Comparison of Myelography, CT Myelography and Magnetic Resonance Imaging in Cervical Spondylosis and Disk Herniation

Larsson, Elna‐Marie; Holtås, Stig; Cronqvist, Sten; Brandt, Lennart

doi:10.1177/028418518903000302

Cited by 51 publications

(16 citation statements)

References 20 publications

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“…However, there is still controversy as to what imaging modality is the gold standard to diagnose this disease in people . Several studies have compared the noncontrast computed tomography (CT), CT‐myelography, and MR imaging findings in humans with cervical compressive myelopathy . In human neurology, discrepancies frequently arise in the interpretation of advanced imaging studies in patients with cervical degenerative disease, especially in differentiating discogenic and osseous pathology and in establishing the severity of disease .…”

Section: Introductionmentioning

confidence: 99%

Comparison of Noncontrast Computed Tomography and High‐field Magnetic Resonance Imaging in the Evaluation of Great Danes With Cervical Spondylomyelopathy

Martín-Vaquero

Costa

Drost

2014

Vet Radiology Ultrasound

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Computed tomography (CT) provides excellent bony detail, whereas magnetic resonance (MR) imaging is superior in evaluating the neural structures. The purpose of this prospective study was to assess interobserver and intermethod agreement in the evaluation of cervical vertebral column morphology and lesion severity in Great Danes with cervical spondylomyelopathy by use of noncontrast CT and high-field MR imaging. Fifteen client-owned affected Great Danes were enrolled. All dogs underwent noncontrast CT under sedation and MR imaging under general anesthesia of the cervical vertebral column. Three observers independently evaluated the images to determine the main site of spinal cord compression, direction and cause of the compression, articular process joint characteristics, and presence of foraminal stenosis. Overall intermethod agreement, intermethod agreement for each observer, overall interobserver agreement, and interobserver agreement between pairs of observers were calculated by use of kappa (κ) statistics. The highest overall intermethod agreements were obtained for the main site of compression and direction of compression with substantial agreements (κ = 0.65 and 0.62, respectively), whereas the lowest was obtained for right-sided foraminal stenosis (κ = 0.39, fair agreement). For both imaging techniques, the highest and lowest interobserver agreements were recorded for the main site of compression and degree of articular joint proliferation, respectively. While different observers frequently agree on the main site of compression using both imaging techniques, there is considerable variation between modalities and among observers when assessing articular process characteristics and foraminal stenosis. Caution should be exerted when comparing image interpretations from multiple observers.

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Section: Introductionmentioning

confidence: 99%

Comparison of Noncontrast Computed Tomography and High‐field Magnetic Resonance Imaging in the Evaluation of Great Danes With Cervical Spondylomyelopathy

Martín-Vaquero

Costa

Drost

2014

Vet Radiology Ultrasound

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“…The diagnostic criteria are, however, unclear [7,43]. Some suggest that cervical radiculopathy is a diagnosis based upon clinical impression [5,9,23,57], which should be confirmed by advanced testing, such as diagnostic imaging [12,15,34,50], or electrophysiology studies [22,27,40]. However, clinical and radiological diagnoses, and electrophysiological testing all have inherent limitations [59].…”

Section: Introductionmentioning

confidence: 99%

A systematic review of the diagnostic accuracy of provocative tests of the neck for diagnosing cervical radiculopathy

et al. 2006

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Clinical provocative tests of the neck, which position the neck and arm inorder to aggravate or relieve arm symptoms, are commonly used in clinical practice in patients with a suspected cervical radiculopathy. Their diagnostic accuracy, however, has never been examined in a systematic review. A comprehensive search was conducted in order to identify all possible studies fulfilling the inclusion criteria. A study was included if: (1) any provocative test of the neck for diagnosing cervical radiculopathy was identified; (2) any reference standard was used; (3) sensitivity and specificity were reported or could be (re-)calculated; and, (4) the publication was a full report. Two reviewers independently selected studies, and assessed methodological quality. Only six studies met the inclusion criteria, which evaluated five provocative tests. In general, Spurling's test demonstrated low to moderate sensitivity and high specificity, as did traction/neck distraction, and Valsalva's maneuver. The upper limb tension test (ULTT) demonstrated high sensitivity and low specificity, while the shoulder abduction test demonstrated low to moderate sensitivity and moderate to high specificity. Common methodological flaws included lack of an optimal reference standard, disease progression bias, spectrum bias, and review bias. Limitations include few primary studies, substantial heterogeneity, and numerous methodological flaws among the studies; therefore, a meta-analysis was not conducted. This review suggests that, when consistent with the history and other physical findings, a positive Spurling's, traction/neck distraction, and Valsalva's might be indicative of a cervical radiculopathy, while a negative ULTT might be used to rule it out. However, the lack of evidence precludes any firm conclusions regarding their diagnostic value, especially when used in primary care. More high quality studies are necessary in order to resolve this issue.

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“…Its high sensitivity for detecting disc disease [1][2][3][4] allows it to show degeneration in both symptomatic and asymptomatic patients. Boden et al 5 consider that abnormal MRI findings in asymptomatic subjects are false-positive results, since it is difficult to distinguish between ageing discs and pathologically degenerate discs which cause symptoms.…”

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confidence: 99%

MRI of cervical intervertebral discs in asymptomatic subjects

Matsumoto

Fujimura

Suzuki

et al. 1998

The Journal of Bone and Joint Surgery. British volume

261

151

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We studied degenerative changes in the cervical intervertebral discs of 497 asymptomatic subjects by MRI and evaluated disc degeneration by loss of signal intensity, posterior and anterior disc protrusion, narrowing of the disc space and foraminal stenosis. In each subject, five disc levels from C2-C3 to C6-C7 were evaluated.The frequency of all degenerative findings increased linearly with age. Disc degeneration was the most common observation, being present in 17% of discs of men and 12% of those of women in their twenties, and 86% and 89% of discs of both men and women over 60 years of age. We found significant differences in frequency between genders for posterior disc protrusion and foraminal stenosis. The former, with demonstrable compression of the spinal cord, was observed in 7.6% of subjects, mostly over 50 years of age.Our results should be taken into account when interpreting the MRI findings in patients with symptomatic disorders of the cervical spine.

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Comparison of Myelography, CT Myelography and Magnetic Resonance Imaging in Cervical Spondylosis and Disk Herniation

Cited by 51 publications

References 20 publications

Comparison of Noncontrast Computed Tomography and High‐field Magnetic Resonance Imaging in the Evaluation of Great Danes With Cervical Spondylomyelopathy

Comparison of Noncontrast Computed Tomography and High‐field Magnetic Resonance Imaging in the Evaluation of Great Danes With Cervical Spondylomyelopathy

A systematic review of the diagnostic accuracy of provocative tests of the neck for diagnosing cervical radiculopathy

MRI of cervical intervertebral discs in asymptomatic subjects

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