Lipiodol

Lipiodol is an iodinated, radio-opaque contrast poppyseed oil that is used to outline structures in radiological investigations. It was first produced by Marcel Guebert in 1901, but the X-ray contrast properties of lipiodol were not discovered before 1918.

It is used in chemoembolization applications as a contrast agent in follow-up imaging. It has an additional use in gastric variceal obliteration as a dilutant that does not affect polymerization of cyanoacrylate.

Lipiodol is also used in lymphangiography, the imaging of the lymphatic system.

Historically lipiodol was often used as a contrast medium at hysterosalpingography (HSG: a procedure to determine tubal patency, used in the investigation of subfertility). It became less commonly utilised in the 1960s to 1980s because the more modern water-soluble media give images that are easier to interpret. There is also an important safety issue with lipiodol in that intravasation (leakage) of the fluid into the venous system has caused complications in the past.

Recently there has been an increasing interest in the use of lipiodol as a therapeutic agent in the management of unexplained infertility, using a procedure called lipiodol flushing. There have been a small number of studies that suggest that flushing the media through the tubes gives a short-term rise in fecundity in patients with unexplained infertility. A systematic review has suggested a significant increase in fertility, especially in those women who have endometriosis when using lipiodol flushing. [Johnson NP. A review of the use of lipiodol flushing for unexplained infertility. Treat Endocrinol 2005; 4: 233-43. PMID 16053340.]

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