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High-dose iohexol myelography.

J H Simon, S E Ekholm, D K Kido

    Radiology
    |May 1, 1987
    PubMed
    Summary
    This summary is machine-generated.

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    High-volume iohexol lumbar myelography (15-24 ml) showed comparable adverse reactions to routine doses, with no major neurological events. This technique offers superior imaging but requires conservative, tailored dosing due to increased side effects.

    Area of Science:

    • Radiology
    • Neurology
    • Medical Imaging

    Background:

    • Iohexol is a non-ionic contrast agent used in myelography.
    • Conventional doses of iohexol have demonstrated relative safety.
    • Higher doses may improve visualization but require safety evaluation.

    Purpose of the Study:

    • To evaluate the safety and efficacy of high-volume iohexol lumbar myelography.
    • To compare adverse reaction rates with conventional doses and other agents.
    • To assess the diagnostic utility of high-dose iohexol for specific anatomical details.

    Main Methods:

    • Lumbar myelography performed using high volumes (15-24 ml) of iohexol (180 mgI/ml) in 48 patients.
    • Adverse reactions including headache, nausea, and vomiting were recorded.

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  • Diagnostic image quality, particularly for upper lumbar and conus regions, was assessed.

    • Main Results:

    • Adverse reaction rates (headache 41%, nausea 14%, vomiting 9%) were comparable to routine-dose metrizamide myelography in patients receiving >17 ml iohexol.
    • Overall adverse reactions were more frequent at higher doses compared to conventional iohexol myelography.
    • No major adverse events such as seizures or encephalopathy occurred.

    Conclusions:

    • High-volume iohexol myelography provides superior visualization of lumbar and conus structures.
    • The safety profile is acceptable, with adverse reactions comparable to other agents, but higher than conventional iohexol.
    • Conservative use and dose tailoring are recommended due to increased adverse reactions at higher volumes.