The following table or figure may be downloaded to PowerPoint for personal use in teaching and presentations. This feature is available to all subscribers to the journal.
You MUST read and follow the guidelines at Request to Reproduce AJR Content if you are distributing or using AJR content beyond academic use (limited distribution, non-revenue producing, or educational purposes).
(Downloading may take up to 30 seconds.
If the slide opens in your browser, select File -> Save As to save it.)
Click on image to view larger version.
Fig. 2B —19-year-old man with glioblastoma multiforme. Two types of infusion
failure were seen in this patient. Forty-eight hours after initiation of
convection-enhanced infusion, leakage of infusate into subarachnoid CSF space
occurred, and hyperintense signal did not develop on T2-weighted MR images.
A-C, Images show failure due to catheter crossing sulcus within
backflow region. D-F, Images show failure due to placement of catheter
tip within subarachnoid space. Human figure indicates imaging plane. Blue line
and indicates plane perpendicular to catheter shown in C and F.
Thick red and thicker and lighter blue indicate catheter trajectories. Oblique
coronal T2-weighted image oriented 90° to A shows catheter
trajectory (red line), superimposed coregistered SPECT signal at 50%
isodose level, and portions of resection cavity medial to catheter trajectory.
A sulcus, through which infusate has leaked into subarachnoid CSF spaces, is
seen extending approximately 1 cm along distal end of catheter tip. Long axis
of region of SPECT signal extends toward subarachnoid space (rather than
circumferentially surrounding catheter tip) indicating leakage of infusate
into subarachnoid space (yellow outline). Leakage accounts for
absence of development of hyperintense signal adjacent to catheter tip.
