Myelography with Iotrolan, an Isotonic Water Soluble Contrast Medium

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Iotrolan, an isotonic water-soluble non-ionic contrast medium, has recently been developed to improve the biological activity of Metrizamide. We used the contrast medium for myelography and CT-myelography, and examined its contrast effect, side effects and desirable examination techniques. A satisfactory contrast effect was obtained in other cases than 3 patients in which contrast was unsatisfactory probably due to technical errors during the early period of use. If the head-end of the examination table was elevated higher than required to prevent the contrast medium from flowing into the ventricule after myelography, the contrast effect became unsatisfactory when cervical CT-myelograms were taken. Therefore, we put pillows of 10cm-height under the head-end of the table to slightly elevate the head-end by ca. 5°, and we placed patients in the prone position for 10-20 seconds just before lumbar CT-myelography. These points seemed to be indispensable to take a good myelogram. Side-effects were mild, and no severe or so-called "major" side effects such as disturbance of consciousness, generalized convulsion fits, etc. were observed. It is concluded that Iotrolan is a good myelographic contrast medium well tolerated by patients, if a radiologist gets skilled in the examination technique.
西日本整形・災害外科学会の論文