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KMID : 0376219840210010095
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Chonnam Medical Journal
1984 Volume.21 No. 1 p.95 ~ p.100
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Lumbar Myelography with Metrizamide
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Abstract
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One of the most controversial subjects in neuroradiology is the use of contrast media in the lumbar subarachnoid space. There is general agreement that the diagnosis of lumbar disk herniation is made in high accuracy with a water-soluble medium than with iophendvlate(Pantopaque) because the former medium gives better-filling of the root sleeves. Another disadvantage with iophendylate is that it is slowly absorbed from the subarachnoid space and a complete withdrawal is seldom achieved so that the small residual amount might therefore exert an irritative effect through the years. Metrizamide is superior to other water-soluble contrast media for examination of the lumbar subarachnoid space mainly because of marked reduction of the spasmogenic effects. Advantages of metrizamide myeloghraphv over oil myelography are: First, better visualization of nerve rots and nerve sle ,ves. Second, removal of the contrast agent is unnecessary at the completion of the study because it is rapidly absorbed from the subarachnoid space. Third, a smaller needle is reguired for insertion. Fourth, lesser incidence of morbidity. Finally, higher accuracy in diagnosing lumbar disk herniation regardless of level. A water-soluble, iodinated and nonionic contrast agent, metizamide (Amipaque), is considered "The medium of choice" for examination of the lumbar subarachnoid space.
Special attention was paid to its possible side-effects, since this is one of the main problems with the use of positive contrast media in the subarachnoid spaces.
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