Within the frame work of lumbar myelography, 158 patients were entered in a double-blind study in order to test a dimeric contrast medium (
iotrolan) against a monomeric one (
iopamidol), both of them non-ionic. A three-step scheme was applied to evaluate the X-ray pictures with respect to contrast quality. Particular attention was paid to the visibility of details, i.e. the nerve root and its course, as well as to how well it could be distinguished in the nerve root sheath. On the basis of a high level of significance (P less than 0.05), comparison of the two
contrast media showed no difference in contrast quality. Sixty-nine percent of the examinations using
iotrolan resulted in excellent contrast quality, whereas the corresponding very good results using
iopamidol lay at 76%. Twenty-nine percent of the patients examined with
iotrolan and 27% of those examined with
iopamidol showed side effects.
Headache occurred most frequently, followed by
nausea,
dizziness and
neck pain. Sixty percent of the patients suffering from postmyelographic reactions reported delayed
headache, which occurred most often with
iotrolan rather than
iopamidol. As for manifestation of other postmyelographic side effects, there were no significant differences (P less than 0.05, Fischer's test) between the two groups of
contrast media.