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Diagnostic value of CT cisternography with intrathecal metrizamide enhancement, comparison with isotope cisternography.

Metrizamide CT cisternography (CTC) was performed for the evaluation of CSF dynamics and the diagnosis of skull-base tumors. Results of CTC in 52 cases examined for the study of CSF dynamics correlated well with those of isotope cisternography. However, the degree and duration of ventricular stasis of metrizamide and its transition into a periventricular low-density area in hydrocephalus were recognized more accurately in CTC. Twenty out of 23 cases with suspected skull-base tumor were diagnosed as positive and confirmed by operation. CTC was especially useful in parasellar, CP angle, and other posterior fossa tumors.

Brain Neoplasms↗

Cervical and lumbar routes for metrizamide cervical examination.

The C1-C2 lateral spinal puncture for metrizamide injection is compared to decubitus lumbar puncture for cervical myelography. By lumbar route, the contrast medium was taken into the cervical region with the patient prone. The instances when the lumbar route could not be used include cervical spinal trauma, spinal deformity, and lumbar epidural infection. Routine metrizamide cervical myelography by the C1-C2 route has better film quality and probably fewer short-term adverse reactions than use of the lumbar route of injection.

Cervical Vertebrae↗

Metrizamide cisternography in the diagnosis of acoustic neurinomas.

Seventy-three cisternographies with metrizamide were performed on 69 patients, mainly for diagnosis of an acoustic neurinoma. Of the 31 patients with pathological findings on cisternography 26 underwent surgery for 23 acoustic neurinomas, one neurinoma of the facial nerve, and two meningiomas. For diagnosing small tumours of the cerebellopontine cistern, cisternography is superior to all other neuroradiological methods. Tomography of the porus acusticus internus and CT scanning are the initial radiological methods in patients with signs of cerebellopontine angle lesions; if no lesion is disclosed by these two methods cisternography with metrizamide should be performed to exclude a small tumour, particularly a small acoustic neurinoma.

Adolescent↗

Metrizamide cisternography and computed tomography for the investigation of pituitary lesions.

Metrizamide cisternography and computed tomography (CT) have been performed on 22 patients suspected of having pituitary or suprasellar lesions, using a low dose of metrizamide. These patients would otherwise have been subjected to air encephalography. The technique is described and the results are presented. The lesions demonstrated included empty sellae and suprasellar extensions of pituitary tumours. We also identified those patients in whom there was no suprasellar extension of a pituitary tumour. The diagnostic information required was obtained in all cases by a combination of the two techniques and air encephalography was avoided in all but one case. The side effects were mild and no serious complications were encountered. We consider this combination of methods to be very useful for the investigation of pituitary lesions.

Humans↗

A comparative study on the two classes of heterogeneous nuclear ribonucleoprotein particles separated in metrizamide density gradient, by electrophoresis of proteins and chase experiments. Evidence for two distinct subfractions of HnRNP in mammalian nuclei.

Heterogeneous nuclear ribonucleoprotein particles (HnRNP) were separated in metrizamide density gradients, into two fractions migrating to 1.31 g ml-1 and 1.18 g ml-1, respectively. Proteins associated with each of these fractions were analysed by SDS-acrylamide gel electrophoresis. It is shown that the whole proteins extracted from these two metrizamide fractions exhibit clearly different electrophoretic patterns: 1.31 HnRNP particles contain as major polypeptide chains molecules with molecular weights ranging from 40,000 to 65,000, while major polypeptides of 1.18 HnRNP are banding in the 30,000-40,000 molecular weight region of the gels. Both fractions contain numerous other associated polypeptide chains whose molecular weights are above 65,000. A possible kinetic relationship between these two HnRNP classes was investigated in vivo by performing chase experiments. No clear evidence for a precursor-product relationship was found. Implications arising from these structural and kinetic observations, and problems relating to nuclear maturation of pre-messenger RNA, are discussed.

Cell Line↗

The effects of metrizamide on the lung.

The pathologic effects of metrizamide on the lung were studied at 24 h and 48 h after its instillation in varying concentrations selectively into the right lungs of a series of immature dogs. Iso-osmolar and slightly hyperosmolar concentrations of metrizamide were found to cause mononuclear interstitial infiltration, focal areas of pneumonia and in some cases alveolar hemorrhage. Control bacterial studies showed that the reaction was aseptic.

Animals↗

Purification of virions and nucleocapsids of herpes simplex virus by means of metrizamide and sodium metrizoate gradients.

The generation of density gradients for ultracentrifuging by freezing and thawing was applied to formation of linear density gradients with sodium metrizoate and metrizamide. Using these gradient materials simple and rapid methods for purification of virions and nucleocapsids of herpes virus were elaborated. Using metrizamide the recovery of infectivity was 10-30 per cent, and the purification of virions measured as reduction of host protein was 1700 times. Using metrizoate, the recovery of nucleocapsids was 30-60 per cent and the purification from host DNA and protein was 900 and 1700 times, respectively.

Capsid↗

Characteristic findings of metrizamide CT cisternography in epidermoids.

The characteristic findings of metrizamide CT cisternography in two cases of epidermoid are reported. The main finding was a "cauliflower-like" appearance and was thought to be caused by the irregular interstices of epidermoids. Metrizamide CT cisternography may be helpful in making a diagnosis of an epidermoid.

Adolescent↗

Evaluation of MR in spinal dysraphism with lipoma: comparison with metrizamide computed tomography.

Magnetic resonance (MR) imaging and metrizamide computed tomography (CT) were performed on three patients with spinal dysraphism with lipoma. Sagittal MR images were superior to metrizamide CT reformatted sagittal images in demonstrating anatomic relationships of the spinal cord, filum terminale and lipoma. In the axial plane, CT proved superior to MR. In all cases, the T1 weighted images with exceptional spatial resolution and excellent fat discrimination were more helpful than T2 weighted images. Although both MR and CT are useful in the initial evaluation of these disorders, subsequent evaluation employing only MR is probably adequate. Promising developments in surface coil imaging may eventually replace CT.

Adolescent↗

Formed visual hallucinations after metrizamide myelography.

About 12 hours after 77-year-old woman underwent metrizamide myelography of the posterior fossa to elucidate the cause of downbeat nystagmus, she developed formed visual hallucinations consisting primarily of brightly colored geometric shapes, cloud formations, and human figures. Her white blood cell count was 26,000/mm3 and her serum creatine phosphokinase level was markedly increased to 438 units/liter. Two days later, the hallucinations had subsided, the white blood cell count had decreased to 17,000/mm3, and the serum creatine phosphokinase level had decreased to 105 units/liter. The hallucinations were probably caused by penetration of the metrizamide into the temporal lobe and visual association cortex.

Aged↗

The use of metrizamide for stabilizing against convection in sedimentation equilibrium.

In meniscus depletion sedimentation equilibrium experiments, the solute concentration gradient in much of the cell is insufficient to stabilize against thermal convection. Experiments with spectrin at 35 degrees C led to sufficient convection that, particularly at low concentrations of solute, no apparent redistribution occurred. At low angular velocity, the density gradient provided by moderate concentrations of NaCl or additional sucrose is inadequate to overcome the convective disturbances. We have found that the use of low concentrations of metrizamide can overcome these problems. The higher molecular weight and lower partial specific volume of metrizamide vis-a-vis sucrose allow a significant and stabilizing density gradient even at angular velocities below 8000 rpm.

Centrifugation, Density Gradient↗

Effect of salts and chromatin concentrations on the buoyant density of chromatin in metrizamide gradient.

Using isopycnic centrifugation in metrizamide gradient, effect of ions and chromatin concentration on the buoyant density of chromatin was quantitatively examined. An elevation followed by gradual decline and secondary increase of the density occurred in accordance with increase in MgCl2 or NaCl concentration. Maximum density was observed at a concentration of these salts known to result in the condensation of chromatin. Release of protein occurred during the phase of density decline. The second increase in density is mainly due to the density increment of DNA in the chromatin. The density was dependent upon the concentration of chromatin in a band formed in the metrizamide gradient, while the density of free DNA and protein was not so greatly affected by their concentration. The density of chromatin in the presence of 0.14 M NaCl was less affected by the chromatin concentration than that in the absence of salt. Calculation of results indicates that grade of hydration of chromatin at concentrations lower than 400 microgram/ml in 1 mM Tris-HCl (pH 8.0) is higher than that expected from its DNA and protein components.

Animals↗

Diagnosis of the empty sella with intrathecal metrizamide computed tomography.

The empty sella syndrome can be diagnosed with high resolution computed tomography. The addition of intrathecal metrizamide defines the degree of extension of the subarachnoid space into the sella turcica, demonstrates the relationship of surrounding structures, and differentiates the empty sella from other isodense or hypodense intrasellar lesions. Photographs from a case of primary empty sella demonstrate the details of anatomy seen with metrizamide computed tomography combined with sagittal reconstruction.

Adult↗

Subfractionation of CsCl-purified H-1 parvovirus on metrizamide gradients.

The different density classes of H-l parvovirus, collected within 30 hr of infection of par-asynchronous cultures, following the standard CsCl purification step, have been shown to be heterogeneous. Rebanding of the denser form (HF, p = 1.46 g/cm3) and the less dense form (LF, p = 1.42 g/cm3) of infectious virus in the nonionic density generating solute, metrizamide, showed that both HF and LF virus bands were heterogeneous in density. The infectivity banded with isotopically labeled virus protein and DNA at 1.32 g/cm3 for both HF and LF virus. Amounts of protein and DNA which varied from preparation to preparation, but which were greater from the HF virus band, were distributed throughout the rest of the gradient, but predominated in a peak at a density of 1.2 g/cm3. The protein in this peak was without hemagglutinating activity but had the molecular weights and proportions of the H-l virion proteins (VPl, VP2', and VPZ). The DNA was of the same size as H-l DNA monomers and its proportion to the protein was similar to that of the infectious peak. The DNA was susceptible to micrococcal nuclease digestion. The nature of this noninfectious viral material thus seemed to be incompletely assembled virus. Radiolabeled H-l virus collected after 72 hr of infection formed a discrete single peak in both CsCl (p = 1.42 g/cm3), and metrizamide gradients (p = 1.32 g/cm3). There was no significant amount of the 1.20 g/cm3 viral protein-DNA complex in these mature preparations.

Centrifugation, Density Gradient↗

Acute chemical meningitis after metrizamide-lumbar myelography.

Severe acute meningitis developed after the use of metrizamide for lumbar myelography; cerebrospinal fluid findings included a white blood cell count of 2300, mostly polymorphonuclear cells, glucose level of 8 mg% and protein level of 253%. This apparent chemical meningitis could not be distinguished, either clinically or by cerebrospinal fluid examination, from acute bacterial meningitis. This case emphasizes that severe acute meningeal reactions, while very rare, can occur after the use of metrizamide for myelography. Such patients must be evaluated promptly to rule out bacterial meningitis and should be followed carefully for possible later sequelae.

Acute Disease↗

Communicating spinal arachnoid cysts: diagnosis by delayed metrizamide computed tomography.

A case of an extradural spinal arachnoid cyst is presented with emphasis on the neuroradiologic characteristics of this lesion. The cyst was definitely diagnosed by delayed metrizamide spinal computed tomography. Extradural spinal arachnoid cysts, or diverticula, have been the subject of much discussion in the neuroradiologic and neurosurgical literature. However, the appearance of a communicating arachnoid cyst on delayed spinal computed tomography after metrizamide myelography is heretofore undescribed in the English language neurosurgical literature.

Adult↗

Spinal metastases of cerebral glioblastoma: the value of computed tomographic metrizamide myelography in the diagnosis.

Spinal metastases from cerebral glioblastoma via the cerebrospinal pathway are rarely detected when the primary tumors are under apparent control. The authors report two adult patients with cerebral glioblastoma who developed spinal symptoms referable to spinal seeding without neurological and computed tomographic findings of the recurrence of the primary tumors. Computed tomographic metrizamide myelography clearly revealed minute deposits of perispinal metastatic tumors that could not be detected by conventional myelography. Even perispinal mass lesions so minute that they are revealed only by computed tomographic metrizamide myelography can invade the spinal cord and cause clinical symptoms.

Adult↗