• Title/Summary/Keyword: MR Myelography

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Comparative Study of Lumbar Magnetic Resonance Imaging and Myelography in Young Soldiers with Herniated Lumbar Disc

  • Kang, Suk-Hyung;Choi, Seung-Hong;Seong, Nak-Jong;Ko, Jung-Min;Cho, Eun-Suk;Ko, Kwang-Pil
    • Journal of Korean Neurosurgical Society
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    • v.48 no.6
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    • pp.501-505
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    • 2010
  • Objective : This study was undertaken to compare the diagnostic performances of magnetic resonance imaging (MRI), MR myelography (MRM) and myelography in young soldiers with a herniated lumbar disc (HLD). Methods : Sixty-five male soldiers with HLD comprised the study cohort. A visual analogue scale for low back pain (VAS-LBP), VAS for leg radiating pain (VAS-LP), and Oswestry disability index (ODI) were applied. Lumbar MR, MRM, and myelographic findings were checked and evaluated by four independent radiologists, respectively. Each radiologist was asked to score (1 to 5) the degree of disc protrusion and nerve root compression using modified grading systems devised by the North American Spine Society and Pfirrmann and the physical examination rules for conscription in the Republic of Korea. Correlated coefficients between clinical and radiological factors were calculated. Interpretational reproducibility between MRI and myelography by four bases were calculated and compared. Results : Mean patient age was $20.5{\pm}1.1$. Mean VAS-LBP and VAS-LP were $6.7{\pm}1.6$ and $7.4{\pm}1.7$, respectively. Mean ODI was $48.0{\pm}16.2%$. Mean MRI, MRM, and myelography scores were $3.3{\pm}0.9$, $3.5{\pm}1.0$, and $3.9{\pm}1.1$, respectively. All scores of diagnostic performances were significantly correlated (p < 0.05). However, none of these scores reflected the severity of patients' symptoms. There was no statistical difference of interpretational reproducibility between MRI and myelography. Conclusion : Although MRI and myelography are based on different principles, they produce similar interpretational reproducibility in young soldiers with a HLD. However, these modalities do not reflect the severity of symptoms.

Detection of Surgery-related Spinal Cerebrospinal Fluid Leakage Using Magnetic Resonance Myelography (자기공명척수조영술을 이용한 수술 후 척추 뇌수막액 누출 평가)

  • Koo, Hyun Jung;Kim, Sang Joon;Chung, Sun J.;Rhim, Seung-Chul
    • Investigative Magnetic Resonance Imaging
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    • v.17 no.2
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    • pp.149-153
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    • 2013
  • Detection of cerebrospinal fluid leakage or exact localization of leakage site after spinal surgery is difficult on conventional imaging studies. We report two patients with surgery-related spinal CSF leakage detected on magnetic resonance (MR) myelography. They presented with severe headache after spinal surgeries, lumbar discectomy and excision of spinal meningioma, respectively. The sites of spinal CSF leakage in the patients were detected accurately on MR myelography, and the patients recovered from the postoperative CSF leakage after being treated with an epidural blood patch or reoperation. MR myelography may be effective in demonstrating the exact site of surgery-related spinal CSF leakage.

Morphologic Changes of L5 Root at Coronal Source Images of MR Myelography in Cases of Foraminal or Extraforaminal Compression

  • Kim, Soo-Beom;Jang, Jee-Soo;Lee, Sang-Ho
    • Journal of Korean Neurosurgical Society
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    • v.46 no.1
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    • pp.11-15
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    • 2009
  • Objective: Two findings easily found at coronal source images of MR myelography (MRM) were evaluated : dorsal root ganglion (DRG) swelling and running course abnormality (RCA) of L5 exiting root at foramen or extraforamen. We tried to find the sensitivity of each finding when root was compressed. Methods: From 2004 July to 2006, one hundred and ten patients underwent one side paraspinal decompression for their L5 root foraminal or extraforaminal compression at L5-S1 level. All kinds of conservative treatments failed to improve leg symptom for several months. Before surgery, MRI, CT and MRM were done. Retrospective radiologic analysis for their preoperative MRM coronal source images was done to specify root compression sites and L5 root morphologic changes. Results: DRG swelling was found in 66 (60%) of 110 patients. DRG swelling has statistically valuable meaning in foraminal root compression (chi-square test, p<0.0001). Seventy-two (66%) in 110 patients showed abnormal alteration of running course. Abnormal running course has statistically valuable meaning in foraminal or extraforaminal root compression (chi-square test, p<0.0001). Conclusion: Three-dimensional MRM provides precise thin sliced coronal images which are most close to real operative views. DRG swelling and running course abnormality of L5 exiting root are two useful findings in diagnosing L5 root compression at L5-S1 foramen or extraforamen. MRM is thought to provide additional diagnostic accuracy expecially in L5-S1 foraminal and extraforaminal area.

Spinal Intradural Extramedullary Cavernoma Presenting with Intracranial Superficial Hemosiderosis

  • Jin, Yong-Jun;Chung, Sang-Bong;Kim, Ki-Jeong;Kim, Hyun-Jib
    • Journal of Korean Neurosurgical Society
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    • v.49 no.6
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    • pp.377-380
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    • 2011
  • A case of intradural extramedullary cavernous angioma is presented with headache, dizziness, and bilateral sensorineural hearing loss caused by an intracranial superficial hemosiderosis. It was incidentally found in a patient with a 3-month history of sustained headache, dizziness and a 3-year history of hearing difficulty. The neurological examination was unremarkable in the lower extremity. MR images showed an intracranial superficial hemosiderosis mostly in the cerebellar region. Myelography and MR images of the thoracolumbar spine revealed an intradural extramedullary mass, which was pathologically proven to be a cavernous angioma. T12 total laminoplastic laminotomy and total tumor removal were performed without any neurologic deficits. The patient's symptoms, including headache and dizziness, have been absent for three years. Intradural extramedullary cavernous angioma can present with an intracranial superficial hemosiderosis as a result of chronic subarachnoid hemorrhage.

Imaging of the Brachial Plexus (상완신경총의 영상)

  • Suh, Kyung-Jin;Lee, Jeong-Hyun;Lee, Gyung Kyu
    • Investigative Magnetic Resonance Imaging
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    • v.11 no.2
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    • pp.119-126
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    • 2007
  • MR (magnetic resonance) imaging of the brachial plexus is challenging because of the complex and tangled anatomy of the brachial plexus and the multifariouness of pathologies that can put on it. Improvements in imaging techniques, including the availability of high resolution MR image systems and high channels multidetector computed tomography (CT), have led to more accurate diagnoses and improved serve for treatment planning. For the purpose of imaging and treatment of the brachioplexopathy, it is considerate to divide traumatic and nontraumatic diseases affecting the brachial plexus. MRI is the current gold standard imaging modality for nontraumatic brachial plexopathy. CT myelography is the preferred for the diagnosis of nerve root avulsions affecting the brachial plexus. Other modalities, such as CT, ultrasonography and positron emission tomography, have a limited role in the evaluation of brachial plexus pathology. High-quality, high-resolution MRI remains the main tool for imaging the brachial plexopathy.

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Spontaneous Intracranial Hypotension : Clinical Presentation, Imaging Features and Treatment

  • Park, Eun-Soo;Kim, Ealmaan
    • Journal of Korean Neurosurgical Society
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    • v.45 no.1
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    • pp.1-4
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    • 2009
  • Objective : In the present study, the authors investigated the clinical and imaging features as well as the therapeutic outcomes of SIH (spontaneous intracranial hypotension) patients. Methods : A retrospective review of 12 SIH patients was carried out. The diagnostic work-up included lumbar tapping and measurement of CSF opening pressure, radioisotope cisternography, brain and spinal magnetic resonance imaging (MRI), and computed tomography (CT) myelography. Autologous epidural blood patching was performed in patients who did not respond to conservative therapies, including analgesics, steroids, hydration and rest. Results : Typical postural headache was found in 11 (91%) patients. Nine (75%) patients showed pachymeningeal enhancement on their initial T1-weighted MR images. The CSF opening pressure was less than 60 mm$H_2O$ in 9 of 11 patients. Autologous epidural blood patching was performed in 7 patients, and all of them showed good responses. Conclusion : SIH can present with various clinical presentations and neuroimaging findings. Autologous epidural blood patching is thought to be the treatment of choice for patients with SIH.