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Adult myelography with iohexol
J G Belanger1, I G Blair, A M Elder
1Department of Radiology, Ottawa Civic Hospital, Ontario.
Summary
This study found both lumbar and cervical approaches effective for myelography using iohexol, with good visualization regardless of injection site. Side effects were mostly mild, with no significant difference in visualization between iohexol concentrations.
Area of Science:
- Radiology
- Neurology
Background:
- Myelography is a diagnostic imaging technique used to visualize the spinal canal.
- Iohexol is a non-ionic, low-osmolar contrast medium commonly used in myelography.
Purpose of the Study:
- To compare visualization quality and side effects of iohexol myelography using lumbar versus cervical approaches.
- To evaluate two different concentrations of iohexol (240 mg I/ml and 300 mg I/ml) in myelography.
Main Methods:
- An open, multicenter trial involving 117 adult patients undergoing myelography.
- Patients received either iohexol 240 mg I/ml or 300 mg I/ml via lumbar or cervical injection.
- 113 myelograms were analyzed for visualization quality and reported side effects.
Main Results:
- Excellent or good visualization was achieved in over 85% of myelograms with a lumbar approach.
- Cervical injection yielded excellent visualization in 100% of cases for the cervical area.
- No significant difference in overall visualization was observed between the two iohexol concentrations.
- Headache was the most common side effect (23 patients); nystagmus was the only severe adverse event.
Conclusions:
- Both lumbar and cervical approaches provide effective visualization for myelography with iohexol.
- Iohexol demonstrates good safety profile in myelography, with mostly mild side effects.
- The choice of injection site may be tailored to the suspected area of disease for optimal imaging.