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Lipiodol (also known as ethiodized oil or iodized poppy seed oil) is an iodinated, oil-based radiopaque contrast medium. It is composed of fatty acid esters of poppy seed oil with organically bound iodine, making it both radio-opaque and lipophilic.

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Historical Perspective

• Introduced in the 1920s as one of the first iodinated contrast agents.
• Initially used for myelography and hysterosalpingography; later replaced in CNS use due to neurotoxicity.
• Still widely used in interventional radiology and lymphatic imaging.

Properties

• Composition: Poppy seed oil esterified with iodine (~480 mg iodine/ml).
• Solubility: Insoluble in water; soluble in organic solvents.
• Viscosity: Highly viscous compared to aqueous contrast media.
• Absorption: Slow, with prolonged tissue retention (weeks to months).
• Radiopacity: Excellent due to high iodine content.

Indications & Uses

Diagnostic Applications

• Lymphangiography: Injected into lymphatic vessels to delineate lymphatic anatomy, lymph nodes, and detect lymphatic leaks or obstruction.
  • Used for chylothorax, chylous ascites, and lymphoma staging (historically more than now).
• Hysterosalpingography (HSG): Used in infertility evaluation.
  • Oil-based media like Lipiodol may improve fertility by flushing effect on fallopian tubes.
• CT lymphography (selective cases)

Therapeutic Applications