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PubMedDate not supplied

Metrizamide myelography and postmyelographic computed tomography: comparative adequacy in the cervical spine.

Metrizamide myelography and postmyelographic computed tomography (CT) were evaluated for relative efficacy when correlated with operative findings in a series of 30 patients. Fifty-seven levels were operated on in the 30 patients with 27 patients diagnosed as having diffuse cervical stenosis, hyperostotic spondylosis, or herniated nucleus pulposus. Metrizamide myelography and CT metrizamide myelography were equally useful in providing preoperative diagnostic information at 44 of 57 levels. Both radiographic techniques agreed with the degree of canal and neural forman stenosis found operatively at more than 80% of levels. This study indicates that either metrizamide myelography or CT myelography alone is sufficient, and that both should be performed only if one fails to answer the clinical question or if syringomyelia or cord tumors are suspected.

Adult↗
PubMed1984

[Comparison of the acute cardiovascular side effects of iopamidol, metrizamide and amidotrizoate after intracoronary and left ventricular injections].

The acute cardiovascular side effects of iopamidol (osmolality: 0.8 osmol/kg), metrizamide (0.6 osmol/kg), and amidotrizoate (2.1 osmol/kg) during coronary arteriography (n = 30) and left ventriculography (n = 9) have been compared in anesthetized closed-chest dogs (n = 5). The influences of these contrast media on hemodynamics, coronary circulation, ECG and physicochemical properties of coronary sinus blood were evaluated. Following intracoronary injection, iopamidol and metrizamide cause positive inotropism while amidotrizoate initially induces cardiodepression. All contrast solutions lead to marked increase of myocardial blood flow. Electrocardiographic changes are greater after amidotrizoate (P less than 0.05). A fall of cationic content in coronary sinus blood is seen after each contrast medium. Amidotrizoate leads to more decrease of potassium (P less than 0.01) and both ionized and total calcium (P less than 0.001). Increase of osmolality and hydrogen ionic content is greater after amidotrizoate than after iopamidol and metrizamide (P less than 0.01). Following left ventricular injection, marked peripheral vasodilation, as seen after amidotrizoate, does not occur after low osmolality compounds. There are no significant differences between iopamidol and metrizamide in spite of the slightly higher osmolality of the former. Thus, both contrast materials should be equivalent with respect to their acute cardiovascular side effects under clinical conditions. Advantages of low osmolality radiological contrast media are discussed.

Animals↗
PubMed1984

[A case of metrizamide encephalopathy with triphasic waves on EEG].

Metrizamide (Amipaque), a water soluble nonionic contrast medium has less toxic effect in comparison with other contrast media, and it is now widely used for myelography, cisternography, ventriculography and cerebrospinal fluid dynamic imaging. However, as the number of cases in which this medium has been utilized has gradually increased, incidents of toxic manifestations have been reported. Among these, there are a considerable number of case reports referring to metrizamide encephalopathy, but only a few authors reported the appearance of triphasic waves on EEG when they occurred. The authors experienced one case of metrizamide encephalopathy accompanied by frequent appearance of triphasic waves on EEG. A 31-year old male was admitted to our hospital with the complaint of right homonymous hemianopsia. At that time he was fully conscious and mentally alert. On CT, 39 mm X 45 mm partially enhanced isodense mass was revealed on the enlarged sella turcica. Laboratory findings showed high titer of prolactin (10200 ng/ml). Premedication of 100 mg phenobarbital i.m. was followed by the tomography of the sella turcica, using 8 ml of 250 mgI/ml metrizamide injected into L 3-L 4 subarachnoid space. Several hours after the examination, he complained of slight nausea and was kept in bed with his head placed in an elevated position. The next morning, he was found to be in a drowsy state. He was disoriented and could not respond adequately to questions asked. His naming of daily necessities was also poor, although he knew how to use them.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMedDate not supplied

Intrathecal dextrose to prevent seizures after metrizamide myelography in dogs.

Seizures are possible complications of metrizamide myelography. The protective effect (as measured by reduction in seizure incidence) of dextrose in solution with metrizamide was studied by conducting a double-blind trail. Fourteen dogs each had two myelograms at five- to 16-day intervals in a crossover study, while ten additional dogs each had a single myelogram. Metrizamide alone and metrizamide in dextrose were used for the myelograms. No significant protective effect of dextrose was found.

Animals↗
PubMedDate not supplied

Intramedullary penetrance of metrizamide in the dog spinal cord.

Metrizamide computed tomography (CT) myelography is clinically useful in the detection of syringohydromyelia. The mechanism by which intrathecally injected metrizamide migrates into the intramedullary cavity is unknown, although reflux into the central canal of the cord via the obex has been postulated. Since intrathecally injected metrizamide has been shown to penetrate normal brain, similar penetrance of the spinal cord might be expected. Five anesthetized mongrel dogs were examined with sequential CT scanning of the cervical spine for 24 hr after intrathecal introduction of metrizamide. The attenuation values of the specified subarachnoid space and the spinal cord at the level of the atlantoaxial joint were recorded. A significant and reproducible increase with time in attenuation values within the cervical spinal cord accompanied by a progressive decrease in attenuation values of the subarachnoid space was observed. The proposed mechanism of cord enhancement, the implication for cord imaging, and the analysis of patients with syringohydromyelia are discussed.

Animals↗
PubMed1980

[Pain reduction in peripheral arteriographies of the upper and lower extremities in a double blind test. Lidocain/ioglicinate versus metrizamide (author's transl)].

36 aortofemoral and 18 brachial angiographies effected under standardized conditions in a double blind test in approximately two equal parts with Lidocain/Ioglicinate and Metrizamide, respectively, were evaluated with regard to vascular pain and sensation of heat during the examination. With the femoralis angiograms reduction of vascular pain was on the average somewhat greater, although this could not be established statistically when using Metrizamide. In the case of the angiogram of the arm, pain was on the average equally low in both cases. Of the 14 patients who had received injections of both contrast media in varying succession at intervals of 20 minutes, 6 patients considered the Metrizamide injection to be more agreeable, whereas 2 preferred the Lidocain/Ioglicinate injection and 6 patients did not notice any significant difference. The average sensation of heat during contrast medium visualisation of the legs and arms was equal with both substances. Lidocain/Ioglicinate and Metrizamide are approximately equally well suited for peripheral angiography of arms and legs, rendering narcosis and strapping down of the extremities unneccessary in normal cases.

Anesthesia, Local↗
PubMed1982

[Total myelography with metrizamide through the lumbar route (author's transl)].

Total myelography with metrizamide at a concentration of 270 mgI/ml was carried out via lumbar puncture in 170 consecutive patients. Good opacification and/or diagnostic value was obtained in the lumbar, thoracic and cervical region at 88.8%, 77.6% and 72.4% respectively. Unsatisfactory results were mostly due to the poor technique of physicians and x-ray technicians. Also it was inadequate to perform this study in some lesions, such as ruptured arterio-venous malformation and occification of posterior longitudinal ligament. Several cases with previous oil myelography showed poor results, because the remaining of Myodil disturbed a good spreading of the newly injected media. It was requested to evacuate oily contrast media prior to metrizamide myelography. One of the most important clues to a successful myleography was to make dilusion of contrast media as little as possible, and the use of high concentration of metrizamide (250-270 mgI/ml) seemed to be tolerated. It was also important to avoid excessive movement of the patient and the rapid transit of the contrast media to the level of interest. It was recommended to study the entire spinal subarachnoid space as a whole. In sixty-three patients out of 170, one or more abnormal myelographical findings were detected at unexpected level. Immediately after the examination the patients were encouraged to drink a large quantity of diuretic beverages such as tee, juice or coffee for the purpose of reducing side effects. As Potts and coworkers and Eldevik and associates reported, it was recognized that the overhydration could reduce the severe side effects after the metrizamide myelography.

Adolescent↗
PubMed1982

Metrizamide gradient centrifugation of histone-DNA complexes.

Mouse DNA was complexed with different combinations of histones. Most of these complexes were separated in metrizamide gradient into two fractions--heavy and light. At the protein: DNA ratio of 0.8 a complex of DNA with five histones contained 60% of DNA in the heavy fraction whereas in the absence of histone H1, this fraction contained only 40% of DNA. Complexes of DNA with the H2A + H2B histone pair banded in metrizamide as one, light fraction at the density of 1.140 g/cm3. DNA reconstituted with the H3 + H4 histone pair formed in metrizamide two peaks of 1.240 g/cm3 and 1.140 g/cm3. Among complexes of DNA with single histones H2A, H2B, H3 and H4 only the complex DNA-H4 formed a component having in metrizamide a density of 1.200 g/cm3, similar to the density of purified chromatin.

Animals↗
PubMed1981

Metrizamide cisternography in the investigation of the empty sella syndrome.

Pneumoencephalography, the usual method for demonstrating air within the sella turcica in empty sella syndrome (ESS), has been approached with reluctance by most physicians because of its technical difficulty and patient morbidity. For these reasons, neuroradiologists have investigated other contrast media in search of an ideal agent; metrizamide seems to be such an agent. Metrizamide is a nondissociable, water-soluble glucose amide containing three iodine molecules. This agent is miscible with CSF, and small recesses of the CSF-brain interface can be delineated with hypocycloidal tomography without performing cumbersome patient maneuvers to fill the cisterns. Furthermore, morbidity has been minimal, particularly with use of lower concentrations of metrizamide, allowed by the sensitivity of computerized tomographic (CT) scanning. Thus, at the present time, metrizamide cisternography (especially in conjunction with CT scanning) appears useful in evaluating an enlarged sella turcica, particularly when considering an entity such as ESS.

Adult↗
PubMed1985

Neonatal metrizamide gastrointestinal series in suspected necrotizing enterocolitis.

The diagnosis of necrotizing enterocolitis (NEC) in neonates may be made by clinical presentation, roentgenographic findings, or a combination of both. Diagnosis leads to immediate treatment including nasogastric suction, parenteral antibiotics, plasma, and close monitoring of clinical, roentgenographic, and laboratory findings. Occasionally, neither the clinical nor plain roentgenographic appearance of an infant allows the diagnosis of NEC to be made or excluded with confidence. In such infants portable isotonic metrizamide gastrointestinal (GI) series were used to help make the decision of whether to begin treatment for NEC or to continue feeding the patient. Of 15 patients examined, two exhibited signs of NEC and were successfully treated medically without GI (tract) sequelae. Twelve neonates had normal results of metrizamide GI series and ten were immediately fed with no GI complication. One of these 12 infants had feedings withheld for several days as a result of a positive blood culture. One infant with severe cardiac and pulmonary disease had profound adynamic ileus and could not be fed. We have found the metrizamide GI series to be a useful study in neonates suspected of having NEC.

Bacteriological Techniques↗
PubMed1984

Nonconvulsive status epilepticus following metrizamide myelography.

Epileptic seizures are a known complication of metrizamide myelography. To our knowledge, this is the first report of a case of nonconvulsive status epilepticus of the absence type following metrizamide myelography. There was symptomatic and electroencephalographic improvement after intravenous administration of antiepileptic drugs, and there was no neurological residual. Nonconvulsive status epilepticus should be considered when impairment of consciousness supervenes after radiographic procedures using metrizamide.

Electroencephalography↗
PubMed1985

Spasticity complicating metrizamide myelography.

Temporary but considerable increase in spasticity following myelography using metrizamide at 300 mgs I/ml concentration occurred in 4 patients. In 3 of the patients the diagnosis is uncertain, but it is likely to be some form of degenerative disease involving motor pathways in two of them; the fourth case has cervical spondylotic myelopathy. The spasticity might be related to the anticholinesterase activity of metrizamide or to competitive inhibition of endogenous glucose metabolism by the deoxyglucose component of the metrizamide molecule.

Female↗
PubMed1986

Influence of certain factors on the manifestations of the adverse effects of metrizamide myelography.

Although metrizamide is now being superseded by other contrast media, the mechanisms of its side effects may be of fundamental importance. One hundred and four consecutive patients with suspected cervical cord or root lesion were studied prospectively for factors which might influence the side effects of metrizamide myelography. Elderly patients were more prone to develop mental confusion. An earlier onset of dizziness and/or vertigo was associated with the lumbar route of intrathecal injection. Perhaps surprisingly, phenobarbitone prophylaxis shortened the duration of confusion and delayed the onset of headaches. Other factors, viz. sex, excess intracranial flow of metrizamide and myelographic blockage were not shown to have a significant influence on the adverse reactions.

Adult↗
PubMed1977

The toxicity of the non-ionic watersoluble contrast medium metrizamide (Amipaque) in selective vertebral angiography. An experimental study in rabbits.

Selective left vertebral angiography was carried out in 21 rabbits comparing the toxic effects of meglumine iothalamate (Conray meglumine), meglumine metrizoate (Isopaque Cerebral) and metrizamide (Amipaque). The iodine concentration for all 3 media was 280 mg/ml. General convulsions were seen in many of the animals with all 3 media. The convulsions occurred at higher doses and were milder with metrizamide than with the 2 other contrast agents. Bradycardia was also seen with all 3 media and there was no statistical significant difference between them in this respect. The mortality was approximately 50% with both meglumine iothalamate and meglumine metrizoate, while no animals died following angiography metrizamide.

Angiography↗
PubMed1984

Excitative effects in anaesthetized rabbits from subarachnoidally injected iso- and hyperosmolar solutions of iohexol and metrizamide.

Equimolar doses of iohexol and metrizamide (0.48 mmol/kg body weight = 185 mg I/kg), administered in solutions iso- and hyperosmolar to the CSF, were injected subarachnoidally into rabbits under pentobarbital anaesthesia. No excitative effects of iohexol were observed in the behaviour of the rabbits during a 3-h period immediately after the injection. Metrizamide caused significant, severe excitative effects, ranging from hyperexcitability to repeated generalized seizures. The frequency and severity of excitative effects were independent of the osmolality of the metrizamide solutions injected.

Anesthesia↗
PubMed1981

Subacute reactions to intrathecal amipaque (metrizamide), conray and dimer X: a structural and ultrastructural study.

Adult New Zealand rabbits were injected intrathecally with 200 or 300 mgI/ml of metrizamide, meglumine iocarmate or meglumine iothalamate. They were placed in the Trendelenburg position for 20 min and allowed to survive for 1, 2 or 3 weeks. Sacrifice was by intraarterial perfusion of aldehydes under anesthesia followed by preparation of brain and major venous sinuses for light and electron microscopy. Major findings were subpial edema and inflammatory reaction of superficial brain, leptomeninges, subarachnoid space and arachnoid granulations. They were most severe after iothalamate and milder after metrizamide. The severity decreased with time. It is of significance that severe reactions occurred after 300 mgI/ml concentration of metrizamide.

Animals↗
PubMed1984

Psychopathometric demonstration and quantification of mental disturbances following myelography with metrizamide and iopamidol.

Groups each consisting of ten patients underwent lumbar and cervical myelography with metrizamide and iopamidol, together with a control group of ten patients who underwent lumbar punctures only. These groups were studied with a psychopathometric test procedure in order to demonstrate and quantify mental disturbances. It was shown that in contrast to myelography with iopamidol, mild mental disturbances are common after myelography with metrizamide. The severity of the mental disturbances after myelography with metrizamide was dependent on the quantity of contrast medium which diffused into the intracranial space after myelography, suggesting a dose-related neurotoxic effect of this substance. Such a correlation was not found with iopamidol.

Adolescent↗
PubMed1980

Complications of cerebral angiography. Comparing metrizamide (Amipaque) and meglumine metrizoate (Isopaque Cerebral).

The complications of cerebral angiography have been carefully recorded in 308 patients referred for cerebral angiography during one year, 1977--1978. The patients were randomly sampled for metrizamide or meglumine metrizoate as contrast medium according to a code list, and the two contrast media were compared using a double blind technique. The frequency of complications was the same for metrizamide and meglumine metrizoate. Metrizamide had the advantage that it caused no discomfort in selective external carotid angiography, while this was a problem with meglumine metrizoate. The study seemed to indicate that factors other than toxicity of the contrast medium are of major importance to explain the complications of cerebral angiography.

Adolescent↗