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Pantopaque: Does It Still Migrate With Gravity After 30 Years?

Frank Ma¹, Jamie Jacobs¹, Linh Bui²

¹Internal Medicine, Adventist Health White Memorial, Los Angeles, USA.

|August 8, 2022

Summary

Pantopaque, an obsolete oil-based contrast agent, may appear in modern CT and MRI scans. Recognizing these remnants is crucial to avoid misdiagnosis as tumors or foreign objects.

Keywords:

arachnoiditis contrast migrate myelogram pantopaque

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Area of Science:

Radiology
Neurology
Medical Imaging

Background:

Pantopaque was an oil-based positive contrast medium utilized for central nervous system imaging.
Its use was discontinued due to adverse effects, notably arachnoiditis.

Observation:

Remnants of Pantopaque can persist and be visualized in contemporary radiographic imaging modalities.
These include computed tomography (CT) and magnetic resonance imaging (MRI).

Findings:

Historical Pantopaque remnants are frequently misidentified in current imaging.
Common misinterpretations include labeling them as tumors or even shotgun pellets.

Implications:

Understanding the historical use of Pantopaque is essential for accurate interpretation of incidental findings.
Correct identification prevents unnecessary patient anxiety and invasive procedures.