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PubMed1994

[3D-MR myelography in diagnosis of lumbar spinal nerve root compression syndromes. Comparative study with conventional myelography].

65 patients with nerve root compression syndrome were examined using a new type of MR-technique, which is comparable to the conventional X-ray myelography. The results of the prospective case study were compared with previous clinical experiences (1). For the examinations a 1.0T whole body MR-system (Siemens Magnetom Impact) was used. A strong T2*-weighted 3D-FISP sequence (TR = 73 ms, TE = 21 ms, alpha = 7 degrees) was applied in sagittal orientation using a circularly polarized oval spine coil. To obtain fat suppression a frequency selective 1-3-3-1 prepulse was applied prior to the imaging sequence. The acquired 3D-data set was evaluated using a Maximum Intensity Projection (MIP) program. Our results confirmed earlier experiences which showed that the diagnostic sensitivity of 3D-MR myelography (3D-MRM) is comparable to that of conventional X-ray myelography. In cases of severe spinal canal stenosis and spondylolisthesises, and in cases of postoperative scar tissue with nerve root compressions, the sensitivity of the 3D-MRM is higher as compared to that of conventional X-ray myelography.

Adult↗
PubMed1992

Spinal leptomeningeal neoplastic disease. Evaluation by MR, myelography and CT myelography.

Out of 16 patients, spinal leptomeningeal neoplastic disease was diagnosed by MRI in 4 patients, myelography in 14 patients and CT myelography in 12 cases. MR was superior to myelography in 2 patients, in another 2 patients MRI was equally diagnostic. The cerebrospinal fluid of every patient contained malignant cells. Histological evidence for primary central nervous system tumors was found in 5 cases. In 10 cases, non-neuraxial malignancy consisted of small cell carcinoma of the lung (7 cases), and leukemia and lymphoma (3 patients). In 1 patient, primary leptomeningeal malignant melanoma was confirmed at autopsy. Preferential thoracolumbar neoplastic morphologic manifestation correlated with the presence of conus and cauda equina syndrome in 9 patients, low back pain, paresthesia and spinal root signs in 7 patients. False-negative interpretation of myelography in 2 patients with positive MR findings, and the impressive sensitivity of gadolinium Dota to improve visualization of subarachnoid spread, favor MRI as an alternative imaging technique in the assessment of patients with suspected intradural extramedullary malignancy.

Adult↗
PubMed1997

Three-dimensional MR myelography of the lumbar spine: comparative case study to X-ray myelography.

Conventional myelography was compared with a new type of MR technique using a fat-suppressing 3D fast imaging with steady precession (FISP) sequence for diagnosis of the lumbar root compression syndrome. 80 patients with discogenic disease in the lumbar spine were examined with a 1.0-T whole-body MR system (Siemens Magnetom Impact, Erlangen, Germany). A strongly T2(*)-weighted 3D FISP sequence was applied in the sagittal orientation. To obtain fat suppression, a frequency-selective 1-3-3-1 prepulse was applied prior to the imaging sequence. The acquired 3D data set was evaluated using a maximum intensity projection (MIP) program. The measurement time was 7 min, 47 s. Magnetic resonance myelography has significant advantages over conventional myelography, particularly in cases of extreme spinal canal stenosis. Compared with the conventional method, this new MR technique shows comparable sensitivity in the visualization of the spinal nerve roots in the lumbar spine.

Case-Control Studies↗
PubMed1981

Myelography with metrizamide--an analysis of the complications encountered in cervical, thoracic and lumbar myelography.

Detailed analysis of complications in 363 patients undergoing myelography with metrizamide is presented. Patients have been separated into three groups: those who had lumbar myelograms via lumbar puncture; patients who had cervical myelograms via lumbar route and patients who had cervical myelograms via cervical puncture (lateral C1/C2. approach). Analysis has revealed that the incidence of minor complications like headaches, nausea, and vomiting is higher than that associated with myodil myelography. Nevertheless, it is concluded that because of lack of long term disability of arachnoiditis, and because of greater diagnostic accuracy, metrizamide represents the best contrast medium for myelography currently available.

Adolescent↗
PubMed1982

Conventional metrizamide myelography (MM) and computed tomographic metrizamide myelography (CTMM) in scoliosis. A comparative study.

A retrospective examination was performed to assess the accuracy of metrizamide myelography (MM) and computed tomographic metrizamide myelography (CTMM) in scoliosis. Of 81 consecutive scoliotic children studied by myelography, 30 had only MM while the remaining 51 had CTMM immediately afterward. CTMM added essential diagnostic information in 13 cases of dysraphism and 4 cases of idiopathic scoliosis; in the remaining cases, both methods gave the same information. The authors conclude that in patients with severe scoliosis, dysraphism, and scoliosis with localized neurological disturbances, CTMM should always be added to MM or be the only examination; while in idiopathic scoliosis with vague neurological disturbances a survey of the entire spine is essential, preferably with MM.

Adolescent↗
PubMed1990

Intrathecal injection of Iohexol for routine myelography and CT myelography in 1,000 cases.

This article is to present the experience in 1,000 cases given intrathecal Iohexol injection during 1985-1988, including conventional myelography in 343 cases, conventional and CT myelography in 572, only CT myelography in 60 and CT cisternography in 25. No convulsions were observed. The frequency of headache was 11.6% and the total uncomfortable subjective reaction was 19.6% after intrathecal injection, but no serious complications were found. Because of very low frequency of side effects after this injection, most of the examinations can be made in the outpatient departments. In our clinical experience, Iohexol appears to be a myelographic contrast medium with diagnostic capabilities and less morbidity compared to Metrizamide. Thus Iohexol seems to be well suited for intrathecal injection and will replace metrizamide in this respect.

Adolescent↗
PubMed1983

The indications for metrizamide myelography. Relationship with complications after myelography.

To test the validity of our impression that in the absence of objective clinical evidence of nerve-root impingement there is a disproportionately high incidence of complications associated with myelography, the results in 248 patients were reviewed retrospectively and those in 110 were studied prospectively. Of all 358 patients, 53 per cent had complications after myelography with injection of metrizamide, of which headache and nausea and vomiting were the most frequent. The incidence of complications in the 112 patients whose objective clinical and myelographic findings were consistent was compared with that in the 180 patients who had only subjective complaints and normal myelographic findings. The incidence of complications was 30 per cent in the former group and 70 per cent in the latter group, an almost twofold difference (p greater than 0.05). The 110 patients in the prospective study were asked to grade the intensity of their headache after myelography. Of the thirty-one patients with positive objective clinical and myelographic findings, ten complained of headache, which was mild in seven (70 per cent) and severe in three. Of the sixty patients with only subjective complaints, thirty-eight complained of headache, which was mild in twelve (32 per cent) and severe in twenty-six.

Adolescent↗
PubMed1985

Aphasia, apraxia and neurogenic stuttering as complications of metrizamide myelography (speech deficits following myelography).

Aphasia following metrizamide myelography has been reported infrequently. During a seven-month period, we examined two patients who developed Broca's aphasia, apraxia of speech, oral-buccal-facial apraxia and neurogenic stuttering after intrathecal metrizamide administration. In each case, focal neurologic deficits were accompanied by clinical, electroencephalographic and radiologic signs of generalized neurologic disease. Serial speech and language evaluations initially revealed severe deficits that were largely resolved by the third day post-myelography. Out-patient follow-up examinations demonstrated persistence of mild speech and language abnormalities in each case. Our findings suggest that metrizamide may cause longlasting neurologic dysfunction.

Aphasia↗
PubMed1978

Cervical myelography with metrizamide (Amipaque). A comparison between conventional and computer-assisted myelography with special reference to the upper cervical and foramen magnum region.

Cervical myelography with metrizamide was performed in a series of 30 patients. Minor modifications to the conventional technique made it possible to carry out measurements of the sagittal diameter of the cord and to improve the opacification of the upper cervical--foramen magnum region. Computer tomography was performed with a head scanner within 1 h after the conventional examination, and the spinal cord surrounded by contrast medium was shown from C-3 to the foramen magnum region. Measurements of the sagittal diameter of the spinal canal and the cord at corresponding levels using the two methods showed good correlation.

Adolescent↗
PubMedDate not supplied

Single-shot turbo spin-echo MR myelography: comparison with 3D-turbo spin-echo MR myelography and T2-turbo spin-echo at 1 T.

In order to reduce the acquisition time, we compared the single-shot-TSE-MR myelography (MRm) and 3D-TSE-MRm. The T2-TSE sequence was the standard of reference. Fifty patients with low back pain, sciatica or cervical radiculopathy were examined at 1.0 T. The shortest AP diameter of the spinal canal, signal-to-noise ratio (SNR) for CSF and cord, contrast-to-noise ratio (CNR) and relative contrast (ReCon) between CSF and cord were calculated. No statistically significant difference was found between the three sequences with regard to the AP diameter of the spinal canal. A significant difference was found in: (i) SNRcord; (ii) SNRCSF; (iii) SS-TSE-MRm (showed the highest CNR) and (iv) SS-TSE-MRm (showed higher ReCon compared to 3D-TSE-MRm). In conclusion, SS-TSE-MRm can be used alternatively to 3D-TSE-MRm reducing the acquisition time down to only 8 s per image.

Adult↗
PubMed1989

[Omnipaque (iohexol) CT myelography (CTM) in the diagnosis of cervical spondylotic myelopathy--correlative study of conventional myelography (a report of 100 cases)].

100 cases of cervical spondylotic myelopathy were studied with both CTM and conventional myelography and the results were compared. It was shown that CTM possesses more advantages over its counterpart as follows: (1) CTM can demonstrate with a higher degree of accuracy the size and configuration of the spinal cord, its internal composition and cystic necrosis, can pick up more herniations, hard and soft, up to 16% (39/252) and better define the position left, middle and right of the protrusion. (2) CTM is capable of making a correct diagnosis of cervical myelopathy and cystic necrosis in the cord. Analysis also showed that the degree of changes of spinal cord seen on CTM correlation closely with severity of the clinical picture. Atrophy and cystic necrosis of the cord are important factors accounting for clinical deterioration and operative failure.

Adult↗
PubMed1993

Epidural and subdural contrast in myelography and CT myelography.

A retrospective study of 624 lumbar myelographic and CT myelographic procedures was undertaken to evaluate the frequency, radiographic and clinical relevance of contrast medium outside the dural sac. Our findings indicate that epidural contrast is frequently identified on CT scans with highly sensitive window settings (in 35.4% of all CT myelographic studies). Standard myelographic films are less sensitive for the detection of epidural contrast (9.6%). Subdural contrast is far less often encountered (in 2.4% of CT myelographic studies and in 3.2% of standard myelographic films). We believe leakage of contrast to occur through the puncture site into the epidural and subdural space.

Adult↗