• Journal of Korean Neurosurgical Society
• /
• v.48 no.6
• /
• pp.501-505
• /
• 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.

• Journal of Veterinary Clinics
• /
• v.18 no.3
• /
• pp.284-287
• /
• 2001

Three dogs referred to Veterinary Medical Teaching Hospital, Seoul National University were diagnosed as intervertebral disc disease. Physical examination, neurologic examination, survey radiograph, and myelography were performed in patients. Case 1 showed narrowing intervertebral space and calcified intervertebral disc material in survey radiograph. Case 2 showed increased opacity in the intervertebral opacity in survey radiograph. All of 3 cases showed extradural pattern during myelography. In survey radiography, radiographic signs consistent with intervertebral disc herniations include narrowing of the disc space and the dorsal intervertebral articular process joint space, small intervertebral foramen, increase opacity in the intervertebral foramen and extruded, mineralized disc material within the vertebral canal. Myelography is useful for evaluating the spinal cord and the cauda equina. Indication for myelography includes confirming a spinal lesion seen or suspected on survey radiograph, defining the extent of a survey lesion, finding a lesion not observed on survey radiograph, and distinguishing between surgical and nonsurgical lesion. In presentcases, two of three cases show radiographic signs of IVDD with survey radiograph and all of three case show extradural pattern during myelography. It is observed that intervertebral disc disease is one of the most important indication for radiographic examination and myelography of the vertebral column of small animals.

• Journal of Korean Neurosurgical Society
• /
• v.30 no.sup2
• /
• pp.322-327
• /
• 2001

Objectives : There are many kinds of method to evaluate neural decompression during operation. They are direct visual and manual inspection, intraoperative ultrasound, endoscope, intraoperative computed tomography and intraoperative myelography. We used intraoperative myelography to evaluate the proper decompression of neural elements during the decompressive surgery. Methods : We injected 10-20cc of nonionic water-soluble contrast materials through direct puncture site of exposed dura during operation or lower lumbar level or lumbar drain inserted preoperatively. 12 patients were included in this study. They were 7 patients of centrally herniated lumbar disc disease, 1 patient of multiple lumbar spinal stenosis, 2 patients of thoracic extradural tumor and 2 cervical fracture & dislocations. Results : 5 of 12 patients showed remained neural compression through intraoperative myelography, so they were operated further through other approach. Myelographic dye is heavier than CSF, so the dependent side of subarachnoid space was visualized only. In one case, CSF leakage through hemovac was detected, but it was treated only bed rest for 5 days after hemovac removal. Conclusion :Intraoperative myelography is an effective method to evaluate neural decompression during spinal surgery. This technique is easy and familiar to us, neurosurgeons.

• Journal of the Korean Society of Radiology
• /
• v.85 no.1
• /
• pp.24-35
• /
• 2024

Spontaneous intracranial hypotension (SIH), which generally presents as orthostatic headache, is increasingly being identified due to improved imaging technologies and heightened awareness. Many prior studies have reported the characteristic brain MRI findings of SIH. However, recently, focus has shifted to spinal MRI, as SIH is believed to be caused by leakage of cerebrospinal fluid from the spinal dural sac. Advanced techniques such as ultrafast CT myelography and digital subtraction myelography have emerged as useful technique to identify the site of cerebrospinal fluid leakage. In this review, we discuss the diagnosis, spinal MRI findings, imaging techniques, and treatment of SIH.

• Investigative Magnetic Resonance Imaging
• /
• v.17 no.2
• /
• pp.149-153
• /
• 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.

• Korean Journal of Veterinary Research
• /
• v.50 no.1
• /
• pp.37-42
• /
• 2010

Evaluation of the myelography was studied in miniature pigs. Radiographs and computed tomographic (CT) images of the whole spine were obtained at clinically healthy twelve miniature pigs of 4 (8.7-10 kg) and 12 (26-31 kg) months. The assessments of the spinal cord were made in accordance with the Pavlov's method and compared area ratio [at spinal cord (SC), vertebral canal (VC) and vertebral body (VB)]. The Pavlov's ratio in the cervical spine was significant larger than that of thoracolumbar in radiographic myelography. On CT myelography, the area of the spinal cord had a significant difference between the cervical and thoracolumbar spine. Among the cervical spine, the ratios of spinal cord and vertebral body (SC : VB), vertebral canal and vertebral body (VC : VB) were minimum at the level of 4th cervical spine in both ages, while maximum at the level of 6th cervical spine in both months. In case of lumbar spine, the ratios of spinal cord and vertebral body (SC : VB) were the largest at the level of 4th lumbar spine in 4 months and at the level of 3rd lumbar spine in 12 months. In addition, the ratio of spinal cord and vertebral body (SC : VB) of the cervical spinal cord was significant lower at 4 months but the lumbar spinal cord showed lower pattern at 12 months old miniature pigs.

• Journal of Veterinary Clinics
• /
• v.20 no.4
• /
• pp.519-522
• /
• 2003

An appearance of herniated intervertebral disc into thoracolumbar vertebral canal was evaluated in two patients using computed tomography (CT). Before CT scanning, plain radiography and myelography were performed in both cases. CT images were compared to those of myelography. Dogs were positioned in sternal recumbency under inhalation anesthesia and transverse slices with 2 mm thickness were obtained around thoracolumbar region. The transverse CT images were examined using both vertebral and spiral window mode. The most common findings on CT images were loss of vertebral canal epidural fat, bulging of vertebral canal disc margins, displacement of spinal cord and flatted vertebral canal. Whereas, narrowed intervertebral disc space and simple extradural pattern were the main findings on plain and contrast radiographs. CT imges showed the extent of the herniated disc lesion, type II intervertebral disc hernation, and the displacement of spinal cord in detail in both occations. It is considered that degree and precise localization of the intervertebral disc herniation and subtle lesion of spinal cord could be identified accurately using computed tomography.

• Journal of Korean Neurosurgical Society
• /
• v.52 no.2
• /
• pp.103-106
• /
• 2012

Objective : To prospectively assess the diagnostic and clinical value of a new technique (3-tesla magnetic resonance myelography, 3T MRM) as compared to computed tomographic discography (disco-CT) in patients with far lateral disc herniation. Methods : We evaluated 3T MRM and disco-CT of 25 patients, whom we suspected of suffering from far lateral disc herniation. Using an assessment scale, 4 observers examined independently both 3T MRM and disco-CT images. We analyzed observer agreement and the accentuation of each image. Results : We found complete matching, and observer agreement, between high resolution images of 3T MRM and disco-CT for diagnosing far lateral disc herniation. Conclusion : We think noninvasive 3T MRM is an appropriate diagnostic tool for far lateral disc herniation as compared to disco-CT.

• Proceedings of the KSMRM Conference
• /
• 1996.10a
• /
• pp.68-68
• /
• 1996

• Journal of Korean Neurosurgical Society
• /
• v.46 no.1
• /
• pp.11-15
• /
• 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.