Initial experience with a nonionic, dimeric contrast medium (iotrolan) in direct and indirect arteriography: a randomized, intraindividual double-blind study in 60 patients.

The new isotonic contrast medium iotrolan has been compared with iopromide in aortofemoral arteriography, selective femoral arteriography, and intravenous digital substraction angiography (DSA). In each case a crossover study design has been chosen with special emphasis on patient comfort. Despite problems in the interpretation of results due to a "hangover" effect in selective peripheral arteriography, it may be concluded: (1) Iotrolan causes significantly less discomfort, such as the feeling of heat and most likely also pain, than iopromide.

Organ-specific and general tolerance of iotrolan 280 after intravenous administration: phase I study in healthy volunteers.

Iotrolan 280, the first water-soluble, nonionic, blood-isotonic, dimeric contrast medium, was administered intravenously to 12 healthy male volunteers. In a Phase I study with an intraindividual design in comparison with placebo, four doses between 0.15 and a maximum of 0.

Gastrointestinal diagnosis with iotrolan: experience in pediatric radiology.

The use of low-osmolar, nonionic, monomeric contrast media has made gastrointestinal diagnosis with water-soluble contrast media less hazardous with a greater diagnostic yield. Since, however, even this group of compounds is hypertonic in comparison with blood, water is still drawn from the body into the bowel, resulting in water and electrolyte shifts and distal dilution of the contrast material with deterioration of the image quality. The use of iotrolan, which is isotonic in comparison with blood, therefore, appears to offer advantages for selected groups of patients.

Indirect lymphography with iotrolan.

Iotrolan was used in concentrations of 240 and 300 mg I/ml for indirect lymphography in a total of 70 patients, and permitted a diagnostic evaluation of the peripheral lymphatics in all cases. The contrast quality was found to correlate with the concentration used. The concentration of 300 mg I/ml Iotrolan was judged to provide the better contrast density and definition.

Iotrolan, a nonionic dimeric contrast medium in myelography.

As part of a clinical Phase III study of the nonionic, dimeric contrast medium iotrolan, differences in opacification, tolerance, and effects on the electroencephalogram after myelography were examined in a double-blind comparison with iohexol. Two groups of 25 patients each received either 10 ml iotrolan 240 mg I/ml or 10 ml iohexol 240 mg I/ml for lumbar myelography, and two groups of 50 patients each received either 10 ml iotrolan 300 mg I/ml or 10 ml iohexol 300 mg I/ml for lumbar, thoracic or cervical myelography. The overall assessment of the opacification in the subarachnoid space, which was moderate in only one case of each group and otherwise good, showed no differences between the preparations.

Iotrolan versus iopamidol: a controlled, multicenter, double-blind study of lumbar and direct cervical myelography.

Iotrolan is a new nonionic, dimeric contrast medium that is distinguished by its special physicochemical and low chemotoxic properties. It displays near isotonicity with blood and cerebrospinal fluid in all clinically used concentrations (190, 240, and 300 mg I/ml). The controlled, double-blind study of iotrolan versus iopamidol presented here shows that iotrolan is significantly superior to the monomeric contrast medium in lumbar and direct cervical myelography.

Tolerance of iotrolan 190 and cerebrospinal fluid-diluted iotrolan 300 at the same iodine concentration in lumbar myelography.

Iotrolan, the radiologically effective ingredient of the contrast medium Isovist, has so little osmotic activity that only solutions of about 300 mg I/ml are isotonic to cerebrospinal fluid (CSF). The osmolality of the contrast medium at lower iodine concentrations has to be increased through additives. Theoretically, iotrolan 300 diluted with CSF is the most physiologic.

Urography with monomeric and dimeric nonionic contrast media: comparative, randomized, double-blind study of iotrolan 280 and iopromide 300.

In a double-blind comparative study between the nonionic, dimeric iotrolan and the nonionic, monomeric iopromide the urographic image quality in the dose 300 mg I/kg body weight is better after iopromide up to 20 minutes after the injection. This result appears to be in contradiction to the results of the animal experimental studies. Possible reasons are discussed.

Vacuum injection--a new indirect fixing method for the demonstration of initial lymphatics in biopsy specimens of human organs.

With the indirect vacuum injection method (IVIM) at a negative pressure of 30 kPa, it is possible to demonstrate the initial lymphatics (IL) by scanning electron microscopy even in biopsy specimens of various organs (minimum size 0.5 X 0.5 cm2).

Clinical use of indirect lymphography in different forms of leg edema.

Indirect lymphography by subepidermal infusion of newly developed nonionic, dimeric contrast media (e.g., Iotrolan) opacifies peripheral lymphatics of the skin.

Scanning electron microscopy of the initial lymphatics of the skin after use of the indirect application technique with glutaraldehyde and MERCOX as compared to clinical findings.

Certain phenomena in the region of the initial lymphatics during clinical examination (indirect lymphography and microlymphography)--namely build-up and course and filling and diffusion--have still to be elucidated. The glutaraldehyde and MERCOX methods were used to simulate indirect application conditions in clinical procedures in skin specimens (human and pig) which were then examined by scanning electron microscopy. The results presented include novel findings on the microtopography of these lymph vessels and the typology of filling refluxes which are of importance when indirect imaging techniques are employed.

Influence of the spread and period of retention of Iotrolan in the subarachnoid space on the side effects rate in myelography.

Fifty patients underwent myelography with the newly developed CSF-isotonic, dimeric, non-ionic contrast medium Iotrolan. Repeat spinal and cranial computerised tomographic studies with measurement of the attenuation values were conducted to demonstrate the administered contrast medium in the spinal canal and intracranial subarachnoid space. The patients were examined neurologically, observed clinically and asked about concomitant symptoms.

New techniques of demonstrating lymph vessels in skin biopsy specimens and intact skin with the scanning electron microscope.

Two new methods now allow the systematic examination of the morphology and micropathology of the initial lymphatics (lymph sinuses and precollectors) in human skin biopsy specimens under the scanning electron microscope. Pertinent studies and findings in the intact skin of anesthetized pigs demonstrate the standard quality of the biopsy preparations. The following are new findings made with these methods: in the skin of the human head, both the lymph sinuses and the precollectors extend as far as the epidermis.

Iotrolan. The first dimeric non-ionic contrast medium for the subarachnoid space.

Iotrolan was administered to 1400 in-patients and out-patients by intrathecal injection within the framework of the clinical investigation. It was used for studies of the lumbar, thoracic, cervical and intracranial areas. It was compared with metrizamide, iopamidol and iohexol in concentrations of 190, 240 and 300 mg I/ml in controlled double-blind trials.

[1st report on indirect lymphography using iotasul in the head and neck region].

The early results in 29 patients with tumours in the head and neck are described, on whom indirect lymphography with the water-soluble contrast medium Iotasul had been carried out (experimental contrast medium, Schering AG). After careful sub-epidermal injection of about 12 ml contrast, either lateral to the eye or in the region of the chin, lymph vessels were seen in 25 patients and lymph nodes in 20. These were demonstrated by conventional radiography or by xero-radiography.

The dermal lymphatics in lymphoedema visualized by indirect lymphography.

Iotasul, a new water-soluble contrast medium, is very suitable for subepidermal infusion (indirect lymphography) for the demonstration of small (initial) dermal lymphatics in the macro-range (precollectors). By this method normal lymph vessels can be demonstrated in the healthy skin of hands and feet which are so fine that they cannot be punctured for direct lymphography. We studied thirty-eight patients with various forms of lymphoedema by indirect lymphography.

Differential diagnosis of lymphedema after indirect lymphography with Iotasul.

Indirect lymphography with Iotasul (interdigital, intradermal infusion) was performed in 32 patients with lymphedema. No side effects were observed. Opacification of the peripheral lymph vessels reveals two distinct patterns: 1.

[Indirect lymphography at the eye and in the face- and neck-region with iotasul (author's transl)].

For the first time the lymphatic pathways of the conjunctiva and the eyelids of dogs could be presented in vivo with the water-soluble X-ray contrast medium iotasul. By means of indirect application the lymph flow could be demonstrated up to the truncus jugularis. Because of the simultaneous infusion of the contrast medium at different points the lymphography of the face- and neck-region is considerably facilitated.