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31,883 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

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.
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PMID:Clinical evaluation of metrizamide for neuroradiology in chilren. 31 Feb 77

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.
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PMID:[Usefulness and adverse effects of intrathecal metrizamide instillation (author's transl)]. 31 37

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.
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PMID:Adverse effects of water-soluble contrast media in myelography, cisternography and ventriculography. A review with special reference to metrizamide. 40 Sep 6

Twenty pediatric and 180 adult patients underwent myelography using metrizamide (Amipaque). All patients were examined and interviewed before and after the studies. New or exacerbated symptoms attributed to metrizamide myelography were graded according to severity. After the procedure, 51 of 200 patients were unchanged from baseline. Headache was the most common complaint, with an overall incidence of 62%. Nausea and/or vomiting occurred in 38%. Back or leg pain, neck stiffness, temperature elevation, and a variety of less common manifestations were also observed. The incidence of sequelae was higher than in comparable Scandinavian studies with this contrast medium.
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PMID:Sequelae of metrizamide myelography in 200 examinations. 41 57

Twenty-three cases suspected of skull base tumors were examined by CT cisternography (CTC) with CT scanner (EMI 1010) from April, 1977 to March, 1978. The lesions in 20 cases were diagnosed as positive and confirmed by operation and/or autopsies. These include five acoustic neurinomas, six pituitary adenomas, two craniopharyngiomas, two skull base meningiomas, one arachnoid cyst and miscellaneous tumors. Isotonic Metrizamide solution four of 2-10 ml was injected via lumbar route. Patients were kept in 30 degrees Trendelenburg position for 60 minutes until the first scanning. Scannings were obtained 1, 3, 6, 24 and in some cases 48 hours after lumbar injection. No side effects except for headache, nausea, vomiting occurred. There were no convulsions. In diagnosing cerebellopontine angle tumors, the indirect signs such as asymmetrical ambient cisterns are of importance, when combined with direct signs, i.e. a shadow defect. Parasellar tumors are usually difficult to diagnose with conventional CT due to streak artifact caused by adjacent bony structure. In CTC the extrasellar extension of pituitary tumors were clearly visible. The size, shape, dimensions and the relationship to the adjacent structures of the craniopharyngiomas were easily demonstrated with CTC especially when a coronal view was added. In arachnoid cyst, CTC demonstrated the delayed turnover of Metrizamide between the cyst cavity and the adjacent subarachnoid space. In conclusion, CTC is an useful neuroradiological diagnostic adjunct because of minimal bony streak artifact and high spatial resolution. It would be expected that small tumors of even 2-3 mm in diameter might be diagnosed, from the fact that the middle cerebral artery in the suprasellar cistern is clearly visible as a shadow defect.
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PMID:[Metrizamide CT cisternography in skull base tumors (author's transl)]. 41 46

Metrizamide, a new water-solution iodinated contrast medium, was evaluated in 63 infants and children, most of whom had lumbosacral or low thoracic lesions. The diagnostic quality was found to be good, and no serious complications or permanent sequelae were encountered. Chief complications were headache, nausea, vomiting and fever. No myoclonic spasms or convulsions were seen. The advantages and disadvantages of metrizamide are discussed.
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PMID:Metrizamide in pediatric myelography. 87 81

Metrizamide is an attractive myelographic agent with several advantages over other available myelographic agents. Radiographic detail is generally superior to Pantopaque and gas myelography, the material need not be aspiradted and does not appear to result in long-term complicaitons. Because of its low neuro-toxicity, it may be allowed to come into contact with the spinal cord and brain, unlike other water-soluble agents. Its main disadvantages are its tendency to diffuse into the CSF when run from one portion of the spinal canal to another and the occurrence of acute toxic effects such as vomiting and, rarely, seizures.
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PMID:Comparison of metrizamide with other myelographic agents. 91 65

We report a case of esophageal rupture in a five-month-old female infant caused by a Foley catheter gastrostomy tube inadvertently placed into the esophagus at the time of tube change. The patient presented with vomiting and progressive respiratory distress and when first evaluated had a left-sided pneumothorax. The esophageal location of the Foley balloon was not initially apparent. Metrizamide radiography demonstrated the esophageal rupture. The patient recovered with drainage of the mediastinal and pleural collections. Physicians and caretakers should be alerted to the mechanical complications of Foley catheter tube gastrostomy, since these complications are mostly preventable and easily diagnosed.
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PMID:Esophageal rupture in an infant secondary to esophageal placement of a Foley catheter gastrostomy tube. 274 4

A retrospective study of 50 patients was undertaken to observe the postoperative side effects experienced by patients undergoing metrizamide (Amipaque) myelography followed by laminectomy on the same day and to compare them with side effects experienced if the laminectomy was postponed at least one day. Results documented that the incidence of nausea was statistically greater in Group 1 (myelogram and surgery the same day) than in Group 2 (delayed surgery). While the occurrence of vomiting and headache in Group 1 was also greater, the numbers did not reach statistical significance. Group 1 did require significantly more doses of antiemetics for a longer period of time. The groups did not differ in the length of time an intravenous (IV) infusion was in place, but Group 1 patients required a significantly greater number of urinary catheterizations for retention and residual for longer than three days. The length of stay and the time from surgery to discharge was the same for both groups.
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PMID:Side effects following metrizamide myelography and lumbar laminectomy. 295 44

Delineation of the thecal sac in CT can be improved by the presence of intrathecal metrizamide. This may be especially helpful in postoperative patients in whom the landmarks are often obscured by epidural scarring. Metrizamide-enhanced CT was performed on outpatients using 2 1/2 ml metrizamide (170 mg I/ml). Follow-up is available on 40 patients. The procedure was well tolerated with only three instances of severe headache, one case of vomiting, and no reported seizures. Adequate opacification was obtained at 92% of the levels examined with fair opacification at the remainder of the levels. This technique is considered a safe and useful outpatient procedure.
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PMID:Low-dose metrizamide spinal computed tomography in outpatients. 375 34


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