Lumbar myelography with iohexol and metrizamide. A comparative multicenter prospective study

Area of Science:

• Radiology
• Neurology
• Medical Imaging

Background:

• Lumbar myelography is a key diagnostic imaging technique.
• Contrast agents are essential for visualizing the spinal canal.
• Metrizamide and iohexol are commonly used iodinated contrast media.

Purpose of the Study:

• To compare the diagnostic quality and adverse reactions of metrizamide and iohexol in lumbar myelography.
• To evaluate patient comfort and safety profiles of the two contrast agents.

Main Methods:

• Prospective, randomized, double-blind study involving 350 patients across seven centers.
• Administration of metrizamide and iohexol at comparable volumes and concentration (180 mg I/ml).
• Assessment of radiographic visualization quality and incidence of adverse events.

Main Results:

• Excellent or good radiographic visualization was achieved in 95% of metrizamide studies and 98% of iohexol studies.
• Iohexol demonstrated a significantly lower incidence of postmyelographic headache (21% vs. 38%) and fewer adverse reactions like nausea, vomiting, and transient confusion.
• A higher percentage of patients experienced no discomfort with iohexol (74%) compared to metrizamide (53%).

Conclusions:

• Iohexol is associated with a more favorable safety profile and improved patient comfort compared to metrizamide for lumbar myelography.
• Both contrast agents provide high-quality diagnostic imaging.
• Iohexol may be preferred due to its reduced adverse event rate.