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Late meningeal effects of myelographic contrast media with special reference to metrizamide

E B Hansen, A Fahrenkrug, J Praestholm

    The British Journal of Radiology
    |May 1, 1978
    PubMed

    Insights

    Repeat myelography with water-soluble contrast media was studied for meningeal changes. Metrizamide showed no cases of adhesive arachnoiditis, unlike other contrast agents, suggesting it is a safer option.

    Area of Science:

    • Radiology
    • Neurology
    • Medical Imaging

    Background:

    • Myelography is a diagnostic imaging technique used to visualize the spinal canal.
    • Water-soluble contrast media are commonly used in myelography.
    • Potential complications include the development of adhesive arachnoiditis.

    Purpose of the Study:

    • To evaluate the incidence of meningeal changes, specifically adhesive arachnoiditis, following repeat myelography with various water-soluble contrast media.
    • To identify risk factors associated with the development of adhesive arachnoiditis.

    Main Methods:

    • Analysis of 256 repeat myelograms from 192 patients.
    • Examination of films for signs of meningeal changes after administration of different water-soluble contrast media.
    • Statistical analysis to identify factors influencing arachnoiditis development.

    Main Results:

    • Adhesive arachnoiditis developed in 5/46 cases after methiodal sodium, 24/96 after iothalamate meglumine, 7/12 after iocarmate meglumine, and 7/10 after iodophendylate.
    • No cases of adhesive arachnoiditis were observed in 90 patients who received metrizamide.
    • Contrast medium dose, observation time, and CSF protein concentration were significant factors.

    Conclusions:

    • Metrizamide appears to be associated with a lower risk of adhesive arachnoiditis compared to other tested water-soluble contrast media.
    • Contrast dose, observation duration, and CSF protein levels are critical in managing arachnoiditis risk.

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