Myelography: A Primer

Harreld, Julie H.; McMenamy, John; Toomay, Seth; Chason, David P.

doi:10.1067/j.cpradiol.2010.06.003

Cited by 11 publications

(20 citation statements)

References 8 publications

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“…CT myelography (CTM) is a diagnostic CT examination with prior intrathecal contrast agent administration. CTM enables the evaluation of various spinal pathologies that contact, displace, or impinge the thecal sac, cord, or nerve roots [1][2][3]. It plays an important role in several indications such as intradural extramedullary cysts, spontaneous intracranial hypotension and postoperative cerebrospinal fluid (CSF) leaks, nerve root avulsion, spinal canal stenosis, arthritis, and other degenerative and meningeal conditions [2,3].…”

Section: Introductionmentioning

confidence: 99%

Single- and Dual-Source CT Myelography: Comparison of Radiation Exposure and Establishment of Diagnostic Reference Levels

et al. 2021

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CT myelography (CTM) is a diagnostic technique for the evaluation of various spinal pathologies, and plays an important role in diagnosis of different diseases such as spontaneous intracranial hypotension and postoperative cerebrospinal fluid leaks. The aims of this study were to examine radiation exposure, establish diagnostic reference levels (DRLs) and compare radiation doses of single- and dual-source examinations and different CTM protocols. In this retrospective study, 183 CTMs comprising 155 single-source and 28 dual-source examinations, performed between May 2015 and December 2020, were analyzed. Dose data included 31 whole spine (A), 23 cervical (B), 10 thoracic (C), and 119 lumbar (D) CTMs. Radiation exposure was reported for volume-weighted CT dose index (CTDIvol) and dose-length product (DLP). Radiation doses for CTDIvol and DLP were distributed as follows (median, IQR): A: 7.44 mGy (6.01–11.17 mGy)/509.7 mGy·cm (382.4–682.9 mGy·cm), B: 9.31 mGy (7.20–14.64 mGy)/214.5 mGy·cm (153.7–308.2 mGy·cm), C: 6.80 mGy (6.14–8.26 mGy)/365.4 mGy·cm (222.8–432.4 mGy·cm), D: 11.02 mGy (7.97–14.89 mGy)/308.0 mGy·cm (224.7–413.7 mGy·cm). Local DRLs could be depicted as follows (CTDIvol/DLP): A: 11 mGy/683 mGy·cm, B: 15 mGy/308 mGy·cm, C: 8 mGy/432 mGy·cm, D: 15 mGy/414 mGy·cm. High image quality was achieved for all anatomical regions. Basically, radiation exposure of CTM differs according to anatomical location.

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Section: Introductionmentioning

confidence: 99%

Single- and Dual-Source CT Myelography: Comparison of Radiation Exposure and Establishment of Diagnostic Reference Levels

et al. 2021

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“…Relatively little literature is available on the complications of myelography 12 , 22) . Myelography is generally safe, with a low risk of infection; thus, limited literature is available that addresses the complication of myelography 12 , 22) . The most significant complication of CTM was intracranial hypotension.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Root Images between Post-Myelographic Computed Tomography and Magnetic Resonance Imaging in Patients with Lumbar Radiculopathy

Park¹,

Lee

Ryu

2017

J Korean Neurosurg Soc

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ObjectiveTo evaluate the diagnostic value of computed tomography-myelography (CTM) compared to that of magnetic resonance imaging (MRI) in patients with lumbar radiculopathy.MethodsThe study included 91 patients presenting with radicular leg pain caused by herniated nucleus pulposus or lateral recess stenosis in the lumbar spine. The degree of nerve root compression on MRI and CTM was classified into four grades. The results of each imaging modality as assessed by two different observers were compared. Visual analog scale score for pain and electromyography result were the clinical parameters used to evaluate the relationships between clinical features and nerve root compression grades on both MRI and CTM. These relationships were quantified by calculating the receiver-operating characteristic curves, and the degree of relationship was compared between MRI and CTM.ResultsMcNemar’s test revealed that the two diagnostic modalities did not show diagnostic concurrence (p<0.0001). Electromyography results did not correlate with grades on either MRI or CTM. The visual analog pain scale score results were correlated better with changes of the grades on CTM than those on MRI (p=0.0007).ConclusionThe present study demonstrates that CTM could better define the pathology of degenerative lumbar spine diseases with radiculopathy than MRI. CTM can be considered as a useful confirmative diagnostic tool when the exact cause of radicular pain in a patient with lumbar radiculopathy cannot be identified by using MRI. However, the invasiveness and potential complications of CTM are still considered to be pending questions to settle.

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“…In their article in 2011, where they described the myelography technique in detail, Harreld et al emphasized the following in the conclusion section: although MRI is more often performed to evaluate back pain, a wellperformed myelogram can provide essential diagnostic information when MRI is not possible or practical, such as in patients for whom MRI is contraindicated or when dynamic imaging is desired [3]. In our article, the contribution of lumbar myelography to the diagnosis and treatment decision in patients who could not be decided by direct radiography, CT and MRI methods were examined.…”

Section: Introductionmentioning

confidence: 99%

The Role and Contribution of Lumbar Myelography in the Diagnosis and Treatment of Patients With Lumbar Degenerative Disorders: Clinical and Statistical Evaluation of Post-Myelography Treatment of 63 Patients

Gündüz¹,

Aydın²,

Ovalıoğlu³

et al. 2021

Cureus

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IntroductionMyelography is a radiological examination method that has been used for the diagnosis of spinal canal pathologies for a long time. More than 90 years of experience has been improved by the development of increasingly less toxic contrast agents. Nowadays, although there are many advanced diagnostic tools, lumbar myelography is a direct imaging technique and so it is a powerful diagnostic method for patients whose treatment has not been decided. The aim of our study is to evaluate the effect of lumbar myelography as a diagnostic method and its contribution to treatment. Materials and methodsBetween January 2016 and April 2018, 63 patients who were admitted to our neurosurgery clinic due to lumbar degenerative disorders and underwent myelography were included in our study. Patients over 30 years of age with lumbar disc disease, narrow spinal canal, and spinal instability, but for whom a surgical decision could not be made, were included in this study. ResultsAfter lumbar myelography, 55 of 63 patients underwent a surgical procedure and 8 were directed to nonsurgical treatment options. The results of the patients were evaluated by Roland-Morris Low Back Pain and Disability Questionnaire (RMQ). Results showed that the contribution of selected treatment protocols to the recovery after myelography was statistically significant. ConclusionNowadays, myelography is not the first choice for the diagnosis of lumbar degenerative disorders. However, according to the results of our study, lumbar myelography is an effective diagnostic tool for specific purposes.

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Myelography: A Primer

Cited by 11 publications

References 8 publications

Single- and Dual-Source CT Myelography: Comparison of Radiation Exposure and Establishment of Diagnostic Reference Levels

Single- and Dual-Source CT Myelography: Comparison of Radiation Exposure and Establishment of Diagnostic Reference Levels

Comparison of Root Images between Post-Myelographic Computed Tomography and Magnetic Resonance Imaging in Patients with Lumbar Radiculopathy

The Role and Contribution of Lumbar Myelography in the Diagnosis and Treatment of Patients With Lumbar Degenerative Disorders: Clinical and Statistical Evaluation of Post-Myelography Treatment of 63 Patients

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