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PubMed1986

Comparison of metrizamide and iohexol for cisternal myelographic examination of dogs.

A double-blind study, using metrizamide, iohexol, or Ringer's solution (control) as cisternal myelographic agents, was performed on 25 dogs. Before myelographic examination was done, each dog was subjected to physical, clinical pathologic, and neurologic examinations, as well as examinations by electroencephalography and computerized tomography. These were repeated 24 hours after completion of the myelographic examination. The group of dogs given metrizamide (group II) had a significantly greater occurrence of seizure activity (6 of 10) than did the control dogs (group I; 0 of 5) or dogs given iohexol (group III; 0 of 10; P less than 0.003). In group II, the CSF microprotein concentration was significantly greater 24 hours after myelography was done than were the values in groups I and III (P less than 0.003). Myelograms of the group II dogs (metrizamide) and group III dogs (iohexol) had similar diagnostic qualities. At 24 hours after myelographic examination was done, computerized tomography scan revealed that each dog given metrizamide and iohexol had myelographic contrast material in the brain and cervical spinal cord parenchyma. Seemingly, iohexol has good diagnostic quality, but is less epileptogenic than metrizamide when used in cervical myelographic examinations of dogs.

Animals↗
PubMed1983

Non-ionic contrast media in cardioangiography in infants. A comparison of iohexol and metrizamide.

Iohexol (300 mg I/ml) was compared with metrizamide (300 mg I/ml) in pediatric cardioangiography. Forty consecutive patients below one year of age were included in an open, randomized, comparative two-group investigation. Immediate extrasystoles occurred frequently at injections of contrast medium, but the frequency did not differ significantly between metrizamide and iohexol. Both contrast media caused only minor changes in heart rate. Iohexol caused a significantly larger increase in end diastolic pressure following injections in the left ventricle than did metrizamide. The pressure changes registered were, however, moderate in both contrast media groups and the difference between the two contrast media is probably of no clinical importance. A moderate plasma volume expansion was noted after injection of both contrast media. Metrizamide caused a slight increase of ASAT in the 10 min blood sample which differed significantly from that of iohexol, but no increase of enzyme activity was noted after 24 h and the change was considered to be of no clinical importance. Image quality was similar with both contrast media. Iohexol and metrizamide were well tolerated in pediatric cardioangiography.

Angiocardiography↗
PubMedDate not supplied

Cholinergic actions of metrizamide.

In a study of the possible mechanisms of the clinical side effects of metrizamide, it was applied to several in vitro model preparations. It was shown that, although high metrizamide concentrations are without noticeable effect on many basic neuronal functions, metrizamide does interfere with cholinergic mechanisms. At concentrations equivalent to, or significantly lower than, those probably achieved during clinical procedures, metrizamide is both an inhibitor of the enzyme acetylcholinesterase and an antagonist of cholinergic transmission. These data suggest the possibility that some of the side effects resulting from clinical procedures employing metrizamide may be explained by its actions on cholinergic synapses.

Acetylcholine↗
PubMedDate not supplied

Comparison of radiographic quality and adverse reactions in myelography with iopamidol and metrizamide.

A randomized double-blind study was conducted to compare the radiographic quality and adverse reactions in myelography of the two nonionic water-soluble contrast media, iopamidol and metrizamide. A total of 46 myelograms were obtained, 28 with iopamidol and 18 with metrizamide. Untoward reactions consisted of nausea, headaches, back and leg pain, neuropsychiatric findings, and urinary retention. Iopamidol caused no reactions in 20 of the 28 cases, while metrizamide caused no reactions in only three of 18 cases. Film quality evaluation showed 22 of the 28 studies with iopamidol were judged excellent, whereas only 11 of the 18 metrizamide studies were judged excellent. The results of this study suggest that iopamidol produces better quality studies with fewer and milder adverse reactions than metrizamide.

Adult↗
PubMedDate not supplied

Discrepancy between metrizamide CT and myelography in diagnosis of cervical disk protrusions.

With the advent of the relatively safe water-soluble contrast medium metrizamide, cervical myelography followed by metrizamide computed tomography (CT) can be performed easily. Sixteen patients with cervical disk protrusions (eight central and eight posterolateral) were studied by both procedures to evaluate the diagnostic value of each. In 75% of the posterolateral disk protrusions, myelography was as diagnostic as metrizamide CT. Metrizamide CT was definitely superior to myelography in 75% of the central disk protrusions with delineation of compressed cord. Information provided by metrizamide CT is detailed enough to allow the selection of a definitive anterior approach without delay.

Cervical Vertebrae↗
PubMedDate not supplied

Concentration of intrathecal 3H-labeled metrizamide in normal dog brain: age-related differences.

Responses to intrathecal metrizamide in dogs were found to be age-related: Adult dogs had seizures; 7-week-old dogs appeared stuporous; 6-day-old dogs were clinically unaffected. The brain metrizamide concentrations 4, 6, and 20 hr after intrathecal injection correlated directly with the occurrence and severity of neurotoxic symptoms. Age-related differences in brain metrizamide concentration may be explained by two factors. The first is the failure of current clinical guidelines to adjust the recommended dosage of metrizamide to reflect differences among age groups in brain weight rather than body weight. This error resulted in lower doses/gram of brain weight being given to the puppies. However, the large differences in brain metrizamide concentrations among the three groups of dogs could not be explained solely by differences in the dose. A second factor, physiologic age-related differences in brain penetration, is believed to be operative. The precise nature of these differences is unclear.

Aging↗
PubMedDate not supplied

Metrizamide myelography for disk disease: continuing need for epidural venography.

Metrizamide is largely replacing iophendylate (Pantopaque) for routine lumbar myelography. Better visualization of the nerve root sheaths should make metrizamide myelography more sensitive in detecting laterally herniated disks, such that epidural venography might be required less often. However, that expectation has not been realized. In over 800 consecutive myelograms, one-half obtained with iophendylate and one-half obtained with metrizamide, 60 patients still required epidural venography. Nearly as many had metrizamide as had iophendylate (28 versus 32). Further, the number of positive epidural venograms with herniated disks confirmed at surgery was not significantly different (12 versus 11). Epidural venography is still indicated after negative or equivocal metrizamide myelography if strong clinical suspicion of herniated disk persists.

Epidural Space↗
PubMedDate not supplied

Plain and metrizamide CT of lumbar disk disease: comparison with myelography.

Computed tomography with and without administration of intrathecal contrast material was evaluated in 100 patients with suspected lumbar disk disease. Metrizamide computed tomography was performed in 75 patients and plain computed tomography was performed in 25. Metrizamide computed tomography was more accurate than plain computed tomography. It also disclosed many lesions not shown by metrizamide myelography at the lumbosacral level. Very few lesions were revealed by myelography that were not seen by metrizamide computed tomography. The small amount of intrathecal metrizamide needed for scanning has practically no side effects. Experience in 12 patients indicates that the procedure may be performed safely on an outpatient basis. This study suggests that computed tomography should be given serious consideration as the primary definitive radiographic examination of suspected lumbar disk disease.

Humans↗
PubMedDate not supplied

Metrizamide myelography and epidural venography. Their role in the diagnosis of lumbar disc herniation and spinal stenosis.

This study compares lumbar epidural venography with metrizamide (Amipaque) myelography as diagnostic modalities in the evaluation of lumbar disc herniation and spinal stenosis. The accuracy of epidural venography and metrizamide myelography was evaluated in 30 surgically confirmed cases of lumbar disc herniation and spinal stenosis to determine their relative diagnostic values. Sensitivities of epidural venography and metrizamide myelography were 83% and 97%, respectively, while the specificities were 88% and 100%, respectively. The conclusions of this study were: (1) The accuracy of metrizamide myelography exceeds that of epidural venography in the diagnosis of lumbar disc herniation and spinal stenosis. (2) Metrizamide myelography is indicated as the primary contrast technique in lumbar disc herniation and spinal stenosis. (3) Epidural venography is indicated as a secondary contrast technique in patients with a congenitally short or tapered dural sac.

Adult↗
PubMed1976

Distribution of histones in alkali-denatured chromatin studied by isopycnic centrifugation in alkaline metrizamide density gradients.

Three types of density gradients - neutral metrizamide, alkaline NaOH-metrizamide and alkaline triethanolamine-metrizamide - were used for studying the distribution of histones between the two DNA strands in alkali-denatured chromatin. It was found possible to avoid both protein redistribution and dissociation by using triethanolamine-metrizamide density gradients at pH 10.5. Under these conditions an alkali-denatured mixture of DNA and chromatin was well separated into the original DNA and DNP. When native or sonicated chromatin was denatured at pH 12.2 and centrifuged in a triethanolamine-metrizamide density gradient at pH 10.5 no peak of free DNA appeared. These results show that both DNA strands remain associated with histone molecules upon alkaline denaturation of chromatin.

Animals↗
PubMed1984

Cortical blindness after metrizamide myelography. Report of a case and proposed pathophysiologic mechanism.

Metrizamide, a nonionic, water-soluble contrast medium, has been increasingly used for myelography. We saw a patient with cortical blindness, seizure, organic psychosis, and asterixis after undergoing attempted metrizamide myelography via C1-2 puncture. Computed tomography demonstrated early penetrance of metrizamide into the brain parenchyma, most prominently in the occipital lobes. A mechanism of direct metrizamide neurotoxicity was proposed.

Adult↗
PubMed1985

Prolonged confusion due to absence status following metrizamide myelography.

A case of absence status epilepticus resulted from metrizamide myelography. The acute confusional state following metrizamide myelography is briefly reviewed and compared with the confusional state resulting from adult-onset absence status. The similarities suggest that absence status may in fact be a relatively common cause of prolonged confusion following the use of metrizamide. Given the difficulty in clinical diagnosis and the excellent response to anticonvulsants, the possibility of absence status should be specifically excluded by EEG in any person suffering prolonged confusion following metrizamide myelography.

Aged↗
PubMed1977

The rate of CSF formation in man: preliminary observations on metrizamide washout as a measure of CSF bulk flow.

Metrizamide, a nonionic, water-soluble contrast agent, was injected into the ventricular system of 3 patients with indwelling ventricular catheters and subcutaneous cerebrospinal fluid reservoirs. A first-order rate constant, k, for metrizamide washout from the right lateral ventricle was determined with reference to mean ventricular metrizamide concentration on serial CAT scans; right ventricular volume, V, was estimated after metrizamide injection by multiplying the appropriate ventricular area on consecutive CAT slices by the nominal slice thickness. The rate of right lateral ventricular CSF formation, If, in our 3 patients was calculated as k X V and ranged from 0.083 to 0.103 ml per minute.

Adult↗
PubMed1978

Clinical evaluation of metrizamide for neuroradiology in chilren.

Metrizamide is a nonionic water-soluble contrast medium for neuroradiological studies that is less irritating to the nervous system than other water-soluble agents. Studies in adults have shown that metrizamide has advantages over currently available media, but experience with children has been limited. Sixty-two children have had myelography or ventriculography using metrizamide. The children ranged in age from 11 days to 22 years. Technically satisfactory studies were obtained in every patient. No major complications were encountered. Minor side-effects included headache in 11 children (18%), mild nausea or vomiting in 16 children (26%), and fever in 4 children (6%). Seizures did not occur. One infant in the study subsequently died of unrelated problems; there was no evidence of arachnoiditis at postmortem examination. Metrizamide is a safe, effective contrast medium for neuroradiological use in children.

Adolescent↗
PubMed1982

Iopamidol vs metrizamide: a double blind study for cervical myelography.

A double-blind study was performed on 20 patients comparing the safety and efficacy of Iopamidol and Metrizamide in cervical myelography. The radiographic qualities of the Iopamidol and Metrizamide examinations were equivalent when using the same volume (12 to 13 ml), concentration (200 mg I/ml), and a C1-2 route of administration. The performance of a CT scan on selected patients in specified areas of interest provided additional diagnostic information in some patients (e.g syringomyelia, degenerative spondylosis). The adverse reactions were mild in the Iopamidol group with 4 of the 10 patients experiencing no adverse reactions. The more severe reactions, including disorientation, agitation, dysarthria, asterixis, hyperreflexia and EEG abnormalities were limited to the Metrizamide group with one or more occurring in 2 of the 10 patients studied. Only one Metrizamide patient experienced no adverse reactions. In this study containing a limited number of patients, Iopamidol was shown to be a diagnostically effective and safer contrast medium for performing cervical myelography.

Chemical Phenomena↗
PubMed1979

Subclinical organic psychosyndromes on intrathecal injection of metrizamide for lumbar myelography.

Eighteen patients with symptoms and signs of possible lumbar disc herniation, who had no evidence of a preexisting organic psychosyndrome were included in the study. An organic psychosyndrome was found in six of them 10 h after lumbar myelography with metrizamide. The psychosyndrome, which was characterized by impaired memory and depression, could be demonstrated only by psychometric methods. In these patients metrizamide could be demonstrated within the basal cisterns by computed tomography 8 h after lumbar injection of the contrast medium. The organic psychosyndrome was completely reversible; five days after myelography it could not be detected any more by psychometric means. The development of an organic psychosyndrome in six of the 18 patients suggests a neurotoxic effect of metrizamide. This assumption is supported by hypo- and areflexia in four patients after intrathecal metrizamide as well as by EEG changes seen in three patients after myelography. There was no correlation between the EEG changes or reflex abnormalities and the organic psychosyndrome.

Adult↗
PubMed1980

The distribution of 125I-metrizamide and 125I-diatrizoate between blood, brain and cerebrospinal fluid in the rabbit.

The entry of 125I-metrizamide and of 125I-diatrizoate from blood into brain has been studied in rabbits. The blood-brain barrier is very tight to both molecules, all cerebral regions having spaces between 0.5 and 2% after maintenance of constant blood levels for 4 h. In extraneural tissues both compounds appear to distribute in extracellular fluid except for accumulation of metrizamide by the liver and perhaps the small intestine. Profiles of radioactivity through cerebral gray matter have been obtained following ventriculocisternal perfusion of artificial cerebrospinal fluid containing 125I-metrizamide. The nature of these profiles and their behavior with time suggest that metrizamide passes through gray matter by simple diffusion, that it is largely distributed in the extracellular fluid and that bake movement across the blood-brain barrier is small.

Animals↗
PubMed1978

Comparison of metrizamide CT cisternography with radionuclide cisternography in abnormal cerebrospinal fluid dynamics.

Metrizamide CT cisternograms were performed on 39 patients with a clinical diagnosis of CSF abnormalities; 20 of these patients underwent radionuclide cisternography as well. Comparison of metrizamide CT and RN cisternography revealed good correlation in the degree, extent, and time sequence of ventricular reflux as well as the extent of cortical staining and cisternal filling. Metrizamide cisternography had the advantage of excellent anatomic detail and lower exposure dose, although minor complications were more frequent with this technique. Metrizamide CT cisternography has a potential to become the preferred method of evaluating patients with abnormal CSF dynamics.

Adolescent↗