Metrizamide脊髓腔攝影術對腦波影響之研究

The Effects of Metrizamide Myelography on Electroencephalographic Changes

賴秋蓮(Chiou-Lian Lai) ； 劉景寛(Ching-Kuan Liu) ； 周敏雄(Min-Shon Chou) ； 林瑞泰(Ruey-Tay Lin) ； 洪純隆(Sheng-Long Howng) ； 陳素貞(Su-Chen Chen)

《The Kaohsiung Journal of Medical Sciences》 5卷6期 (1989/06) Pp. 324-329

https://doi.org/10.6452/KJMS.198906.0324

摘要

Metrizamide為一種非離子性的水溶性對比劑，它用於脊髓攝影術有很好的顥像力，因是由蜘蛛膜下腔注射，所以必需考慮它對腦組織新陳代謝的影響，而腦電圖檢查是一種非侵犯性且能客觀的評估腦功能變化的方法。本研究即利用此一特性，希望能由頸部或腰部metrizamide脊髓腔攝影術後腦電圖之變化，來探討metrizamide對腦組織的影響，結果顯示：頸部或腰部metrizamide脊髓腔攝影術後，約二分之一的患者臨床會出現不良反應之症狀及異常腦波，而頸部或腰部兩種不同的檢查方式，臨床症狀及異常腦波發生的機率並無統計學上有意義之差別，但由臨床不良反應之發生及異常腦波乲出現，在項部或腰部metrizamide脊髓腔攝影術後，二者的相關性並不相同，我們推測可能是因其作用機轉不同所致。更希望能藉本研究來了解metrizamide對腦組織的作用機轉，而進一步預防metrizamide脊髓腔攝影術後不良反應之發生。

並列摘要

Metrizamide, a non-ionic water soluble contrast medium, is used in myelography for detecting spinal cord lesions. Because it is an injection in the subarachnoid space, the effects on the central nervous system following metrizamide myelography should be studied. Electroencephalography can offer a non-invasive and objective method for evaluating the functions of the central nervous system.
From September to December 1986,30cases which had received cervical or lumbar metrizamide myelography were collected. After myelography, in addition to a history review and neurologic examination, electroencephalography was carried out within 24 hours. If the EEG record revealed abnormal, a series of EEG follow-ups were conducted until recordings were normal.
The incidence of clinical adverse effects following Metrizamide myelography was 53.3%and 66.6% respectively in cervical and lumbar injections. No significant difference was found between the two groups. Secondly, the abnormal rate of the EEG record was 40.0% and 60.0% following cervical and lumbar myelography. The difference was also not significant. Lastly, the relation between clinical adverse effects and an abnormal EEG records was poor in cervical metrizamide myelography but good in lumbar myelography.
The conclusions suggested by this research that the clinical adverse effects and the abnormal EEG record after metrizamide myelography are transient and are reversible changes. The mechanism of complications following cervical and lumbar metrizamide are different. Although complications may occur following cervical and lumbar metrizamide myelography, it remains a practical method in detecting spinal cord lesions.

並列關鍵字

metrizamide ； myelography ； electroencephalography(EEG)