A Prospective Comparison of Iotrolan and Iohexol in Lumbar Myelography

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Abstract
In a double-blind study 238 patients were examined with lumbar myelography using iotrolan or iohexol in randomized sequence in order to evaluate the image quality, the safety and tolerance of iotrolan by monitoring the adverse effects with special attention to late reactions. There were no serious complications. On the first day 28 patients (24%) had headache after iotrolan and 41 (34%) after iohexol. This difference was not significant, and these frequencies are similiar to those found after spinal puncture alone. The second most frequent side effect was neck pain; the duration of neck pain were significantly longer after myelography with iohexol than with iotrolan. There was a significantly higher frequency of adverse effects in females the first 24 hours, but during examination and on days 2 to 4 there were no differences between males and females. Anamnestic information or myelographic diagnosis could not predict which patients would have side effects. The image quality was excellent or good in all examinations but one. It is concluded that iotrolan is a safe contrast medium well suited for lumbar myelography.