Postmyelographic CT Evaluation of Multiple Blocks Due to Metastases
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A case of intraspinal metastatic carcinoma that presented on combined cervical and lumbar puncture metrizamide myelography as complete blocks at T2 and T12 is described. The extent of disease in the long segment of the spinal canal was inaccessible to conventional myelography. This case illustrates the importance of postmyelogram CT for accurate assessment of disease and for treatment planning.Keywords:
Metrizamide
Spinal disease
Vertebral canal
Intrathecal
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.
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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.
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Iohexol
Intrathecal
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Metrizamide (Amipaque) is a new water-soluble contrast medium for myelography. It differs from the conventional contrast media in that, because of its lower toxicity, it can be used also for cervical and thoracic myelography. The method of examination in myelography with water-soluble contrast media differs in some respects from that in myelography with oil-soluble contrast media. For the thoracic region, tomography is highly recommendable. After a description of the method of examination used, some examples of the abnormalities found are presented.
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Metrizamide
Osteoblastoma
Vertebral canal
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Metrizamide
Lumbar disc disease
Neuroradiology
Spinal disease
Disc herniation
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Five cases of intradural arachnoid cysts were reported. Two rare cases were in cervical region, other three cases in thoracic region. Clinical and radiological findings were discussed in 67 cases including ours. All our cases with chronic clinical course except one showing spastic para- or tetraparese, sensory disturbance and gait disturbances were not much different to other reported cases in neurological findings. Plain radiography, tomography and intravenous enhanced CT were not effective. In all of the cases spinal CT was performed following metrizamide myelography. Only one cyst failed to detect during metrizamide myelography, but a metrizamide CT revealed the intradural arachnoid cyst even in this case. Vonofakos says that metrizamide myelogram failed to found the arachnoid cysts, however, we could confirm them by performing metrizamide CT about 3 hours after conventional myelography. Moreover reconstruction technique was very effective in ascertaining the shape and the extention of the tumors. Especially it is recommended to do delayed metrizamide CT with ReView technique in order to show the detailed relation between the cyst and the spinal cord. In conclusion, we emphasize the accurate neurological examination, the importance of total myelography and the improvement of fluoroscopic technique in myelography and CT scanning.
Metrizamide
Arachnoid cyst
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A case of intraspinal metastatic carcinoma that presented on combined cervical and lumbar puncture metrizamide myelography as complete blocks at T2 and T12 is described. The extent of disease in the long segment of the spinal canal was inaccessible to conventional myelography. This case illustrates the importance of postmyelogram CT for accurate assessment of disease and for treatment planning.
Metrizamide
Spinal disease
Vertebral canal
Intrathecal
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Metrizamide
Chordoma
Vertebral canal
Vertebral column
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Cerebrospinal fluid and blood were examined for immunologic factors before and after metrizamide myelography in 13 patients who underwent lumbar myelography and seven patients who underwent thoracic myelography. Clinical symptoms were also recorded. The results were consistent with a toxic reaction to the contrast medium, rather than an immunologic one.
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