Iohexol versus metrizamide for cervical myelography: double-blind trial

Area of Science:

• Radiology
• Neuroradiology
• Medical Imaging

Background:

• Cervical myelography is a diagnostic imaging technique used to visualize the spinal cord and nerve roots in the neck.
• Metrizamide has been a commonly used contrast agent, but its safety profile is a concern.

Purpose of the Study:

• To compare the safety and efficacy of iohexol, an investigational aqueous contrast agent, against metrizamide for cervical myelography.
• To evaluate contrast-related morbidity in a prospective, randomized, double-blind trial.

Main Methods:

• A prospective, randomized, double-blind study involving 60 patients undergoing cervical myelography via lateral C1-C2 puncture.
• Patients were allocated to receive either iohexol (30 patients) or metrizamide (30 patients).
• Radiographic quality and contrast-related adverse events were assessed.

Main Results:

• Both iohexol and metrizamide produced radiographs of comparable quality.
• Contrast-related morbidity occurred in 13% of patients receiving iohexol (4/30) versus 37% of patients receiving metrizamide (11/30).
• Iohexol demonstrated a significantly lower incidence of adverse events.

Conclusions:

• Iohexol is a safer and effective alternative to metrizamide for cervical myelography.
• The reduced morbidity associated with iohexol supports its use in this diagnostic procedure.