Ekholm S E
Invest Radiol. 1985 Jan-Feb;20(1 Suppl):S18-21. doi: 10.1097/00004424-198501002-00006.
Nonionic contrast media represent a significant advance for myelography due to their substantially lower neurotoxicity. Some side effects have been noted with metrizamide, however. Origins of adverse effects have not been clearly defined. Studies reviewed here investigated the effects of two nonionic contrast media, metrizamide and iohexol, on glucose metabolism in neural tissue cells in vitro using rat hippocampal tissue slices. Isotonic metrizamide produced metabolic disturbances that may partially explain some clinical adverse effects. It was hypothesized that iohexol, which, unlike metrizamide, does not contain a 2-deoxy-D-glucose component, would not have this effect. A series of in vitro experiments compared the two media. Results showed no evidence that iohexol caused metabolic disturbances, but in vitro there was a depressive effect on metabolism from hypertonicity. In vivo water will rapidly diffuse toward hypertonic areas, thus neutralizing the osmotic effect. The lesser metabolic effect suggests that iohexol would be safer than metrizamide for subarachnoid examinations.
由于神经毒性显著降低，非离子型造影剂代表了脊髓造影术的一项重大进展。然而，甲泛葡胺已出现一些副作用。不良反应的起源尚未明确界定。此处回顾的研究使用大鼠海马组织切片，在体外研究了两种非离子型造影剂甲泛葡胺和碘海醇对神经组织细胞葡萄糖代谢的影响。等渗甲泛葡胺产生了代谢紊乱，这可能部分解释了一些临床不良反应。据推测，与甲泛葡胺不同，碘海醇不含2-脱氧-D-葡萄糖成分，不会产生这种效应。一系列体外实验对这两种造影剂进行了比较。结果显示，没有证据表明碘海醇会引起代谢紊乱，但在体外，高渗会对代谢产生抑制作用。在体内，水会迅速向高渗区域扩散，从而抵消渗透效应。较小的代谢效应表明，在蛛网膜下腔检查中，碘海醇比甲泛葡胺更安全。
