Lumbar myelography with iohexol and metrizamide: a comparative multicenter prospective study

Area of Science:

• Radiology
• Neuroradiology
• Medical Imaging

Background:

• Lumbar myelography is a key diagnostic imaging technique.
• Metrizamide and iohexol are commonly used iodinated contrast agents.
• Assessing diagnostic quality and patient safety is crucial for contrast media selection.

Purpose of the Study:

• To compare the diagnostic quality of radiographs.
• To evaluate adverse reactions between metrizamide and iohexol in lumbar myelography.
• To determine the optimal contrast agent for patient safety and imaging efficacy.

Main Methods:

• Prospective randomized double-blind study.
• 350 patients undergoing lumbar myelography across seven centers.
• Comparison of metrizamide and iohexol at 180 mg I/mL concentration.

Main Results:

• Excellent radiographic visualization achieved in 95% (metrizamide) and 98% (iohexol) of cases.
• Significantly fewer patients experienced discomfort with iohexol (74%) versus metrizamide (53%).
• Lower incidence of postmyelographic headache (21% vs 38%), nausea, vomiting, and confusion with iohexol.

Conclusions:

• Iohexol demonstrates superior safety and tolerability compared to metrizamide.
• Iohexol offers comparable diagnostic quality with a significantly reduced adverse event profile.
• Iohexol is recommended as a preferred contrast agent for lumbar myelography.