients with a history of a severe anaphylactoid reaction to iodinated radiocontrast media or those who refused the use of iodinated contrast material were included in the study. Results. In fourteen patients, 58 discs were studied. The post discography MRIs identified seven annular tears and seven annular fissures. None of the fourteen patients reported symptoms suggestive of allergic reaction either during or after discography. Conclusions. Discography using intradiscal administration of gadolinium followed by MRI provides a method of obtaining a clinically pertinent study in a subset of patients who likely would not be offered the procedure, secondary to severe anaphylactoid reactions to iodinated contrast materials.