metrizamide and Neurofibromatosis-1

An intrathoracic meningocele is a protrusion of spinal meninges through an intervertebral foramen into the thoracic cavity. The majority occur in association with neurofibromatosis, and bilateral or multiple lesions are rarely seen. In conventional radiography, small meningoceles may be hidden behind other mediastinal structures. To investigate paraspinal masses, computed tomography (CT) with intrathecal contrast material is likely to result in more frequent detection of unsuspected lateral meningoceles. This report details our experience with CT metrizamide myelography in a case of multiple bilateral intrathoracic meningoceles.

Topics: Aged; Female; Humans; Meningocele; Metrizamide; Myelography; Neurofibromatosis 1; Radiography, Thoracic; Tomography, X-Ray Computed

Computed tomographic myelography (CTM) is the procedure of choice in patients exhibiting spinal manifestations of neurofibromatosis. Due to the lack of specificity of several of the more important plain spine radiographic findings in this disease, CTM may be necessary to distinguish between surgical and nonsurgical entities. CTM will determine the size, shape, and intraspinal extension of posterior mediastinal neural tumors and separate them from the more common thoracic meningoceles. CTM will likewise elucidate the causes of posterior vertebral body scalloping, distinguishing between dural ectasia and neural tumor. CTM will also frequently demonstrate additional asymptomatic lesions at other levels.

Topics: Adult; Child; Diagnosis, Differential; Female; Humans; Male; Mediastinal Neoplasms; Meningocele; Metrizamide; Myelography; Neurilemmoma; Neurofibromatosis 1; Spinal Cord; Spinal Cord Neoplasms; Spinal Neoplasms; Tomography, X-Ray Computed

Twenty-two spinal neurinomas, admitted to the Department of Neurosurgery, Kyoto University Medical School during the past 40 years, were retrospectively analysed under the circumstances that most of lower spinal and or spinal cord tumors had usually been handled by orthopedic surgeons in Japan. Of the total of 22 cases, there were 14 cervical, 6 thoracic and 2 lumbar neurinomas. Age distribution was from 16 to 70 years of age with the average 38. Von Recklinghausen's disease accompanied spinal neurinoma in 4 cases. Of 3 cases under the age of 20, two were associated with von Recklinghausen's disease. Motor deficits were the prominent clinical symptoms on admission in 63% of the cases, while pains were the initial symptoms in 77% of the cases. Twenty-nine percent of cervical neurinomas were of dumbbell type, extending both in the intraspinal and extraspinal spaces. In addition to the conventional neuroradiologic investigations, CT metrizamide myelography was extremely advantageous in detecting the localization and relation of spinal neurinomas to the spine and spinal cord as well as bony changes. Laser surgery was utilized in the recent two cases of spinal neurinomas of dumbbell type. It was found useful in that it enabled intraspinal decompression by a non-touch technique prior to laminectomy.

Topics: Adolescent; Adult; Aged; Female; Humans; Laser Therapy; Male; Metrizamide; Middle Aged; Myelography; Neoplasms, Multiple Primary; Neurilemmoma; Neurofibromatosis 1; Neuroma, Acoustic; Spinal Cord Neoplasms; Spinal Neoplasms

Topics: Astrocytoma; Chondroma; Hemangioma; Humans; Medulloblastoma; Meningioma; Metrizamide; Neurofibromatosis 1; Spinal Cord Neoplasms; Tomography, X-Ray Computed

Metrizamide (Amipaque) is a new water-soluble contrast medium for myelography. It differs from the conventional contrast media in that, because of its lower toxicity, it can be used also for cervical and thoracic myelography. The method of examination in myelography with water-soluble contrast media differs in some respects from that in myelography with oil-soluble contrast media. For the thoracic region, tomography is highly recommendable. After a description of the method of examination used, some examples of the abnormalities found are presented.

Topics: Adult; Arteriovenous Malformations; Female; Headache; Humans; Iodobenzoates; Male; Metrizamide; Middle Aged; Myelography; Neurofibromatosis 1; Solubility; Spinal Cord Diseases; Tomography, X-Ray