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Metrizamide myelography for disk disease: continuing need for epidural venography
AJNR. American Journal of Neuroradiology
|May 1, 1981
Summary
Metrizamide myelography did not reduce the need for epidural venography in diagnosing herniated disks. The diagnostic accuracy for herniated disks remained similar between metrizamide and iophendylate.
Area of Science:
- Neurology
- Radiology
- Neurosurgery
Background:
- Metrizamide is increasingly used for lumbar myelography, aiming to improve nerve root sheath visualization.
- This enhanced visualization was expected to increase sensitivity for detecting herniated disks and reduce reliance on epidural venography.
Purpose of the Study:
- To evaluate if metrizamide myelography is more sensitive than iophendylate (Pantopaque) for detecting herniated disks.
- To determine if metrizamide myelography reduces the need for subsequent epidural venography.
Main Methods:
- A comparative study of over 800 consecutive lumbar myelograms.
- Half of the myelograms were performed using iophendylate, and the other half using metrizamide.
- Patients requiring epidural venography were identified and outcomes compared.
Main Results:
- 60 patients required epidural venography, with similar numbers for both metrizamide (28) and iophendylate (32).
- The number of positive epidural venograms confirming herniated disks at surgery was not significantly different between the two agents (12 vs. 11).
Conclusions:
- Metrizamide myelography did not prove more sensitive than iophendylate for detecting herniated disks.
- Epidural venography remains indicated following negative or equivocal metrizamide myelography when clinical suspicion for herniated disk is high.
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