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The penetration into rabbit spinal cord of two nonionic contrast media, iohexol and metrizamide, and a reference tracer, technetium DTPA, were compared. The spinal subarachnoid space was perfused for 4 hours with a CSF solution to which technetium DTPA and either iohexol or metrizamide had been added. The contrast media and technetium DTPA concentrations reached a plateau level in CSF outflow within 80 minutes. The contrast media concentrations in CSF were higher than the technetium DTPA (P less than .001). In the cord tissue, technetium DTPA reached higher concentrations than the contrast media (P less than .001), and iohexol reached higher concentrations relative to technetium DTPA than metrizamide (P less than .001). The mean contrast media distribution volumes in the thoracic cord were 13% (iohexol) and 12% (metrizamide). The smaller distribution volume observed for metrizamide could be related to the larger effective size of "associated" metrizamide molecules or an interference with diffusion perhaps related to binding to glucose carriers.

Iohexol (Omnipaque) was used for enhancement of brain CT in 17 patients with previous adverse reactions to contrast media. Two of these patients also had cerebral angiography using iohexol. No premedication was given. The only adverse reaction was a skin reaction 24 hours after the iohexol injection, which might have been induced by the contrast medium or treatment with antibiotics. Five of the patients had repeated iohexol injections at different occasions without adverse reactions.