metrizamide and Lipoma

The sensitivity of magnetic resonance imaging (MRI) to tissue alterations is particularly useful in spinal cord imaging. In addition to excellent anatomic display of this compact and complex area, syrinx cavities, tumors, and degenerating disks can be identified before they cause the anatomic distortion often necessary for detection by conventional means.

Topics: Astrocytoma; Bone Marrow Diseases; Brain Diseases; Ependymoma; Humans; Intervertebral Disc Displacement; Lipoma; Magnetic Resonance Spectroscopy; Meningeal Neoplasms; Metrizamide; Myelography; Neurofibroma; Spinal Cord; Spinal Cord Diseases; Spinal Cord Neoplasms; Spinal Diseases; Spinal Injuries; Spine; Syringomyelia; Tomography, X-Ray Computed

The spinal anomaly designated dorsal dysraphism with lipoma (lipomyeloschisis) consists of skin-covered, focal spina bifida; focal partial clefting of the dorsal half of the spinal cord; continuity of the dorsal cleft with the central canal of the cord above (and occasionally below) the cleft; deficiency of the dura underlying the spina bifida; deep extension of subcutaneous lipoma through the spina bifida and the dural deficiency to insert directly into the cleft on the dorsal half of the cord; variable cephalic extension of lipoma into the contiguous central canal of the cord; and variable ballooning of the subarachnoid space to form an associated meningocele. The variable individual expressions of the anomaly are best understood by reference to their archetypal concept. Careful analysis of radiographic and surgical findings in human lipomyeloschisis and correlation with an animal model of lipomyeloschisis indicate that plain spine radiographs and high-resolution metrizamide computed tomographic myelography successfully delineate the precise anatomic derangements associated with lipomyeloschisis and provide the proper basis for planning surgical therapy of this condition.

Topics: Adult; Animals; Chick Embryo; Child; Child, Preschool; Female; Humans; Infant; Infant, Newborn; Lipoma; Male; Meningocele; Meningomyelocele; Metrizamide; Myelography; Neural Tube Defects; Spina Bifida Occulta; Spinal Cord; Tomography, X-Ray Computed

Magnetic resonance (MR) imaging and metrizamide computed tomography (CT) were performed on three patients with spinal dysraphism with lipoma. Sagittal MR images were superior to metrizamide CT reformatted sagittal images in demonstrating anatomic relationships of the spinal cord, filum terminale and lipoma. In the axial plane, CT proved superior to MR. In all cases, the T1 weighted images with exceptional spatial resolution and excellent fat discrimination were more helpful than T2 weighted images. Although both MR and CT are useful in the initial evaluation of these disorders, subsequent evaluation employing only MR is probably adequate. Promising developments in surface coil imaging may eventually replace CT.

Topics: Adolescent; Child, Preschool; Female; Humans; Infant; Lipoma; Magnetic Resonance Spectroscopy; Male; Meningomyelocele; Metrizamide; Spinal Cord; Spinal Cord Neoplasms; Tomography, X-Ray Computed

To evaluate the clinical efficacy of magnetic resonance imaging (MRI) of lumbosacral lipomas, the magnetic resonance images of nine patients were reviewed. T1- and T2-weighted spin echo sequences were used with a 0.5-T magnetic resonance system. The tethered or low-positioned conus medullaris, the lipoma itself, the lipoma--cord interface, the subarachnoid space, and hydromyelia were clearly disclosed. The nerve rootlets were not as clear. These results indicate the possible discontinuance of myelography and metrizamide computed tomography (CT) cisternography for such imaging. The diagnostic modalities of choice for lumbosacral lipoma imaging are plain spine films, plain CT scan, and MRI.

Topics: Adolescent; Adult; Aged; Child; Child, Preschool; Evaluation Studies as Topic; Female; Humans; Infant; Lipoma; Magnetic Resonance Spectroscopy; Male; Metrizamide; Myelography; Spinal Cord; Spinal Cord Neoplasms; Tomography, X-Ray Computed

Display of the specific anatomic derangements by high-resolution computed tomographic (= CT) scan provides an important basis for planning corrective surgery of lumbosacral lipoma. In this paper, analysis of four infants and a child with lumbosacral lipoma revealed following discrepancy between the image by CT scan and operative finding. Most of lipoma showed a sharply outlined area of low density (approximately -100 H.U.) in the CT scan. Lipoma in the spinal cord parenchym represented intermingled fatty and neural tissue. There were also relatively high density areas in some cases and correspondingly, there were very fibrous lipomas, which could be identified by microscopic histological examination. Although there was a general correlation between the site of lumbosacral skin abnormality and underlying intraspinal lesion, some case does not match perfectly. In conclusion, a removal of the lumbosacral lipoma for the tethering effect always preferable to a total extirpation even though with technological advances in operative magnification and surgical instrumentation and a removal of the compressing lamina is necessary for adequate decompression.

Topics: Child; Female; Humans; Infant; Infant, Newborn; Lipoma; Lumbosacral Region; Male; Metrizamide; Myelography; Spinal Cord Neoplasms; Tomography, X-Ray Computed

The tethered conus is probably a rather unknown entity. Every patient, adult or child, with spinal dysraphia, presenting an unexplained progressive urological, neurological and/or orthopedic disturbance can have a tethered cord. With lumbar myelography using metrizamide it is possible to diagnose the low positioned conus and its tethering causes. A review of the clinical symptoms and diagnostic radiology, illustrated with myelographic evidence, is given.

Topics: Adolescent; Adult; Child; Child, Preschool; Female; Humans; Infant; Lipoma; Male; Metrizamide; Myelography; Nervous System Diseases; Paralysis; Sensation; Spina Bifida Occulta; Spinal Cord; Spinal Cord Neoplasms; Syndrome

A 42-year-old male was admitted with a one year and two months history of hypesthesia below the epigastric region and gait disturbance. On examination, increased ATR and PTR were bilaterally noticed with sensory disturbance below about Th.5 dermatome level. No cutaneous manifestations were detected on his back. Plain x-ray films showed no spina bifida. Metrizamide myelography showed a space-occupying mass at the Th.5 level. At operation, an extradural tumor, severely adhesived to the dura matter, was totally removed. Histologically, the tumor was composed of fatty tissues, thin-walled vessel spaces and small vessels, diagnosed as spinal hemangiolipoma. Seventeen reported cases of spinal epidural hemangiolipoma were reviewed. Spinal epidural hemangiolipomas occur in the middle aged patients with high incidence and at the mid-thoracic level. There are two types of hemangiolipoma, namely non-infiltrating and infiltrating. In the latter case, a wide excision should be performed to include normal surrounding tissue. In women's cases, particularly during the pregnancy, the fluctuation of the symptoms occurs. The effectiveness of CT and myelography in diagnosing of spinal lipomas was discussed.

Topics: Adult; Hemangioma; Humans; Lipoma; Male; Metrizamide; Myelography; Spinal Cord Neoplasms

Topics: Adult; Humans; Laminectomy; Lipoma; Lumbosacral Region; Male; Metrizamide; Myelography; Spinal Cord Neoplasms; Tomography, X-Ray Computed

Topics: Astrocytoma; Humans; Lipoma; Meningeal Neoplasms; Meningioma; Metrizamide; Myelography; Neurilemmoma; Radiographic Image Enhancement; Spinal Cord Neoplasms; Tomography, X-Ray Computed

Metrizamide, a new water-solution iodinated contrast medium, was evaluated in 63 infants and children, most of whom had lumbosacral or low thoracic lesions. The diagnostic quality was found to be good, and no serious complications or permanent sequelae were encountered. Chief complications were headache, nausea, vomiting and fever. No myoclonic spasms or convulsions were seen. The advantages and disadvantages of metrizamide are discussed.

Topics: Adolescent; Adult; Arachnoiditis; Child; Child, Preschool; Contrast Media; Dermoid Cyst; Humans; Infant; Infant, Newborn; Intervertebral Disc Displacement; Iodobenzoates; Lipoma; Meningocele; Metrizamide; Myelography; Sacrum; Spinal Cord; Spinal Cord Neoplasms; Spondylolisthesis