1naresh2naresh<pre>Array
(
    [urn:ac.highwire.org:guest:identity] => Array
        (
            [runtime-id] => urn:ac.highwire.org:guest:identity
            [type] => guest
            [service-id] => ajnr-ac.highwire.org
            [access-type] => Controlled
            [privilege] => Array
                (
                    [urn:ac.highwire.org:guest:privilege] => Array
                        (
                            [runtime-id] => urn:ac.highwire.org:guest:privilege
                            [type] => privilege-set
                            [privilege-set] => GUEST
                        )

                )

            [credentials] => Array
                (
                    [method] => guest
                )

        )

    [0ac028d3-c4c0-4114-9b68-8efe389b4ab7] => Array
        (
            [runtime-id] => 0ac028d3-c4c0-4114-9b68-8efe389b4ab7
            [type] => toll-free-key
            [service-id] => ajnr-ac.highwire.org
            [access-type] => Controlled
            [privilege] => Array
                (
                    [846e1b49-11f0-4260-bedf-b04b108b0b90] => Array
                        (
                            [runtime-id] => 846e1b49-11f0-4260-bedf-b04b108b0b90
                            [type] => toll-free-key
                        )

                )

            [credentials] => Array
                (
                    [method] => toll-free-key
                    [value] => tf_ipsecsha;fa09d1b95758e5f95e6aa5383487bb7195192fa9
                )

        )

)
1naresh2naresh<pre>Array
(
    [urn:ac.highwire.org:guest:identity] => Array
        (
            [runtime-id] => urn:ac.highwire.org:guest:identity
            [type] => guest
            [service-id] => ajnr-ac.highwire.org
            [access-type] => FreeToRead
            [privilege] => Array
                (
                    [urn:ac.highwire.org:guest:privilege] => Array
                        (
                            [runtime-id] => urn:ac.highwire.org:guest:privilege
                            [type] => privilege-set
                            [privilege-set] => GUEST
                        )

                )

            [credentials] => Array
                (
                    [method] => guest
                )

        )

    [b6815cbd-decf-4f74-8738-4d55d15e846b] => Array
        (
            [runtime-id] => b6815cbd-decf-4f74-8738-4d55d15e846b
            [type] => toll-free-key
            [service-id] => ajnr-ac.highwire.org
            [access-type] => FreeToRead
            [privilege] => Array
                (
                    [7483c26f-41ce-47df-a9c0-34c1b8214a60] => Array
                        (
                            [runtime-id] => 7483c26f-41ce-47df-a9c0-34c1b8214a60
                            [type] => toll-free-key
                        )

                )

            [credentials] => Array
                (
                    [method] => toll-free-key
                    [value] => tf_ipsecsha;fa09d1b95758e5f95e6aa5383487bb7195192fa9
                )

        )

)
1naresh2naresh<pre>Array
(
    [urn:ac.highwire.org:guest:identity] => Array
        (
            [runtime-id] => urn:ac.highwire.org:guest:identity
            [type] => guest
            [service-id] => ajnr-ac.highwire.org
            [access-type] => FreeToRead
            [privilege] => Array
                (
                    [urn:ac.highwire.org:guest:privilege] => Array
                        (
                            [runtime-id] => urn:ac.highwire.org:guest:privilege
                            [type] => privilege-set
                            [privilege-set] => GUEST
                        )

                )

            [credentials] => Array
                (
                    [method] => guest
                )

        )

    [e9c45a74-3591-49ff-855d-65ee446312fe] => Array
        (
            [runtime-id] => e9c45a74-3591-49ff-855d-65ee446312fe
            [type] => toll-free-key
            [service-id] => ajnr-ac.highwire.org
            [access-type] => FreeToRead
            [privilege] => Array
                (
                    [58716115-7c49-4ffc-b7e8-88d2639d4fae] => Array
                        (
                            [runtime-id] => 58716115-7c49-4ffc-b7e8-88d2639d4fae
                            [type] => toll-free-key
                        )

                )

            [credentials] => Array
                (
                    [method] => toll-free-key
                    [value] => tf_ipsecsha;fa09d1b95758e5f95e6aa5383487bb7195192fa9
                )

        )

)
1naresh2naresh<pre>Array
(
    [urn:ac.highwire.org:guest:identity] => Array
        (
            [runtime-id] => urn:ac.highwire.org:guest:identity
            [type] => guest
            [service-id] => ajnr-ac.highwire.org
            [access-type] => FreeToRead
            [privilege] => Array
                (
                    [urn:ac.highwire.org:guest:privilege] => Array
                        (
                            [runtime-id] => urn:ac.highwire.org:guest:privilege
                            [type] => privilege-set
                            [privilege-set] => GUEST
                        )

                )

            [credentials] => Array
                (
                    [method] => guest
                )

        )

    [71e62a9b-9df8-4ca4-bd71-3b9af9b8767e] => Array
        (
            [runtime-id] => 71e62a9b-9df8-4ca4-bd71-3b9af9b8767e
            [type] => toll-free-key
            [service-id] => ajnr-ac.highwire.org
            [access-type] => FreeToRead
            [privilege] => Array
                (
                    [f771a690-0ce1-4d9d-b3db-dca0f53692a6] => Array
                        (
                            [runtime-id] => f771a690-0ce1-4d9d-b3db-dca0f53692a6
                            [type] => toll-free-key
                        )

                )

            [credentials] => Array
                (
                    [method] => toll-free-key
                    [value] => tf_ipsecsha;fa09d1b95758e5f95e6aa5383487bb7195192fa9
                )

        )

)
1naresh2naresh<pre>Array
(
    [urn:ac.highwire.org:guest:identity] => Array
        (
            [runtime-id] => urn:ac.highwire.org:guest:identity
            [type] => guest
            [service-id] => ajnr-ac.highwire.org
            [access-type] => Controlled
            [privilege] => Array
                (
                    [urn:ac.highwire.org:guest:privilege] => Array
                        (
                            [runtime-id] => urn:ac.highwire.org:guest:privilege
                            [type] => privilege-set
                            [privilege-set] => GUEST
                        )

                )

            [credentials] => Array
                (
                    [method] => guest
                )

        )

    [0ac028d3-c4c0-4114-9b68-8efe389b4ab7] => Array
        (
            [runtime-id] => 0ac028d3-c4c0-4114-9b68-8efe389b4ab7
            [type] => toll-free-key
            [service-id] => ajnr-ac.highwire.org
            [access-type] => Controlled
            [privilege] => Array
                (
                    [846e1b49-11f0-4260-bedf-b04b108b0b90] => Array
                        (
                            [runtime-id] => 846e1b49-11f0-4260-bedf-b04b108b0b90
                            [type] => toll-free-key
                        )

                )

            [credentials] => Array
                (
                    [method] => toll-free-key
                    [value] => tf_ipsecsha;fa09d1b95758e5f95e6aa5383487bb7195192fa9
                )

        )

)
1naresh2naresh<pre>Array
(
    [urn:ac.highwire.org:guest:identity] => Array
        (
            [runtime-id] => urn:ac.highwire.org:guest:identity
            [type] => guest
            [service-id] => ajnr-ac.highwire.org
            [access-type] => Controlled
            [privilege] => Array
                (
                    [urn:ac.highwire.org:guest:privilege] => Array
                        (
                            [runtime-id] => urn:ac.highwire.org:guest:privilege
                            [type] => privilege-set
                            [privilege-set] => GUEST
                        )

                )

            [credentials] => Array
                (
                    [method] => guest
                )

        )

    [0ac028d3-c4c0-4114-9b68-8efe389b4ab7] => Array
        (
            [runtime-id] => 0ac028d3-c4c0-4114-9b68-8efe389b4ab7
            [type] => toll-free-key
            [service-id] => ajnr-ac.highwire.org
            [access-type] => Controlled
            [privilege] => Array
                (
                    [846e1b49-11f0-4260-bedf-b04b108b0b90] => Array
                        (
                            [runtime-id] => 846e1b49-11f0-4260-bedf-b04b108b0b90
                            [type] => toll-free-key
                        )

                )

            [credentials] => Array
                (
                    [method] => toll-free-key
                    [value] => tf_ipsecsha;fa09d1b95758e5f95e6aa5383487bb7195192fa9
                )

        )

)
1naresh2naresh<pre>Array
(
    [urn:ac.highwire.org:guest:identity] => Array
        (
            [runtime-id] => urn:ac.highwire.org:guest:identity
            [type] => guest
            [service-id] => ajnr-ac.highwire.org
            [access-type] => Controlled
            [privilege] => Array
                (
                    [urn:ac.highwire.org:guest:privilege] => Array
                        (
                            [runtime-id] => urn:ac.highwire.org:guest:privilege
                            [type] => privilege-set
                            [privilege-set] => GUEST
                        )

                )

            [credentials] => Array
                (
                    [method] => guest
                )

        )

    [0ac028d3-c4c0-4114-9b68-8efe389b4ab7] => Array
        (
            [runtime-id] => 0ac028d3-c4c0-4114-9b68-8efe389b4ab7
            [type] => toll-free-key
            [service-id] => ajnr-ac.highwire.org
            [access-type] => Controlled
            [privilege] => Array
                (
                    [846e1b49-11f0-4260-bedf-b04b108b0b90] => Array
                        (
                            [runtime-id] => 846e1b49-11f0-4260-bedf-b04b108b0b90
                            [type] => toll-free-key
                        )

                )

            [credentials] => Array
                (
                    [method] => toll-free-key
                    [value] => tf_ipsecsha;fa09d1b95758e5f95e6aa5383487bb7195192fa9
                )

        )

)
1naresh2naresh<pre>Array
(
    [urn:ac.highwire.org:guest:identity] => Array
        (
            [runtime-id] => urn:ac.highwire.org:guest:identity
            [type] => guest
            [service-id] => ajnr-ac.highwire.org
            [access-type] => Controlled
            [privilege] => Array
                (
                    [urn:ac.highwire.org:guest:privilege] => Array
                        (
                            [runtime-id] => urn:ac.highwire.org:guest:privilege
                            [type] => privilege-set
                            [privilege-set] => GUEST
                        )

                )

            [credentials] => Array
                (
                    [method] => guest
                )

        )

    [0ac028d3-c4c0-4114-9b68-8efe389b4ab7] => Array
        (
            [runtime-id] => 0ac028d3-c4c0-4114-9b68-8efe389b4ab7
            [type] => toll-free-key
            [service-id] => ajnr-ac.highwire.org
            [access-type] => Controlled
            [privilege] => Array
                (
                    [846e1b49-11f0-4260-bedf-b04b108b0b90] => Array
                        (
                            [runtime-id] => 846e1b49-11f0-4260-bedf-b04b108b0b90
                            [type] => toll-free-key
                        )

                )

            [credentials] => Array
                (
                    [method] => toll-free-key
                    [value] => tf_ipsecsha;fa09d1b95758e5f95e6aa5383487bb7195192fa9
                )

        )

)
1naresh2naresh<pre>Array
(
    [urn:ac.highwire.org:guest:identity] => Array
        (
            [runtime-id] => urn:ac.highwire.org:guest:identity
            [type] => guest
            [service-id] => ajnr-ac.highwire.org
            [access-type] => FreeToRead
            [privilege] => Array
                (
                    [urn:ac.highwire.org:guest:privilege] => Array
                        (
                            [runtime-id] => urn:ac.highwire.org:guest:privilege
                            [type] => privilege-set
                            [privilege-set] => GUEST
                        )

                )

            [credentials] => Array
                (
                    [method] => guest
                )

        )

    [a907c3d1-1c5a-4db1-bfc0-d923c00a4c32] => Array
        (
            [runtime-id] => a907c3d1-1c5a-4db1-bfc0-d923c00a4c32
            [type] => toll-free-key
            [service-id] => ajnr-ac.highwire.org
            [access-type] => FreeToRead
            [privilege] => Array
                (
                    [93fc47d7-5d78-4005-aefe-48b33043f0c7] => Array
                        (
                            [runtime-id] => 93fc47d7-5d78-4005-aefe-48b33043f0c7
                            [type] => toll-free-key
                        )

                )

            [credentials] => Array
                (
                    [method] => toll-free-key
                    [value] => tf_ipsecsha;fa09d1b95758e5f95e6aa5383487bb7195192fa9
                )

        )

)
<!DOCTYPE html>
<html lang="en" dir="ltr" 
  xmlns="http://www.w3.org/1999/xhtml"
  xmlns:mml="http://www.w3.org/1998/Math/MathML">
  <head prefix="og: http://ogp.me/ns# article: http://ogp.me/ns/article# book: http://ogp.me/ns/book#" >
    <!--[if IE]><![endif]-->
<link rel="dns-prefetch" href="//securepubads.g.doubleclick.net" />
<link rel="dns-prefetch" href="//scholar.google.com" />
<link rel="dns-prefetch" href="//cdn.jsdelivr.net" />
<link rel="dns-prefetch" href="//www.google.com" />
<link rel="dns-prefetch" href="//www.googletagmanager.com" />
<meta http-equiv="Content-Type" content="text/html; charset=utf-8" />
<link rel="shortlink" href="/node/69522" />
<meta name="Generator" content="Drupal 7 (http://drupal.org)" />
<link rel="shortcut icon" href="http://ajnr-stage2.stage.highwire.org/sites/default/files/images/favicon.ico" type="image/vnd.microsoft.icon" />
<meta name="issue_cover_image" content="http://ajnr-stage2.stage.highwire.org/sites/default/files/highwire/ajnr/40/8.cover-source.jpg" />
<meta name="type" content="article" />
<meta name="category" content="research-article" />
<meta name="HW.identifier" content="/ajnr/40/8/1257.atom" />
<meta name="HW.pisa" content="ajnr;40/8/1257" />
<meta name="DC.Format" content="text/html" />
<meta name="DC.Language" content="en" />
<meta name="DC.Title" content="Intrathecal Use of Gadobutrol for Glymphatic MR Imaging: Prospective Safety Study of 100 Patients" />
<meta name="DC.Identifier" content="10.3174/ajnr.A6136" />
<meta name="DC.Date" content="2019-08-01" />
<meta name="DC.Publisher" content="American Journal of Neuroradiology" />
<meta name="DC.Rights" content="© 2019 by American Journal of Neuroradiology" />
<meta name="DC.AccessRights" content="restricted" />
<meta name="DC.Description" content="BACKGROUND AND PURPOSE: Intrathecal contrast-enhanced glymphatic MR imaging has shown promise in assessing glymphatic function in patients with dementia. The purpose of this study was to determine the safety profile and feasibility of this new MR imaging technique.

MATERIALS AND METHODS: A prospective safety and feasibility study was performed in 100 consecutive patients (58 women and 42 men, 51 ± 19 years of age) undergoing glymphatic MR imaging from September 2015 to August 2018. Short- and long-term serious and nonserious adverse events were registered clinically and by interview after intrathecal administration of 0.5 mL of gadobutrol (1.0 mmol/mL) along with 3 mL of iodixanol (270 mg I/mL). Adverse events are presented as numbers and percentages.

RESULTS: One serious adverse event (anaphylaxis) occurred in a patient with known allergy to iodine-containing contrast agents (1%). The main nonserious adverse events during the first 1–3 days after contrast injection included severe headache (28%) and severe nausea (34%), though the frequency depended heavily on the diagnosis. After 4 weeks, adverse events had resolved.

CONCLUSIONS: Intrathecal administration of gadobutrol in conjunction with iodixanol for glymphatic MR imaging is safe and feasible. We cannot conclude whether short-duration symptoms such as headache and nausea were caused by gadobutrol, iodixanol, the lumbar puncture, or the diagnosis. The safety profile closely resembles that of iodixanol alone.

gMRI
:   glymphatic MR imaging
iNPH
:   idiopathic normal pressure hydrocephalus" />
<meta name="DC.Contributor" content="C.S. Edeklev" />
<meta name="DC.Contributor" content="M. Halvorsen" />
<meta name="DC.Contributor" content="G. Løvland" />
<meta name="DC.Contributor" content="S.A.S. Vatnehol" />
<meta name="DC.Contributor" content="Ø. Gjertsen" />
<meta name="DC.Contributor" content="B. Nedregaard" />
<meta name="DC.Contributor" content="R. Sletteberg" />
<meta name="DC.Contributor" content="G. Ringstad" />
<meta name="DC.Contributor" content="P.K. Eide" />
<meta name="article:published_time" content="2019-08-01" />
<meta name="article:section" content="Patient Safety" />
<meta name="citation_title" content="Intrathecal Use of Gadobutrol for Glymphatic MR Imaging: Prospective Safety Study of 100 Patients" />
<meta name="citation_abstract" lang="en" content="&lt;h3&gt;BACKGROUND AND PURPOSE:&lt;/h3&gt;
&lt;p&gt;Intrathecal contrast-enhanced glymphatic MR imaging has shown promise in assessing glymphatic function in patients with dementia. The purpose of this study was to determine the safety profile and feasibility of this new MR imaging technique.&lt;/p&gt;&lt;h3&gt;MATERIALS AND METHODS:&lt;/h3&gt;
&lt;p&gt;A prospective safety and feasibility study was performed in 100 consecutive patients (58 women and 42 men, 51 ± 19 years of age) undergoing glymphatic MR imaging from September 2015 to August 2018. Short- and long-term serious and nonserious adverse events were registered clinically and by interview after intrathecal administration of 0.5 mL of gadobutrol (1.0 mmol/mL) along with 3 mL of iodixanol (270 mg I/mL). Adverse events are presented as numbers and percentages.&lt;/p&gt;&lt;h3&gt;RESULTS:&lt;/h3&gt;
&lt;p&gt;One serious adverse event (anaphylaxis) occurred in a patient with known allergy to iodine-containing contrast agents (1%). The main nonserious adverse events during the first 1–3 days after contrast injection included severe headache (28%) and severe nausea (34%), though the frequency depended heavily on the diagnosis. After 4 weeks, adverse events had resolved.&lt;/p&gt;&lt;h3&gt;CONCLUSIONS:&lt;/h3&gt;
&lt;p&gt;Intrathecal administration of gadobutrol in conjunction with iodixanol for glymphatic MR imaging is safe and feasible. We cannot conclude whether short-duration symptoms such as headache and nausea were caused by gadobutrol, iodixanol, the lumbar puncture, or the diagnosis. The safety profile closely resembles that of iodixanol alone.&lt;/p&gt;" />
<meta name="citation_journal_title" content="American Journal of Neuroradiology" />
<meta name="citation_publisher" content="American Journal of Neuroradiology" />
<meta name="citation_publication_date" content="2019/08/01" />
<meta name="citation_mjid" content="ajnr;40/8/1257" />
<meta name="citation_id" content="40/8/1257" />
<meta name="citation_public_url" content="http://ajnr-stage2.stage.highwire.org/content/40/8/1257" />
<meta name="citation_abstract_html_url" content="http://ajnr-stage2.stage.highwire.org/content/40/8/1257.abstract" />
<meta name="citation_full_html_url" content="http://ajnr-stage2.stage.highwire.org/content/40/8/1257.full" />
<meta name="citation_pdf_url" content="http://ajnr-stage2.stage.highwire.org/content/ajnr/40/8/1257.full.pdf" />
<meta name="citation_issn" content="0195-6108" />
<meta name="citation_issn" content="1936-959X" />
<meta name="citation_doi" content="10.3174/ajnr.A6136" />
<meta name="citation_pmid" content="31320462" />
<meta name="citation_volume" content="40" />
<meta name="citation_issue" content="8" />
<meta name="citation_article_type" content="Research Article" />
<meta name="citation_section" content="Patient Safety" />
<meta name="citation_firstpage" content="1257" />
<meta name="citation_lastpage" content="1264" />
<meta name="citation_author" content="C.S. Edeklev" />
<meta name="citation_author_institution" content="aFrom the Department of Neurosurgery (C.S.E., M.H., P.K.E.)" />
<meta name="citation_author_orcid" content="https://orcid.org/0000-0002-0269-3256" />
<meta name="citation_author" content="M. Halvorsen" />
<meta name="citation_author_institution" content="aFrom the Department of Neurosurgery (C.S.E., M.H., P.K.E.)" />
<meta name="citation_author_orcid" content="https://orcid.org/0000-0002-8412-2130" />
<meta name="citation_author" content="G. Løvland" />
<meta name="citation_author_institution" content="bInterventional Centre (G.L., S.A.S.V.)" />
<meta name="citation_author_orcid" content="https://orcid.org/0000-0002-1866-9613" />
<meta name="citation_author" content="S.A.S. Vatnehol" />
<meta name="citation_author_institution" content="bInterventional Centre (G.L., S.A.S.V.)" />
<meta name="citation_author_orcid" content="https://orcid.org/0000-0002-7900-0534" />
<meta name="citation_author" content="Ø. Gjertsen" />
<meta name="citation_author_institution" content="cDepartment of Radiology and Nuclear Medicine (Ø.G., B.N. R.S., G.R.), Oslo University Hospital, Rikshospitalet, Oslo, Norway" />
<meta name="citation_author_orcid" content="https://orcid.org/0000-0002-3525-4399" />
<meta name="citation_author" content="B. Nedregaard" />
<meta name="citation_author_institution" content="cDepartment of Radiology and Nuclear Medicine (Ø.G., B.N. R.S., G.R.), Oslo University Hospital, Rikshospitalet, Oslo, Norway" />
<meta name="citation_author_orcid" content="https://orcid.org/0000-0001-5335-8899" />
<meta name="citation_author" content="R. Sletteberg" />
<meta name="citation_author_institution" content="cDepartment of Radiology and Nuclear Medicine (Ø.G., B.N. R.S., G.R.), Oslo University Hospital, Rikshospitalet, Oslo, Norway" />
<meta name="citation_author_orcid" content="https://orcid.org/0000-0001-7674-5242" />
<meta name="citation_author" content="G. Ringstad" />
<meta name="citation_author_institution" content="cDepartment of Radiology and Nuclear Medicine (Ø.G., B.N. R.S., G.R.), Oslo University Hospital, Rikshospitalet, Oslo, Norway" />
<meta name="citation_author_orcid" content="https://orcid.org/0000-0003-0919-4510" />
<meta name="citation_author" content="P.K. Eide" />
<meta name="citation_author_institution" content="aFrom the Department of Neurosurgery (C.S.E., M.H., P.K.E.)" />
<meta name="citation_author_institution" content="dInstitute of Clinical Medicine (P.K.E.), Faculty of Medicine, University of Oslo, Oslo, Norway." />
<meta name="citation_author_orcid" content="https://orcid.org/0000-0001-6881-9280" />
<meta name="citation_reference" content="citation_journal_title=Science Translational Medicine;citation_journal_abbrev=Sci Transl Med;citation_author=JJ. Iliff;citation_author=M. Wang;citation_author=Y. Liao;citation_title=A Paravascular Pathway Facilitates CSF Flow Through the Brain Parenchyma and the Clearance of Interstitial Solutes, Including Amyloid {beta};citation_pages=147ra111-147ra111;citation_volume=4;citation_year=2012;citation_issue=147;citation_pmid=22896675;citation_doi=10.1126/scitranslmed.3003748" />
<meta name="citation_reference" content="citation_journal_title=Lancet Neurol;citation_author=MK. Rasmussen;citation_author=H. Mestre;citation_author=M. Nedergaard;citation_title=The glymphatic pathway in neurological disorders;citation_pages=1016-24;citation_volume=17;citation_year=2018;citation_pmid=30353860;citation_doi=10.1016/S1474-4422(18)30318-1" />
<meta name="citation_reference" content="citation_journal_title=J Clin Invest;citation_author=JJ. Iliff;citation_author=H. Lee;citation_author=M. Yu;citation_title=Brain-wide pathway for waste clearance captured by contrast-enhanced MRI;citation_pages=1299-309;citation_volume=123;citation_year=2013;citation_pmid=23434588;citation_doi=10.1172/JCI67677" />
<meta name="citation_reference" content="citation_journal_title=J Transl Med;citation_author=L. Yang;citation_author=BT. Kress;citation_author=HJ. Weber;citation_title=Evaluating glymphatic pathway function utilizing clinically relevant intrathecal infusion of CSF tracer;citation_pages=107;citation_volume=11;citation_year=2013;citation_pmid=23635358;citation_doi=10.1186/1479-5876-11-107" />
<meta name="citation_reference" content="citation_journal_title=JCI Insight;citation_author=G. Ringstad;citation_author=LM. Valnes;citation_author=AM. Dale;citation_title=Brain-wide glymphatic enhancement and clearance in humans assessed with MRI;citation_volume=3;citation_year=2018;citation_pmid=29997300;citation_doi=10.1172/jci.insight.121537" />
<meta name="citation_reference" content="citation_journal_title=Brain;citation_author=G. Ringstad;citation_author=SA. Vatnehol;citation_author=PK. Eide;citation_title=Glymphatic MRI in idiopathic normal pressure hydrocephalus;citation_pages=2691-705;citation_volume=140;citation_year=2017;citation_pmid=28969373;citation_doi=10.1093/brain/awx191" />
<meta name="citation_reference" content="citation_journal_title=J Cereb Blood Flow Metab;citation_author=PK. Eide;citation_author=G. Ringstad;citation_title=Delayed clearance of cerebrospinal fluid tracer from entorhinal cortex in idiopathic normal pressure hydrocephalus: a glymphatic magnetic resonance imaging study;citation_year=2018;citation_pmid=29485341;citation_doi=10.1177/0271678X18760974" />
<meta name="citation_reference" content="citation_journal_title=Nature;citation_author=A. Louveau;citation_author=I. Smirnov;citation_author=TJ. Keyes;citation_title=Structural and functional features of central nervous system lymphatic vessels;citation_pages=337-41;citation_volume=523;citation_year=2015;citation_pmid=26030524;citation_doi=10.1038/nature14432" />
<meta name="citation_reference" content="citation_journal_title=J Exp Med;citation_author=A. Aspelund;citation_author=S. Antila;citation_author=ST. Proulx;citation_title=A dural lymphatic vascular system that drains brain interstitial fluid and macromolecules;citation_volume=212;citation_year=2015;citation_pmid=26077718;citation_doi=10.1084/jem.20142290" />
<meta name="citation_reference" content="citation_journal_title=Sci Rep;citation_author=PK. Eide;citation_author=SA. Vatnehol;citation_author=KE. Emblem;citation_title=Magnetic resonance imaging provides evidence of glymphatic drainage from human brain to cervical lymph nodes;citation_pages=7194;citation_volume=8;citation_year=2018;citation_pmid=29740121;citation_doi=10.1038/s41598-018-25666-4" />
<meta name="citation_reference" content="citation_journal_title=Radiology;citation_author=T. Kanda;citation_author=K. Ishii;citation_author=H. Kawaguchi;citation_title=High signal intensity in the dentate nucleus and globus pallidus on unenhanced T1-weighted MR images: relationship with increasing cumulative dose of a gadolinium-based contrast material;citation_pages=834-41;citation_volume=270;citation_year=2014;citation_pmid=24475844;citation_doi=10.1148/radiol.13131669" />
<meta name="citation_reference" content="citation_journal_title=Lancet Neurol;citation_author=International Society for Magnetic Resonance in Medicine;citation_title=Gadolinium deposition in the brain: summary of evidence and recommendations;citation_pages=564-70;citation_volume=16;citation_year=2017;citation_pmid=28653648;citation_doi=10.1016/S1474-4422(17)30158-8" />
<meta name="citation_reference" content="citation_journal_title=Radiology;citation_author=A. Radbruch;citation_author=R. Haase;citation_author=PJ. Kieslich;citation_title=No signal intensity increase in the dentate nucleus on unenhanced T1-weighted MR images after more than 20 serial injections of macrocyclic gadolinium-based contrast agents;citation_pages=699-707;citation_volume=282;citation_year=2017;citation_pmid=27925871;citation_doi=10.1148/radiol.2016162241" />
<meta name="citation_reference" content="citation_journal_title=Radiology;citation_author=F. Berger;citation_author=RA. Kubik-Huch;citation_author=T. Niemann;citation_title=Gadolinium distribution in cerebrospinal fluid after administration of a gadolinium-based MR contrast agent in humans;citation_pages=703-09;citation_volume=288;citation_year=2018;citation_pmid=29737953;citation_doi=10.1148/radiol.2018171829" />
<meta name="citation_reference" content="citation_journal_title=Radiology;citation_author=AK. Nehra;citation_author=RJ. McDonald;citation_author=AM. Bluhm;citation_title=Accumulation of gadolinium in human cerebrospinal fluid after gadobutrol-enhanced MR imaging: a prospective observational cohort study;citation_pages=416-23;citation_volume=288;citation_year=2018;citation_pmid=29737947;citation_doi=10.1148/radiol.2018171105" />
<meta name="citation_reference" content="citation_journal_title=Eur Radiol;citation_author=G. Jost;citation_author=T. Frenzel;citation_author=J. Lohrke;citation_title=Penetration and distribution of gadolinium-based contrast agents into the cerebrospinal fluid in healthy rats: a potential pathway of entry into the brain tissue;citation_pages=2877-85;citation_volume=27;citation_year=2017;citation_pmid=27832312;citation_doi=10.1007/s00330-016-4654-2" />
<meta name="citation_reference" content="citation_journal_title=J Neurol Sci;citation_author=PK. Eide;citation_author=AH. Pripp;citation_author=GA. Ringstad;citation_title=Magnetic resonance imaging biomarkers indicate a central venous hypertension syndrome in patients with symptomatic pineal cysts;citation_pages=207-16;citation_volume=363;citation_year=2016;citation_pmid=27000252;citation_doi=10.1016/j.jns.2016.02.038" />
<meta name="citation_reference" content="citation_journal_title=Neurosurgical focus [electronic resource];citation_journal_abbrev=Neurosurg Focus;citation_author=G. Pradilla;citation_author=G. Jallo;citation_title=Potential mechanisms and clinical significance of global cerebral edema following aneurysmal subarachnoid hemorrhage.;citation_pages=E7-E7;citation_volume=22;citation_year=2007;citation_issue=5;citation_pmid=17613238" />
<meta name="citation_reference" content="citation_journal_title=AJNR Am J Neuroradiol;citation_author=JJ. Akbar;citation_author=PH. Luetmer;citation_author=KM. Schwartz;citation_title=The role of MR myelography with intrathecal gadolinium in localization of spinal CSF leaks in patients with spontaneous intracranial hypotension;citation_volume=33;citation_year=2012;citation_pmid=22173753;citation_doi=10.3174/ajnr.A2815" />
<meta name="citation_reference" content="citation_journal_title=AJNR Am J Neuroradiol;citation_author=H. Selcuk;citation_author=S. Albayram;citation_author=H. Ozer;citation_title=Intrathecal gadolinium-enhanced MR cisternography in the evaluation of CSF leakage;citation_volume=31;citation_year=2010;citation_pmid=19762462;citation_doi=10.3174/ajnr.A1788" />
<meta name="citation_reference" content="citation_journal_title=Neuroradiology;citation_journal_abbrev=Neuroradiology;citation_author=ET. Tali;citation_author=N. Ercan;citation_author=M. Kaymaz;citation_title=Intrathecal gadolinium (gadopentetate dimeglumine)-enhanced MR cisternography used to determine potential communication between the cerebrospinal fluid pathways and intracranial arachnoid cysts.;citation_pages=744-754;citation_volume=46;citation_year=2004;citation_issue=9;citation_pmid=15289956;citation_doi=10.1007/s00234-004-1240-0" />
<meta name="citation_reference" content="citation_journal_abbrev=Diagn Interv Radiol;citation_author=O. Algin;citation_author=B. Hakyemez;citation_author=G. Ocakoğlu;citation_title=MR cisternography: is it useful in the diagnosis of normal-pressure hydrocephalus and the selection of &quot;good shunt responders&quot;?;citation_pages=105-111;citation_volume=17;citation_year=2011;citation_issue=2;citation_pmid=20683818;citation_doi=10.4261/1305-3825.DIR.3133-09.1" />
<meta name="citation_reference" content="citation_journal_title=Neuroradiology;citation_author=S. Nacar Dogan;citation_author=O. Kizilkilic;citation_author=B. Kocak;citation_title=Intrathecal gadolinium-enhanced MR cisternography in patients with otorhinorrhea: 10-year experience of a tertiary referral center;citation_pages=471-77;citation_volume=60;citation_year=2018;citation_pmid=29572604;citation_doi=10.1007/s00234-018-2014-4" />
<meta name="citation_reference" content="citation_journal_title=Neuroradiology;citation_journal_abbrev=Neuroradiology;citation_author=K. Aydin;citation_author=K. Guven;citation_author=S. Sencer;citation_title=MRI cisternography with gadolinium-containing contrast medium: its role, advantages and limitations in the investigation of rhinorrhoea.;citation_pages=75-80;citation_volume=46;citation_year=2004;citation_issue=1;citation_pmid=14615855;citation_doi=10.1007/s00234-003-1004-2" />
<meta name="citation_reference" content="citation_journal_title=Neurosurgery;citation_journal_abbrev=Neurosurgery;citation_author=K. Aydin;citation_author=E. Terzibasioglu;citation_author=S. Sencer;citation_title=Localization of cerebrospinal fluid leaks by gadolinium-enhanced magnetic resonance cisternography: a 5-year single-center experience.;citation_pages=584-589;citation_volume=62;citation_year=2008;citation_issue=3;citation_pmid=18425007;citation_doi=10.1227/01.neu.0000317306.39203.24" />
<meta name="citation_reference" content="citation_journal_title=European radiology;citation_journal_abbrev=Eur Radiol;citation_author=W. Reiche;citation_author=Y. Komenda;citation_author=B. Schick;citation_title=MR cisternography after intrathecal Gd-DTPA application.;citation_pages=2943-2949;citation_volume=12;citation_year=2002;citation_issue=12;citation_pmid=12439574" />
<meta name="citation_reference" content="citation_journal_title=Investigative radiology;citation_journal_abbrev=Invest Radiol;citation_author=IO. Skalpe;citation_author=GJ. Tang;citation_title=Magnetic resonance imaging contrast media in the subarachnoid space. A comparison between gadodiamide injection and gadopentetate dimeglumine in an experimental study in pigs.;citation_pages=140-148;citation_volume=32;citation_year=1997;citation_issue=3;citation_pmid=9055126;citation_doi=10.1097/00004424-199703000-00002" />
<meta name="citation_reference" content="citation_journal_title=Radiology;citation_author=JR. Jinkins;citation_author=M. Rudwan;citation_author=G. Krumina;citation_title=Intrathecal gadolinium-enhanced MR cisternography in the evaluation of clinically suspected cerebrospinal fluid rhinorrhea in humans: early experience;citation_volume=222;citation_year=2002;citation_pmid=11818627;citation_doi=10.1148/radiol.2222010249" />
<meta name="citation_reference" content="citation_journal_title=Investigative radiology;citation_journal_abbrev=Invest Radiol;citation_author=ET. Tali;citation_author=N. Ercan;citation_author=G. Krumina;citation_title=Intrathecal gadolinium (gadopentetate dimeglumine) enhanced magnetic resonance myelography and cisternography: results of a multicenter study.;citation_pages=152-159;citation_volume=37;citation_year=2002;citation_issue=3;citation_pmid=11882795;citation_doi=10.1097/00004424-200203000-00008" />
<meta name="citation_reference" content="citation_journal_title=American Journal of Neuroradiology;citation_journal_abbrev=Am. J. Neuroradiol.;citation_author=DE. Ray;citation_author=JB. Cavanagh;citation_author=CC. Nolan;citation_title=Neurotoxic effects of gadopentetate dimeglumine: behavioral disturbance and morphology after intracerebroventricular injection in rats;citation_pages=365-373;citation_volume=17;citation_year=1996;citation_issue=2;citation_pmid=8938312" />
<meta name="citation_reference" content="citation_journal_title=Clinical radiology;citation_journal_abbrev=Clin Radiol;citation_author=L. Li;citation_author=FQ. Gao;citation_author=B. Zhang;citation_title=Overdosage of intrathecal gadolinium and neurological response.;citation_pages=1063-1068;citation_volume=63;citation_year=2008;citation_issue=9;citation_pmid=18718238;citation_doi=10.1016/j.crad.2008.02.004" />
<meta name="citation_reference" content="citation_journal_title=Journal of Korean medical science;citation_journal_abbrev=J Korean Med Sci;citation_author=KW. Park;citation_author=SB. Im;citation_author=BT. Kim;citation_title=Neurotoxic manifestations of an overdose intrathecal injection of gadopentetate dimeglumine.;citation_pages=505-508;citation_volume=25;citation_year=2010;citation_issue=3;citation_pmid=20191058;citation_doi=10.3346/jkms.2010.25.3.505" />
<meta name="citation_reference" content="citation_journal_title=Journal of neurology;citation_journal_abbrev=J Neurol;citation_author=S. Arlt;citation_author=L. Cepek;citation_author=HH. Rustenbeck;citation_title=Gadolinium encephalopathy due to accidental intrathecal administration of gadopentetate dimeglumine.;citation_pages=810-812;citation_volume=254;citation_year=2007;citation_issue=6;citation_pmid=17401744;citation_doi=10.1007/s00415-006-0439-x" />
<meta name="citation_reference" content="citation_journal_title=J Pain Palliat Care Pharmacother;citation_author=C. Reeves;citation_author=E. Galang;citation_author=R. Padalia;citation_title=Intrathecal injection of gadobutrol: a tale of caution;citation_pages=139-43;citation_volume=31;citation_year=2017;citation_pmid=28489466;citation_doi=10.1080/15360288.2017.1313353" />
<meta name="citation_reference" content="citation_journal_title=European radiology;citation_journal_abbrev=Eur Radiol;citation_author=Y. Palmers;citation_author=FP. Kuhn;citation_author=D. Petersen;citation_title=Comparison in myelography between iodixanol 270 and 320 mgI/ml and iotrolan 300 mgI/ml: a multicentre, randomised, parallel-group, double-blind, phase III trial.;citation_pages=686-691;citation_volume=12;citation_year=2002;citation_issue=3;citation_pmid=11870488;citation_doi=10.1007/s003300100881" />
<meta name="citation_reference" content="citation_journal_title=AJNR Am J Neuroradiol;citation_author=R. Watts;citation_author=JM. Steinklein;citation_author=L. Waldman;citation_title=Measuring glymphatic flow in man using quantitative contrast-enhanced MRI;citation_volume=40;citation_year=2019;citation_pmid=30679221;citation_doi=10.3174/ajnr.A5931" />
<meta name="twitter:title" content="Intrathecal Use of Gadobutrol for Glymphatic MR Imaging: Prospective Safety Study of 100 Patients" />
<meta name="twitter:card" content="summary_large_image" />
<meta name="twitter:image" content="http://ajnr-stage2.stage.highwire.org/sites/default/files/highwire/ajnr/40/8.cover-source.jpg" />
<meta name="twitter:description" content="BACKGROUND AND PURPOSE: Intrathecal contrast-enhanced glymphatic MR imaging has shown promise in assessing glymphatic function in patients with dementia. The purpose of this study was to determine the safety profile and feasibility of this new MR imaging technique.

MATERIALS AND METHODS: A prospective safety and feasibility study was performed in 100 consecutive patients (58 women and 42 men, 51 ± 19 years of age) undergoing glymphatic MR imaging from September 2015 to August 2018. Short- and long-term serious and nonserious adverse events were registered clinically and by interview after intrathecal administration of 0.5 mL of gadobutrol (1.0 mmol/mL) along with 3 mL of iodixanol (270 mg I/mL). Adverse events are presented as numbers and percentages.

RESULTS: One serious adverse event (anaphylaxis) occurred in a patient with known allergy to iodine-containing contrast agents (1%). The main nonserious adverse events during the first 1–3 days after contrast injection included severe headache (28%) and severe nausea (34%), though the frequency depended heavily on the diagnosis. After 4 weeks, adverse events had resolved.

CONCLUSIONS: Intrathecal administration of gadobutrol in conjunction with iodixanol for glymphatic MR imaging is safe and feasible. We cannot conclude whether short-duration symptoms such as headache and nausea were caused by gadobutrol, iodixanol, the lumbar puncture, or the diagnosis. The safety profile closely resembles that of iodixanol alone.

gMRI
:   glymphatic MR imaging
iNPH
:   idiopathic normal pressure hydrocephalus" />
<meta name="og-title" property="og:title" content="Intrathecal Use of Gadobutrol for Glymphatic MR Imaging: Prospective Safety Study of 100 Patients" />
<meta name="og-url" property="og:url" content="http://ajnr-stage2.stage.highwire.org/content/40/8/1257" />
<meta name="og-site-name" property="og:site_name" content="American Journal of Neuroradiology" />
<meta name="og-description" property="og:description" content="BACKGROUND AND PURPOSE: Intrathecal contrast-enhanced glymphatic MR imaging has shown promise in assessing glymphatic function in patients with dementia. The purpose of this study was to determine the safety profile and feasibility of this new MR imaging technique.

MATERIALS AND METHODS: A prospective safety and feasibility study was performed in 100 consecutive patients (58 women and 42 men, 51 ± 19 years of age) undergoing glymphatic MR imaging from September 2015 to August 2018. Short- and long-term serious and nonserious adverse events were registered clinically and by interview after intrathecal administration of 0.5 mL of gadobutrol (1.0 mmol/mL) along with 3 mL of iodixanol (270 mg I/mL). Adverse events are presented as numbers and percentages.

RESULTS: One serious adverse event (anaphylaxis) occurred in a patient with known allergy to iodine-containing contrast agents (1%). The main nonserious adverse events during the first 1–3 days after contrast injection included severe headache (28%) and severe nausea (34%), though the frequency depended heavily on the diagnosis. After 4 weeks, adverse events had resolved.

CONCLUSIONS: Intrathecal administration of gadobutrol in conjunction with iodixanol for glymphatic MR imaging is safe and feasible. We cannot conclude whether short-duration symptoms such as headache and nausea were caused by gadobutrol, iodixanol, the lumbar puncture, or the diagnosis. The safety profile closely resembles that of iodixanol alone.

gMRI
:   glymphatic MR imaging
iNPH
:   idiopathic normal pressure hydrocephalus" />
<meta name="og-type" property="og:type" content="article" />
<meta name="og-image" property="og:image" content="http://ajnr-stage2.stage.highwire.org/sites/default/files/highwire/ajnr/40/8.cover-source.jpg" />
<meta name="viewport" content="width=device-width, initial-scale=1" />
<link rel="alternate" type="application/vnd.ms-powerpoint" title="Powerpoint" href="/content/40/8/1257.ppt" />
<link rel="alternate" type="text/plain" title="Full Text (Plain)" href="/content/40/8/1257.full.txt" />
<link rel="alternate" type="application/pdf" title="Full Text (PDF)" href="/content/40/8/1257.full.pdf" />
<link rel="canonical" href="http://ajnr-stage2.stage.highwire.org/content/40/8/1257" />
<script>window.dataLayer = window.dataLayer || [];window.dataLayer.push({"page":{"hwTitle":"Intrathecal Use of Gadobutrol for Glymphatic MR Imaging: Prospective Safety Study of 100 Patients","hwUrl":"http://ajnr-stage2.stage.highwire.org/content/40/8/1257","hwPath":"/content/40/8/1257.abstract","hwType":"journal page"},"user":{"hwMemberID":"","hwLoggedIntoInstitutionID":"","hwLoggedIntoInstitution":"","hwAccessUsageTerms":"guest","hwRegisteredUser":"no","hwHasFullTextAccess":"yes","hwEntitled":"no"},"content":{"hwIssueDate":"2019-08-01","hwIssueDateTime":"2019-08-01 00:00:00","hwPublicationDate":"2019-08-14","hwPublicationDateTime":"2019-08-14 08:00:37","hwNlmArticleType":"research-article","hwDOI":"10.3174/ajnr.A6136","hwAuthors":"C.S. Edeklev,M. Halvorsen,G. L\u00f8vland,S.A.S. Vatnehol,\u00d8. Gjertsen,B. Nedregaard,R. Sletteberg,G. Ringstad,P.K. Eide","hwContributors":"","hwIsEarlyRelease":"no","hwEissn":"1936-959X","hwPissn":"0195-6108","hwVolume":"40","hwIssue":"8","hwArticleType":"Patient Safety","hwTabView":"main_tab","hwViewType":"abstract","hwAccessType":"Free","hwOpenAccess":"no","hwFreeAccess":"yes","hwTaxonomy":"","hwCorpusCode":"ajnr","hwType":"article","hwSubtitle":null,"hwOverline":null,"hwPisaId":"ajnr;40/8/1257","hwFirstPage":"1257","hwLastPage":"1264","hwIsLatestVersion":"yes","hwIsCurrentIssue":"no","hwIsOpenIssue":"no","hwHasFullText":"yes","hwHasPDF":"yes","hwParentTitle":"American Journal of Neuroradiology: 40 (8)","hwElectronicPubDate":"2019-08-14","hwElectronicPubDateTime":"2019-08-14 08:00:37"}});
//--><!]]></script>
    <title>Intrathecal Use of Gadobutrol for Glymphatic MR Imaging: Prospective Safety Study of 100 Patients | American Journal of Neuroradiology</title>  
    <link type="text/css" rel="stylesheet" href="/sites/default/files/advagg_css/css__BJ6Ou6QsBRtnFTmxaakamOIS8n4QswDP2XnnZ1sxtaM__NBuvkP6eInGIkb1aJvUHx5PX79XApuxBDkk_77W5tYk__Op4k-kV4DoWc7bsUP7umKmZ0WXfmoYdRDoZFPNSd-oM.css" media="all" />
<link type="text/css" rel="stylesheet" href="/sites/default/files/advagg_css/css__azeXjFYQUa4gTbdEg4sgM2osudOlAYwVv6vNmRXI3ac__zr83wx5lNxUVx-jSIFm8RDKOeMAB7RbaBxriFHS3dt4__Op4k-kV4DoWc7bsUP7umKmZ0WXfmoYdRDoZFPNSd-oM.css" media="all" />
<link type="text/css" rel="stylesheet" href="/sites/default/files/advagg_css/css__Ep75tNOnm8H2Mejav16FnGCfM1sLwyporbQrCIgwg3g__vXGjszfa0bvxzymQ8Cfns-o2huFvm80jp3igN8XcYeI__Op4k-kV4DoWc7bsUP7umKmZ0WXfmoYdRDoZFPNSd-oM.css" media="all" />
<link type="text/css" rel="stylesheet" href="/sites/default/files/advagg_css/css__TKi6DXKzgLPdEthh1Tnc63zY1QF4rLZHoM06Xy7VN6g__zaEHphFiBcrl8WVy_4n080y02dQ7HKxd_aqZbYgQ5Z0__Op4k-kV4DoWc7bsUP7umKmZ0WXfmoYdRDoZFPNSd-oM.css" media="all" />
<link type="text/css" rel="stylesheet" href="/sites/all/modules/highwire/highwire/highwire.style.highwire.css?sycxuq" media="all" />
<link type="text/css" rel="stylesheet" href="/sites/default/files/advagg_css/css__368m7sVtRu23rjqTxGZiVyTf_Vgj9GfVKn_6XVu-Ktw__awmYo-4mw13F7nmNUNtBYLumKanDZb8salegB2jkN90__Op4k-kV4DoWc7bsUP7umKmZ0WXfmoYdRDoZFPNSd-oM.css" media="all" />
<link type="text/css" rel="stylesheet" href="//cdn.jsdelivr.net/qtip2/2.2.1/jquery.qtip.min.css" media="all" />
<link type="text/css" rel="stylesheet" href="/sites/default/files/advagg_css/css__hdrV1jPSgxW0fPsRrK3sQAuhpElWcUo2f4JtkNIdb-Y__EwYsXwfG_cT9y3A9Cx4FsJxJRuF38Um_dApnuovtq68__Op4k-kV4DoWc7bsUP7umKmZ0WXfmoYdRDoZFPNSd-oM.css" media="all" />
<style type="text/css" media="all">
/* <![CDATA[ */
#sliding-popup.sliding-popup-bottom,#sliding-popup.sliding-popup-bottom .eu-cookie-withdraw-banner,.eu-cookie-withdraw-tab{background:#000000;}#sliding-popup.sliding-popup-bottom.eu-cookie-withdraw-wrapper{background:transparent}#sliding-popup .popup-content #popup-text h1,#sliding-popup .popup-content #popup-text h2,#sliding-popup .popup-content #popup-text h3,#sliding-popup .popup-content #popup-text p,.eu-cookie-compliance-secondary-button,.eu-cookie-withdraw-tab{color:#ffffff !important;}.eu-cookie-withdraw-tab{border-color:#ffffff;}.eu-cookie-compliance-more-button{color:#ffffff !important;}

/* ]]> */
</style>

<!--[if lte IE 7]>
<link type="text/css" rel="stylesheet" href="/sites/default/files/advagg_css/css__ElJr3PIJEvw3qLXc1cnYiLj2G4KgDPSXFOfm6Phf8hw__JdWGm15cDWjsK6KrFlQVXQix9YgNeYysf22XZHj-Y-c__Op4k-kV4DoWc7bsUP7umKmZ0WXfmoYdRDoZFPNSd-oM.css" media="all" />
<![endif]-->
<link type="text/css" rel="stylesheet" href="/sites/default/files/advagg_css/css__Wnlyen9qEpwh_Qaf9okEu4QdVGM0BDothxeqA6Nbvo8__EJmw6SZD9bYoS8jocCpPYS3JFRURpdzmuvJoAUNiI-g__Op4k-kV4DoWc7bsUP7umKmZ0WXfmoYdRDoZFPNSd-oM.css" media="all" />
<link type="text/css" rel="stylesheet" href="/sites/default/files/advagg_css/css__nv7Hafs9UucfV8bmT4epWF4zWAFU2G9JLHVgOOHDqbA__k9QUw6MohZGXV0YlzqvUpPTbyzhbizsKOi4x3aA7Tx0__Op4k-kV4DoWc7bsUP7umKmZ0WXfmoYdRDoZFPNSd-oM.css" media="all" />

<!--[if (lt IE 9)&(!IEMobile)]>
<link type="text/css" rel="stylesheet" href="/sites/default/files/advagg_css/css__XH6bpcI0f2dImc-p674DLCZtWBGb-QwxJK1YexVGtno__vUceGprdo5nIhV6DH93X7fI3r8RcTJbChbas9TQXeW4__Op4k-kV4DoWc7bsUP7umKmZ0WXfmoYdRDoZFPNSd-oM.css" media="all" />
<![endif]-->

<!--[if gte IE 9]><!-->
<link type="text/css" rel="stylesheet" href="/sites/default/files/advagg_css/css__2WBMox6sOrN42ss5lCnH7WWVRdFdJCxtTKnQJYRwTE4__yqNvNYLvMpjy3ffuJrjjm9uW2i-Me1c23KLYuWHaqio__Op4k-kV4DoWc7bsUP7umKmZ0WXfmoYdRDoZFPNSd-oM.css" media="all" />
<!--<![endif]-->
<link type="text/css" rel="stylesheet" href="/sites/default/files/advagg_css/css__wxg7u6KrkAKrph8zjmzjNAiqxtVP2vhMWX2NZ6DPPZE__ECvRNuvDf2Tm_Pc-j1mEkt48QjmIz2s2CyWDspWAhhI__Op4k-kV4DoWc7bsUP7umKmZ0WXfmoYdRDoZFPNSd-oM.css" media="all" />
    <script type="text/javascript">
<!--//--><![CDATA[//><!--
/*!
 * yepnope1.5.4
 * (c) WTFPL, GPLv2
 */
(function(a,b,c){function d(a){return"[object Function]"==o.call(a)}function e(a){return"string"==typeof a}function f(){}function g(a){return!a||"loaded"==a||"complete"==a||"uninitialized"==a}function h(){var a=p.shift();q=1,a?a.t?m(function(){("c"==a.t?B.injectCss:B.injectJs)(a.s,0,a.a,a.x,a.e,1)},0):(a(),h()):q=0}function i(a,c,d,e,f,i,j){function k(b){if(!o&&g(l.readyState)&&(u.r=o=1,!q&&h(),l.onload=l.onreadystatechange=null,b)){"img"!=a&&m(function(){t.removeChild(l)},50);for(var d in y[c])y[c].hasOwnProperty(d)&&y[c][d].onload()}}var j=j||B.errorTimeout,l=b.createElement(a),o=0,r=0,u={t:d,s:c,e:f,a:i,x:j};1===y[c]&&(r=1,y[c]=[]),"object"==a?l.data=c:(l.src=c,l.type=a),l.width=l.height="0",l.onerror=l.onload=l.onreadystatechange=function(){k.call(this,r)},p.splice(e,0,u),"img"!=a&&(r||2===y[c]?(t.insertBefore(l,s?null:n),m(k,j)):y[c].push(l))}function j(a,b,c,d,f){return q=0,b=b||"j",e(a)?i("c"==b?v:u,a,b,this.i++,c,d,f):(p.splice(this.i++,0,a),1==p.length&&h()),this}function k(){var a=B;return a.loader={load:j,i:0},a}var l=b.documentElement,m=a.setTimeout,n=b.getElementsByTagName("script")[0],o={}.toString,p=[],q=0,r="MozAppearance"in l.style,s=r&&!!b.createRange().compareNode,t=s?l:n.parentNode,l=a.opera&&"[object Opera]"==o.call(a.opera),l=!!b.attachEvent&&!l,u=r?"object":l?"script":"img",v=l?"script":u,w=Array.isArray||function(a){return"[object Array]"==o.call(a)},x=[],y={},z={timeout:function(a,b){return b.length&&(a.timeout=b[0]),a}},A,B;B=function(a){function b(a){var a=a.split("!"),b=x.length,c=a.pop(),d=a.length,c={url:c,origUrl:c,prefixes:a},e,f,g;for(f=0;f<d;f++)g=a[f].split("="),(e=z[g.shift()])&&(c=e(c,g));for(f=0;f<b;f++)c=x[f](c);return c}function g(a,e,f,g,h){var i=b(a),j=i.autoCallback;i.url.split(".").pop().split("?").shift(),i.bypass||(e&&(e=d(e)?e:e[a]||e[g]||e[a.split("/").pop().split("?")[0]]),i.instead?i.instead(a,e,f,g,h):(y[i.url]?i.noexec=!0:y[i.url]=1,f.load(i.url,i.forceCSS||!i.forceJS&&"css"==i.url.split(".").pop().split("?").shift()?"c":c,i.noexec,i.attrs,i.timeout),(d(e)||d(j))&&f.load(function(){k(),e&&e(i.origUrl,h,g),j&&j(i.origUrl,h,g),y[i.url]=2})))}function h(a,b){function c(a,c){if(a){if(e(a))c||(j=function(){var a=[].slice.call(arguments);k.apply(this,a),l()}),g(a,j,b,0,h);else if(Object(a)===a)for(n in m=function(){var b=0,c;for(c in a)a.hasOwnProperty(c)&&b++;return b}(),a)a.hasOwnProperty(n)&&(!c&&!--m&&(d(j)?j=function(){var a=[].slice.call(arguments);k.apply(this,a),l()}:j[n]=function(a){return function(){var b=[].slice.call(arguments);a&&a.apply(this,b),l()}}(k[n])),g(a[n],j,b,n,h))}else!c&&l()}var h=!!a.test,i=a.load||a.both,j=a.callback||f,k=j,l=a.complete||f,m,n;c(h?a.yep:a.nope,!!i),i&&c(i)}var i,j,l=this.yepnope.loader;if(e(a))g(a,0,l,0);else if(w(a))for(i=0;i<a.length;i++)j=a[i],e(j)?g(j,0,l,0):w(j)?B(j):Object(j)===j&&h(j,l);else Object(a)===a&&h(a,l)},B.addPrefix=function(a,b){z[a]=b},B.addFilter=function(a){x.push(a)},B.errorTimeout=1e4,null==b.readyState&&b.addEventListener&&(b.readyState="loading",b.addEventListener("DOMContentLoaded",A=function(){b.removeEventListener("DOMContentLoaded",A,0),b.readyState="complete"},0)),a.yepnope=k(),a.yepnope.executeStack=h,a.yepnope.injectJs=function(a,c,d,e,i,j){var k=b.createElement("script"),l,o,e=e||B.errorTimeout;k.src=a;for(o in d)k.setAttribute(o,d[o]);c=j?h:c||f,k.onreadystatechange=k.onload=function(){!l&&g(k.readyState)&&(l=1,c(),k.onload=k.onreadystatechange=null)},m(function(){l||(l=1,c(1))},e),i?k.onload():n.parentNode.insertBefore(k,n)},a.yepnope.injectCss=function(a,c,d,e,g,i){var e=b.createElement("link"),j,c=i?h:c||f;e.href=a,e.rel="stylesheet",e.type="text/css";for(j in d)e.setAttribute(j,d[j]);g||(n.parentNode.insertBefore(e,n),m(c,0))}})(this,document);

//--><!]]>
</script>
<script type="text/javascript" src="/sites/all/libraries/modernizr/modernizr.min.js?sycxuq"></script>
<script type="text/javascript">
<!--//--><![CDATA[//><!--
yepnope({
  test: Modernizr.matchmedia,
  nope: '/sites/all/libraries/media-match/media.match.min.js'
});
//--><!]]>
</script>
<script type="text/javascript" src="/sites/default/files/advagg_js/js__wH8myWXKi4A-QKdUKDXzJAnGs-FRS1A2ZzTTNzjRAdI__4MCtOZK_Ov0QKyRlXNLGQ2LRlYRGWj9ArT-NpFox3QA__Op4k-kV4DoWc7bsUP7umKmZ0WXfmoYdRDoZFPNSd-oM.js"></script>
<script type="text/javascript">
<!--//--><![CDATA[//><!--
var googletag = googletag || {};
googletag.cmd = googletag.cmd || [];
googletag.slots = googletag.slots || {};
//--><!]]>
</script>
<script type="text/javascript" src="//securepubads.g.doubleclick.net/tag/js/gpt.js"></script>
<script type="text/javascript" src="/sites/default/files/advagg_js/js__9ici6QMeDS-cROq8R0RhuICsMGMP2wcJZNQQFsqQi44__kScSwG4RXGl1LXnj4qqt0ZxtNX4Gh2TK5W-o8Uup4SA__Op4k-kV4DoWc7bsUP7umKmZ0WXfmoYdRDoZFPNSd-oM.js"></script>
<script type="text/javascript" src="/sites/default/files/advagg_js/js__fwhbnUWIxW-jFl55E2mBYVtZTjGhJ1JWyZYAJ2cEd3A__jCrCuWCJIPYPe1FzZoUvsJWEjkNMmRIQHYek1h7idBE__Op4k-kV4DoWc7bsUP7umKmZ0WXfmoYdRDoZFPNSd-oM.js"></script>
<script type="text/javascript">
<!--//--><![CDATA[//><!--
googletag.slots["rhs"] = googletag.defineSlot("/446583111/RHS_300x250", [300, 250], "dfp-ad-rhs")
  .addService(googletag.pubads());
//--><!]]>
</script>
<script type="text/javascript" src="/sites/default/files/advagg_js/js__UR8BHznwml64Vq0ijSGFwlm-xe9ttj1aripHInFCOLw__irCalsu-H_fRTOPqjyCv1O8Ax7fqY6DDf-uMOV1dvGY__Op4k-kV4DoWc7bsUP7umKmZ0WXfmoYdRDoZFPNSd-oM.js"></script>
<script type="text/javascript">
<!--//--><![CDATA[//><!--
var mapping = googletag.sizeMapping()
  .addSize([768, 0], [728, 90])
  .addSize([0, 0], [300, 50])
  .build();
googletag.slots["bottom_leaderboard"] = googletag.defineSlot("/446583111/Bottom_Banner_728x90", [[728, 90], [300, 50]], "dfp-ad-bottom_leaderboard")
  .addService(googletag.pubads())
  .defineSizeMapping(mapping);
//--><!]]>
</script>
<script type="text/javascript" src="/sites/default/files/advagg_js/js__bQc6kyz_Gw2afC1F6wguCBh8Z8nev-hxX6F2Tw4bq6k__CO2faEsYCquY82rVj6as9HScSnogGHeR-oh5fSQydG0__Op4k-kV4DoWc7bsUP7umKmZ0WXfmoYdRDoZFPNSd-oM.js"></script>
<script type="text/javascript">
<!--//--><![CDATA[//><!--
var mapping = googletag.sizeMapping()
  .addSize([768, 0], [728, 90])
  .addSize([0, 0], [300, 50])
  .build();
googletag.slots["top_leaderboard"] = googletag.defineSlot("/446583111/Top_Leaderboard_728x90", [[728, 90], [300, 50]], "dfp-ad-top_leaderboard")
  .addService(googletag.pubads())
  .defineSizeMapping(mapping);
//--><!]]>
</script>
<script type="text/javascript" src="/sites/default/files/advagg_js/js__wS6WUeF11NLeJgCqxc-dMvjhALAMQG1jlaeWdG8yVZc__CPiombDS21ooaYdmqHXdcMoJwB2FMn18JzO97LewQxc__Op4k-kV4DoWc7bsUP7umKmZ0WXfmoYdRDoZFPNSd-oM.js"></script>
<script type="text/javascript">
<!--//--><![CDATA[//><!--
document.createElement( "picture" );
//--><!]]>
</script>
<script type="text/javascript" src="/sites/default/files/advagg_js/js__UK1ygaa8bCfT-jsjqYRdRLDZ5N17950T7K5WPC9XtpI__NqLYT1T1SMBsKukLWIe82VgCZYYCMHZX_f609-a1rj8__Op4k-kV4DoWc7bsUP7umKmZ0WXfmoYdRDoZFPNSd-oM.js"></script>
<script type="text/javascript">
<!--//--><![CDATA[//><!--
googletag.cmd.push(function() {
  googletag.pubads().enableAsyncRendering();
  googletag.pubads().enableSingleRequest();
  googletag.pubads().collapseEmptyDivs();
  googletag.pubads().addEventListener("slotRenderEnded", function (event) {
    if (event.isEmpty) {
      var id = event.slot.getSlotElementId();
      var x = document.getElementById(id);
      if (x.parentElement.classList.contains("dfp-tag-wrapper")) {
        x.parentElement.style.display = "none";
      }
    }
  });
  googletag.pubads().setTargeting("page:hwTitle", "Intrathecal Use of Gadobutrol for Glymphatic MR Imaging: Prospective Safety Study of 100 Patients");
  googletag.pubads().setTargeting("page:hwUrl", "http://ajnr-stage2.stage.highwire.org/content/40/8/1257");
  googletag.pubads().setTargeting("page:hwPath", "/content/40/8/1257.abstract");
  googletag.pubads().setTargeting("page:hwType", "journal page");
  googletag.pubads().setTargeting("user:hwAccessUsageTerms", "guest");
  googletag.pubads().setTargeting("user:hwRegisteredUser", "no");
  googletag.pubads().setTargeting("user:hwHasFullTextAccess", "yes");
  googletag.pubads().setTargeting("user:hwEntitled", "no");
  googletag.pubads().setTargeting("content:hwIssueDate", "2019-08-01");
  googletag.pubads().setTargeting("content:hwIssueDateTime", "2019-08-01 00:00:00");
  googletag.pubads().setTargeting("content:hwPublicationDate", "2019-08-14");
  googletag.pubads().setTargeting("content:hwPublicationDateTime", "2019-08-14 08:00:37");
  googletag.pubads().setTargeting("content:hwNlmArticleType", "research-article");
  googletag.pubads().setTargeting("content:hwDOI", "10.3174/ajnr.A6136");
  googletag.pubads().setTargeting("content:hwAuthors", ["C.S. Edeklev","M. Halvorsen","G. Løvland","S.A.S. Vatnehol","Ø. Gjertsen","B. Nedregaard","R. Sletteberg","G. Ringstad","P.K. Eide"]);
  googletag.pubads().setTargeting("content:hwIsEarlyRelease", "no");
  googletag.pubads().setTargeting("content:hwEissn", "1936-959X");
  googletag.pubads().setTargeting("content:hwPissn", "0195-6108");
  googletag.pubads().setTargeting("content:hwVolume", "40");
  googletag.pubads().setTargeting("content:hwIssue", "8");
  googletag.pubads().setTargeting("content:hwArticleType", "Patient Safety");
  googletag.pubads().setTargeting("content:hwTabView", "main_tab");
  googletag.pubads().setTargeting("content:hwViewType", "abstract");
  googletag.pubads().setTargeting("content:hwAccessType", "Free");
  googletag.pubads().setTargeting("content:hwOpenAccess", "no");
  googletag.pubads().setTargeting("content:hwFreeAccess", "yes");
  googletag.pubads().setTargeting("content:hwCorpusCode", "ajnr");
  googletag.pubads().setTargeting("content:hwType", "article");
  googletag.pubads().setTargeting("content:hwPisaId", "ajnr;40/8/1257");
  googletag.pubads().setTargeting("content:hwFirstPage", "1257");
  googletag.pubads().setTargeting("content:hwLastPage", "1264");
  googletag.pubads().setTargeting("content:hwIsLatestVersion", "yes");
  googletag.pubads().setTargeting("content:hwIsCurrentIssue", "no");
  googletag.pubads().setTargeting("content:hwIsOpenIssue", "no");
  googletag.pubads().setTargeting("content:hwHasFullText", "yes");
  googletag.pubads().setTargeting("content:hwHasPDF", "yes");
  googletag.pubads().setTargeting("content:hwParentTitle", "American Journal of Neuroradiology: 40 (8)");
  googletag.pubads().setTargeting("content:hwElectronicPubDate", "2019-08-14");
  googletag.pubads().setTargeting("content:hwElectronicPubDateTime", "2019-08-14 08:00:37");
});

googletag.enableServices();
//--><!]]>
</script>
<script type="text/javascript" src="/sites/default/files/advagg_js/js__3vwOA0BwlnyBkt9H4CLg6FgNyKAh--OmfOxFOIu_5S4__EXTgktcHbQ7BQfelY6CnrqgPRc4i4eD6XcZ4i3xs5RU__Op4k-kV4DoWc7bsUP7umKmZ0WXfmoYdRDoZFPNSd-oM.js"></script>
<script type="text/javascript" async="async" src="https://scholar.google.com/scholar_js/casa.js"></script>
<script type="text/javascript" src="/sites/default/files/advagg_js/js__11OTRBANYp_FPYy8gxuWv8XYK780LivNl9ef5qg3rfw__TEVdNksA7-zrPiZwnenYHdToBjuVChsDlzQL_vP4NkY__Op4k-kV4DoWc7bsUP7umKmZ0WXfmoYdRDoZFPNSd-oM.js"></script>
<script type="text/javascript" src="//cdn.jsdelivr.net/qtip2/2.2.1/jquery.qtip.min.js"></script>
<script type="text/javascript" src="/sites/default/files/advagg_js/js__yiXGyyzC1oV2sZBtAUN2DFoM2mAH5KP0iYCqS1dmafE__UiTPqZo1iNHqhqhx1lKGu2xkUGpxmin5ny6_22C53JA__Op4k-kV4DoWc7bsUP7umKmZ0WXfmoYdRDoZFPNSd-oM.js"></script>
<script type="text/javascript">
<!--//--><![CDATA[//><!--
if(typeof window.MathJax === "undefined") window.MathJax = { menuSettings: { zoom: "Click" } };
//--><!]]>
</script>
<script type="text/javascript" src="/sites/default/files/advagg_js/js__gzglMimeshoybn5FdOUfx5zFIzXjSZCarAdAqdFwzb0__XnS2ZmP_Eu1FvGruois2GWaJM4qn-3H8Rt4VF8dvyrA__Op4k-kV4DoWc7bsUP7umKmZ0WXfmoYdRDoZFPNSd-oM.js"></script>
<script type="text/javascript" src="https://www.google.com/recaptcha/api.js?hl=en&amp;render=explicit&amp;onload=drupalRecaptchaOnload"></script>
<script type="text/javascript" src="/sites/default/files/advagg_js/js__4ykqVVdSaGtVGauctG3E3Uojp_237f35KQ7wMtKX9S4__4JHByHSitU6UdWxmWARTSoZyB2PFgzkw__raxGdvbvk__Op4k-kV4DoWc7bsUP7umKmZ0WXfmoYdRDoZFPNSd-oM.js"></script>
<script type="text/javascript">
<!--//--><![CDATA[//><!--

      $(document).ready(function() {
          $.getJSON("//www.deepdyve.com/rental-link?docId=10.3174/ajnr.A6136&journal=1936-959X&fieldName=journal_doi&affiliateId=asnr&format=jsonp&callback=?", function(data) {
            if (data.status === "ok") {
              // Update the href url so it goes straight to the article page
              $(".js-deepdyve-link a").attr("href", data.url);
              $(".js-deepdyve-link").show();
            } else if (data.status === "not_found") {
              $(".js-deepdyve-link").hide();
            }
          });
        });
//--><!]]>
</script>
<script type="text/javascript" src="/sites/default/files/advagg_js/js__4lG8Nd_Z78ebRQwNtbOlh_jt-whQYFW5Try6DwQUwAM__8EEmyuTE_JxYCL1fbIkxkI5UUKYRtta33k484QkazhA__Op4k-kV4DoWc7bsUP7umKmZ0WXfmoYdRDoZFPNSd-oM.js"></script>
<script type="text/javascript" async="async" src="https://www.googletagmanager.com/gtag/js?id=G-4CRTLTY8KW"></script>
<script type="text/javascript">
<!--//--><![CDATA[//><!--
window.dataLayer = window.dataLayer || [];function gtag(){dataLayer.push(arguments)};gtag("js", new Date());gtag("set", "developer_id.dMDhkMT", true);gtag("config", "G-4CRTLTY8KW", {"groups":"default","anonymize_ip":true});
//--><!]]>
</script>
<script type="text/javascript" src="/sites/default/files/advagg_js/js__xwmR_XUqgIHdKocIkn2GiqYMVWJ0gY7OwpoARPRxEYM__CdSkXbn46iKUJfVct1nUx50N8MQ35eZOCMya9EuGbeU__Op4k-kV4DoWc7bsUP7umKmZ0WXfmoYdRDoZFPNSd-oM.js"></script>
<script type="text/javascript" src="/sites/default/files/advagg_js/js__156__G_TX0wWbp2x4EuISKOgbs4NaeHZ2KmXq85T6UI__w2izI_4UeJKq2XZJo79kNkQyxp_-2ptYjzA3YJcr-tg__Op4k-kV4DoWc7bsUP7umKmZ0WXfmoYdRDoZFPNSd-oM.js"></script>
<script type="text/javascript" src="/sites/default/files/advagg_js/js__az53Pz-SG0wejB-7UDzC-AbKqNFb4dAiZbq9Ymbj0sY__8FyXs8A34T1jX6OUXsgX27-4ASoy8QDncslXiOc2PK4__Op4k-kV4DoWc7bsUP7umKmZ0WXfmoYdRDoZFPNSd-oM.js"></script>
<script type="text/javascript">
<!--//--><![CDATA[//><!--
jQuery.extend(Drupal.settings, {"basePath":"\/","pathPrefix":"","ajaxPageState":{"theme":"jcore_1","theme_token":"o55dv-mtJg_O7PVKd0q2scken6rOI8LX5WhaHGydESk","js":{"sites\/all\/libraries\/modernizr\/modernizr.min.js":1,"sites\/all\/modules\/contrib\/jquery_update\/replace\/jquery\/1.8\/jquery.min.js":1,"misc\/jquery-extend-3.4.0.js":1,"misc\/jquery.once.js":1,"misc\/drupal.js":1,"sites\/all\/modules\/contrib\/jquery_update\/replace\/ui\/ui\/minified\/jquery.ui.core.min.js":1,"sites\/all\/modules\/contrib\/jquery_update\/replace\/ui\/ui\/minified\/jquery.ui.widget.min.js":1,"sites\/all\/modules\/contrib\/jquery_update\/replace\/ui\/ui\/minified\/jquery.ui.button.min.js":1,"sites\/all\/modules\/contrib\/jquery_update\/replace\/ui\/ui\/minified\/jquery.ui.mouse.min.js":1,"sites\/all\/modules\/contrib\/jquery_update\/replace\/ui\/ui\/minified\/jquery.ui.draggable.min.js":1,"sites\/all\/modules\/contrib\/jquery_update\/replace\/ui\/ui\/minified\/jquery.ui.position.min.js":1,"sites\/all\/modules\/contrib\/jquery_update\/replace\/ui\/ui\/minified\/jquery.ui.resizable.min.js":1,"sites\/all\/modules\/contrib\/jquery_update\/replace\/ui\/ui\/minified\/jquery.ui.dialog.min.js":1,"sites\/all\/modules\/contrib\/jquery_update\/replace\/ui\/ui\/minified\/jquery.ui.tooltip.min.js":1,"sites\/all\/modules\/contrib\/jquery_update\/replace\/ui\/ui\/minified\/jquery.ui.accordion.min.js":1,"sites\/all\/libraries\/jquery.bgiframe\/jquery.bgiframe.js":1,"sites\/all\/libraries\/jquery.hoverIntent\/jquery.hoverIntent.js":1,"sites\/all\/libraries\/superfish\/superfish.js":1,"sites\/all\/modules\/contrib\/nice_menus\/js\/nice_menus.js":1,"sites\/all\/modules\/contrib\/eu_cookie_compliance\/js\/jquery.cookie-1.4.1.min.js":1,"sites\/all\/modules\/highwire\/highwire\/js\/highwire.equal-heights.js":1,"sites\/all\/modules\/highwire\/highwire\/js\/highwire.panels-ajax-tab.js":1,"sites\/all\/libraries\/colorbox\/jquery.colorbox-min.js":1,"sites\/all\/modules\/contrib\/colorbox\/js\/colorbox.js":1,"sites\/all\/modules\/contrib\/colorbox\/styles\/default\/colorbox_style.js":1,"https:\/\/scholar.google.com\/scholar_js\/casa.js":1,"sites\/all\/modules\/highwire\/highwire\/highwire_log\/highwire_log.js":1,"sites\/all\/modules\/highwire\/highwire\/highwire_user\/js\/highwire_user_meta.js":1,"sites\/all\/modules\/contrib\/panels_ajax_tab\/js\/panels_ajax_tab.js":1,"\/\/cdn.jsdelivr.net\/qtip2\/2.2.1\/jquery.qtip.min.js":1,"sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_article_reference_popup.js":1,"sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_at_symbol.js":1,"sites\/all\/modules\/contrib\/captcha\/captcha.js":1,"misc\/textarea.js":1,"sites\/all\/modules\/contrib\/recaptcha\/js\/recaptcha.js":1,"https:\/\/www.google.com\/recaptcha\/api.js?hl=en\u0026render=explicit\u0026onload=drupalRecaptchaOnload":1,"sites\/all\/modules\/highwire\/highwire\/highwire_citation\/plugins\/content_types\/js\/highwire_citation_export.js":1,"sites\/all\/modules\/highwire\/highwire\/plugins\/content_types\/js\/minipanel_dialog_link.js":1,"sites\/all\/modules\/highwire\/highwire\/plugins\/content_types\/js\/highwire_share_dialog.js":1,"sites\/all\/modules\/highwire\/highwire\/plugins\/content_types\/js\/clipboard.min.js":1,"sites\/all\/modules\/highwire\/highwire\/plugins\/content_types\/js\/highwire_clipboard.js":1,"sites\/all\/modules\/contrib\/service_links\/js\/twitter_button.js":1,"sites\/all\/modules\/contrib\/service_links\/js\/facebook_like.js":1,"sites\/all\/modules\/contrib\/service_links\/js\/google_plus_one.js":1,"sites\/all\/modules\/highwire\/highwire\/plugins\/content_types\/js\/highwire_article_nav.js":1,"sites\/all\/modules\/highwire\/highwire\/plugins\/content_types\/js\/highwire_nav_float.js":1,"sites\/all\/modules\/highwire\/highwire\/plugins\/content_types\/js\/highwire_citing_links.js":1,"sites\/all\/modules\/highwire\/highwire\/highwire_search\/plugins\/content_types\/js\/highwire_search_similar_articles.js":1,"sites\/all\/modules\/contrib\/panels_accordion\/js\/panels_accordion.js":1,"sites\/all\/modules\/highwire\/highwire\/js\/highwire.article-citation-access.js":1,"sites\/all\/modules\/highwire\/highwire\/js\/highwire.article-citation-author-tooltip.js":1,"sites\/all\/modules\/highwire\/highwire\/highwire_responsive\/plugins\/styles\/highwire_responsive_toggle\/highwire_responsive_toggle.js":1,"sites\/all\/modules\/contrib\/google_analytics\/googleanalytics.js":1,"https:\/\/www.googletagmanager.com\/gtag\/js?id=G-4CRTLTY8KW":1,"sites\/all\/themes\/highwire\/jcore_1\/js\/theme-scripts.js":1,"sites\/all\/modules\/highwire\/highwire\/highwire_responsive\/js\/highwire-mediaqueries.js":1,"sites\/all\/libraries\/enquire.js\/enquire.min.js":1,"sites\/all\/modules\/contrib\/picture\/picturefill2\/picturefill.min.js":1,"sites\/all\/modules\/contrib\/picture\/picture.min.js":1,"sites\/all\/modules\/highwire\/highwire\/plugins\/content_types\/js\/highwire_panels_ajax_tab.js":1,"sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_openurl.js":1,"sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_google_scholar_sprinkle.js":1,"sites\/all\/modules\/highwire\/highwire\/plugins\/content_types\/js\/highwire_article_trendmd.js":1,"sites\/all\/modules\/highwire\/highwire\/highwire_user\/plugins\/content_types\/js\/highwire_user_salutation.js":1,"sites\/all\/modules\/contrib\/eu_cookie_compliance\/js\/eu_cookie_compliance.js":1,"http:\/\/securepubads.g.doubleclick.net\/tag\/js\/gpt.js":1,"sites\/all\/modules\/highwire\/highwire\/js\/highwire.gtranslate.js":1,"sites\/all\/modules\/highwire\/highwire\/highwire_datalayer\/js\/highwire_datalayer.js":1,"sites\/all\/themes\/contrib\/omega\/omega\/js\/jquery.formalize.js":1,"sites\/all\/themes\/contrib\/omega\/omega\/js\/omega-mediaqueries.js":1,"sites\/all\/themes\/contrib\/omega\/omega\/js\/omega-equalheights.js":1},"css":{"modules\/system\/system.base.css":1,"modules\/system\/system.menus.css":1,"modules\/system\/system.messages.css":1,"modules\/system\/system.theme.css":1,"misc\/ui\/jquery.ui.core.css":1,"misc\/ui\/jquery.ui.theme.css":1,"misc\/ui\/jquery.ui.button.css":1,"misc\/ui\/jquery.ui.resizable.css":1,"misc\/ui\/jquery.ui.dialog.css":1,"misc\/ui\/jquery.ui.tooltip.css":1,"misc\/ui\/jquery.ui.accordion.css":1,"sites\/all\/modules\/contrib\/date\/date_api\/date.css":1,"sites\/all\/modules\/contrib\/date\/date_popup\/themes\/datepicker.1.7.css":1,"modules\/field\/theme\/field.css":1,"sites\/all\/modules\/highwire\/highwire\/highwire_draw\/css\/highwire-draw.css":1,"sites\/all\/modules\/highwire\/highwire\/highwire_folders\/highwire_folders.css":1,"sites\/all\/modules\/highwire\/highwire\/highwire_responsive\/css\/highwire-responsive.css":1,"sites\/all\/modules\/highwire\/highwire\/highwire_saved_searches\/highwire_saved_searches.css":1,"sites\/all\/modules\/highwire\/highwire\/highwire_user\/highwire_user.css":1,"modules\/node\/node.css":1,"sites\/all\/modules\/contrib\/picture\/picture_wysiwyg.css":1,"modules\/search\/search.css":1,"modules\/user\/user.css":1,"sites\/all\/modules\/contrib\/views\/css\/views.css":1,"sites\/all\/modules\/contrib\/ckeditor\/css\/ckeditor.css":1,"sites\/all\/modules\/contrib\/colorbox\/styles\/default\/colorbox_style.css":1,"sites\/all\/modules\/contrib\/ctools\/css\/ctools.css":1,"sites\/all\/modules\/contrib\/google_admanager\/google_admanager.css":1,"sites\/all\/modules\/highwire\/highwire\/highwire.style.highwire.css":1,"sites\/all\/modules\/highwire\/highwire\/css\/nlm-elements.css":1,"sites\/all\/modules\/contrib\/panels\/css\/panels.css":1,"public:\/\/ctools\/css\/263bfdb18936424f0ade19d6bd885f37.css":1,"sites\/all\/modules\/contrib\/panels_ajax_tab\/css\/panels_ajax_tab.css":1,"sites\/all\/modules\/highwire\/highwire\/plugins\/content_types\/css\/highwire_corrections.css":1,"sites\/all\/modules\/highwire\/highwire\/highwire.style.markup.css":1,"\/\/cdn.jsdelivr.net\/qtip2\/2.2.1\/jquery.qtip.min.css":1,"sites\/all\/modules\/highwire\/highwire\/plugins\/layouts\/highwire_2col_stacked\/highwire-2col-stacked.css":1,"sites\/all\/modules\/contrib\/forward\/forward.css":1,"sites\/all\/modules\/highwire\/highwire\/plugins\/content_types\/css\/highwire_share_link.css":1,"sites\/all\/modules\/highwire\/highwire\/plugins\/content_types\/css\/highwire_copy_permalink.css":1,"sites\/all\/modules\/highwire\/highwire\/plugins\/content_types\/css\/highwire_citing_links.css":1,"sites\/all\/modules\/highwire\/highwire\/plugins\/content_types\/css\/highwire_reports_feed.css":1,"sites\/all\/modules\/highwire\/highwire\/css\/highwire-article-citation-list.css":1,"sites\/all\/modules\/highwire\/highwire\/highwire_responsive\/plugins\/styles\/highwire_responsive_toggle\/highwire_responsive_toggle.css.less":1,"sites\/all\/modules\/contrib\/nice_menus\/css\/nice_menus.css":1,"sites\/all\/modules\/contrib\/nice_menus\/css\/nice_menus_default.css":1,"sites\/all\/modules\/contrib\/panels\/plugins\/layouts\/onecol\/onecol.css":1,"sites\/all\/modules\/contrib\/eu_cookie_compliance\/css\/eu_cookie_compliance.css":1,"sites\/all\/modules\/highwire\/highwire\/css\/highwire.gtranslate.css":1,"sites\/all\/modules\/highwire\/highwire\/highwire_theme_tools\/css\/font-hwicons.css":1,"sites\/all\/modules\/highwire\/highwire\/highwire_theme_tools\/css\/font-hwicons-glyphs.css":1,"sites\/all\/themes\/highwire\/jcore_1\/eu_cookie_compliance.css":1,"sites\/all\/themes\/highwire\/jcore_1\/css\/font-awesome-ie7.css":1,"sites\/all\/themes\/contrib\/omega\/alpha\/css\/alpha-reset.css":1,"sites\/all\/themes\/contrib\/omega\/alpha\/css\/alpha-mobile.css":1,"sites\/all\/themes\/contrib\/omega\/alpha\/css\/alpha-alpha.css":1,"sites\/all\/themes\/contrib\/omega\/omega\/css\/formalize.css":1,"sites\/all\/themes\/contrib\/omega\/omega\/css\/omega-text.css":1,"sites\/all\/themes\/contrib\/omega\/omega\/css\/omega-branding.css":1,"sites\/all\/themes\/contrib\/omega\/omega\/css\/omega-menu.css":1,"sites\/all\/themes\/contrib\/omega\/omega\/css\/omega-forms.css":1,"sites\/all\/modules\/highwire\/highwire\/css\/highwire-forms.css":1,"sites\/all\/themes\/highwire\/jcore_1\/css\/mobile-reset.css":1,"sites\/all\/themes\/highwire\/jcore_1\/css\/font-awesome.css":1,"sites\/all\/themes\/highwire\/jcore_1\/css\/forms.css":1,"sites\/all\/themes\/highwire\/jcore_1\/css\/global.css":1,"sites\/all\/themes\/highwire\/jcore_1\/css\/jquery-ui-elements.css":1,"sites\/all\/themes\/highwire\/jcore_1\/css\/text.css":1,"sites\/all\/themes\/highwire\/jcore_1\/css\/eletters.css":1,"sites\/all\/themes\/highwire\/jcore_1\/css\/colors.css.less":1,"ie::normal::sites\/all\/themes\/highwire\/jcore_1\/css\/jcore-1-jcore-default.css":1,"ie::normal::sites\/all\/themes\/highwire\/jcore_1\/css\/jcore-1-jcore-default-normal.css":1,"ie::normal::sites\/all\/themes\/highwire\/jcore_1\/css\/grid\/jcore_default\/normal\/jcore-default-normal-30.css":1,"narrow::sites\/all\/themes\/highwire\/jcore_1\/css\/jcore-1-jcore-default.css":1,"narrow::sites\/all\/themes\/highwire\/jcore_1\/css\/jcore-1-jcore-default-narrow.css":1,"sites\/all\/themes\/highwire\/jcore_1\/css\/grid\/jcore_default\/narrow\/jcore-default-narrow-30.css":1,"normal::sites\/all\/themes\/highwire\/jcore_1\/css\/jcore-1-jcore-default.css":1,"normal::sites\/all\/themes\/highwire\/jcore_1\/css\/jcore-1-jcore-default-normal.css":1,"sites\/all\/themes\/highwire\/jcore_1\/css\/grid\/jcore_default\/normal\/jcore-default-normal-30.css":1,"wide::sites\/all\/themes\/highwire\/jcore_1\/css\/jcore-1-jcore-default.css":1,"wide::sites\/all\/themes\/highwire\/jcore_1\/css\/jcore-1-jcore-default-wide.css":1,"sites\/all\/themes\/highwire\/jcore_1\/css\/grid\/jcore_default\/wide\/jcore-default-wide-30.css":1,"sites\/all\/modules\/shared\/jnl_ajnr_styles\/css\/jnl-ajnr-styles.css.less":1,"sites\/all\/modules\/shared\/jnl_ajnr_styles\/css\/jnl-ajnr-breakpoints.css.less":1}},"colorbox":{"opacity":"0.85","current":"{current} of {total}","previous":"\u00ab Prev","next":"Next \u00bb","close":"Close","maxWidth":"98%","maxHeight":"98%","fixed":true,"mobiledetect":true,"mobiledevicewidth":"480px"},"highwire":{"nid":"69522","apath":"\/ajnr\/40\/8\/1257.atom","pisa":"ajnr;40\/8\/1257","ac":{"\/ajnr\/40\/8\/1257.atom":{"access":{"full":true,"reprint":true,"abstract":true},"pisa_id":"","apath":"\/ajnr\/40\/8\/1257.atom","jcode":"ajnr"},"ajnr;40\/8\/1257":{"access":{"full":true},"pisa_id":"ajnr;40\/8\/1257","apath":"","jcode":"ajnr"}},"processed":["highwire_math"],"markup":[{"requested":"abstract","variant":"abstract","view":"abstract","pisa":"ajnr;40\/8\/1257"},{"requested":"full-text","variant":"full-text","view":"full","pisa":"ajnr;40\/8\/1257"}],"trendmd":{"trendmd-suggestions":"{\u0022element\u0022:\u0022#trendmd-suggestions\u0022,\u0022track_id\u0022:\u0022null\u0022}"},"modal_window_width":"560","share_modal_width":"560","share_modal_title":"Share this Article","dataLayer":"{\u0022page\u0022:{\u0022hwTitle\u0022:\u0022Intrathecal Use of Gadobutrol for Glymphatic MR Imaging: Prospective Safety Study of 100 Patients\u0022,\u0022hwUrl\u0022:\u0022http:\\\/\\\/ajnr-stage2.stage.highwire.org\\\/content\\\/40\\\/8\\\/1257\u0022,\u0022hwPath\u0022:\u0022\\\/content\\\/40\\\/8\\\/1257.abstract\u0022,\u0022hwType\u0022:\u0022journal page\u0022},\u0022user\u0022:{\u0022hwMemberID\u0022:\u0022\u0022,\u0022hwLoggedIntoInstitutionID\u0022:\u0022\u0022,\u0022hwLoggedIntoInstitution\u0022:\u0022\u0022,\u0022hwAccessUsageTerms\u0022:\u0022guest\u0022,\u0022hwRegisteredUser\u0022:\u0022no\u0022,\u0022hwHasFullTextAccess\u0022:\u0022yes\u0022,\u0022hwEntitled\u0022:\u0022no\u0022},\u0022content\u0022:{\u0022hwIssueDate\u0022:\u00222019-08-01\u0022,\u0022hwIssueDateTime\u0022:\u00222019-08-01 00:00:00\u0022,\u0022hwPublicationDate\u0022:\u00222019-08-14\u0022,\u0022hwPublicationDateTime\u0022:\u00222019-08-14 08:00:37\u0022,\u0022hwNlmArticleType\u0022:\u0022research-article\u0022,\u0022hwDOI\u0022:\u002210.3174\\\/ajnr.A6136\u0022,\u0022hwAuthors\u0022:\u0022C.S. Edeklev,M. Halvorsen,G. L\\u00f8vland,S.A.S. Vatnehol,\\u00d8. Gjertsen,B. Nedregaard,R. Sletteberg,G. Ringstad,P.K. Eide\u0022,\u0022hwContributors\u0022:\u0022\u0022,\u0022hwIsEarlyRelease\u0022:\u0022no\u0022,\u0022hwEissn\u0022:\u00221936-959X\u0022,\u0022hwPissn\u0022:\u00220195-6108\u0022,\u0022hwVolume\u0022:\u002240\u0022,\u0022hwIssue\u0022:\u00228\u0022,\u0022hwArticleType\u0022:\u0022Patient Safety\u0022,\u0022hwTabView\u0022:\u0022main_tab\u0022,\u0022hwViewType\u0022:\u0022abstract\u0022,\u0022hwAccessType\u0022:\u0022Free\u0022,\u0022hwOpenAccess\u0022:\u0022no\u0022,\u0022hwFreeAccess\u0022:\u0022yes\u0022,\u0022hwTaxonomy\u0022:\u0022\u0022,\u0022hwCorpusCode\u0022:\u0022ajnr\u0022,\u0022hwType\u0022:\u0022article\u0022,\u0022hwSubtitle\u0022:null,\u0022hwOverline\u0022:null,\u0022hwPisaId\u0022:\u0022ajnr;40\\\/8\\\/1257\u0022,\u0022hwFirstPage\u0022:\u00221257\u0022,\u0022hwLastPage\u0022:\u00221264\u0022,\u0022hwIsLatestVersion\u0022:\u0022yes\u0022,\u0022hwIsCurrentIssue\u0022:\u0022no\u0022,\u0022hwIsOpenIssue\u0022:\u0022no\u0022,\u0022hwHasFullText\u0022:\u0022yes\u0022,\u0022hwHasPDF\u0022:\u0022yes\u0022,\u0022hwParentTitle\u0022:\u0022American Journal of Neuroradiology: 40 (8)\u0022,\u0022hwElectronicPubDate\u0022:\u00222019-08-14\u0022,\u0022hwElectronicPubDateTime\u0022:\u00222019-08-14 08:00:37\u0022}}"},"highwire_panel_tabs":[{"panel_name":"jnl_ajnr_tab_pdf","panel_ajax_tab":"jnl_ajnr_tab_pdf"}],"panel_ajax_tab":{"path":"sites\/all\/modules\/contrib\/panels_ajax_tab"},"instances":"{\u0022highwire_abstract_tooltip\u0022:{\u0022content\u0022:{\u0022text\u0022:\u0022\u0022},\u0022style\u0022:{\u0022tip\u0022:{\u0022width\u0022:20,\u0022height\u0022:20,\u0022border\u0022:1,\u0022offset\u0022:0,\u0022corner\u0022:true},\u0022classes\u0022:\u0022qtip-custom hw-tooltip hw-abstract-tooltip qtip-shadow qtip-rounded\u0022,\u0022classes_custom\u0022:\u0022hw-tooltip hw-abstract-tooltip\u0022},\u0022position\u0022:{\u0022at\u0022:\u0022right center\u0022,\u0022my\u0022:\u0022left center\u0022,\u0022viewport\u0022:true,\u0022adjust\u0022:{\u0022method\u0022:\u0022shift\u0022}},\u0022show\u0022:{\u0022event\u0022:\u0022mouseenter click \u0022,\u0022solo\u0022:true},\u0022hide\u0022:{\u0022event\u0022:\u0022mouseleave \u0022,\u0022fixed\u0022:1,\u0022delay\u0022:\u0022100\u0022}},\u0022highwire_author_tooltip\u0022:{\u0022content\u0022:{\u0022text\u0022:\u0022\u0022},\u0022style\u0022:{\u0022tip\u0022:{\u0022width\u0022:15,\u0022height\u0022:15,\u0022border\u0022:1,\u0022offset\u0022:0,\u0022corner\u0022:true},\u0022classes\u0022:\u0022qtip-custom hw-tooltip hw-author-tooltip qtip-shadow qtip-rounded\u0022,\u0022classes_custom\u0022:\u0022hw-tooltip hw-author-tooltip\u0022},\u0022position\u0022:{\u0022at\u0022:\u0022top center\u0022,\u0022my\u0022:\u0022bottom center\u0022,\u0022viewport\u0022:true,\u0022adjust\u0022:{\u0022method\u0022:\u0022\u0022}},\u0022show\u0022:{\u0022event\u0022:\u0022mouseenter \u0022,\u0022solo\u0022:true},\u0022hide\u0022:{\u0022event\u0022:\u0022mouseleave \u0022,\u0022fixed\u0022:1,\u0022delay\u0022:\u0022100\u0022}},\u0022highwire_reflinks_tooltip\u0022:{\u0022content\u0022:{\u0022text\u0022:\u0022\u0022},\u0022style\u0022:{\u0022tip\u0022:{\u0022width\u0022:15,\u0022height\u0022:15,\u0022border\u0022:1,\u0022mimic\u0022:\u0022top center\u0022,\u0022offset\u0022:0,\u0022corner\u0022:true},\u0022classes\u0022:\u0022qtip-custom hw-tooltip hw-ref-link-tooltip qtip-shadow qtip-rounded\u0022,\u0022classes_custom\u0022:\u0022hw-tooltip hw-ref-link-tooltip\u0022},\u0022position\u0022:{\u0022at\u0022:\u0022bottom left\u0022,\u0022my\u0022:\u0022top left\u0022,\u0022viewport\u0022:true,\u0022adjust\u0022:{\u0022method\u0022:\u0022flip\u0022}},\u0022show\u0022:{\u0022event\u0022:\u0022mouseenter \u0022,\u0022solo\u0022:true},\u0022hide\u0022:{\u0022event\u0022:\u0022mouseleave \u0022,\u0022fixed\u0022:1,\u0022delay\u0022:\u0022100\u0022}}}","qtipDebug":"{\u0022leaveElement\u0022:0}","urlIsAjaxTrusted":{"\/content\/40\/8\/1257.abstract":true},"ws_fl":{"width":100,"height":21},"ws_gpo":{"size":"","annotation":"","lang":"","callback":"","width":300},"highwire_search_similar_articles":{"highwire-search-similar-articles-list-1":{"conf":{"context":"requiredcontext_entity:node_1","override_title":1,"override_title_text":"\u003Ci class=\u0022icon-caret-right\u0022\u003E\u003C\/i\u003E Similar Articles","number_per_page":"5","show_pager":0,"more_link_path":"similar\/articles","more_link":1,"empty_message":"No similar articles are available.","citation_style":"jcore_standard","title_type":"prefer_short","title_as_link":0,"display_subtitle":0,"choose_pubdate":"ppubdate","display_markup_snippet":"","display_original_link":0,"display_access_indicator":0,"display_cme_link":0,"display_access_indicator_text":0,"display_highlight_image":"0","display_variants":0,"display_supplements":0,"display_abstract_tooltip":0,"display_author_tooltip":0,"override_title_heading":"h2","citation_settings_source":"citation_manager","citation_manager_wrapper":{"citation_manager_citation":"jcore_list_title_only"},"corpus_config_wrapper":{"corpus_config_citation_context":[]},"cache_enabled":1,"cache_time":"600","short_title_options":{"char_count":"50","add_ellipsis":0},"access_indicator_settings":{"open_access":{"icon":"icon-unlock","title":"Open Access"},"user_access":{"icon":"icon-ok-sign","title":"You have access"},"no_access":{"icon":"icon-lock","title":"Restricted access"}},"pdf_download":{"display_pdf_download":0,"pdf_download_icon":"icon-cloud-download","pdf_download_text":"PDF"},"include_on_behalf":1,"show_mark_citation":0,"display_infotrieve_link":0,"infotrieve_link_settings":{"icon":"icon-usd","link_caption":"Order full text via Infotrieve"},"highlight_image_style":"","featured_image_variant":"large","featured_image_click_image":"colorbox","display_google_scholar_tooltip":1,"display_pubmed_tooltip":1,"display_advanced_search_tooltip":1,"display_author_landing_page_tooltip":1,"display_orcid_tooltip":0,"display_ads_search_tooltip":0,"display_agricola_tooltip":0,"author_site_search_path":"","display_translations":0,"display_translations_text":"","display_translations_text_icon":"","bundle_overrides_checkboxes":{"highwire_book_fragment":{"selector":0},"highwire_news_story":{"selector":0},"highwire_book_edition":{"selector":0},"highwire_article":{"selector":0},"highwire_issue":{"selector":0},"highwire_comment":{"selector":0},"highwire_fragment":{"selector":0},"highwire_book_section":{"selector":0},"highwire_journal":{"selector":0}},"bundle_overrides":{"highwire_book_fragment":{"selector":0,"citation_style":"jcore_title_and_author","cache_enabled":1,"cache_time":"600","title_type":"full","short_title_options":{"char_count":"50","add_ellipsis":0},"title_as_link":0,"display_subtitle":0,"choose_pubdate":"ppubdate","display_markup_snippet":"","highlight_image_toggle":0,"display_original_link":0,"display_access_indicator":"0","access_indicator_settings":{"open_access":{"icon":"icon-unlock","title":"Open Access"},"user_access":{"icon":"icon-ok-sign","title":"You have access"},"no_access":{"icon":"icon-lock","title":"Restricted access"}},"display_variants":0,"display_supplements":0,"pdf_download":{"display_pdf_download":0,"pdf_download_icon":"icon-cloud-download","pdf_download_text":"PDF"},"include_on_behalf":1,"cpath_prefix":"\/content","show_mark_citation":0,"display_infotrieve_link":0,"infotrieve_link_settings":{"icon":"icon-usd","link_caption":"Order full text via Infotrieve"},"display_highlight_image":0,"highlight_image_style":"thumbnail","display_fragment_caption":1,"display_parent_citation":1,"parent_citation_type":"highwire_book_section","parent_citation_settings":{"citation_style":"folio_book_sections_standard","cache_enabled":1,"cache_time":"600","title_type":"full","short_title_options":{"char_count":"50","add_ellipsis":0},"title_as_link":0,"display_subtitle":0,"choose_pubdate":"ppubdate","display_markup_snippet":"","highlight_image_toggle":0,"display_original_link":0,"display_access_indicator":0,"access_indicator_settings":{"open_access":{"icon":"icon-unlock","title":"Open Access"},"user_access":{"icon":"icon-ok-sign","title":"You have access"},"no_access":{"icon":"icon-lock","title":"Restricted access"}},"display_variants":0,"display_supplements":0,"pdf_download":{"display_pdf_download":0,"pdf_download_icon":"icon-cloud-download","pdf_download_text":"PDF"},"include_on_behalf":1,"cpath_prefix":"\/content","show_mark_citation":0,"display_infotrieve_link":0,"infotrieve_link_settings":{"icon":"icon-usd","link_caption":"Order full text via Infotrieve"},"display_highlight_image":0,"highlight_image_style":"","display_abstract_tooltip":0,"display_author_tooltip":0,"display_google_scholar_tooltip":1,"display_pubmed_tooltip":1,"display_advanced_search_tooltip":1,"display_author_landing_page_tooltip":0,"author_site_search_path":"search\/"}},"highwire_news_story":{"selector":0,"citation_style":"mla","cache_enabled":1,"cache_time":"600","title_type":"full","short_title_options":{"char_count":"50","add_ellipsis":0},"title_as_link":0,"display_subtitle":0,"choose_pubdate":"ppubdate","display_markup_snippet":"","highlight_image_toggle":0,"display_original_link":0,"display_access_indicator":0,"access_indicator_settings":{"open_access":{"icon":"icon-unlock","title":"Open Access"},"user_access":{"icon":"icon-ok-sign","title":"You have access"},"no_access":{"icon":"icon-lock","title":"Restricted access"}},"display_variants":0,"display_supplements":0,"pdf_download":{"display_pdf_download":0,"pdf_download_icon":"icon-cloud-download","pdf_download_text":"PDF"},"include_on_behalf":1,"cpath_prefix":"\/content","show_mark_citation":0,"display_infotrieve_link":0,"infotrieve_link_settings":{"icon":"icon-usd","link_caption":"Order full text via Infotrieve"},"display_highlight_image":"0","highlight_image_style":"","featured_image_click_image":"nothing","display_author_tooltip":0,"display_google_scholar_tooltip":0,"display_pubmed_tooltip":0,"display_advanced_search_tooltip":0},"highwire_book_edition":{"selector":0,"citation_style":"folio_books_standard","cache_enabled":1,"cache_time":"600","title_type":"full","short_title_options":{"char_count":"50","add_ellipsis":0},"title_as_link":0,"display_subtitle":0,"choose_pubdate":"ppubdate","display_markup_snippet":"","highlight_image_toggle":0,"display_original_link":0,"display_access_indicator":0,"access_indicator_settings":{"open_access":{"icon":"icon-unlock","title":"Open Access"},"user_access":{"icon":"icon-ok-sign","title":"You have access"},"no_access":{"icon":"icon-lock","title":"Restricted access"}},"display_variants":0,"display_supplements":0,"pdf_download":{"display_pdf_download":0,"pdf_download_icon":"icon-cloud-download","pdf_download_text":"PDF"},"include_on_behalf":1,"cpath_prefix":"\/content","show_mark_citation":0,"display_infotrieve_link":0,"infotrieve_link_settings":{"icon":"icon-usd","link_caption":"Order full text via Infotrieve"},"display_highlight_image":0,"highlight_image_style":"","display_author_tooltip":0,"display_google_scholar_tooltip":1,"display_pubmed_tooltip":1,"display_advanced_search_tooltip":1,"display_author_landing_page_tooltip":1,"display_orcid_tooltip":1,"author_site_search_path":"search\/"},"highwire_article":{"selector":0,"citation_style":"mla","cache_enabled":1,"cache_time":"600","title_type":"full","short_title_options":{"char_count":"50","add_ellipsis":0},"title_as_link":0,"display_subtitle":0,"choose_pubdate":"ppubdate","display_markup_snippet":"","highlight_image_toggle":0,"display_original_link":0,"display_access_indicator":0,"access_indicator_settings":{"open_access":{"icon":"icon-unlock","title":"Open Access"},"user_access":{"icon":"icon-ok-sign","title":"You have access"},"no_access":{"icon":"icon-lock","title":"Restricted access"}},"display_variants":0,"display_supplements":0,"pdf_download":{"display_pdf_download":0,"pdf_download_icon":"icon-cloud-download","pdf_download_text":"PDF"},"include_on_behalf":0,"cpath_prefix":"\/content","show_mark_citation":0,"display_infotrieve_link":0,"infotrieve_link_settings":{"icon":"icon-usd","link_caption":"Order full text via Infotrieve"},"display_highlight_image":"0","highlight_image_style":"","featured_image_variant":"large","featured_image_click_image":"nothing","display_cme_link":0,"display_abstract_tooltip":0,"display_author_tooltip":0,"display_google_scholar_tooltip":1,"display_pubmed_tooltip":1,"display_advanced_search_tooltip":1,"display_author_landing_page_tooltip":1,"display_orcid_tooltip":1,"display_ads_search_tooltip":0,"display_agricola_tooltip":0,"author_site_search_path":"search\/","display_translations":0,"display_translations_text":"Translations Available","display_translations_text_icon":"icon-globe"},"highwire_issue":{"selector":0,"citation_style":"mla","cache_enabled":1,"cache_time":"600","title_type":"full","short_title_options":{"char_count":"50","add_ellipsis":0},"title_as_link":0,"display_subtitle":0,"choose_pubdate":"ppubdate","display_markup_snippet":"","highlight_image_toggle":0,"display_original_link":0,"display_access_indicator":0,"access_indicator_settings":{"open_access":{"icon":"icon-unlock","title":"Open Access"},"user_access":{"icon":"icon-ok-sign","title":"You have access"},"no_access":{"icon":"icon-lock","title":"Restricted access"}},"display_variants":0,"display_supplements":0,"pdf_download":{"display_pdf_download":0,"pdf_download_icon":"icon-cloud-download","pdf_download_text":"PDF"},"include_on_behalf":1,"cpath_prefix":"\/content","show_mark_citation":0,"display_infotrieve_link":0,"infotrieve_link_settings":{"icon":"icon-usd","link_caption":"Order full text via Infotrieve"},"display_highlight_image":0,"highlight_image_style":"","featured_image_click_image":"nothing","display_author_tooltip":0,"display_google_scholar_tooltip":1,"display_pubmed_tooltip":1,"display_advanced_search_tooltip":1,"display_author_landing_page_tooltip":0,"display_orcid_tooltip":1,"author_site_search_path":"search\/"},"highwire_comment":{"selector":0,"citation_style":"highwire_comment","show_title":0,"title_as_link":0,"title_as_link_type":"tab_view","author_format_type":"fullname","author_format_custom":"","author_list_separator":", ","date_format":"(j F Y)","display_comment_body":1,"display_attachment":1,"display_conflict_of_interest":1},"highwire_fragment":{"selector":0,"citation_style":"jcore_title_and_author","cache_enabled":1,"cache_time":"600","title_type":"full","short_title_options":{"char_count":"50","add_ellipsis":0},"title_as_link":0,"display_subtitle":0,"choose_pubdate":"ppubdate","display_markup_snippet":"","highlight_image_toggle":0,"display_original_link":0,"display_access_indicator":"0","access_indicator_settings":{"open_access":{"icon":"icon-unlock","title":"Open Access"},"user_access":{"icon":"icon-ok-sign","title":"You have access"},"no_access":{"icon":"icon-lock","title":"Restricted access"}},"display_variants":0,"display_supplements":0,"pdf_download":{"display_pdf_download":0,"pdf_download_icon":"icon-cloud-download","pdf_download_text":"PDF"},"include_on_behalf":1,"cpath_prefix":"\/content","show_mark_citation":0,"display_infotrieve_link":0,"infotrieve_link_settings":{"icon":"icon-usd","link_caption":"Order full text via Infotrieve"},"display_highlight_image":0,"highlight_image_style":"","display_fragment_caption":1,"fragment_image_settings":{"fragment_image_variant":"medium","fragment_click_image":"colorbox","show_download_links":1},"display_parent_citation":1,"parent_citation_type":"highwire_article","parent_citation_settings":{"citation_style":"mla","cache_enabled":1,"cache_time":"600","title_type":"full","short_title_options":{"char_count":"50","add_ellipsis":0},"title_as_link":0,"display_subtitle":0,"choose_pubdate":"ppubdate","display_markup_snippet":"","highlight_image_toggle":0,"display_original_link":0,"display_access_indicator":0,"access_indicator_settings":{"open_access":{"icon":"icon-unlock","title":"Open Access"},"user_access":{"icon":"icon-ok-sign","title":"You have access"},"no_access":{"icon":"icon-lock","title":"Restricted access"}},"display_variants":0,"display_supplements":0,"pdf_download":{"display_pdf_download":0,"pdf_download_icon":"icon-cloud-download","pdf_download_text":"PDF"},"include_on_behalf":0,"cpath_prefix":"\/content","show_mark_citation":0,"display_infotrieve_link":0,"infotrieve_link_settings":{"icon":"icon-usd","link_caption":"Order full text via Infotrieve"},"display_highlight_image":"0","highlight_image_style":"","featured_image_variant":"large","featured_image_click_image":"nothing","display_cme_link":0,"display_abstract_tooltip":0,"display_author_tooltip":0,"display_google_scholar_tooltip":1,"display_pubmed_tooltip":1,"display_advanced_search_tooltip":1,"display_author_landing_page_tooltip":1,"display_orcid_tooltip":1,"display_ads_search_tooltip":0,"display_agricola_tooltip":0,"author_site_search_path":"search\/","display_translations":0,"display_translations_text":"Translations Available","display_translations_text_icon":"icon-globe"}},"highwire_book_section":{"selector":0,"citation_style":"folio_book_sections_standard","cache_enabled":1,"cache_time":"600","title_type":"full","short_title_options":{"char_count":"50","add_ellipsis":0},"title_as_link":0,"display_subtitle":0,"choose_pubdate":"ppubdate","display_markup_snippet":"","highlight_image_toggle":0,"display_original_link":0,"display_access_indicator":0,"access_indicator_settings":{"open_access":{"icon":"icon-unlock","title":"Open Access"},"user_access":{"icon":"icon-ok-sign","title":"You have access"},"no_access":{"icon":"icon-lock","title":"Restricted access"}},"display_variants":0,"display_supplements":0,"pdf_download":{"display_pdf_download":0,"pdf_download_icon":"icon-cloud-download","pdf_download_text":"PDF"},"include_on_behalf":1,"cpath_prefix":"\/content","show_mark_citation":0,"display_infotrieve_link":0,"infotrieve_link_settings":{"icon":"icon-usd","link_caption":"Order full text via Infotrieve"},"display_highlight_image":0,"highlight_image_style":"","display_abstract_tooltip":0,"display_author_tooltip":0,"display_google_scholar_tooltip":1,"display_pubmed_tooltip":1,"display_advanced_search_tooltip":1,"display_author_landing_page_tooltip":0,"author_site_search_path":"search\/"},"highwire_journal":{"selector":0,"citation_style":"mla","cache_enabled":1,"cache_time":"600","title_type":"full","short_title_options":{"char_count":"50","add_ellipsis":0},"title_as_link":0,"display_subtitle":0,"choose_pubdate":"ppubdate","display_markup_snippet":"","highlight_image_toggle":0,"display_original_link":0,"display_access_indicator":0,"access_indicator_settings":{"open_access":{"icon":"icon-unlock","title":"Open Access"},"user_access":{"icon":"icon-ok-sign","title":"You have access"},"no_access":{"icon":"icon-lock","title":"Restricted access"}},"display_variants":0,"display_supplements":0,"pdf_download":{"display_pdf_download":0,"pdf_download_icon":"icon-cloud-download","pdf_download_text":"PDF"},"include_on_behalf":1,"cpath_prefix":"\/content","show_mark_citation":0,"display_infotrieve_link":0,"infotrieve_link_settings":{"icon":"icon-usd","link_caption":"Order full text via Infotrieve"},"display_highlight_image":0,"highlight_image_style":"","display_author_tooltip":0,"display_google_scholar_tooltip":1,"display_pubmed_tooltip":1,"display_advanced_search_tooltip":1,"display_author_landing_page_tooltip":0,"display_orcid_tooltip":1,"author_site_search_path":"search\/"}},"cpath_prefix":"\/content","ajax_loading_icon_classes":"icon-spinner icon-spin icon-2x","ajax_loading_text":"","highlight_image_toggle":0,"more_link_label":"See more","url_parameters":{"q":"node\/69522","variant":"abstract"}},"nid":"69522"}},"panels_accordion":{"highwire_article_accordion_container":{"heightStyle":"content","autoHeight":false,"collapsible":0,"region_accordion_id":"highwire_article_accordion_container","active":0,"animated":"slide"}},"color":{"logo":"http:\/\/ajnr-stage2.stage.highwire.org\/sites\/default\/files\/ajnr-web-logo_0.png"},"nice_menus_options":{"delay":800,"speed":"fast"},"highwireResponsive":{"enquire_enabled":1,"breakpoints_configured":1,"breakpoints":{"zero":"all and (min-width: 0px)","xsmall":"all and (min-width: 380px)","narrow":"all and (min-width: 768px) and (min-device-width: 768px), (max-device-width: 800px) and (min-width: 768px) and (orientation:landscape)","normal":"all and (min-width: 980px) and (min-device-width: 980px), all and (max-device-width: 1024px) and (min-width: 1024px) and (orientation:landscape)","wide":"all and (min-width: 1220px)"}},"eu_cookie_compliance":{"popup_enabled":1,"popup_agreed_enabled":0,"popup_hide_agreed":false,"popup_clicking_confirmation":true,"popup_scrolling_confirmation":false,"popup_html_info":"\u003Cdiv\u003E\n  \u003Cdiv class=\u0022popup-content info\u0022\u003E\n    \u003Cdiv id=\u0022popup-text\u0022\u003E\n      \u003Cp\u003EWe use cookies on this site to enhance your user experience. By clicking any link on this page you are giving your consent for us to set cookies.\u003C\/p\u003E\n    \u003C\/div\u003E\n    \u003Cdiv id=\u0022popup-buttons\u0022\u003E\n      \u003Cbutton type=\u0022button\u0022 role=\u0022dialog\u0022 aria-labelledby=\u0022Continue\u0022\n        class=\u0022agree-button eu-cookie-compliance-default-button\u0022\u003EContinue\u003C\/button\u003E\n                  \u003Cbutton type=\u0022button\u0022 role=\u0022dialog\u0022 aria-labelledby=\u0022Find out more\u0022\n        class=\u0022find-more-button eu-cookie-compliance-more-button\u0022\u003EFind out more\u003C\/button\u003E\n          \u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E","use_mobile_message":false,"mobile_popup_html_info":"\u003Cdiv\u003E\n  \u003Cdiv class=\u0022popup-content info\u0022\u003E\n    \u003Cdiv id=\u0022popup-text\u0022\u003E\n          \u003C\/div\u003E\n    \u003Cdiv id=\u0022popup-buttons\u0022\u003E\n      \u003Cbutton type=\u0022button\u0022 role=\u0022dialog\u0022 aria-labelledby=\u0022Continue\u0022\n        class=\u0022agree-button eu-cookie-compliance-default-button\u0022\u003EContinue\u003C\/button\u003E\n                  \u003Cbutton type=\u0022button\u0022 role=\u0022dialog\u0022 aria-labelledby=\u0022Find out more\u0022\n        class=\u0022find-more-button eu-cookie-compliance-more-button\u0022\u003EFind out more\u003C\/button\u003E\n          \u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E","mobile_breakpoint":"768","popup_html_agreed":"\u003Cdiv\u003E\n  \u003Cdiv class=\u0022popup-content agreed\u0022\u003E\n    \u003Cdiv id=\u0022popup-text\u0022\u003E\n      \u003Cp\u003EThank you for accepting cookies. You can now hide this message or find out more about cookies.\u003C\/p\u003E\n    \u003C\/div\u003E\n    \u003Cdiv id=\u0022popup-buttons\u0022\u003E\n      \u003Cbutton type=\u0022button\u0022 class=\u0022hide-popup-button eu-cookie-compliance-hide-button\u0022\u003EHide\u003C\/button\u003E\n              \u003Cbutton type=\u0022button\u0022 class=\u0022find-more-button eu-cookie-compliance-more-button-thank-you\u0022 \u003EFind out more\u003C\/button\u003E\n          \u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E","popup_use_bare_css":false,"popup_height":"auto","popup_width":"100%","popup_delay":1000,"popup_link":"\/help\/cookie-policy","popup_link_new_window":1,"popup_position":null,"popup_language":"en","store_consent":false,"better_support_for_screen_readers":0,"reload_page":0,"domain":"","popup_eu_only_js":0,"cookie_lifetime":365,"cookie_session":false,"disagree_do_not_show_popup":0,"method":"default","whitelisted_cookies":"","withdraw_markup":"\u003Cbutton type=\u0022button\u0022 class=\u0022eu-cookie-withdraw-tab\u0022\u003EPrivacy settings\u003C\/button\u003E\n\u003Cdiv class=\u0022eu-cookie-withdraw-banner\u0022\u003E\n  \u003Cdiv class=\u0022popup-content info\u0022\u003E\n    \u003Cdiv id=\u0022popup-text\u0022\u003E\n      \u003Cp\u003E\u0026lt;h2\u0026gt;We use cookies on this site to enhance your user experience\u0026lt;\/h2\u0026gt;\u0026lt;p\u0026gt;You have given your consent for us to set cookies.\u0026lt;\/p\u0026gt;\u003C\/p\u003E\n    \u003C\/div\u003E\n    \u003Cdiv id=\u0022popup-buttons\u0022\u003E\n      \u003Cbutton type=\u0022button\u0022 class=\u0022eu-cookie-withdraw-button\u0022\u003EWithdraw consent\u003C\/button\u003E\n    \u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E\n","withdraw_enabled":false},"googleanalytics":{"account":["G-4CRTLTY8KW"],"trackOutbound":1,"trackMailto":1,"trackDownload":1,"trackDownloadExtensions":"7z|aac|arc|arj|asf|asx|avi|bin|csv|doc(x|m)?|dot(x|m)?|exe|flv|gif|gz|gzip|hqx|jar|jpe?g|js|mp(2|3|4|e?g)|mov(ie)?|msi|msp|pdf|phps|png|ppt(x|m)?|pot(x|m)?|pps(x|m)?|ppam|sld(x|m)?|thmx|qtm?|ra(m|r)?|sea|sit|tar|tgz|torrent|txt|wav|wma|wmv|wpd|xls(x|m|b)?|xlt(x|m)|xlam|xml|z|zip","trackColorbox":1},"omega":{"layouts":{"primary":"normal","order":["narrow","normal","wide"],"queries":{"narrow":"all and (min-width: 768px) and (min-device-width: 768px), (max-device-width: 800px) and (min-width: 768px) and (orientation:landscape)","normal":"all and (min-width: 980px) and (min-device-width: 980px), all and (max-device-width: 1024px) and (min-width: 1024px) and (orientation:landscape)","wide":"all and (min-width: 1220px)"}}}});
//--><!]]>
</script>
    <!--[if lt IE 9]><script src="http://html5shiv.googlecode.com/svn/trunk/html5.js"></script><![endif]-->
  </head>
  <body class="html not-front not-logged-in page-node page-node- page-node-69522 node-type-highwire-article context-content hw-default-jcode-ajnr hw-article-type-research-article hw-article-category-patient-safety">
<!-- Google Tag Manager -->
<noscript><iframe src="//www.googletagmanager.com/ns.html?id=GTM-MXP45WNH" height="0" width="0" style="display:none;visibility:hidden"></iframe></noscript>
<script type="text/javascript">(function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0];var j=d.createElement(s);var dl=l!='dataLayer'?'&l='+l:'';j.src='//www.googletagmanager.com/gtm.js?id='+i+dl;j.type='text/javascript';j.async=true;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-MXP45WNH');</script>
<!-- End Google Tag Manager -->
    <div id="skip-link">
      <a href="#main-content" class="element-invisible element-focusable">Skip to main content</a>
    </div>
    <div class="region region-page-top" id="region-page-top">
  <div class="region-inner region-page-top-inner">
      </div>
</div>    <div class="page clearfix footer-borders panels-page panels-layout-jcore_2col" id="page">
      <header id="section-header" class="section section-header">
  <div id="zone-advertising-top-wrapper" class="zone-wrapper zone-advertising-top-wrapper clearfix">  
  <div id="zone-advertising-top" class="zone zone-advertising-top clearfix container-30">
    <div class="grid-28 suffix-1 prefix-1 region region-ad-top" id="region-ad-top">
  <div class="region-inner region-ad-top-inner">
    <div class="block block-panels-mini mobile-hiddens rtecenter block-jnl-ajnr-ad-leaderboard block-panels-mini-jnl-ajnr-ad-leaderboard odd block-without-title" id="block-panels-mini-jnl-ajnr-ad-leaderboard">
  <div class="block-inner clearfix">
                
    <div class="content clearfix">
      <div class="panel-display panel-1col clearfix" id="mini-panel-jnl_ajnr_ad_leaderboard">
  <div class="panel-panel panel-col">
    <div><div class="panel-pane pane-dfp-pane text-center" >
  
      
  
  <div class="pane-content">
    <div id="dfp-ad-top_leaderboard-wrapper" class="dfp-tag-wrapper">
<div class="slug">Advertisement</div>
<div  id="dfp-ad-top_leaderboard" class="dfp-tag-wrapper">
  <script type="text/javascript">
    googletag.cmd.push(function() {
      googletag.display("dfp-ad-top_leaderboard");
    });
  </script>
</div>
</div>  </div>

  
  </div>
</div>
  </div>
</div>
    </div>
  </div>
</div>  </div>
</div>  </div>
</div><div id="zone-superheader-wrapper" class="zone-wrapper zone-superheader-wrapper clearfix mobile-only print-hidden">  
  <div id="zone-superheader" class="zone zone-superheader clearfix mobile-only print-hidden container-30">
    <div class="grid-30 region region-superheader" id="region-superheader">
  <div class="region-inner region-superheader-inner">
    <div class="block block-panels-mini block-responsive-menu block-panels-mini-responsive-menu odd block-without-title" id="block-panels-mini-responsive-menu">
  <div class="block-inner clearfix">
                
    <div class="content clearfix">
      <div class="panel-display panel-1col clearfix" id="mini-panel-responsive_menu">
  <div class="panel-panel panel-col">
    <div><div id="unique-id3" class="highwire-responsive-toggle-group"><div class="panel-pane pane-panels-mini pane-responsive-menu-main-menu" >
  
        <h2 class="pane-title"><span class="icon-reorder"></span><span class="element-invisible">Main menu</span></h2>
    
  
  <div class="pane-content">
    <div class="panel-display panel-1col clearfix" id="mini-panel-responsive_menu_main_menu">
  <div class="panel-panel panel-col">
    <div><div class="panel-pane pane-menu-tree pane-main-menu" >
  
      
  
  <div class="pane-content">
    <div class="menu-block-wrapper menu-block-ctools-main-menu-1 menu-name-main-menu parent-mlid-main-menu:0 menu-level-1">
  <nav class="menubar-nav"><ul class="menu" role="menu"><li class="first leaf menu-mlid-772" role="menuitem"><a href="/" class="" data-icon-position="" data-hide-link-title="0">Home</a></li>
<li class="expanded active-trail menu-mlid-773" role="menuitem"><a href="/content/current" data-hide-link-title="0" class="active active-trail" data-icon-position="">Content</a><nav class="menubar-nav"><ul class="menu" role="menu"><li class="first expanded menu-mlid-774" role="menuitem"><a href="/content/current" data-hide-link-title="0" class="" data-icon-position="">Current Issue</a></li>
<li class="leaf menu-mlid-1747" role="menuitem"><a href="/content/early/preprint" data-hide-link-title="0" class="" data-icon-position="">Publication Preview--Preprint</a></li>
<li class="leaf menu-mlid-775" role="menuitem"><a href="/content/early/recent" data-hide-link-title="0" class="" data-icon-position="">Publication Preview--Ahead of Print</a></li>
<li class="leaf menu-mlid-776" role="menuitem"><a href="/content/by/year" data-hide-link-title="0" class="" data-icon-position="">Past Issue Archive</a></li>
<li class="leaf menu-mlid-900" role="menuitem"><a href="/cow/by/year" data-hide-link-title="0" class="" data-icon-position="">Case of the Week Archive</a></li>
<li class="leaf menu-mlid-1006" role="menuitem"><a href="/cc/by/year" data-hide-link-title="0" class="" data-icon-position="">Classic Case Archive</a></li>
<li class="leaf menu-mlid-901" role="menuitem"><a href="/com/by/year" data-hide-link-title="0" class="" data-icon-position="">Case of the Month Archive</a></li>
<li class="last leaf menu-mlid-1334" role="menuitem"><a href="http://www.ajnr.org/content/covid-19-content-and-resources" data-hide-link-title="0" class="" data-icon-position="">COVID-19 Content and Resources</a></li>
</ul></nav></li>
<li class="expanded menu-mlid-784" role="menuitem"><a href="/content/about-us" class="" data-icon-position="" data-hide-link-title="0">About Us</a><nav class="menubar-nav"><ul class="menu" role="menu"><li class="first leaf menu-mlid-785" role="menuitem"><a href="/page/content/About" data-hide-link-title="0" class="" data-icon-position="">About AJNR</a></li>
<li class="leaf menu-mlid-899" role="menuitem"><a href="https://www.ajnr.org/page/content/Ed-Board" data-hide-link-title="0" class="" data-icon-position="">Editorial Board</a></li>
<li class="last leaf menu-mlid-864" role="menuitem"><a href="http://www.asnr.org" data-hide-link-title="0" target="_blank" class="" data-icon-position="">American Society of Neuroradiology</a></li>
</ul></nav></li>
<li class="expanded menu-mlid-1746" role="menuitem"><a href="/" class="" data-icon-position="" data-hide-link-title="0">For Authors</a><nav class="menubar-nav"><ul class="menu" role="menu"><li class="first leaf menu-mlid-1725" role="menuitem"><a href="https://www.ajnr.org/content/author-policies" data-hide-link-title="0" class="" data-icon-position="">Author Policies</a></li>
<li class="leaf menu-mlid-1856" role="menuitem"><a href="https://www.ajnr.org/preprint_publishing" data-hide-link-title="0" class="" data-icon-position="">Preprint Publishing</a></li>
<li class="last leaf menu-mlid-1726" role="menuitem"><a href="https://www.ajnr.org/content/manuscript-submission-guidelines" data-hide-link-title="0" class="" data-icon-position="">Manuscript Submission Guidelines</a></li>
</ul></nav></li>
<li class="leaf menu-mlid-862" role="menuitem"><a href="https://mc.manuscriptcentral.com/ajnr" data-hide-link-title="0" target="_blank" class="" data-icon-position="">Submit a Manuscript</a></li>
<li class="expanded menu-mlid-1184" role="menuitem"><a href="/content/about-us" data-hide-link-title="0" class="" data-icon-position="">Special Collections</a><nav class="menubar-nav"><ul class="menu" role="menu"><li class="first leaf menu-mlid-1733" role="menuitem"><a href="http://www.ajnr.org/cc/CSF-Spinal-Leak" data-hide-link-title="0" class="" data-icon-position="">Spinal CSF Leak Articles (Jan 2020-June 2024)</a></li>
<li class="leaf menu-mlid-1185" role="menuitem"><a href="http://www.ajnr.org/cc/most-impactful-ajnr-articles" data-hide-link-title="0" class="" data-icon-position="">Most Impactful AJNR Articles</a></li>
<li class="last leaf menu-mlid-1896" role="menuitem"><a href="http://www.ajnr.org/cc/2024-Awards" data-hide-link-title="0" class="" data-icon-position="">2024 AJNR Journal Awards</a></li>
</ul></nav></li>
<li class="last expanded menu-mlid-788" role="menuitem"><a href="/content/advertising" class="" data-icon-position="" data-hide-link-title="0">More</a><nav class="menubar-nav"><ul class="menu" role="menu"><li class="first leaf menu-mlid-780" role="menuitem"><a href="/content/subscriber-help-and-services" data-hide-link-title="0" class="" data-icon-position="">Subscribers</a></li>
<li class="leaf menu-mlid-863" role="menuitem"><a href="https://marketplace.copyright.com/rs-ui-web/mp/details/journal/122810747" data-hide-link-title="0" class="" data-icon-position="">Permissions</a></li>
<li class="leaf menu-mlid-782" role="menuitem"><a href="/page/content/Ads" data-hide-link-title="0" class="" data-icon-position="">Advertisers</a></li>
<li class="leaf menu-mlid-790" role="menuitem"><a href="/alerts" data-hide-link-title="0" class="" data-icon-position="">Alerts</a></li>
<li class="last leaf menu-mlid-791" role="menuitem"><a href="/feedback" class="" data-icon-position="" data-hide-link-title="0">Feedback</a></li>
</ul></nav></li>
</ul></nav></div>
  </div>

  
  </div>
</div>
  </div>
</div>
  </div>

  
  </div>
<div class="panel-pane pane-panels-mini pane-responsive-menu-user-menu" >
  
        <h2 class="pane-title"><span class="icon-gear"></span><span class="element-invisible">User menu</span></h2>
    
  
  <div class="pane-content">
    <div class="panel-display panel-1col clearfix" id="mini-panel-responsive_menu_user_menu">
  <div class="panel-panel panel-col">
    <div><div class="panel-pane pane-menu-tree pane-user-menu" >
  
      
  
  <div class="pane-content">
    <div class="menu-block-wrapper menu-block-ctools-user-menu-1 menu-name-user-menu parent-mlid-user-menu:0 menu-level-1">
  <nav class="menubar-nav"><ul class="menu" role="menu"><li class="first leaf menu-mlid-801" role="menuitem"><a href="/content/subscriber-help-and-services" data-hide-link-title="0" class="" data-icon-position="">Subscribe</a></li>
<li class="leaf menu-mlid-802" role="menuitem"><a href="/alerts" data-hide-link-title="0" class="" data-icon-position="">Alerts</a></li>
<li class="leaf menu-mlid-803" role="menuitem"><a href="/user/login?destination=/content/40/8/1257%3Fvariant%3Dabstract" class="" data-icon-position="" data-hide-link-title="0">Log in</a></li>
<li class="last leaf menu-mlid-17" role="menuitem"><a href="/user/logout?current=node/69522" class="" data-icon-position="" data-hide-link-title="0">Log out</a></li>
</ul></nav></div>
  </div>

  
  </div>
<div class="panel-separator"></div><div class="panel-pane pane-highwire-user-identities" >
  
      
  
  <div class="pane-content">
    <div class="highwire-user-message" data-separator="|"><span class="highwire-user-institution" data-id-type="institution" data-identity="a%3A2%3A%7Bs%3A4%3A%22show%22%3Bi%3A1%3Bs%3A7%3A%22message%22%3Bs%3A50%3A%22Institution%3A%20%5Bidentity%3Ainstitutional_display_name%5D%22%3B%7D"></span></div>  </div>

  
  </div>
</div>
  </div>
</div>
  </div>

  
  </div>
<div class="panel-pane pane-panels-mini pane-responsive-menu-search" >
  
        <h2 class="pane-title"><span class="icon-search"></span><span class="element-invisible">Search</span></h2>
    
  
  <div class="pane-content">
    <div class="panel-display panel-1col clearfix" id="mini-panel-responsive_menu_search">
  <div class="panel-panel panel-col">
    <div><div class="panel-pane pane-highwire-seach-qsearch-nocontext" >
  
      
  
  <div class="pane-content">
    <form class="highwire-quicksearch button-style-mini button-style-mini" action="/content/40/8/1257.abstract" method="post" id="highwire-search-qsearch-nocontext-form" accept-charset="UTF-8"><div><div class="form-item form-item-label-invisible form-type-textfield form-item-keywords">
  <label class="element-invisible" for="quick_search_header_keywords_540398373">Search for this keyword </label>
 <input placeholder="Search..." type="text" id="quick_search_header_keywords_540398373" name="keywords" value="" size="60" maxlength="128" class="form-text" />
</div>
<div class="button-wrapper button-mini"><span class="icon-search"></span><input data-icon-only="1" data-font-icon="icon-search" data-icon-position="after" type="submit" id="quick_search_header_submit_1806279633" name="op" value="Search" class="form-submit" /></div><input type="hidden" name="form_build_id" value="form-SgW15gb4OEKkIGJYZEkZV-D9OafCXXVmQ1HWCCpQHto" />
<input type="hidden" name="form_id" value="highwire_search_qsearch_nocontext_form" />
</div></form>  </div>

  
  </div>
<div class="panel-separator"></div><div class="panel-pane pane-custom pane-1 highwire-responsive-advanced-search-link pane-menu-tree" >
  
      
  
  <div class="pane-content">
    <ul class="menu">
  <li><a href="/search" title="Advanced search">Advanced search</a></li>
  </ul>  </div>

  
  </div>
</div>
  </div>
</div>
  </div>

  
  </div>
</div></div>
  </div>
</div>
    </div>
  </div>
</div><div class="block block-panels-mini block-hw-small-logo block-panels-mini-hw-small-logo even block-without-title" id="block-panels-mini-hw-small-logo">
  <div class="block-inner clearfix">
                
    <div class="content clearfix">
      <div class="panel-display panel-1col clearfix" id="mini-panel-hw_small_logo">
  <div class="panel-panel panel-col">
    <div><div class="panel-pane pane-small-logo" >
  
      
  
  <div class="pane-content">
    <a href="/" class="" data-icon-position="" data-hide-link-title="0"><img src="http://ajnr-stage2.stage.highwire.org/sites/default/files/ajnr-logo.png" alt="American Journal of Neuroradiology" title="American Journal of Neuroradiology" /></a>  </div>

  
  </div>
</div>
  </div>
</div>
    </div>
  </div>
</div>  </div>
</div>  </div>
</div><div id="zone-user-wrapper" class="zone-wrapper zone-user-wrapper clearfix mobile-hidden print-hidden">  
  <div id="zone-user" class="zone zone-user clearfix equal-height-container mobile-hidden print-hidden container-30">    
  	    <div class="grid-30 region region-user-second equal-height-element" id="region-user-second">
  <div class="region-inner region-user-second-inner">
    <div class="block block-panels-mini text-right no-margin-bottom block-jnl-ajnr-uid-strng block-panels-mini-jnl-ajnr-uid-strng odd block-without-title" id="block-panels-mini-jnl-ajnr-uid-strng">
  <div class="block-inner clearfix">
                
    <div class="content clearfix">
      <div class="panel-display panel-1col clearfix" id="mini-panel-jnl_ajnr_uid_strng">
  <div class="panel-panel panel-col">
    <div><div class="panel-pane pane-highwire-user-identities" >
  
      
  
  <div class="pane-content">
    <div class="highwire-user-message" data-separator=" | "><span class="highwire-user-institution" data-id-type="institution" data-identity="a%3A2%3A%7Bs%3A4%3A%22show%22%3Bi%3A1%3Bs%3A7%3A%22message%22%3Bs%3A85%3A%22%3Cspan%20class%3D%22narrow-hidden%22%3EInstitution%3A%20%3C%2Fspan%3E%5Bidentity%3Ainstitutional_display_name%5D%22%3B%7D"></span></div>  </div>

  
  </div>
</div>
  </div>
</div>
    </div>
  </div>
</div>  </div>
</div>  </div>
</div>  
  <div id="zone-branding" class="zone zone-branding clearfix mobile-hidden print-display-block container-30">
    <div class="grid-19 prefix-1 region region-branding print-display-block" id="region-branding">
  <div class="region-inner region-branding-inner">
        <div class="branding-data clearfix">
            <div class="logo-img">
        <a href="/" rel="home" class="" data-icon-position="" data-hide-link-title="0"><img alt="American Journal of Neuroradiology" src="http://ajnr-stage2.stage.highwire.org/sites/default/files/ajnr-web-logo_0.png" /></a>      </div>
                        <hgroup class="site-name-slogan element-invisible">        
                                <h2 class="site-name element-invisible"><a href="/" title="Home" class="" data-icon-position="" data-hide-link-title="0">American Journal of Neuroradiology</a></h2>
                              </hgroup>
          </div>
          </div>
</div><div class="grid-9 suffix-1 region region-branding-second print-hidden" id="region-branding-second">
  <div class="region-inner region-branding-second-inner">
    <div class="block block-panels-mini text-right no-margin-bottom block-jnl-ajnr-user-menu block-panels-mini-jnl-ajnr-user-menu odd block-without-title" id="block-panels-mini-jnl-ajnr-user-menu">
  <div class="block-inner clearfix">
                
    <div class="content clearfix">
      <div class="panel-display panel-1col clearfix" id="mini-panel-jnl_ajnr_user_menu">
  <div class="panel-panel panel-col">
    <div><div class="panel-pane pane-block pane-system-user-menu links inline pane-system" >
  
      
  
  <div class="pane-content">
    <nav class="menubar-nav"><ul class="menu" role="menu"><li class="first leaf" role="menuitem"><a href="/content/subscriber-help-and-services" data-hide-link-title="0" class="" data-icon-position="">Subscribe</a></li>
<li class="leaf" role="menuitem"><a href="/alerts" data-hide-link-title="0" class="" data-icon-position="">Alerts</a></li>
<li class="leaf" role="menuitem"><a href="/user/login?destination=/content/40/8/1257%3Fvariant%3Dabstract" class="" data-icon-position="" data-hide-link-title="0">Log in</a></li>
<li class="last leaf" role="menuitem"><a href="/user/logout?current=node/69522" class="" data-icon-position="" data-hide-link-title="0">Log out</a></li>
</ul></nav>  </div>

  
  </div>
</div>
  </div>
</div>
    </div>
  </div>
</div><div class="block block-panels-mini block-jnl-ajnr-search-box block-panels-mini-jnl-ajnr-search-box even block-without-title" id="block-panels-mini-jnl-ajnr-search-box">
  <div class="block-inner clearfix">
                
    <div class="content clearfix">
      <div class="panel-display panel-1col clearfix" id="mini-panel-jnl_ajnr_search_box">
  <div class="panel-panel panel-col">
    <div><div class="panel-pane pane-highwire-seach-quicksearch no-margin-bottom" >
  
      
  
  <div class="pane-content">
    <form class="highwire-quicksearch button-style-mini button-style-mini" action="/content/40/8/1257.abstract" method="post" id="highwire-search-quicksearch-form-0" accept-charset="UTF-8"><div><div class="form-item form-item-label-invisible form-type-textfield form-item-keywords">
  <label class="element-invisible" for="search_rightsidebar_keywords_308872410">Search for this keyword </label>
 <input placeholder="search" type="text" id="search_rightsidebar_keywords_308872410" name="keywords" value="" size="60" maxlength="128" class="form-text" />
</div>
<div class="button-wrapper button-mini"><span class="icon-search"></span><input data-icon-only="1" data-font-icon="icon-search" data-icon-position="after" type="submit" id="search_rightsidebar_submit_378144213" name="op" value="Search" class="form-submit" /></div><input type="hidden" name="form_build_id" value="form-nYjpcmbxfFUzza8dhuYbkT_V0B847sBmEcihegSuDh8" />
<input type="hidden" name="form_id" value="highwire_search_quicksearch_form_0" />
</div></form>  </div>

  
  </div>
<div class="panel-separator"></div><div class="panel-pane pane-custom pane-2" >
  
      
  
  <div class="pane-content">
    <p><a href="/search">Advanced Search</a></p>  </div>

  
  </div>
</div>
  </div>
</div>
    </div>
  </div>
</div>  </div>
</div>  </div>
  
  <div id="zone-menu" class="zone zone-menu clearfix mobile-hidden container-30">
    <div class="grid-28 suffix-1 prefix-1 region region-menu region-menu-bg-opaque region-menu-no-border" id="region-menu">
  <div class="region-inner region-menu-inner">
        <div class="block block-nice-menus block-1 block-nice-menus-1 odd block-without-title" id="block-nice-menus-1">
  <div class="block-inner clearfix">
                
    <div class="content clearfix">
      <nav class="menubar-nav"><ul class="nice-menu nice-menu-down nice-menu-main-menu" id="nice-menu-1" role="menu"><li class="menu-772 menu-path-front first odd " role="menuitem"><a href="/" class="" data-icon-position="" data-hide-link-title="0">Home</a></li>
<li class="menu-773 menuparent  menu-path-content-current active-trail  even " role="menuitem"><a href="/content/current" data-hide-link-title="0" class="active" data-icon-position="">Content</a><ul role="menu"><li class="menu-774 menu-path-content-current first odd " role="menuitem"><a href="/content/current" data-hide-link-title="0" class="" data-icon-position="">Current Issue</a></li>
<li class="menu-1747 menu-path-content-early-preprint  even " role="menuitem"><a href="/content/early/preprint" data-hide-link-title="0" class="" data-icon-position="">Publication Preview--Preprint</a></li>
<li class="menu-775 menu-path-content-early-recent  odd " role="menuitem"><a href="/content/early/recent" data-hide-link-title="0" class="" data-icon-position="">Publication Preview--Ahead of Print</a></li>
<li class="menu-776 menu-path-content-by-year  even " role="menuitem"><a href="/content/by/year" data-hide-link-title="0" class="" data-icon-position="">Past Issue Archive</a></li>
<li class="menu-900 menu-path-cow-by-year  odd " role="menuitem"><a href="/cow/by/year" data-hide-link-title="0" class="" data-icon-position="">Case of the Week Archive</a></li>
<li class="menu-1006 menu-path-cc-by-year  even " role="menuitem"><a href="/cc/by/year" data-hide-link-title="0" class="" data-icon-position="">Classic Case Archive</a></li>
<li class="menu-901 menu-path-com-by-year  odd " role="menuitem"><a href="/com/by/year" data-hide-link-title="0" class="" data-icon-position="">Case of the Month Archive</a></li>
<li class="menu-1334 menu-path-ajnrorg-content-covid-19-content-and-resources  even last" role="menuitem"><a href="http://www.ajnr.org/content/covid-19-content-and-resources" data-hide-link-title="0" class="" data-icon-position="">COVID-19 Content and Resources</a></li>
</ul></li>
<li class="menu-784 menuparent  menu-path-node-7  odd " role="menuitem"><a href="/content/about-us" class="" data-icon-position="" data-hide-link-title="0">About Us</a><ul role="menu"><li class="menu-785 menu-path-node-935 first odd " role="menuitem"><a href="/page/content/About" data-hide-link-title="0" class="" data-icon-position="">About AJNR</a></li>
<li class="menu-899 menu-path-sajnrorg-page-content-ed-board  even " role="menuitem"><a href="https://www.ajnr.org/page/content/Ed-Board" data-hide-link-title="0" class="" data-icon-position="">Editorial Board</a></li>
<li class="menu-864 menu-path-asnrorg  odd last" role="menuitem"><a href="http://www.asnr.org" data-hide-link-title="0" target="_blank" class="" data-icon-position="">American Society of Neuroradiology</a></li>
</ul></li>
<li class="menu-1746 menuparent  menu-path-front  even " role="menuitem"><a href="/" class="" data-icon-position="" data-hide-link-title="0">For Authors</a><ul role="menu"><li class="menu-1725 menu-path-sajnrorg-content-author-policies first odd " role="menuitem"><a href="https://www.ajnr.org/content/author-policies" data-hide-link-title="0" class="" data-icon-position="">Author Policies</a></li>
<li class="menu-1856 menu-path-sajnrorg-preprint-publishing  even " role="menuitem"><a href="https://www.ajnr.org/preprint_publishing" data-hide-link-title="0" class="" data-icon-position="">Preprint Publishing</a></li>
<li class="menu-1726 menu-path-sajnrorg-content-manuscript-submission-guidelines  odd last" role="menuitem"><a href="https://www.ajnr.org/content/manuscript-submission-guidelines" data-hide-link-title="0" class="" data-icon-position="">Manuscript Submission Guidelines</a></li>
</ul></li>
<li class="menu-862 menu-path-smcmanuscriptcentralcom-ajnr  odd " role="menuitem"><a href="https://mc.manuscriptcentral.com/ajnr" data-hide-link-title="0" target="_blank" class="" data-icon-position="">Submit a Manuscript</a></li>
<li class="menu-1184 menuparent  menu-path-node-7  even " role="menuitem"><a href="/content/about-us" data-hide-link-title="0" class="" data-icon-position="">Special Collections</a><ul role="menu"><li class="menu-1733 menu-path-ajnrorg-cc-csf-spinal-leak first odd " role="menuitem"><a href="http://www.ajnr.org/cc/CSF-Spinal-Leak" data-hide-link-title="0" class="" data-icon-position="">Spinal CSF Leak Articles (Jan 2020-June 2024)</a></li>
<li class="menu-1185 menu-path-ajnrorg-cc-most-impactful-ajnr-articles  even " role="menuitem"><a href="http://www.ajnr.org/cc/most-impactful-ajnr-articles" data-hide-link-title="0" class="" data-icon-position="">Most Impactful AJNR Articles</a></li>
<li class="menu-1896 menu-path-ajnrorg-cc-2024-awards  odd last" role="menuitem"><a href="http://www.ajnr.org/cc/2024-Awards" data-hide-link-title="0" class="" data-icon-position="">2024 AJNR Journal Awards</a></li>
</ul></li>
<li class="menu-788 menuparent  menu-path-node-9  odd last" role="menuitem"><a href="/content/advertising" class="" data-icon-position="" data-hide-link-title="0">More</a><ul role="menu"><li class="menu-780 menu-path-node-960 first odd " role="menuitem"><a href="/content/subscriber-help-and-services" data-hide-link-title="0" class="" data-icon-position="">Subscribers</a></li>
<li class="menu-863 menu-path-smarketplacecopyrightcom-rs-ui-web-mp-details-journal-122810747  even " role="menuitem"><a href="https://marketplace.copyright.com/rs-ui-web/mp/details/journal/122810747" data-hide-link-title="0" class="" data-icon-position="">Permissions</a></li>
<li class="menu-782 menu-path-node-937  odd " role="menuitem"><a href="/page/content/Ads" data-hide-link-title="0" class="" data-icon-position="">Advertisers</a></li>
<li class="menu-790 menu-path-alerts  even " role="menuitem"><a href="/alerts" data-hide-link-title="0" class="" data-icon-position="">Alerts</a></li>
<li class="menu-791 menu-path-node-10  odd last" role="menuitem"><a href="/feedback" class="" data-icon-position="" data-hide-link-title="0">Feedback</a></li>
</ul></li>
</ul></nav>
    </div>
  </div>
</div><div class="block block-menu text-right block-menu-social-media block-menu-menu-social-media even block-without-title" id="block-menu-menu-social-media">
  <div class="block-inner clearfix">
                
    <div class="content clearfix">
      <nav class="menubar-nav"><ul class="menu" role="menu"><li class="first leaf" role="menuitem"><a href="http://www.twitter.com/TheAJNR" target="_blank" class="link-icon-only link-icon"><span class="hw-icon-x-twitter"></span> <span class="title element-invisible">Follow AJNR on Twitter</span></a></li>
<li class="leaf" role="menuitem"><a href="http://www.facebook.com/AmJNeuroradiol" target="_blank" class="link-icon-only link-icon"><span class="icon-facebook-sign icon-2x"></span> <span class="title element-invisible">Visit AJNR on Facebook</span></a></li>
<li class="leaf" role="menuitem"><a href="https://www.instagram.com/the_ajnr/?hl=en" class="link-icon-only link-icon"><span class="icon-instagram icon-2x"></span> <span class="title element-invisible">Follow AJNR on Instagram</span></a></li>
<li class="leaf" role="menuitem"><a href="https://www.linkedin.com/company/american-journal-of-neuroradiology" class="link-icon-only link-icon"><span class="icon-linkedin icon-2x"></span> <span class="title element-invisible">Join AJNR on LinkedIn</span></a></li>
<li class="last leaf" role="menuitem"><a href="/rss" class="link-icon-only link-icon"><span class="icon-rss icon-2x"></span> <span class="title element-invisible">RSS Feeds</span></a></li>
</ul></nav>    </div>
  </div>
</div>  </div>
</div>
  </div>
  
  <div id="zone-header" class="zone zone-header clearfix container-30">
  	      <div id="messages" class="grid-28 prefix-1 suffix-1"><div role="alert" class="messages status highwire">
<div class="msg-col-left"><span class="icon icon-info-sign"></span></div><div class="msg-col-right"> <ul>
  <li>Getting new auth cookie, if you see this message a lot, tell someone!</li>
  <li>Getting new auth cookie, if you see this message a lot, tell someone!</li>
 </ul>
</div></div>
</div>
          </div>
</header>    
      <section id="section-content" class="section section-content">
    
  <div id="zone-content" class="zone zone-content clearfix container-30">    
        
    <div class="grid-28 suffix-1 prefix-1 region region-content" id="region-content">
  <div class="region-inner region-content-inner">
    <a id="main-content"></a>
                        <div class="block block-system block-main block-system-main odd block-without-title" id="block-system-main">
  <div class="block-inner clearfix">
                
    <div class="content clearfix">
      <div class="panel-display panels-960-layout jcore-2col-layout" >
	  <div class="panel-row-wrapper panel-row-first clearfix">
		
		<div class="top-wrapper">
			<div class="panel-panel panel-region-top">
			  <div class="inside"><div class="panel-pane pane-highwire-article-citation" >
  
      
  
  <div class="pane-content">
    <div class="highwire-article-citation highwire-citation-type-highwire-article node69522--5" data-node-nid="69522" id="top-node-69522--62093743624" data-pisa="ajnr;40/8/1257" data-pisa-master="ajnr;ajnr.A6136" data-apath="/ajnr/40/8/1257.atom" data-hw-author-tooltip-instance="highwire_author_tooltip"><div class="highwire-cite highwire-cite-highwire-article highwire-citation-jcore-article-title-complete clearfix has-author-tooltip highwire-citation-highwire-article-top-a">
  
  
      <div class="highwire-cite-overline"><span  class="highwire-cite-metadata-article-type highwire-cite-metadata">Research Article</span><span class="separator-pipe"></span><span  class="highwire-cite-metadata-art-cat highwire-cite-metadata"><span class="wrapper">Patient Safety</span></span></div>
  
      <div class="highwire-cite-access"><span class="highwire-citation-access highwire-citation-access-check" data-pisa-id="ajnr;ajnr.A6136" data-atom-uri="/ajnr/40/8/1257.atom" data-request-view="full"></span></div>
  
      <h1 class="highwire-cite-title" id="page-title">Intrathecal Use of Gadobutrol for Glymphatic MR Imaging: Prospective Safety Study of 100 Patients</h1>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0">C.S. Edeklev</span>, <span class="highwire-citation-author" data-delta="1">M. Halvorsen</span>, <span class="highwire-citation-author" data-delta="2">G. Løvland</span>, <span class="highwire-citation-author" data-delta="3">S.A.S. Vatnehol</span>, <span class="highwire-citation-author" data-delta="4">Ø. Gjertsen</span>, <span class="highwire-citation-author" data-delta="5">B. Nedregaard</span>, <span class="highwire-citation-author" data-delta="6">R. Sletteberg</span>, <span class="highwire-citation-author" data-delta="7">G. Ringstad</span> and <span class="highwire-citation-author" data-delta="8">P.K. Eide</span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">August 2019,  </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">40 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(8) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">1257-1264; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata">DOI: https://doi.org/10.3174/ajnr.A6136 </span></div>
  
  
  
</div>
<div id="hw-article-author-popups-top-node-69522--62093743624" style="display: none;"><div class="author-tooltip-0"><div class="author-tooltip-name">C.S. Edeklev </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Department of Neurosurgery (C.S.E., M.H., P.K.E.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=C.S.%2BEdeklev%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Edeklev%20C&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AC.S.%2BEdeklev%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0002-0269-3256" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for C.S. Edeklev</a></li></ul></div><div class="author-tooltip-1"><div class="author-tooltip-name">M. Halvorsen </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Department of Neurosurgery (C.S.E., M.H., P.K.E.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=M.%2BHalvorsen%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Halvorsen%20M&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AM.%2BHalvorsen%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0002-8412-2130" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for M. Halvorsen</a></li></ul></div><div class="author-tooltip-2"><div class="author-tooltip-name">G. Løvland </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>b</span>Interventional Centre (G.L., S.A.S.V.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=G.%2BL%C3%B8vland%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=L%C3%B8vland%20G&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AG.%2BL%25C3%25B8vland%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0002-1866-9613" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for G. Løvland</a></li></ul></div><div class="author-tooltip-3"><div class="author-tooltip-name">S.A.S. Vatnehol </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>b</span>Interventional Centre (G.L., S.A.S.V.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=S.A.S.%2BVatnehol%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Vatnehol%20S&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AS.A.S.%2BVatnehol%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0002-7900-0534" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for S.A.S. Vatnehol</a></li></ul></div><div class="author-tooltip-4"><div class="author-tooltip-name">Ø. Gjertsen </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>c</span>Department of Radiology and Nuclear Medicine (Ø.G., B.N. R.S., G.R.), Oslo University Hospital, Rikshospitalet, Oslo, Norway</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=%C3%98.%2BGjertsen%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Gjertsen%20%C3%98&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3A%25C3%2598.%2BGjertsen%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0002-3525-4399" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for Ø. Gjertsen</a></li></ul></div><div class="author-tooltip-5"><div class="author-tooltip-name">B. Nedregaard </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>c</span>Department of Radiology and Nuclear Medicine (Ø.G., B.N. R.S., G.R.), Oslo University Hospital, Rikshospitalet, Oslo, Norway</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=B.%2BNedregaard%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Nedregaard%20B&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AB.%2BNedregaard%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0001-5335-8899" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for B. Nedregaard</a></li></ul></div><div class="author-tooltip-6"><div class="author-tooltip-name">R. Sletteberg </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>c</span>Department of Radiology and Nuclear Medicine (Ø.G., B.N. R.S., G.R.), Oslo University Hospital, Rikshospitalet, Oslo, Norway</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=R.%2BSletteberg%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Sletteberg%20R&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AR.%2BSletteberg%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0001-7674-5242" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for R. Sletteberg</a></li></ul></div><div class="author-tooltip-7"><div class="author-tooltip-name">G. Ringstad </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>c</span>Department of Radiology and Nuclear Medicine (Ø.G., B.N. R.S., G.R.), Oslo University Hospital, Rikshospitalet, Oslo, Norway</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=G.%2BRingstad%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Ringstad%20G&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AG.%2BRingstad%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0003-0919-4510" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for G. Ringstad</a></li></ul></div><div class="author-tooltip-8"><div class="author-tooltip-name">P.K. Eide </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Department of Neurosurgery (C.S.E., M.H., P.K.E.)</div><div class='author-affiliation'><span class='nlm-sup'>d</span>Institute of Clinical Medicine (P.K.E.), Faculty of Medicine, University of Oslo, Oslo, Norway.</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=P.K.%2BEide%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Eide%20P&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AP.K.%2BEide%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0001-6881-9280" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for P.K. Eide</a></li></ul></div></div></div>  </div>

  
  </div>
</div>
			</div>
		</div>
	
	</div> <!-- /.panel-row-wrapper -->	
	  
  <div class="panel-row-wrapper clearfix">
		
		<div class="main-content-wrapper grid-17 suffix-1 alpha">
			<div class="panel-panel panel-region-content">
			  <div class="inside"><div class="panel-pane pane-highwire-panel-tabs pane-panels-ajax-tab-tabs" >
  
      
  
  <div class="pane-content">
    <div class="item-list"><ul class="tabs inline panels-ajax-tab"><li class="first"><a href="/content/40/8/1257" class="panels-ajax-tab-tab" data-panel-name="jnl_ajnr_tab_art" data-target-id="highwire_article_tabs" data-entity-context="node:69522" data-trigger="" data-url-enabled="1">Article</a><a href="/panels_ajax_tab/jnl_ajnr_tab_art/node:69522/1" rel="nofollow" style="display:none" class="js-crawler-link"></a></li><li><a href="/content/40/8/1257/tab-figures-data" class="panels-ajax-tab-tab" data-panel-name="jnl_ajnr_tab_data" data-target-id="highwire_article_tabs" data-entity-context="node:69522" data-trigger="tab-figures-data" data-url-enabled="1">Figures &amp; Data</a><a href="/panels_ajax_tab/jnl_ajnr_tab_data/node:69522/1" rel="nofollow" style="display:none" class="js-crawler-link"></a></li><li><a href="/content/40/8/1257/tab-references" class="panels-ajax-tab-tab" data-panel-name="jnl_ajnr_tab_refs" data-target-id="highwire_article_tabs" data-entity-context="node:69522" data-trigger="tab-references" data-url-enabled="1">References</a><a href="/panels_ajax_tab/jnl_ajnr_tab_refs/node:69522/1" rel="nofollow" style="display:none" class="js-crawler-link"></a></li><li><a href="/content/40/8/1257/tab-article-info" class="panels-ajax-tab-tab" data-panel-name="jnl_ajnr_tab_info" data-target-id="highwire_article_tabs" data-entity-context="node:69522" data-trigger="tab-article-info" data-url-enabled="1">Info &amp; Metrics</a><a href="/panels_ajax_tab/jnl_ajnr_tab_info/node:69522/1" rel="nofollow" style="display:none" class="js-crawler-link"></a></li><li class="last"><a href="/content/ajnr/40/8/1257.full.pdf" class="panels-ajax-tab-tab" data-panel-name="jnl_ajnr_tab_pdf" data-target-id="highwire_article_tabs" data-entity-context="node:69522" data-trigger="tab-pdf" data-url-enabled="1"><i class="icon-file-alt"></i> PDF</a><a href="/panels_ajax_tab/jnl_ajnr_tab_pdf/node:69522/1" rel="nofollow" style="display:none" class="js-crawler-link"></a></li></ul></div>  </div>

  
  </div>
<div class="panel-separator"></div><div class="panel-pane pane-highwire-panel-tabs-container" >
  
      
  
  <div class="pane-content">
    <div data-panels-ajax-tab-preloaded="jnl_ajnr_tab_art" id="panels-ajax-tab-container-highwire_article_tabs" class="panels-ajax-tab-container"><div class="panels-ajax-tab-loading" style ="display:none"><img class="loading" src="http://ajnr-stage2.stage.highwire.org/sites/all/modules/contrib/panels_ajax_tab/images/loading.gif" alt="Loading" title="Loading" /></div><div class="panels-ajax-tab-wrap-jnl_ajnr_tab_art"><div class="panel-display panel-1col clearfix" >
  <div class="panel-panel panel-col">
    <div><div class="panel-pane pane-highwire-markup" >
  
      
  
  <div class="pane-content">
    <div class="highwire-markup"><div xmlns="http://www.w3.org/1999/xhtml" data-highwire-cite-ref-tooltip-instance="highwire_reflinks_tooltip" class="content-block-markup" xmlns:xhtml="http://www.w3.org/1999/xhtml"><div class="article abstract-view "><span class="highwire-journal-article-marker-start"></span><div class="section abstract" id="abstract-2"><h2>Abstract</h2><div id="sec-1" class="subsection"><p id="p-3"><strong>BACKGROUND AND PURPOSE:</strong> Intrathecal contrast-enhanced glymphatic MR imaging has shown promise in assessing glymphatic function in patients with dementia. The purpose of this study was to determine the safety profile and feasibility of this new MR imaging technique.</p></div><div id="sec-2" class="subsection"><p id="p-4"><strong>MATERIALS AND METHODS:</strong> A prospective safety and feasibility study was performed in 100 consecutive patients (58 women and 42 men, 51 ± 19 years of age) undergoing glymphatic MR imaging from September 2015 to August 2018. Short- and long-term serious and nonserious adverse events were registered clinically and by interview after intrathecal administration of 0.5 mL of gadobutrol (1.0 mmol/mL) along with 3 mL of iodixanol (270 mg I/mL). Adverse events are presented as numbers and percentages.</p></div><div id="sec-3" class="subsection"><p id="p-5"><strong>RESULTS:</strong> One serious adverse event (anaphylaxis) occurred in a patient with known allergy to iodine-containing contrast agents (1%). The main nonserious adverse events during the first 1–3 days after contrast injection included severe headache (28%) and severe nausea (34%), though the frequency depended heavily on the diagnosis. After 4 weeks, adverse events had resolved.</p></div><div id="sec-4" class="subsection"><p id="p-6"><strong>CONCLUSIONS:</strong> Intrathecal administration of gadobutrol in conjunction with iodixanol for glymphatic MR imaging is safe and feasible. We cannot conclude whether short-duration symptoms such as headache and nausea were caused by gadobutrol, iodixanol, the lumbar puncture, or the diagnosis. The safety profile closely resembles that of iodixanol alone.</p></div></div><div class="section glossary" id="glossary-1"><h2 class="">ABBREVIATIONS:</h2><dl id="def-list-1"><dt id="def-item-1">gMRI<span class="def-item-dt-sep"></span></dt><dd>glymphatic MR imaging<span class="def-item-dd-sep"></span></dd><dt id="def-item-2">iNPH<span class="def-item-dt-sep"></span></dt><dd>idiopathic normal pressure hydrocephalus</dd></dl></div><ul class="copyright-statement"><li class="fn" id="copyright-statement-1">© 2019 by American Journal of Neuroradiology</li></ul><span class="highwire-journal-article-marker-end"></span></div><span class="related-urls"></span></div><a href="http://ajnr-stage2.stage.highwire.org/content/40/8/1257.full" class="hw-link hw-link-article-full-text" data-icon-position="" data-hide-link-title="0">View Full Text</a></div>  </div>

  
  </div>
<div class="panel-separator"></div><div class="panel-pane pane-highwire-article-trendmd" >
  
      
  
  <div class="pane-content">
    <div id="trendmd-suggestions"></div>  </div>

  
  </div>
</div>
  </div>
</div>
</div></div>  </div>

  
  </div>
<div class="panel-separator"></div><div class="panel-pane pane-highwire-node-pager" >
  
      
  
  <div class="pane-content">
    <div class="pager highwire-pager pager-mini clearfix highwire-node-pager highwire-article-pager"><span class="pager-prev"><a href="/content/40/8/1252" title="Risk Factors for Perceptual-versus-Interpretative Errors in Diagnostic Neuroradiology" rel="prev" class="pager-link-prev link-icon"><span class="icon-circle-arrow-left"></span> <span class="title">Previous</span></a></span><span class="pager-next"><a href="/content/40/8/1265" title="Gadolinium Retention in the Brain: An MRI Relaxometry Study of Linear and Macrocyclic Gadolinium-Based Contrast Agents in Multiple Sclerosis" rel="next" class="pager-link-next link-icon-right link-icon"><span class="title">Next</span> <span class="icon-circle-arrow-right"></span></a></span></div>  </div>

  
  </div>
<div class="panel-separator"></div><div class="panel-pane pane-highwire-back-to-top" >
  
      
  
  <div class="pane-content">
    <a href="#page" class="back-to-top" data-icon-position="" data-hide-link-title="0"><span class="icon-chevron-up"></span> Back to top</a>  </div>

  
  </div>
</div>
			</div>
		</div>
		
		<div class="sidebar-right-wrapper grid-10 omega">
			<div class="panel-panel panel-region-sidebar-right">
			  <div class="inside"><div class="panel-pane pane-panels-mini pane-jnl-ajnr-art-issue pane-style-alt-content" >
  
        <h2 class="pane-title">In this issue</h2>
    
  
  <div class="pane-content">
    <div class="panel-display panel-1col clearfix" id="mini-panel-jnl_ajnr_art_issue">
  <div class="panel-panel panel-col">
    <div><div class="panel-pane pane-highwire-article-citation" >
  
      
  
  <div class="pane-content">
    <div class="highwire-article-citation highwire-citation-type-highwire-issue node69506" data-node-nid="69506" id="node-69506--21764842896" data-pisa="ajnr;40/8" data-pisa-master="ajnr;40/8" data-apath="/ajnr/40/8.atom"><div class="highwire-cite highwire-cite-highwire-issue highwire-citation-jcore-issue-widget clearfix">
    
      <div class="highwire-cite-highlight"><a href="/content/40/8"  class="highlight-image-linked"><img class="highlight-image" src="http://ajnr-stage2.stage.highwire.org/sites/default/files/styles/medium/public/highwire/ajnr/40/8.cover-source.jpg?itok=MlFyBuFX" alt="American Journal of Neuroradiology: 40 (8)" /></a></div>
  
  <div class="highwire-cite-col">
      
      
          <a href="/content/40/8" class="highwire-cite-linked-title" data-icon-position="" data-hide-link-title="0"><span class="highwire-cite-title">American Journal of Neuroradiology</span></a>      
      
        	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-volume highwire-cite-metadata">Vol. 40</span>, <span  class="highwire-cite-metadata-issue highwire-cite-metadata">Issue 8 </span><div  class="highwire-cite-metadata-pubdate highwire-cite-metadata">1 Aug 2019 </div></div>
      
      
        	<div class="highwire-cite-extras"><div class='highwire-article-citation-variant-list'><ul class="links variants-list"><li class="toc first"><a href="/content/40/8.toc" class="highwire-variant-link variant-toc " title="Table of Contents" rel="alternate" type="text/html" data-icon-position="" data-hide-link-title="0">Table of Contents</a></li><li class="index-by-author"><a href="/content/40/8.index-by-author" class="highwire-variant-link variant-index-by-author " title="Index by author" rel="alternate" data-icon-position="" data-hide-link-title="0">Index by author</a></li><li class="enclosure-complete-issue last"><a href="/content/ajnr/40/8/local/complete-issue.pdf" class="highwire-variant-link variant-enclosure" title="Complete Issue (PDF)" rel="alternative" data-icon-position="" data-hide-link-title="0">Complete Issue (PDF)</a></li></ul></div></div>
      </div>

</div></div>  </div>

  
  </div>
</div>
  </div>
</div>
  </div>

  
  </div>
<div class="panel-separator"></div><div class="panel-pane pane-panels-mini pane-jnl-ajnr-ad-rhs" >
  
      
  
  <div class="pane-content">
    <div class="panel-display panel-1col clearfix" id="mini-panel-jnl_ajnr_ad_rhs">
  <div class="panel-panel panel-col">
    <div><div class="panel-pane pane-dfp-pane text-center" >
  
      
  
  <div class="pane-content">
    <div id="dfp-ad-rhs-wrapper" class="dfp-tag-wrapper">
<div class="slug">Advertisement</div>
<div  id="dfp-ad-rhs" class="dfp-tag-wrapper">
  <script type="text/javascript">
    googletag.cmd.push(function() {
      googletag.display("dfp-ad-rhs");
    });
  </script>
</div>
</div>  </div>

  
  </div>
</div>
  </div>
</div>
  </div>

  
  </div>
<div class="panel-separator"></div><div class="panel-pane pane-panels-mini pane-jnl-ajnr-art-tools" >
  
      
  
  <div class="pane-content">
    <div id="mini-panel-jnl_ajnr_art_tools" class="highwire-2col-stacked panel-display">
	  
  <div class="panel-row-wrapper clearfix">
		<div class="content-left-wrapper content-column">
          <div class="panel-panel panel-region-content-left">
            <div class="inside"><div class="panel-pane pane-highwire-variant-link" >
  
      
  
  <div class="pane-content">
    <a href="/content/ajnr/40/8/1257.full-text.print" target="_blank" rel="nofollow" class="link-icon"><span class="icon-print"></span> <span class="title">Print</span></a>  </div>

  
  </div>
<div class="panel-pane pane-highwire-variant-link text-no-wrap" >
  
      
  
  <div class="pane-content">
    <a href="/content/ajnr/40/8/1257.full-text.pdf" target="_blank" class="link-icon"><span class="icon-download-alt"></span> <span class="title">Download PDF</span></a>  </div>

  
  </div>
<div class="panel-pane pane-minipanel-dialog-link pane-jnl-ajnr-art-email" >
  
      
  
  <div class="pane-content">
    <div class='minipanel-dialog-wrapper'><div class='minipanel-dialog-link-link'><a href="/" oncontextmenu="javascript: return false;" class="minipanel-dialog-link-trigger link-icon" title="Email this Article"><span class="icon-envelope"></span> <span class="title">Email Article</span></a></div><div class='minipanel-dialog-link-mini' style='display:none'><div class="panel-display panel-1col clearfix" id="mini-panel-jnl_ajnr_art_email">
  <div class="panel-panel panel-col">
    <div><div class="panel-pane pane-block pane-forward-form pane-forward" >
  
      
  
  <div class="pane-content">
    <form action="/content/40/8/1257.abstract" method="post" id="forward-form" accept-charset="UTF-8"><div><div id="edit-instructions" class="form-item form-item-label-before form-type-item">
 <p>Thank you for your interest in spreading the word on American Journal of Neuroradiology.</p><p>NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.</p>
</div>
<div class="form-item form-item-label-before form-type-textfield form-item-email">
  <label for="edit-email">Your Email <span class="form-required" title="This field is required.">*</span></label>
 <input type="text" id="edit-email" name="email" value="" size="58" maxlength="256" class="form-text required" />
</div>
<div class="form-item form-item-label-before form-type-textfield form-item-name">
  <label for="edit-name">Your Name <span class="form-required" title="This field is required.">*</span></label>
 <input type="text" id="edit-name" name="name" value="" size="58" maxlength="256" class="form-text required" />
</div>
<div class="form-item form-item-label-before form-type-textarea form-item-recipients">
  <label for="edit-recipients">Send To <span class="form-required" title="This field is required.">*</span></label>
 <div class="form-textarea-wrapper resizable"><textarea id="edit-recipients" name="recipients" cols="50" rows="5" class="form-textarea required"></textarea></div>
<div class="description">Enter multiple addresses on separate lines or separate them with commas.</div>
</div>
<div id="edit-page" class="form-item form-item-label-before form-type-item">
  <label for="edit-page">You are going to email the following </label>
 <a href="/content/40/8/1257" class="active" data-icon-position="" data-hide-link-title="0">Intrathecal Use of Gadobutrol for Glymphatic MR Imaging: Prospective Safety Study of 100 Patients</a>
</div>
<div id="edit-subject" class="form-item form-item-label-before form-type-item">
  <label for="edit-subject">Message Subject </label>
 (Your Name) has sent you a message from American Journal of Neuroradiology
</div>
<div id="edit-body" class="form-item form-item-label-before form-type-item">
  <label for="edit-body">Message Body </label>
 (Your Name) thought you would like to see the American Journal of Neuroradiology web site.
</div>
<div class="form-item form-item-label-before form-type-textarea form-item-message">
  <label for="edit-message--2">Your Personal Message </label>
 <div class="form-textarea-wrapper resizable"><textarea id="edit-message--2" name="message" cols="50" rows="10" class="form-textarea"></textarea></div>
</div>
<input type="hidden" name="path" value="node/69522" />
<input type="hidden" name="path_cid" value="" />
<input type="hidden" name="forward_footer" value="" />
<input type="hidden" name="form_build_id" value="form-n0uU2ZGsx7Gb9eg1DPOhP2rC16AMG-HdL5VW4-gZMbk" />
<input type="hidden" name="form_id" value="forward_form" />
<fieldset class="captcha form-wrapper"><legend><span class="fieldset-legend">CAPTCHA</span></legend><div class="fieldset-wrapper"><div class="fieldset-description">This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.</div><input type="hidden" name="captcha_sid" value="108805634" />
<input type="hidden" name="captcha_token" value="8fa7cacefe8a23f3f68c3a98d6420f1e" />
<input type="hidden" name="captcha_response" value="Google no captcha" />
<div class="g-recaptcha" data-sitekey="6LfnJVIUAAAAAE-bUOMg0MJGki4lqSvDmhJp19fN" data-theme="light" data-type="image"></div></div></fieldset>
<div class="form-actions form-wrapper" id="edit-actions"><input type="submit" id="edit-submit" name="op" value="Send Message" class="form-submit" /></div></div></form>  </div>

  
  </div>
</div>
  </div>
</div>
</div></div>  </div>

  
  </div>
<div class="panel-pane pane-minipanel-dialog-link pane-jnl-ajnr-cite-tool" >
  
      
  
  <div class="pane-content">
    <div class='minipanel-dialog-wrapper'><div class='minipanel-dialog-link-link'><a href="/highwire/citation/69522/download" oncontextmenu="javascript: return false;" class="minipanel-dialog-link-trigger link-icon" title="Citation Tools"><span class="icon-globe"></span> <span class="title">Citation Tools</span></a></div><div class='minipanel-dialog-link-mini' style='display:none'><div class="panel-display panel-1col clearfix" id="mini-panel-jnl_ajnr_cite_tool">
  <div class="panel-panel panel-col">
    <div><div class="panel-pane pane-highwire-citation-export" >
  
      
  
  <div class="pane-content">
    <div class="highwire-citation-export">  
  <div class="highwire-citation-info">
      <div class="highwire-article-citation highwire-citation-type-highwire-article cite-tool-node69522" data-node-nid="69522" id="citation-node-69522--2868972936" data-pisa="ajnr;40/8/1257" data-pisa-master="ajnr;ajnr.A6136" data-apath="/ajnr/40/8/1257.atom"><div class="highwire-cite highwire-cite-highwire-article highwire-citation-jcore-standard clearfix">
  
  
  
  
      <div class="highwire-cite-title">Intrathecal Use of Gadobutrol for Glymphatic MR Imaging: Prospective Safety Study of 100 Patients</div>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0"><span class="nlm-given-names">C.S.</span> <span class="nlm-surname">Edeklev</span></span>, <span class="highwire-citation-author" data-delta="1"><span class="nlm-given-names">M.</span> <span class="nlm-surname">Halvorsen</span></span>, <span class="highwire-citation-author" data-delta="2"><span class="nlm-given-names">G.</span> <span class="nlm-surname">Løvland</span></span>, <span class="highwire-citation-author" data-delta="3"><span class="nlm-given-names">S.A.S.</span> <span class="nlm-surname">Vatnehol</span></span>, <span class="highwire-citation-author" data-delta="4"><span class="nlm-given-names">Ø.</span> <span class="nlm-surname">Gjertsen</span></span>, <span class="highwire-citation-author" data-delta="5"><span class="nlm-given-names">B.</span> <span class="nlm-surname">Nedregaard</span></span>, <span class="highwire-citation-author" data-delta="6"><span class="nlm-given-names">R.</span> <span class="nlm-surname">Sletteberg</span></span>, <span class="highwire-citation-author" data-delta="7"><span class="nlm-given-names">G.</span> <span class="nlm-surname">Ringstad</span></span>, <span class="highwire-citation-author" data-delta="8"><span class="nlm-given-names">P.K.</span> <span class="nlm-surname">Eide</span></span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">Aug 2019, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">40 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(8) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">1257-1264; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A6136 </span></div>
  
  
  
</div>
</div>  </div>
  <div class="highwire-citation-formats">
  	      <h2>Citation Manager Formats</h2>
        <div class="highwire-citation-formats-links">
      <span class="Z3988" title="ctx_ver=Z39.88-2004&amp;rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&amp;rft.spage=1257&amp;rft.epage=1264&amp;rft.atitle=Intrathecal%20Use%20of%20Gadobutrol%20for%20Glymphatic%20MR%20Imaging%3A%20Prospective%20Safety%20Study%20of%20100%20Patients&amp;rft.volume=40&amp;rft.issue=8&amp;rft.date=2019-08-01%2000%3A00%3A00&amp;rft.stitle&amp;rft.jtitle=American%20Journal%20of%20Neuroradiology&amp;rft.au=Edeklev%2C+C.S.&amp;rft.au=Halvorsen%2C+M.&amp;rft.au=L%C3%B8vland%2C+G.&amp;rft.au=Vatnehol%2C+S.A.S.&amp;rft.au=Gjertsen%2C+%C3%98.&amp;rft.au=Nedregaard%2C+B.&amp;rft.au=Sletteberg%2C+R.&amp;rft.au=Ringstad%2C+G.&amp;rft.au=Eide%2C+P.K."></span><ul class="hw-citation-links inline button button-alt button-grid clearfix"><li class="bibtext first"><a href="/highwire/citation/69522/bibtext" class="hw-download-citation-link" data-icon-position="" data-hide-link-title="0">BibTeX</a></li><li class="bookends"><a href="/highwire/citation/69522/bookends" class="hw-download-citation-link" data-icon-position="" data-hide-link-title="0">Bookends</a></li><li class="easybib"><a href="/highwire/citation/69522/easybib" class="hw-download-citation-link" data-icon-position="" data-hide-link-title="0">EasyBib</a></li><li class="endnote-tagged"><a href="/highwire/citation/69522/endnote-tagged" class="hw-download-citation-link" data-icon-position="" data-hide-link-title="0">EndNote (tagged)</a></li><li class="endnote-8-xml"><a href="/highwire/citation/69522/endnote-8-xml" class="hw-download-citation-link" data-icon-position="" data-hide-link-title="0">EndNote 8 (xml)</a></li><li class="medlars"><a href="/highwire/citation/69522/medlars" class="hw-download-citation-link" data-icon-position="" data-hide-link-title="0">Medlars</a></li><li class="mendeley"><a href="/highwire/citation/69522/mendeley" class="hw-download-citation-link" data-icon-position="" data-hide-link-title="0">Mendeley</a></li><li class="papers"><a href="/highwire/citation/69522/papers" class="hw-download-citation-link" data-icon-position="" data-hide-link-title="0">Papers</a></li><li class="refworks-tagged"><a href="/highwire/citation/69522/refworks-tagged" class="hw-download-citation-link" data-icon-position="" data-hide-link-title="0">RefWorks Tagged</a></li><li class="reference-manager"><a href="/highwire/citation/69522/reference-manager" class="hw-download-citation-link" data-icon-position="" data-hide-link-title="0">Ref Manager</a></li><li class="ris"><a href="/highwire/citation/69522/ris" class="hw-download-citation-link" data-icon-position="" data-hide-link-title="0">RIS</a></li><li class="zotero last"><a href="/highwire/citation/69522/zotero" class="hw-download-citation-link" data-icon-position="" data-hide-link-title="0">Zotero</a></li></ul>    </div>
  </div>
</div>
  </div>

  
  </div>
</div>
  </div>
</div>
</div></div>  </div>

  
  </div>
</div>
          </div>
        </div>
        
        <div class="content-right-wrapper content-column">
          <div class="panel-panel panel-region-content-right">
            <div class="inside"><div class="panel-pane pane-highwire-share-link highwire_clipboard_link_ajax"  id="shareit">
  
      
  
  <div class="pane-content">
    <a href="/" class="link-icon"><span class="icon-share-alt"></span> <span class="title">Share</span></a>  </div>

  
  </div>
<div class="panel-pane pane-panels-mini pane-jnl-ajnr-share highwire_clipboard_form_ajax_shareit" >
  
      
  
  <div class="pane-content">
    <div class="panel-display panel-1col clearfix" id="mini-panel-jnl_ajnr_share">
  <div class="panel-panel panel-col">
    <div><div class="panel-pane pane-highwire-article-citation large-margin-bottom" >
  
      
  
  <div class="pane-content">
    <div class="highwire-article-citation highwire-citation-type-highwire-article node69522--3" data-node-nid="69522" id="share-node-69522--42145205082" data-pisa="ajnr;40/8/1257" data-pisa-master="ajnr;ajnr.A6136" data-apath="/ajnr/40/8/1257.atom"><div class="highwire-cite highwire-cite-highwire-article highwire-citation-jcore-standard clearfix">
  
  
  
  
      <div class="highwire-cite-title">Intrathecal Use of Gadobutrol for Glymphatic MR Imaging: Prospective Safety Study of 100 Patients</div>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0"><span class="nlm-given-names">C.S.</span> <span class="nlm-surname">Edeklev</span></span>, <span class="highwire-citation-author" data-delta="1"><span class="nlm-given-names">M.</span> <span class="nlm-surname">Halvorsen</span></span>, <span class="highwire-citation-author" data-delta="2"><span class="nlm-given-names">G.</span> <span class="nlm-surname">Løvland</span></span>, <span class="highwire-citation-author" data-delta="3"><span class="nlm-given-names">S.A.S.</span> <span class="nlm-surname">Vatnehol</span></span>, <span class="highwire-citation-author" data-delta="4"><span class="nlm-given-names">Ø.</span> <span class="nlm-surname">Gjertsen</span></span>, <span class="highwire-citation-author" data-delta="5"><span class="nlm-given-names">B.</span> <span class="nlm-surname">Nedregaard</span></span>, <span class="highwire-citation-author" data-delta="6"><span class="nlm-given-names">R.</span> <span class="nlm-surname">Sletteberg</span></span>, <span class="highwire-citation-author" data-delta="7"><span class="nlm-given-names">G.</span> <span class="nlm-surname">Ringstad</span></span>, <span class="highwire-citation-author" data-delta="8"><span class="nlm-given-names">P.K.</span> <span class="nlm-surname">Eide</span></span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">Aug 2019, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">40 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(8) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">1257-1264; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A6136 </span></div>
  
  
  
</div>
</div>  </div>

  
  </div>
<div class="panel-separator"></div><div class="panel-pane pane-highwire-article-clipboard-copy large-margin-bottom" >
  
      
  
  <div class="pane-content">
    <div class = "clipboard-copy">
  <span class="label-url">
    <label for="dynamic">Share This Article:</label>
  </span>
  <span class="input-text-url">
    <input type="text" id="dynamic" value="http://ajnr-stage2.stage.highwire.org/content/40/8/1257" size="50"/>
  </span>
  <span class="copy-button button">
    <button id="copy-dynamic" class="clipboardjs-button" data-clipboard-target="#dynamic" data-clipboard-alert-style="tooltip" data-clipboard-alert-text="Copied!">Copy</button>
  </span>
</div>
  </div>

  
  </div>
<div class="panel-separator"></div><div class="panel-pane pane-service-links" >
  
      
  
  <div class="pane-content">
    <div class="service-links"><a href="http://del.icio.us/post?url=http%3A//ajnr-stage2.stage.highwire.org/content/40/8/1257&amp;title=Intrathecal%20Use%20of%20Gadobutrol%20for%20Glymphatic%20MR%20Imaging%3A%20Prospective%20Safety%20Study%20of%20100%20Patients" id="delicious" title="Bookmark this post on del.icio.us" class="service-links-delicious" rel="nofollow" target="_blank" data-icon-position="" data-hide-link-title="0"><img src="http://ajnr-stage2.stage.highwire.org/sites/all/modules/highwire/highwire/images/delicious-32.png" alt="del.icio.us logo" /></a> <a href="http://twitter.com/share?url=http%3A//ajnr-stage2.stage.highwire.org/content/40/8/1257&amp;text=Intrathecal%20Use%20of%20Gadobutrol%20for%20Glymphatic%20MR%20Imaging%3A%20Prospective%20Safety%20Study%20of%20100%20Patients" id="twitter" title="Share this on Twitter" class="service-links-twitter" rel="nofollow" target="_blank" data-icon-position="" data-hide-link-title="0"><img src="http://ajnr-stage2.stage.highwire.org/sites/all/modules/highwire/highwire/images/twitter.png" alt="Twitter logo" /></a> <a href="http://www.facebook.com/sharer.php?u=http%3A//ajnr-stage2.stage.highwire.org/content/40/8/1257&amp;t=Intrathecal%20Use%20of%20Gadobutrol%20for%20Glymphatic%20MR%20Imaging%3A%20Prospective%20Safety%20Study%20of%20100%20Patients" id="facebook" title="Share on Facebook" class="service-links-facebook" rel="nofollow" target="_blank" data-icon-position="" data-hide-link-title="0"><img src="http://ajnr-stage2.stage.highwire.org/sites/all/modules/highwire/highwire/images/fb-blue.png" alt="Facebook logo" /></a> <a href="http://www.mendeley.com/import/?url=http%3A//ajnr-stage2.stage.highwire.org/content/40/8/1257&amp;title=Intrathecal%20Use%20of%20Gadobutrol%20for%20Glymphatic%20MR%20Imaging%3A%20Prospective%20Safety%20Study%20of%20100%20Patients" id="mendeley" title="Share on Mendeley" class="service-links-mendeley" rel="nofollow" target="_blank" data-icon-position="" data-hide-link-title="0"><img src="http://ajnr-stage2.stage.highwire.org/sites/all/modules/highwire/highwire/images/mendeley.png" alt="Mendeley logo" /></a></div>  </div>

  
  </div>
</div>
  </div>
</div>
  </div>

  
  </div>
<div class="panel-pane pane-service-links" >
  
      
  
  <div class="pane-content">
    <div class="service-links"><div class="item-list"><ul><li class="first"><a href="http://twitter.com/share?url=http%3A//ajnr-stage2.stage.highwire.org/content/40/8/1257&amp;count=horizontal&amp;via=&amp;text=Intrathecal%20Use%20of%20Gadobutrol%20for%20Glymphatic%20MR%20Imaging%3A%20Prospective%20Safety%20Study%20of%20100%20Patients&amp;counturl=http%3A//ajnr-stage2.stage.highwire.org/content/40/8/1257" class="twitter-share-button service-links-twitter-widget" id="twitter_widget" title="Tweet This" rel="nofollow" target="_blank" data-icon-position="" data-hide-link-title="0"><span class="element-invisible">Tweet Widget</span></a></li><li><a href="http://www.facebook.com/plugins/like.php?href=http%3A//ajnr-stage2.stage.highwire.org/content/40/8/1257&amp;layout=button_count&amp;show_faces=false&amp;action=like&amp;colorscheme=light&amp;width=100&amp;height=21&amp;font=&amp;locale=" id="facebook_like" title="I Like it" class="service-links-facebook-like" rel="nofollow" target="_blank" data-icon-position="" data-hide-link-title="0"><span class="element-invisible">Facebook Like</span></a></li><li class="last"><a href="http://ajnr-stage2.stage.highwire.org/content/40/8/1257" id="google_plus_one" title="Plus it" class="service-links-google-plus-one" rel="nofollow" target="_blank" data-icon-position="" data-hide-link-title="0"><span class="element-invisible">Google Plus One</span></a></li></ul></div></div>  </div>

  
  </div>
</div>
          </div>
        </div>
	</div> <!-- /.panel-row-wrapper -->	
	
	</div>

  </div>

  
  </div>
<div class="panel-separator"></div><div class="panel-pane pane-jnl-ajnr-rental" >
  
      
  
  <div class="pane-content">
    <span class="js-deepdyve-link">
            <a class="button btn btn-primary btn-sm" role="button"  href="https://www.deepdyve.com/doc-view?docId=10.3174/ajnr.A6136&fieldName=journal_doi&affiliateId=asnr"><i class="icon-usd"> </i> Purchase</a>  </div>

  
  </div>
<div class="panel-separator"></div><div class="panel-pane pane-highwire-article-nav mobile-hidden pane-style-alt-content" >
  
        <h2 class="pane-title">Jump to section</h2>
    
  
  <div class="pane-content">
    <div class="highwire-list-wrapper highwire-article-nav highwire-nav-float"><div class="highwire-list"><ul data-highwire-float="1" data-highwire-float-class="grid-10 alpha omega"><li class="parent first odd"><a href="/content/40/8/1257" class="highwire-article-nav-jumplink" data-panel-ajax-tab="jnl_ajnr_tab_art" data-is-tab-link="true" data-icon-position="" data-hide-link-title="0">Article</a><div class="highwire-list"><ul><li class="first odd"><a href="#abstract-2" class="highwire-article-nav-jumplink first" data-panel-ajax-tab="jnl_ajnr_tab_art" data-icon-position="" data-hide-link-title="0">Abstract</a></li><li class="even"><a href="#glossary-1" class="highwire-article-nav-jumplink" data-panel-ajax-tab="jnl_ajnr_tab_art" data-icon-position="" data-hide-link-title="0">ABBREVIATIONS:</a></li><li class="odd"><a href="#sec-5" class="highwire-article-nav-jumplink" data-panel-ajax-tab="jnl_ajnr_tab_art" data-icon-position="" data-hide-link-title="0">Materials and Methods</a></li><li class="even"><a href="#sec-12" class="highwire-article-nav-jumplink" data-panel-ajax-tab="jnl_ajnr_tab_art" data-icon-position="" data-hide-link-title="0">Results</a></li><li class="odd"><a href="#sec-17" class="highwire-article-nav-jumplink" data-panel-ajax-tab="jnl_ajnr_tab_art" data-icon-position="" data-hide-link-title="0">Discussion</a></li><li class="even"><a href="#sec-19" class="highwire-article-nav-jumplink" data-panel-ajax-tab="jnl_ajnr_tab_art" data-icon-position="" data-hide-link-title="0">Conclusions</a></li><li class="odd"><a href="#fn-group-1" class="highwire-article-nav-jumplink" data-panel-ajax-tab="jnl_ajnr_tab_art" data-icon-position="" data-hide-link-title="0">Footnotes</a></li><li class="last even"><a href="#ref-list-1" class="highwire-article-nav-jumplink last" data-panel-ajax-tab="jnl_ajnr_tab_art" data-icon-position="" data-hide-link-title="0">REFERENCES</a></li></ul></div></li><li class="even"><a href="/content/40/8/1257/tab-figures-data" class="highwire-article-nav-jumplink" data-panel-ajax-tab="jnl_ajnr_tab_data" data-is-tab-link="true" data-icon-position="" data-hide-link-title="0">Figures &amp; Data</a></li><li class="odd"><a href="/content/40/8/1257/tab-references" class="highwire-article-nav-jumplink" data-panel-ajax-tab="jnl_ajnr_tab_refs" data-is-tab-link="true" data-icon-position="" data-hide-link-title="0">References</a></li><li class="even"><a href="/content/40/8/1257/tab-article-info" class="highwire-article-nav-jumplink" data-panel-ajax-tab="jnl_ajnr_tab_info" data-is-tab-link="true" data-icon-position="" data-hide-link-title="0">Info &amp; Metrics</a></li><li class="last odd"><a href="/content/40/8/1257.full.pdf" class="highwire-article-nav-jumplink" data-icon-position="" data-hide-link-title="0"><i class="icon-file-alt"></i> PDF</a></li></ul></div></div>  </div>

  
  </div>
<div class="panel-separator"></div><div class="panel-pane pane-panels-mini pane-jnl-ajnr-accordion" >
  
      
  
  <div class="pane-content">
    <div class="panel-display panel-1col clearfix" id="mini-panel-jnl_ajnr_accordion">
  <div class="panel-panel panel-col">
    <div><div id="highwire_article_accordion_container"><h3 ><i class="icon-caret-right"></i> Related Articles</h3><div><div class="highwire-list highwire-related-articles highwire-article-citation-list"><ul class="highwire-related-articles-list"><li class="first last odd"><div class="no-results">No related articles found.</div></li></ul></div><div class='highwire-list-footer'><div class="highwire-related-articles-footer"><ul class="links inline"><li class="related-pubmed first"><a href="/lookup/external-ref?link_type=MED_NBRS&amp;access_num=31320462" target="_blank" class="" data-icon-position="" data-hide-link-title="0">PubMed</a></li><li class="related-google-scholar last"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=related&amp;author%5B0%5D=C.S.%2BEdeklev&amp;author%5B1%5D=M.%2BHalvorsen&amp;author%5B2%5D=G.%2BL%C3%B8vland&amp;author%5B3%5D=S.A.S.%2BVatnehol&amp;author%5B4%5D=%C3%98.%2BGjertsen&amp;author%5B5%5D=B.%2BNedregaard&amp;author%5B6%5D=R.%2BSletteberg&amp;author%5B7%5D=G.%2BRingstad&amp;author%5B8%5D=P.K.%2BEide&amp;title=Intrathecal%2BUse%2Bof%2BGadobutrol%2Bfor%2BGlymphatic%2BMR%2BImaging%3A%2BProspective%2BSafety%2BStudy%2Bof%2B100%2BPatients&amp;publication_year=2019&amp;path=content/40/8/1257" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Google Scholar</a></li></ul></div></div></div><h3 ><i class="icon-caret-right"></i> Cited By...</h3><div><div class="highwire-list highwire-cited-by"><ul><li class="first odd"><a href="http://medrxiv.org/cgi/content/full/2025.07.23.25331971v1" class="" data-icon-position="" data-hide-link-title="0"><div class="highwire-cite-title">Human brain MRI data of CSF tracer evolution over 72h for data-integrated simulations</div></a><div class="variant-links"></div></li><li class="even"><a href="http://www.ajnr.org/cgi/content/full/45/10/1605" class="" data-icon-position="" data-hide-link-title="0"><div class="highwire-cite-title">Different Glymphatic Kinetics in Spontaneous Intracranial Hypotension</div></a><div class="variant-links"></div></li><li class="odd"><a href="http://www.ajnr.org/cgi/content/full/44/5/511" class="" data-icon-position="" data-hide-link-title="0"><div class="highwire-cite-title">Prospective Safety Study of Intrathecal Gadobutrol in Different Doses</div></a><div class="variant-links"></div></li><li class="even"><a href="http://www.ajnr.org/cgi/content/full/44/5/511" class="" data-icon-position="" data-hide-link-title="0"><div class="highwire-cite-title">Prospective Safety Study of Intrathecal Gadobutrol in Different Doses</div></a><div class="variant-links"></div></li><li class="odd"><a href="http://rapm.bmj.com/cgi/content/full/47/9/511" class="" data-icon-position="" data-hide-link-title="0"><div class="highwire-cite-title">American Society of Regional Anesthesia and Pain Medicine contrast shortage position statement</div></a><div class="variant-links"></div></li><li class="last even"><a href="http://biorxiv.org/cgi/content/full/2020.10.21.348078v1" class="" data-icon-position="" data-hide-link-title="0"><div class="highwire-cite-title">Noninvasive Ultrasonic Glymphatic Induction Enhances Intrathecal Drug Delivery</div></a><div class="variant-links"></div></li></ul></div><div class='highwire-list-footer'><ul class="links inline"><li class="citing-cross-ref first"><a href="/crossref-forward-links/ajnr/40/8/1257#crossref" class="hw-crossref hw-crossref-link-ajax" data-list-wrapper="hw-crossref-list-wrapper" target="_blank" data-icon-position="" data-hide-link-title="0">Crossref</a></li><li class="citing-google-scholar last"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=citedby&amp;path=content/40/8/1257" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Google Scholar</a></li></ul></div><div title="Crossref Cited-by Linking Search Results" style="display:none;" class="hw-crossref-list-wrapper"><p class = "hw-crossref-message">This article has not yet been cited by articles in journals that are participating in Crossref Cited-by Linking.</p></div></div><h3 ><i class="icon-caret-right"></i> More in this TOC Section</h3><div><div class="highwire-list highwire-article-citation-list"><ul><li class="first odd"><div class="highwire-article-citation highwire-citation-type-highwire-article node102317" data-node-nid="102317" id="node-102317--21621731633" data-pisa="ajnr;44/5/511" data-pisa-master="ajnr;ajnr.A7841" data-apath="/ajnr/44/5/511.atom"><div class="highwire-cite highwire-cite-highwire-article highwire-citation-jcore-standard-title-only clearfix">
  
  
  
  
      <a href="/content/44/5/511" class="highwire-cite-linked-title" data-icon-position="" data-hide-link-title="0"><span class="highwire-cite-title">Prospective Safety Study of Intrathecal Gadobutrol in Different Doses</span></a>  
  
  
  
  
</div>
</div></li><li class="even"><div class="highwire-article-citation highwire-citation-type-highwire-article node90914" data-node-nid="90914" id="node-90914--21088891108" data-pisa="ajnr;42/5/824" data-pisa-master="ajnr;ajnr.A7031" data-apath="/ajnr/42/5/824.atom"><div class="highwire-cite highwire-cite-highwire-article highwire-citation-jcore-standard-title-only clearfix">
  
  
  
  
      <a href="/content/42/5/824" class="highwire-cite-linked-title" data-icon-position="" data-hide-link-title="0"><span class="highwire-cite-title">Impact of Kidney Function on CNS Gadolinium Deposition in Patients Receiving Repeated Doses of Gadobutrol</span></a>  
  
  
  
  
</div>
</div></li><li class="last odd"><div class="highwire-article-citation highwire-citation-type-highwire-article node74419" data-node-nid="74419" id="node-74419--2412814883" data-pisa="ajnr;41/4/632" data-pisa-master="ajnr;ajnr.A6472" data-apath="/ajnr/41/4/632.atom"><div class="highwire-cite highwire-cite-highwire-article highwire-citation-jcore-standard-title-only clearfix">
  
  
  
  
      <a href="/content/41/4/632" class="highwire-cite-linked-title" data-icon-position="" data-hide-link-title="0"><span class="highwire-cite-title">Contrast-Induced Acute Kidney Injury in Radiologic Management of Acute Ischemic Stroke in the Emergency Setting</span></a>  
  
  
  
  
</div>
</div></li></ul></div><div class='highwire-list-footer'><a href="/content/by/section/Patient%20Safety" class="" data-icon-position="" data-hide-link-title="0">Show more <span class="wrapper">Patient Safety</span></a></div></div><h3 ><i class="icon-caret-right"></i> Similar Articles</h3><div><div class="highwire-search-similar-ajax-wrapper" id="highwire-search-similar-articles-list-1"><div class="highwire-ajax-loading"><span class="icon-spinner icon-spin icon-2x"></span></div></div></div></div></div>
  </div>
</div>
  </div>

  
  </div>
</div>
			</div>
		</div>
	
	</div> <!-- /.panel-row-wrapper -->	
	
	</div>

    </div>
  </div>
</div><div class="block block-panels-mini more-padding-top mobile-hiddens block-jnl-ajnr-ad-bot-leaderboard block-panels-mini-jnl-ajnr-ad-bot-leaderboard even block-without-title" id="block-panels-mini-jnl-ajnr-ad-bot-leaderboard">
  <div class="block-inner clearfix">
                
    <div class="content clearfix">
      <div class="panel-display panel-1col clearfix" id="mini-panel-jnl_ajnr_ad_bot_leaderboard">
  <div class="panel-panel panel-col">
    <div><div class="panel-pane pane-dfp-pane text-center" >
  
      
  
  <div class="pane-content">
    <div id="dfp-ad-bottom_leaderboard-wrapper" class="dfp-tag-wrapper">
<div class="slug">Advertisement</div>
<div  id="dfp-ad-bottom_leaderboard" class="dfp-tag-wrapper">
  <script type="text/javascript">
    googletag.cmd.push(function() {
      googletag.display("dfp-ad-bottom_leaderboard");
    });
  </script>
</div>
</div>  </div>

  
  </div>
</div>
  </div>
</div>
    </div>
  </div>
</div>      </div>
</div>  </div>
</section>    
  
      <footer id="section-footer" class="section section-footer">
    
  <div id="zone-postscript" class="zone zone-postscript clearfix container-30">
    <div class="grid-28 suffix-1 prefix-1 region region-postscript-fourth" id="region-postscript-fourth">
  <div class="region-inner region-postscript-fourth-inner">
    <div class="block block-panels-mini block-jnl-ajnr-footer block-panels-mini-jnl-ajnr-footer odd block-without-title" id="block-panels-mini-jnl-ajnr-footer">
  <div class="block-inner clearfix">
                
    <div class="content clearfix">
      <div class="panel-display panels-960-row jcore-row-4col clearfix" id="mini-panel-jnl_ajnr_footer">
  <div class="panel-panel panel-region-col-1 grid-7 alpha">
    <div class="inside"><div class="panel-pane pane-block pane-menu-navigate pane-menu" >
  
        <h2 class="pane-title">News and Updates</h2>
    
  
  <div class="pane-content">
    <nav class="menubar-nav"><ul class="menu" role="menu"><li class="first leaf" role="menuitem"><a href="https://www.ajnr.org/cc/2024-Awards" data-hide-link-title="0" class="" data-icon-position="">2024 Journal Award Winners</a></li>
<li class="last leaf" role="menuitem"><a href="/page/content/Reviewer-Recognition" data-hide-link-title="0" class="" data-icon-position="">Thanks to our 2023 Distinguished Reviewers</a></li>
</ul></nav>  </div>

  
  </div>
</div>
  </div>
  <div class="panel-panel panel-region-col-2 grid-7">
    <div class="inside"><div class="panel-pane pane-block pane-menu-more-information pane-menu" >
  
        <h2 class="pane-title">Resources</h2>
    
  
  <div class="pane-content">
    <nav class="menubar-nav"><ul class="menu" role="menu"><li class="first leaf" role="menuitem"><a href="/page/content/EBM" data-hide-link-title="0" class="" data-icon-position="">Evidence-Based Medicine Level Guide</a></li>
<li class="leaf" role="menuitem"><a href="/content/browse-podcast-archives" data-hide-link-title="0" class="" data-icon-position="">AJNR Podcast Archive</a></li>
<li class="leaf" role="menuitem"><a href="/content/institutional-subscriptions" data-hide-link-title="0" class="" data-icon-position="">Librarian Resources</a></li>
<li class="last leaf" role="menuitem"><a href="http://www.ajnr.org/page/content/Terms-and-Conditions" data-hide-link-title="0" class="" data-icon-position="">Terms and Conditions</a></li>
</ul></nav>  </div>

  
  </div>
</div>
  </div>
  <div class="panel-panel panel-region-col-3 grid-7">
    <div class="inside"><div class="panel-pane pane-block pane-menu-add-journals pane-menu" >
  
        <h2 class="pane-title">Opportunities</h2>
    
  
  <div class="pane-content">
    <nav class="menubar-nav"><ul class="menu" role="menu"><li class="first last leaf" role="menuitem"><a href="/page/content/Publons" data-hide-link-title="0" class="" data-icon-position="">Get Peer Review Credit from Publons</a></li>
</ul></nav>  </div>

  
  </div>
</div>
  </div>
  <div class="panel-panel panel-region-col-4 grid-7 omega">
    <div class="inside"><div class="panel-pane pane-block pane-menu-other-services pane-menu" >
  
        <h2 class="pane-title">American Society of Neuroradiology</h2>
    
  
  <div class="pane-content">
    <nav class="menubar-nav"><ul class="menu" role="menu"><li class="first leaf" role="menuitem"><a href="http://www.neurographics.org/" data-hide-link-title="0" class="" data-icon-position="">Neurographics</a></li>
<li class="leaf" role="menuitem"><a href="http://www.asnr.org/index.php/education/fellowship-portal/" data-hide-link-title="0" class="" data-icon-position="">Fellowship Portal</a></li>
<li class="last leaf" role="menuitem"><a href="https://www.asnr.org/membership-types/" data-hide-link-title="0" class="" data-icon-position="">Not an ASNR Member? Join Now</a></li>
</ul></nav>  </div>

  
  </div>
</div>
  </div>
</div>    </div>
  </div>
</div>  </div>
</div>  </div>
  
  <div id="zone-footer" class="zone zone-footer clearfix container-30">
    <div class="grid-28 suffix-1 prefix-1 region region-footer-first" id="region-footer-first">
  <div class="region-inner region-footer-first-inner">
    <div class="block block-panels-mini block-jnl-ajnr-foot-info block-panels-mini-jnl-ajnr-foot-info odd block-without-title" id="block-panels-mini-jnl-ajnr-foot-info">
  <div class="block-inner clearfix">
                
    <div class="content clearfix">
      <div class="panel-display panel-1col clearfix" id="mini-panel-jnl_ajnr_foot_info">
  <div class="panel-panel panel-col">
    <div><div class="panel-pane pane-page-logo-footer" >
  
      
  
  <div class="pane-content">
    <img class="footer-logo" src="http://ajnr-stage2.stage.highwire.org/sites/default/files/ajnr-logo.png" alt="" />  </div>

  
  </div>
<div class="panel-separator"></div><div class="panel-pane pane-snippet pane-footer-copyright-text" >
  
      
  
  <div class="pane-content">
    <div class="snippet footer-copyright-text" id="footer-copyright-text">
  
      
  <div class="snippet-content">
    <p>&copy; 2025 by the <a href="http://www.asnr.org">American Society of Neuroradiology</a> All rights, including for text and data mining, AI training, and similar technologies, are reserved.<br />
Print ISSN: 0195-6108 Online ISSN: 1936-959X</p>
  </div>

</div>
  </div>

  
  </div>
<div class="panel-separator"></div><div class="panel-pane pane-highwire-branding" >
  
      
  
  <div class="pane-content">
    <a href="http://home.highwire.org" target="_blank" class="highwire-branding-link" data-icon-position="" data-hide-link-title="0"><img class="logo-highwire" src="http://ajnr-stage2.stage.highwire.org/sites/all/modules/highwire/highwire/plugins/content_types/images/logo_small_hw_white.png" width="190" height="31" alt="Powered by HighWire" /></a>  </div>

  
  </div>
</div>
  </div>
</div>
    </div>
  </div>
</div>  </div>
</div>  </div>
</footer>  </div>    <div class="region region-page-bottom" id="region-page-bottom">
  <div class="region-inner region-page-bottom-inner">
      </div>
</div><script type="text/javascript" src="/sites/default/files/advagg_js/js__bnwyEQSuZLC-kZnFqCi5iE02nOCzM7DjY7zYxcN9nsQ__VBiBT_qq_eHMMO2Q1rXK1u-hHff31XLUkmi9dgjuPeY__Op4k-kV4DoWc7bsUP7umKmZ0WXfmoYdRDoZFPNSd-oM.js"></script>
<script type="text/javascript" src="/sites/default/files/advagg_js/js__GM3GJPR36rRIz0TRkjC5OQwrioSyN9aoYRivDhCO_AM__qAl84FcCv2jyN22yFGS5Oc85cjd9zKX6p_cFNLGhe-M__Op4k-kV4DoWc7bsUP7umKmZ0WXfmoYdRDoZFPNSd-oM.js" async="async"></script>
<script type="text/javascript" src="/sites/default/files/advagg_js/js__puuQ6qZuZflSOzhCnY-jgY7Fv9AlRwAQ8SzEc4pSqOs__QdvWVdmkPpxtURk1sK0nHm-KZ4OJQjVuYZTnLqK1Isw__Op4k-kV4DoWc7bsUP7umKmZ0WXfmoYdRDoZFPNSd-oM.js"></script>
<script type="text/javascript">
<!--//--><![CDATA[//><!--
function euCookieComplianceLoadScripts() {}
//--><!]]>
</script>
<script type="text/javascript">
<!--//--><![CDATA[//><!--
var eu_cookie_compliance_cookie_name = "";
//--><!]]>
</script>
<script type="text/javascript" src="/sites/default/files/advagg_js/js__WcTpt-w0y1FyXrxZNriX8Ts1KjsFTDpdvZaw9yhRn24__aFJpdvsZPb1v9rWrq-WXbz_WQ9IThQN-mFTCdm1cfXc__Op4k-kV4DoWc7bsUP7umKmZ0WXfmoYdRDoZFPNSd-oM.js"></script>
  </body>
</html>