metrizamide and Neoplasm-Metastasis

New lesions were shown by Tc99m bone scans to have developed in sixty patients with known metastatic cancer or high-risk primary cancer and normal neurologic examinations; they were further evaluated with plain radiographs, spinal computed tomography (CT), and CT myelography (CT-M) according to an algorithm. Three groups were identified based on plain radiographs: group 1 (normal radiograph), group 2 (compression fracture as indicated by radiograph), group 3 (evidence of metastasis as indicated by radiograph). In group 1 (n = 18), spinal CT revealed that 33% of the patients had benign disease and 67%, metastases; epidural compression was seen in 25% of the patients with metastasis as indicated by CT-M. In group 2 (n = 26), CT-M disclosed that 38% had a benign compression fracture and 62% had metastases and that 63% of the patients with metastases had an epidural compression. In group 3 (n = 16), spinal CT revealed that 15 patients had metastases (one patient had benign disease). Epidural cord compression was seen in 47% of the patients with metastatic disease. In all groups, the presence of cortical bone discontinuity around the neural canal (seen in 31 patients) was highly associated with epidural compression (seen in 20 patients). Our approach allowed the early and accurate diagnosis of spinal metastasis and epidural tumor as well as the diagnosis of benign disease and was useful in planning optimal local therapy.

Topics: Bone and Bones; Female; Humans; Male; Metrizamide; Myelography; Neoplasm Metastasis; Neoplasms; Spinal Neoplasms; Spine; Technetium; Tomography, X-Ray Computed

Computed tomography (CT) has made a profound impact on the diagnosis and treatment of neuroblastomas and ganglioneuromas. The size, location, calcification, composition, and contiguous spread of the tumors has been well demonstrated by CT. CT is essential for their staging, subsequent treatment, and follow-up. Seventy-seven children were reviewed, 67 with neuroblastoma and 10 with ganglioneuroma seen between 1976 and 1980. Fifty-eight had one or more body CT scans, 22 had metrizamide myelography and/or CT metrizamide myelography, and three patients had cranial CT. Intraspinal extension of tumor occurred in 11 instances, several requiring decompressive surgery. A workup plan for optimal use of CT and CT metrizamide myelography was developed from this experience.

Topics: Adolescent; Brain Neoplasms; Child; Child, Preschool; Female; Ganglioneuroma; Humans; Infant; Infant, Newborn; Male; Metrizamide; Myelography; Neoplasm Metastasis; Neuroblastoma; Retrospective Studies; Spinal Cord Neoplasms; Tomography, X-Ray Computed

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.

Topics: Adult; Aged; Carcinoma; Cerebral Ventricle Neoplasms; Cerebral Ventriculography; Cerebrospinal Fluid; Cerebrospinal Fluid Shunts; Female; Humans; Hydrocephalus; Injections, Intraventricular; Male; Meningeal Neoplasms; Metrizamide; Neoplasm Metastasis; Tomography, X-Ray Computed

A survey is made of the development of water-soluble contrast media and of the experimental and preliminary clinical investigations of the new water-soluble contrast medium metrizamide. The experiences with the medium indicate that its use in the subarachnoid space is safe and reliable.

Topics: Animals; Contrast Media; Humans; Intervertebral Disc Displacement; Metrizamide; Myelography; Neoplasm Metastasis; Neurilemmoma; Spinal Cord Neoplasms; Spinal Neoplasms

Metrizamide seems to be a suitable contrast medium for ventriculography and myelography. This contrast medium is less toxic and far less epileptogenic and spasmogenic than the other water-soluble contrast media in current use. No serious complications were noted in the present series. Transient changes in EEG were recorded, mainly with cervical myelographies. However, it is too early to evaluate the long-term side effects.

Topics: Adolescent; Adult; Aged; Cerebral Aqueduct; Cerebral Ventricle Neoplasms; Cerebral Ventriculography; Child; Child, Preschool; Contrast Media; Humans; Infant; Infant, Newborn; Intervertebral Disc Displacement; Metrizamide; Middle Aged; Myelography; Neoplasm Metastasis; Neurilemmoma; Pineal Gland; Spinal Cord Neoplasms; Teratoma

The radiologic appearances at gas myelography were analysed in 57 metastatic lesions, all histologically verified, or having known primary tumours. Five of these cases were also examined with a water-soluble contrast medium, metrizamide. The results were correlated to the findings at surgery and to tumour pathology. It is concluded that myelographic findings simulating juxtamedullary growth are usually due to local indentation of the dura by the extradural tumour, and not to intradural extension.

Topics: Adolescent; Adult; Aged; Breast Neoplasms; Child; Child, Preschool; Contrast Media; Histiocytosis, Langerhans-Cell; Humans; Infant; Lymphoma, Large B-Cell, Diffuse; Lymphoma, Non-Hodgkin; Metrizamide; Middle Aged; Myelography; Neoplasm Metastasis; Spinal Cord Neoplasms