Lumbar myelography with metrizamide-a new non-ionic contrast medium

Area of Science:

• Radiology
• Neuroradiology
• Pharmacology

Background:

• Current water-soluble contrast media are salts that dissociate in solution.
• Metrizamide is a non-dissociating substituted amide, offering high iodine content with low osmolality.
• This unique property suggests potentially lower neurotoxicity compared to existing agents.

Purpose of the Study:

• To clinically assess the safety and efficacy of metrizamide for lumbar myelography.
• To evaluate adverse reactions associated with metrizamide in a large patient cohort.
• To compare metrizamide's safety profile with established contrast media.

Main Methods:

• A clinical trial involving 201 patients undergoing lumbar myelography with metrizamide.
• Detailed recording and analysis of radiological procedures and patient-reported adverse reactions.
• Examination of the lower dorsal subarachnoid space in a subset of patients.

Main Results:

• No serious adverse effects, such as muscle spasm or epilepsy, were observed.
• Minor adverse reactions, including headache (43%), nausea, and vomiting, occurred with similar frequency to meglumine iocarmate.
• No increased toxic reactions were noted when examining the lower dorsal subarachnoid space.

Conclusions:

• Metrizamide is a safe and effective contrast medium for lumbar and lower dorsal myelography.
• Its favorable safety profile suggests it may largely replace oil-based contrast agents for these procedures.
• Further trials are warranted to evaluate metrizamide in the upper dorsal and cervical regions.