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Journal of Neurology, Neurosurgery, and... Jun 1966
Topics: Dermoid Cyst; Humans; Male; Middle Aged; Myelography; Spinal Cord Neoplasms
PubMed: 5937643
DOI: 10.1136/jnnp.29.3.262 -
Journal of Veterinary Internal Medicine Sep 2020Three-dimensional computed tomographic (CT) evaluation of the cervical vertebral column enables more accurate identification of osseous and soft tissue lesions than...
BACKGROUND
Three-dimensional computed tomographic (CT) evaluation of the cervical vertebral column enables more accurate identification of osseous and soft tissue lesions than traditional latero-lateral radiography. However, examination of the complete cervical vertebral column has been limited by horse size, preventing evaluation of the caudal cervical vertebrae.
OBJECTIVES
To describe a technique to enable CT myelography of the complete cervical spine and describe the findings in 51 horses.
ANIMALS
Records of 51 horses presented for evaluation of cervical vertebral lesions.
METHODS
A retrospective review of clinical records from all horses presented for CT myelography to further investigate possible cervical vertebral lesions was performed. A description of a novel approach to CT myelography in horses and retrospective review of the findings in clinical cases has been included.
RESULTS
Degenerative joint disease was identified at 1 or more dorsal articular process joint in 50/51 horses, of which 44/51 had a site of grade 2 or greater. Spinal cord compression was observed on CT myelography in 31/51 horses, whereas attenuation of the dorsal contrast column was identified radiographically in 11/50 horses. Thirty-three horses showed narrowing or obliteration of the intervertebral foramina at 1 or more site and osteochondral fragments were seen in 11/51 horses.
CONCLUSIONS AND CLINICAL IMPORTANCE
Computed tomography myelography is relatively safe and an easily performed technique with the correct equipment, enabling evaluation of the cervical vertebral structures of horses in all planes and volumetrically. It is possible that lesion extent might be underestimated with this diagnostic modality, hence interpretation should be complimented with flexed and extended views radiographically.
Topics: Animals; Cervical Vertebrae; Horse Diseases; Horses; Myelography; Retrospective Studies; Spinal Cord Compression; Tomography, X-Ray Computed
PubMed: 32705729
DOI: 10.1111/jvim.15848 -
AJNR. American Journal of Neuroradiology Jul 2014Although most infants with brachial plexus palsy recover function spontaneously, approximately 10-30% benefit from surgical treatment. Pre-operative screening for nerve...
BACKGROUND AND PURPOSE
Although most infants with brachial plexus palsy recover function spontaneously, approximately 10-30% benefit from surgical treatment. Pre-operative screening for nerve root avulsions is helpful in planning reconstruction. Our aim was to compare the diagnostic value of CT myelography, MR myelography, and both against a surgical criterion standard for detection of complete nerve root avulsions in birth brachial plexus palsy.
MATERIALS AND METHODS
Nineteen patients who underwent a preoperative CT and/or MR myelography and subsequent brachial plexus exploration were included. Imaging studies were analyzed for the presence of abnormalities potentially predictive of nerve root avulsion. Findings of nerve root avulsion on surgical exploration were used as the criterion standard to assess the predictive value of imaging findings.
RESULTS
Ninety-five root levels were examined. When the presence of any pseudomeningocele was used as a predictor, the sensitivity was 0.73 for CT and 0.68 for MR imaging and the specificity was 0.96 for CT and 0.97 for MR imaging. When presence of pseudomeningocele with absent rootlets was used as the predictor, the sensitivity was 0.68 for CT and 0.68 for MR imaging and the specificity was 0.96 for CT and 0.97 for MR imaging. The use of both CT and MR imaging did not increase diagnostic accuracy. Rootlet findings in the absence of pseudomeningocele were not helpful in predicting complete nerve root avulsion.
CONCLUSIONS
Findings of CT and MR myelography were highly correlated. Given the advantages of MR myelography, it is now the single technique for preoperative evaluation of nerve root avulsion at our institution.
Topics: Brachial Plexus; Brachial Plexus Neuropathies; Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Magnetic Resonance Imaging; Male; Myelography; Radiculopathy; Reproducibility of Results; Sensitivity and Specificity; Tomography, X-Ray Computed
PubMed: 24676008
DOI: 10.3174/ajnr.A3878 -
Journal of the American Veterinary... Dec 2017
Topics: Animals; Arachnoid Cysts; Diagnosis, Differential; Dog Diseases; Dogs; Female; Magnetic Resonance Imaging; Myelography; Neurilemmoma; Neurologic Examination; Paralysis; Spinal Cord Neoplasms; Tomography, X-Ray Computed
PubMed: 29190194
DOI: 10.2460/javma.251.12.1379 -
AJNR. American Journal of Neuroradiology Jan 2021Decubitus CT myelography is a reported method to identify CSF-venous fistulas in patients with spontaneous intracranial hypotension. One of the main advantages of...
Decubitus CT myelography is a reported method to identify CSF-venous fistulas in patients with spontaneous intracranial hypotension. One of the main advantages of decubitus CT myelography in detecting CSF-venous fistulas is using gravity to dependently opacify the CSF-venous fistula, which can be missed on traditional myelographic techniques. Most of the CSF-venous fistulas in the literature have been identified in patients receiving general anesthesia and digital subtraction myelography, a technique that is not performed at all institutions. In this article, we discuss the decubitus CT myelography technique and how to implement it in daily practice.
Topics: Adult; Aged; Aged, 80 and over; Cerebrospinal Fluid Leak; Female; Fistula; Humans; Image Interpretation, Computer-Assisted; Intracranial Hypotension; Male; Middle Aged; Myelography; Patient Positioning; Tomography, X-Ray Computed
PubMed: 33122215
DOI: 10.3174/ajnr.A6844 -
Annals of the Royal College of Surgeons... May 1980A series of 24 patients presenting with features of both cervical and lumbar spondylosis and disc disease has been studied in order to evaluate the results of surgical...
A series of 24 patients presenting with features of both cervical and lumbar spondylosis and disc disease has been studied in order to evaluate the results of surgical treatment. Myelography is essential for confirmation of multifocal lesions. In all but 4 cases beneficial results were obtained after decompression of the predominantly involved region of the spinal canal. These 4 patients were improved after both lumbar and cervical laminectomy in two stages with an interval of 3-6 months. Morbidity was insignificant.
Topics: Adult; Aged; Cervical Vertebrae; Female; Humans; Intervertebral Disc; Lumbar Vertebrae; Male; Middle Aged; Myelography; Spinal Diseases; Spinal Osteophytosis; Syndrome
PubMed: 7396348
DOI: No ID Found -
Journal of the American Veterinary... Jun 2011To determine intraobserver, interobserver, and intermethod agreement for results of myelography, computed tomography-myelography (CTM), and low-field magnetic resonance...
Intraobserver, interobserver, and intermethod agreement for results of myelography, computed tomography-myelography, and low-field magnetic resonance imaging in dogs with disk-associated wobbler syndrome.
OBJECTIVE
To determine intraobserver, interobserver, and intermethod agreement for results of myelography, computed tomography-myelography (CTM), and low-field magnetic resonance imaging (MRI) in dogs with disk-associated wobbler syndrome (DAWS).
DESIGN
Prospective cross-sectional study.
ANIMALS
22 dogs with DAWS.
PROCEDURES
All dogs underwent myelography, CTM, and low-field MRI. Each imaging study was interpreted twice by 4 observers who were blinded to signalment and clinical information of the patients. The following variables were assessed by all 3 techniques: number, site, and direction of spinal cord compressions; narrowed intervertebral disk spaces; vertebral body abnormalities; spondylosis deformans; and abnormal articular facets. Intervertebral foraminal stenosis was assessed on CTM and MRI images. Intraobserver, interobserver, and intermethod agreement were calculated by κ and weighted κ statistics.
RESULTS
There was very good to good intraobserver agreement for most variables assessed by myelography and only moderate intraobserver agreement for most variables assessed by CTM and low-field MRI. There was moderate to fair interobserver and intermethod agreement for most variables assessed by the 3 diagnostic techniques. There was very good or good intraobserver, interobserver, or intermethod agreement for the site and direction of the worst spinal cord compression as assessed by all the imaging modalities; abnormal articular facets and intervertebral foraminal stenosis were the least reliably assessed variables, with poor interobserver agreement regardless of imaging modality used.
CONCLUSIONS AND CLINICAL RELEVANCE
There was considerable variation in image interpretation among observers and between use of various imaging modalities; these imaging techniques should be considered complementary in assessment of dogs with DAWS.
Topics: Animals; Cervical Vertebrae; Cross-Sectional Studies; Dog Diseases; Dogs; Intervertebral Disc Displacement; Magnetic Resonance Imaging; Myelography; Observer Variation; Spinal Cord Compression; Spondylosis; Tomography, X-Ray Computed
PubMed: 21671815
DOI: 10.2460/javma.238.12.1601 -
AJNR. American Journal of Neuroradiology Feb 2019The significance of renal contrast on CT myelography is uncertain. This project examined different patient populations undergoing CT myelography for the presence of...
BACKGROUND AND PURPOSE
The significance of renal contrast on CT myelography is uncertain. This project examined different patient populations undergoing CT myelography for the presence of renal contrast to determine whether this finding is of diagnostic value in spontaneous intracranial hypotension.
MATERIALS AND METHODS
Four groups of patients were analyzed for renal contrast on CT myelography. The control group underwent CT myelography for reasons other than spontaneous intracranial hypotension ( = 47). Patients in study group 1 had spontaneous intracranial hypotension but CT myelography negative for dural CSF leak and CSF venous fistula ( = 83). Patients in study group 2 had spontaneous intracranial hypotension and CT myelography positive for dural CSF leak ( = 44). Patients in study group 3 had spontaneous intracranial hypotension and CT myelography suggestive of CSF venous fistula due to a hyperdense paraspinal vein ( = 17, eleven surgically confirmed).
RESULTS
Renal contrast was present on the initial CT myelography in 0/47 patients in the control group, 10/83 patients in group one, 1/44 patients in group 2, and 7/17 patients in group 3. Renal contrast on initial CT myelography in patients with suspected or surgically confirmed CSF venous fistula was significantly more likely than in patients with a dural CSF leak ( = .0003).
CONCLUSIONS
Renal contrast on initial CT myelography was seen only in patients with spontaneous intracranial hypotension. This was more common in confirmed/suspected CSF venous fistulas compared with dural leaks. Early renal contrast in patients with spontaneous intracranial hypotension should prompt scrutiny for a hyperdense paraspinal vein, and, if none is found, potentially advanced diagnostic studies.
Topics: Adult; Cerebrospinal Fluid Leak; Female; Humans; Intracranial Hypotension; Kidney Tubules, Collecting; Male; Middle Aged; Myelography; Tomography, X-Ray Computed
PubMed: 30655256
DOI: 10.3174/ajnr.A5934 -
Clinical Neurology and Neurosurgery Jun 2022Spontaneous intracranial hypotension (SIH) can be effectively treated by epidural blood patch (EBP) following the primary unsuccessful conservative therapy....
OBJECTIVE
Spontaneous intracranial hypotension (SIH) can be effectively treated by epidural blood patch (EBP) following the primary unsuccessful conservative therapy. Nevertheless, multi-site cerebrospinal fluid (CSF) leaks or those originating at the cervical or thoracic spine remain therapeutically challenging. Therefore, this study aimed to present our experience in the treatment of thoracic CSF leaks using epidural catheters for the EBP infusion.
METHODS
Three patients presenting with typical orthostatic headaches were qualified for an EBP procedure. Preoperative MRI scans, myelography, and CT myelography were performed. Additionally, delayed CT myelography was repeated after 3 h to identify the CSF leakage site. Patients were followed-up clinically and radiologically for three months.
RESULTS
The CT myelography identified CSF leak at the T2-3 (case 1), T5-12 (case 2), and T3-7 level (Case 3). A 0.06" diameter lumbar drainage catheter (Case 1 and 2) or Abbot's spinal cord stimulation (SCS) catheter (Case 3) was inserted epidurally through the lower thoracic/lumbar single-entry point and advanced into the identified thoracic leak site. The average volume of injected blood was 15.7 ml. No procedure-related complications were observed, and all patients improved clinically.
CONCLUSIONS
Epidural catheters remain safe and effective in treating thoracic and multi-site CSF leaks. In addition, Abbot's SCS catheter was found superior to the lumbar drainage catheter due to higher rigidity and bigger diameter despite being shorter than the lumbar drainage catheter.
Topics: Blood Patch, Epidural; Catheters; Cerebrospinal Fluid Leak; Humans; Intracranial Hypotension; Magnetic Resonance Imaging; Myelography
PubMed: 35490562
DOI: 10.1016/j.clineuro.2022.107268 -
AJNR. American Journal of Neuroradiology 1987Four normal controls and 26 cases of Arnold-Chiari I malformations and/or syringomyelia were reviewed. The pathologic cases included five isolated Arnold-Chiari I... (Comparative Study)
Comparative Study
Four normal controls and 26 cases of Arnold-Chiari I malformations and/or syringomyelia were reviewed. The pathologic cases included five isolated Arnold-Chiari I malformations, nine communicating syringomyelia, five idiopathic syringomyelia, four posttraumatic syringomyelia, one syringomyelia with hemangioblastoma, and two postshunt syringomyelia. The objectives of this study were to compare the accuracy of conventional metrizamide myelography with CT metrizamide myelography and to study indirectly the hydrodynamics of CSF flow in syringomyelia by comparing the sequential enhancement patterns of the spinal cords and cord cavities in the different groups of patients. Twenty-five patients underwent conventional metrizamide myelography immediately before CT metrizamide myelography, and one patient underwent CT metrizamide myelography only. Scans were obtained 1-2 hr, 4-8 hr, and 12-24 hr after injection of metrizamide, but not all patients were scanned during all three intervals. CT metrizamide myelography was found to be more sensitive than conventional metrizamide myelography in the diagnosis of both Arnold-Chiari I malformation and syringomyelia. Performing just an immediate and a delayed scan was found to be more cost-effective than doing all three scans. Contrary to previous reports, it was found that delayed (12-24 hr) scans demonstrated more syrinx cavities than intermediate ones. In studying the sequential enhancement patterns of the spinal cords and cord cavities, some interesting trends were observed that tend to support the theories of Aboulker and of Ball and Dayan of transneural passage of CSF into cord cavities in syringomyelia.
Topics: Adult; Aged; Arnold-Chiari Malformation; Female; Humans; Male; Metrizamide; Middle Aged; Myelography; Radiographic Image Enhancement; Spinal Cord; Syringomyelia; Time Factors; Tomography, X-Ray Computed
PubMed: 3101451
DOI: No ID Found