腰骶神经根疾病MR脊髓造影的影像学评价

目的：观察和评价核磁共振（MR）脊髓造影术对腰骶神经根疾病的诊断价值。方法：MR为Siemens Mag-neton Impact 1.0Tfhv 导扫描机，所采用的扫描序列为脂肪抑制重T2SE序列，重建方法为最大信号强度投影法（MIP）的MR脊髓造影技术，检查75例慢性腰腿痛患者。结果：MR脊髓造影能清晰地显示腰骶硬脊膜外腔、神经根及其神经根鞘的形态与结构。75例MR脊髓造影中，11例为腰骶部神经根病变。其中神经根变异6例，占8.0％；神经根囊肿2例，占2.6％；神经根纤维瘤3你，占4.0％。在MR脊髓造影图像上表现各有其特点。结论：神经根疾病在MR脊髓造影的影像上有其特征性的表现，能为临床诊断椎管内神经根病变提供满意的影像学依据。     

脊髓造影与CTM联合应用诊断腰椎间盘突出症46例报告

本文报告手术证实的46例腰椎间盘突出症术前经正位、侧位的中立、过伸、过屈位脊髓造影符合率为87%,CTM的符合率为97.7%,而两者联合应用则诊断准确率可提高到100%.     

腰椎间盘突出症的X线诊断(附115例X线平片、造影及手术对照分析)

本文介绍了115例(125个病变椎间盘)腰椎间盘突出症患者的平片及脊髓造影的X线征象,并与手术结果对照分析,诊断准确率为91.2％。椎体后缘唇样骨质增生和骨内软骨结节、椎间隙的前窄后宽等征象对椎间盘突出有定位诊断价值。腰骶椎脊髓造影显示硬膜囊和神经根的压迫征象,对于腰椎间盘突出的定位诊断及鉴别诊断均有重要意义。     

Magnetic resonance imaging findings of remnants of an intradural oil-based contrast agent: report of a case

Background

Myodil (iophendylate), an oil-based positive contrast media, now discontinued, was widely used for performing myelography 30–70 years ago. We identified this agent as the explanation for uncommon magnetic resonance imaging (MRI) findings in a patient with thoracic spinal fracture.

Design

Case report and literature review.

Findings

An 81-year-old man complained of back pain after falling down stairs. Anamnesis revealed that he had undergone myelography with an oil-based contrast agent about 60 years previously as a part of the diagnostic workup for back pain and sudden onset of gait difficulty. Plain radiography of the thoraco-lumbar spine showed a fracture of the eleventh thoracic vertebra and a radio-opaque, oval shadow at the level of the T9–T10 vertebrae. Many small radio-opaque dots with the appearance of a string of pearls were seen from T8 to L3 vertebrae. MRI revealed a sharply demarcated intradural extramedullary mass, of approximately 5 mm in diameter on the left side of the dura in the region of the T9–T10. The mass showed high signal intensity on T1-weighted MRI, and low signal intensity on T2-weighted MRI.

Conclusions

Increased awareness of this rare presentation of procedures performed in the past is essential when atypical radiographic images are encountered. This case illustrates rare sequelae of Myodil use manifesting decades after administration.     

Post-myelogram headache—physiological or psychological?

Summary Psychological aspects of post-lumbar puncture headache have hitherto received little attention. A hundred consecutive patients admitted for elective myelography were studied. Post-myelogram headache was assessed by an independent observer and found to be strongly associated with normality of the test (P<0.001). Psychological testing showed a trend between Hospital Anxiety Depression score and normality of myelogram as well as development of headache, although this did not achieve statistical significance. This study suggested that there is a large psychological as well as organic component to post-myelogram headache.     

Lumbosacrale Myelographie mit einem Kontrastmittel (Dimer-X) ohne Lumbalanaesthesie

Zusammenfassung Es wird über Erfahrungen mit dem neuen wasserlöslichen Kontrastmittel Dimer-X bei der lumbosacralen Myelographie berichtet. Neben der genauen Darstellung der Cauda equina und der Wurzeltaschen wird die gute Verträglichkeit des Mittels hervorgehoben. Irreversible Folgen oder gravierende akute Komplikationen wurden nicht beobachtet.

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Lumbosacral myelography with a contrast medium (Dimer-X) without spinal anesthesia

Summary Results of lumbosacral myelography with a new water-soluble contrast medium (Dimer-X) are reported. The precise visualisation of the cauda equina and the roots and the good tolerance of the contrast substance are emphasized. Irreversible lesions or severe acute complications were not observed.

     

Plexiform neurofibroma (rankenneurofibrom) of the cauda equina

Summary The clinical and neuroradiological findings in a rare case of plexiform neurofibroma with bone scintigraphy, myelography and selective spinal angiography are described. The difficulties with the preoperative differential diagnosis from other intraspinal space occupying lesions are discussed and the importance of intraoperative biopsy and electrical stimulation is stressed.     

Relative efficacy of clinical examination,electromyography, plain film radiography,myelography and lumbar phlebography in the diagnosis of low back pain and sciatica

Summary The procedures used in the investigation of low back pain and sciatica have been subjected to a double statistical analysis to determine their diagnostic accuracy, since contradictory opinions have been experessed in the literature. It was found that only lumbar phlebography was more accurate than the most simple procedure, the clinical examination. Myelography is more accurate than clinical examination only in making a positive diagnosis. In this case, it equals the reliability of lumbar phlebography, but so does plain film radiography which however leads to a positive diagnosis less constantly. Lumbar phlebography is the most accurate procedure for making a nagative diagnosis, mainly by avoiding a false negative conclusion. A comparison is made with the statements in the literature and the complementary use of the different procedures is proposed for the investigation of low back pain and sciatica.     

Visualization of the craniocervical subarachnoid spaces

Summary A very simple procedure is described which leads to adequate visualization of the structures in the craniocervical area that are otherwise often very insufficiently investigated during myelography routinely performed with metrizamide.     

Oxygen myelography for cervical spinal cord injuries

Summary Oxygen myelographies were performed on 15 patients with cervical spinal cord injuries, in seven of whom narrowing of the spinal cord was caused by a fracture-dislocation. In eight the fracture was of bursting type, and the neurological involvement in these was more severe than in the former type. The main findings in seven early myelograms were swelling of the cord (3/7) and non-visualization of the spinal canal at the injury level (6/7). The main findings in eight late myelograms were narrowing of the cord (5/8) and anterior stretching of the cord over the obstructing bony ridge.