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PubMedDate not supplied

Metrizamide in urography. II. A comparison of 51Cr-EDTA clearance and metrizamide clearance in man.

In nine subjects undergoing urography with metrizamide measurements of total serum clearance of 51Cr-EDTA have been made before, during, and after the urography. During the urography both total serum clearances and renal clearances were determined for 51Cr-EDTA and metrizamide. The present study in man confirms the previous results from investigations in rabbits, that most of the intravenously injected metrizamide is excreted through the kidneys, that tubular reabsorption of metrizamide occurs and suggests that metrizamide might be used with advantage for urography.

Chromium Radioisotopes↗
PubMed1979

[Usefulness and adverse effects of intrathecal metrizamide instillation (author's transl)].

Radiographic quality as well as adverse effects of intrathecal metrizamide instillation was prospectively investigated in thirty-three clinical cases admitted to the department of neurosurgery, University of Tokyo Hospital, and Kantoh Teishin Hospital. Metrizamide CT cisternography was performed in fifteen cases using in most cases 10 ml of 170 mg I/ml solution through lumbar route. Eleven cases exhibited "normal" pattern CSF circulation and the remaining four, "delayed" pattern. Eight cases (53%) experienced headache, nausea, and/or vomiting several hours after the instillation. All of these belong to the "normal" pattern group. Four cases of "normal" pattern received electroencephalographic examinations before and after metrizamide instillation. Three revealed appearance of negative spike and slow wave burst or sharp waves one to twenty-four hours after the instillation, along with penetration of metrizamide into brain parenchyma. Diagnostic quality was interpreted as "good" in eleven cases. Small acoustic neurinoma, pituitary adenoma, arachnoid cyst, and subdural hygroma were diagnosed among others. Metrizamide ventriculography was done in four cases. No untoward effect of significance was attributed to metrizamide per se. Cervical myelograpy and/or CT myelography was done in fourteen cases using, in most cases, 10 ml of metrizamide 170 mgI/ml. Polytome tomography with metrizamide instillation through lateral cervical puncture was highly diagnostic, whereas, ordinary X-ray with lumbar instillation yielded less satisfactory results. CT myelography in cases of subarachnoid block required good consideration on instillation site and positioning of the patient. Six cases (50%) among twelve cases where metrizamide had run into the cranial cavity experienced headache, nausea, and/or vomiting to a lesser degree than those of cisterno graphy. Metrizamide is the first contrast agent ever made which can be safely introduced into human subarachnoid space, if administered judiciously, nervous. However, metrizamide is weakly toxic to central system and provokes minor untoward effects as well as electroencephalographic abnormalities and, sometimes, clinical convulsive seizure. It would be wiser to restrict the dosage of metrizamide in cisternographic study, expecially in cases of "normal" pattern CSF circulation, to 1.2 gI or 7 ml of 170 mg I/ml solution. Routine use of X-ray cisternography should thus be discouraged because it needs higher concentration of metrizamide in the intracranial cisterns.

Adolescent↗
PubMed1979

The effect of metrizamide on the electroencephalogram: a prospective study in 61 patients.

A prospective study was made of changes in the electroencephalogram after the use of metrizamide for myelography and posterior fossa cisternography in 61 patients (62 studies). The EEG changed in 21 patients (34%); 3 of these had had previously abnormal records, and the abnormalities were accentuated on the second recording. Eight developed paroxysmal activity, including spike and wave in 1. EEG changes appeared 24 to 48 hours after the use of metrizamide in 6 patients whose intervening EEGs were normal. The percentage of records that changed tended to increase as metrizamide was brought to more rostral levels. Symptoms following the use of metrizamide were reviewed in 58 patients. Although there were no seizures in the present series, seizures did occur with subsequent use of metrizamide in 3 other patients at our institution. Previous reports may have underestimated the frequency of EEG changes after metrizamide since these may require 24 to 48 hours to develop. The appearance of such activity suggests that the use of metrizamide in patients with known seizure disorders, the anatomical level to which metrizamide is brought during radiography, removal of contrast medium, and further investigation of premedication with anticonvulsants all require careful consideration when use of metrizamide is being contemplated.

Adult↗
PubMed1976

Studies on metrizamide-protein interactions.

1. The apparent density of catalase after isopycnic centrifugation in metrizamide gradients is dependent on the metrizamide concentration into which the enzyme is dissolved at the beginning of the centrifugation. 2. This different behaviour of the enzyme in metrizamide gradients is due to the formation of a metrizamide-protein complex which is more dense than the uncomplexed catalase. 3. A bimodal distribution of the catalase, with additional heavy bands, was only observed in metrizamide gradients in light water, where rather high metrizamide concentrations are needed even for a banding of the uncomplexed enzyme. 4. The half-life of the metrizamide-protein complex is less than 5 min. This was shown by spectroscopical measurements and band sedimentation analysis in an analytical ultracentrifuge.

Binding Sites↗
PubMed1977

Adverse effects of water-soluble contrast media in myelography, cisternography and ventriculography. A review with special reference to metrizamide.

The adverse effects following lumbar myelography and ventriculography with meglumine iothalamate (Conray Meglumin), meglumine iocarmate (Dimer-X, Bis-Conray) and metrizamide (Amipaque), and after thoracic and cervical myelography and cisternography with metrizamide are reviewed. In addition to the published material information given to Nyegaard & Co. from several hospitals participating in clinical trials with metrizamide is also reported. The frequency of minor adverse effects (headache, nausea, vomiting) seems to be about the same with all the three water-soluble contrast media. Convulsions, either localized to the lower part of the body or generalized, may be a problem with meglumine iothalamate and meglumine iocarmate, while the epileptogenic effect is markedly lower with metrizamide. With a technique directed towards preventing contrast medium of high concentration from passing intracranially, the frequency of serious adverse effects may be kept at a very low level. Late adverse effects (adhesive arachnoiditis) occurring after all other water-soluble contrast media are a very minor problem after metrizamide. Serious complications have not been recorded following ventriculography and cisternography with metrizamide. Metrizamide is considered to be the water-soluble contrast medium best suited for use in the subarachnoid space and cerebral ventricles.

Cerebral Ventriculography↗
PubMedDate not supplied

Metrizamide in experimental urography. V. Renal excretion mechanism of a non-ionic contrast medium in rabbit and cat.

The excretion mechanisms of the non-ionic contrast medium, metrizamide, and the ionic, sodium diatrizoate, are compared to investigate the potential usefulness of metrizamide in clinical urography. A mixture of 125I-labeled metrizamide and 131I-labeled diatrizoate was injected intravenously to rabbits or cats. Urine, bile and blood were analyzed for their concentration of iodine. From these concentrations the renal and total clearance was calculated. In the rabbit the excretion of metrizamide was also compared with that of 3H-inulin with or without influence of p-aminohippurate or probenecid. The earlier reported relatively low urinary iodine concentrations after intravenous injection to rabbits of low doses were explained by the following findings: In the rabbit the volume of distribution, the renal clearance and the total clearance of metrizamide were smaller than those measured for diatrizoate and inulin. The biological half-life in serum measured 30-150 min after injection was the same for all three compounds. No indication of tubular secretion was found. The excretion mechanism of the contrast media exhibits species differences as no differences between metrizamide and diatrizoate in the parameters mentioned above could be measured in the cat.

Aminohippuric Acids↗
PubMed1979

Modification of periventricular hypodensity in hydrocephalus with ventricular reflux in metrizamide CT cisternography.

An analysis of metrizamide computed tomography (CT) cisternographic findings in cases of communicating hydrocephalus has been carried out. Serial observations of the density in the periventricular area in 19 cases with metrizamide ventricular reflux have revealed the following different patterns: (a) precontrast periventricular hypodensity diminishing after CT cisternography and possibly indicating transependymal metrizamide migration (two cases); (b) periventricular hypodensity unchanged (two cases); (c) minimal periventricular hypodensity with slight rise in its attenuation values after ventricular metrizamide reflux (four cases); and (d) no periventricular hypodensity and no change after reflux (six cases). Our preliminary experience indicates that the presence of periventricular hypodensity with an increase in its attenuation values following ventricular reflux of metrizamide is possibly a criterion that may be used in favor of a cerebrospinal fluid shunting operation.

Adult↗
PubMed1977

Arachnoiditis following myelography with metrizamide in monkeys. Effect of blood in the cerebrospinal fluid.

Monkeys were injected intrathecally with blood, metrizamide (Amipaque) or a mixture of blood and metrizamide. Twelve weeks later the animals were examined for evidence of arachnoiditis. Either blood or metrizamide alone in sufficient amounts resulted in arachnoiditis. The addition of blood to metrizamide did not alter the severity or risk of arachnoiditis from experimental myelography with metrizamide.

Animals↗
PubMed1979

Application of metrizamide in the radiographic evaluation of the neurologically diseased patient.

Metrizamide (Amipaque) is a new water-soluble contrast agent for use in the intrathecal space. Extensive animal and clinical studies have demonstrated its low toxicity. The advantages to the use of metrizamide include the fact that it is miscible with cerebrospinal fluid and can fill narrow spaces, is sufficiently radiopaque to outline delicate structures within the central nervous system, is completely resorbed from the subarachnoid space, and, to date, has not been implicated in the formation of adhesive arachnoiditis. Application of metrizamide to the evaluation of neurologically diseased patients has included myelography, intracranial cisternography, and ventriculography, as well as various techniques in conjunction with computerized tomography. These various uses of metrizamide are discussed together with some indications and advantages. Metrizamide has now replaced Pantopaque and gas as the most commonly used intrathecal contrast agent at the University of Texas Health Science Center at Dallas.

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↗
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↗
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↗
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↗
PubMed1978

Metrizamide washout as a measure of CSF bulk flow.

Metrizamide was injected into the ventricular system of three adults and five children with indwelling ventricular catheters and subcutaneous CSF reservoirs. A first-order rate constant, k, for metrizamide washout from one lateral ventricle was determined with reference to ventricular metrizamide concentration on serial (up to six) postinjection CT scans. Lateral ventricular volume, Vv, was estimated after metrizamide injection by a planimetric method and by partial volume analysis, an interactive computerized technique. The rate of lateral ventricular CSF formation, If, was calculated as k X Vv and ranged from 0.0622 to 0.103 ml/min. Precise measurements of lateral ventricular CSF bulk flow depend upon adequate mixing of the injected contrast material with ventricular CSF and accurate measurements of lateral ventricular volume.

Adult↗
PubMed1979

Purification of rodent eosinophils on discontinuous metrizamide gradients.

Methods are described for the purification of rat and mouse eosinophils. Peritoneal exudate cells obtained from Schistosoma mansoni- or Trichinella spiralis-infected mice were plated on plastic dishes, and the nonadherent cells were centrifuged over discontinuous hypertonic metrizamide gradients. Approximately 41% of those eosinophils present in the original preparations were recovered from the interfaces between 20% and 22% metrizamide at an average of 88% purity. Peritoneal cells obtained from either uninfected or S. mansoni-infected rats were placed directly onto metrizamide gradients. After centrifugation, essentially all eosinophils present in the original preparations were recovered at the interface between 18.5% and 22.5% metrizamide, with an average of 80% purity. These methods for eosinophil purification have proven to be reproducible and to yield cells which are morphologically preserved and functional, as demonstrated by their ability to respond to a chemotactic stimulus.

Animals↗
PubMed1979

[Conventional-radiographic and computer-assisted cisternography of the posterior fossa with metrizamide (author's transl)].

Conventional radiographic and computer-assisted (CT) cisternography of the posterior fossa using Metrizamide was carried out in 25 and 33 patients respectively. The contrast medium was injected by the lumbar or cervical route. During conventional cisternography, contrast medium distribution is most easily controlled by a lateral injection at the level of the first to second cervical vertebra. Because of its physical properties, Metrizamide results in good demonstration of detail. CT cisternography is usually able to demonstrate an extra-cerebral space-occupying lesion with a diameter greater than 1 cm. This procedure has fewer complications due to the contrast medium or the technique, since small amounts of Metrizamide achieve an adequate increase in the density of the CSF; it is therefore possible to inject this by a lumbar route and to carry out the entire examination with the patient supine. Both conventional and CT cisternography permit very accurate diagnosis in the region of the foramen magnum. Both procedures can be used on their own or as an addition to conventional Metrizamide myelography.

Cranial Fossa, Posterior↗