metrizamide and Spinal-Cord-Neoplasms

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

Topics: Adult; Aged; Arteriovenous Malformations; Cervical Vertebrae; Female; Humans; Joint Dislocations; Ligaments; Male; Metrizamide; Microsurgery; Middle Aged; Myelography; Ossification, Heterotopic; Spinal Cord; Spinal Cord Diseases; Spinal Cord Neoplasms; Spinal Diseases; Syringomyelia; Tomography, X-Ray Computed

Topics: Contrast Media; Humans; Injections, Spinal; Metrizamide; Spinal Cord Diseases; Spinal Cord Neoplasms; Syringomyelia; Tomography, X-Ray Computed

Topics: Atrophy; Contrast Media; Glioma; Humans; Intervertebral Disc Displacement; Iodobenzoates; Metrizamide; Myelography; Spinal Cord; Spinal Cord Compression; Spinal Cord Neoplasms; Subarachnoid Space

Computer tomography of the cervical spinal canal was carried out in 54 patients after the intrathecal injection of metrizamide (CT myelography). In 43 patients this was done after conventional myelography, in eleven it was the primary examination. In 32 patients the examination proved normal and in 22 abnormal. Correlation between the CT findings and conventional myelography was excellent. Quite small intraspinal structures both normal and abnormal, could be demonstrated. CT myelography is particularly valuable for determining the special relationships within the vertebral canal. The procedure can supplement and confirm conventional myelography, for instance round the foramen magnum. Under certain circumstances it may be regarded as the method of choice, since it is simpler for the patient and less likely to produce complications due to the contrast medium.

Topics: Adolescent; Adult; Aged; Child; Clinical Trials as Topic; Female; Humans; Injections, Spinal; Male; Metrizamide; Middle Aged; Myelography; Posture; Radiographic Image Enhancement; Spinal Cord; Spinal Cord Diseases; Spinal Cord Neoplasms; Tomography, X-Ray Computed

Topics: Ependymoma; Humans; Meningeal Neoplasms; Metrizamide; Myelography; Neurilemmoma; Spinal Cord Neoplasms; Tomography, X-Ray Computed

Topics: Adolescent; Adult; Female; Glioma; Humans; Male; Metrizamide; Middle Aged; Neurilemmoma; Spinal Cord Neoplasms; Tomography, X-Ray Computed

Topics: Adult; Contrast Media; Dermoid Cyst; Humans; Male; Metrizamide; Myelography; Spinal Cord Neoplasms; Tomography, X-Ray Computed

The clinical data and imaging studies of 12 patients with intramedullary metastases were reviewed retrospectively to see if these lesions had a typical radiographic appearance and to determine the sensitivity of the various radiologic examinations. The lesions were identified antemortem by either myelography, CT, MR, and/or intraoperative spinal sonography (IOSS). Final diagnosis was based on biopsy material from either the spinal cord lesion, another metastatic site, and/or the primary tumor. Ten patients had primary tumors located outside the central nervous system, while only two patients had primary brain tumors. Metrizamide myelography and CT demonstrated a definite intramedullary mass in nine of 11 patients. In five patients the mass was relatively small, well-defined, single, and resembled a primary spinal cord neoplasm. In the other four patients, longer and sometimes several segments of the cord were involved. These appeared irregular and nodular and were often associated with intradural lesions at separate sites. MR detected not only enlargement and abnormal signal in the cord but also clinically unsuspected brain lesions. IOSS localized lesions for biopsy and monitored tumor resection. These various imaging procedures showed that cord metastases were often more extensive than anticipated clinically. Spread of tumor into the spinal and intracranial subarachnoid space was common. Imaging of the entire spinal canal and brain, preferably with MR, is therefore recommended to aid in diagnosis, prognosis, and treatment.

Topics: Adult; Aged; Biopsy; Female; Humans; Intraoperative Care; Magnetic Resonance Spectroscopy; Male; Metrizamide; Middle Aged; Myelography; Retrospective Studies; Spinal Cord; Spinal Cord Neoplasms; Tomography, X-Ray Computed; Ultrasonography

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

A modified spinal cord puncture technique that was combined with CT metrizamide syringography for the evaluation of potentially cystic spinal cord lesions has been used in 5 patients. This procedure proved to be safe and efficacious in the preoperative differentiation of cystic neoplasms from syringohydromyelia. It also aided in planning a surgical approach by revealing details of the tumor location and/or syrinx dynamics. Spinal cord puncture associated with CT metrizamide syringography has a role in the diagnosis and therapy of patients with cystic spinal cord lesions.

Topics: Adult; Arnold-Chiari Malformation; Biopsy, Needle; Child, Preschool; Diagnosis, Differential; Female; Humans; Male; Metrizamide; Radiography; Spinal Cord Diseases; Spinal Cord Neoplasms; Spinal Puncture; Syringomyelia

A rare case of von Hippel-Lindau disease showing only spinal cord symptoms is reported. This 18-year-old boy was admitted to our clinic because of urinary disturbance, slowly progressive muscle weakness and sensory disturbance of his body and four extremities. Myelography demonstrated an expanding spinal cord and a figure of complete block of contrast medium at the lower cervical level. Dilated syrinx below the level of Th-3 was shown by delayed scan (19 hr.) of metrizamide CT myelography. These findings suggest that metrizamide could pass through the cord substance from the subarachnoid space into a syrinx cavity. Contrast enhancement CT scan revealed a slightly high density mass lesion at the level of Th-1 and a more marked tumor stain at the level of C-5 and 6. Syringo-subarachnoid shunt was done but the spinal intramedullary tumors were so deeply situated in the spinal cord that total removal of them was abandoned. The pathological diagnosis was hemangioblastoma. There were also a hemangioma at the right retina and multiple small tumor stains in the cerebellum, but they presented no clinical symptoms.

Topics: Adolescent; Angiomatosis; Humans; Male; Metrizamide; Neurologic Examination; Spinal Cord; Spinal Cord Neoplasms; Tomography, X-Ray Computed; von Hippel-Lindau Disease

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

The usefulness of intravenous contrast-enhanced CT in delineating intraspinal cord tumors has not been well documented. To determine if intradural spinal tumors enhance, if the location and type of tumor can be determined, and if a double dose of contrast material provides more information than a single dose, a retrospective study of 23 patients with proven intradural extramedullary or intramedullary tumors was performed. All the tumors studied with CT after intravenous contrast enhancement showed that most lesions (18/23) enhanced, contrary to published reports. Contrast-enhanced studies delineated the extent of the tumor, helping to separate solid and cystic components. The enhancement pattern of ependymomas and astrocytomas was similar, while schwannomas had a characteristic appearance. A double dose of intravenous contrast material had no apparent advantage over a single dose.

Topics: Adolescent; Adult; Aged; Astrocytoma; Child; Child, Preschool; Ependymoma; Female; Humans; Infant; Iothalamate Meglumine; Male; Metrizamide; Middle Aged; Myelography; Neurilemmoma; Retrospective Studies; 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

Intramedullary schwannoma without evidence of von Recklinghausen's disease is extremely rare. Only 23 cases have been reported in the literature. A 42-years-old woman with transverse type myelopathy at the level of Th 6, was referred to our department. Myelography showed diffuse swelling of the thoracic cord. Delayed myelo CT scan revealed the existence of syrinx at C 6 and Th 10 spinal cord level. On NMR spin echo image, high intensity signal with an ovoid shape was visualized in Th 7-8 spinal cord parenchyma and the syrinx was verified below the level of C 5. Based on these findings, she was diagnosed as having Th 7-8 intramedullary spinal cord tumor. Th 6 to Th 9 laminectomy followed by the complete removal of well encapsulated tumor was performed. The rostral and caudal pole of the tumor was found to be located intramedullary. The tumor at the level of Th 7-8, extended not only to the extramedullary space but also to the extradural space. Histopathological examination revealed that the specimen was Antoni A type neurinoma. She showed good recovery. Following hypotheses have been postulated on the cytogenesis of intramedullary schwannoma in the literature: Central displacement of Schwann cells during embryonic development. Schwann cells ensheathing aberrant intramedullary nerve fibers. Schwann cells along the intramedullary perivascular nerve plexus. A critical area where posterior root loose their sheath on entering the pia mater. Transformation of pial cells of neuroectodermal origin into Schwann cells. The cytogenesis of these reported cases may not be identical.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Adult; Female; Humans; Magnetic Resonance Spectroscopy; Metrizamide; Myelography; Neurilemmoma; Spinal Cord Neoplasms; Tomography, X-Ray Computed

Spinal metastases from cerebral glioblastoma via the cerebrospinal pathway are rarely detected when the primary tumors are under apparent control. The authors report two adult patients with cerebral glioblastoma who developed spinal symptoms referable to spinal seeding without neurological and computed tomographic findings of the recurrence of the primary tumors. Computed tomographic metrizamide myelography clearly revealed minute deposits of perispinal metastatic tumors that could not be detected by conventional myelography. Even perispinal mass lesions so minute that they are revealed only by computed tomographic metrizamide myelography can invade the spinal cord and cause clinical symptoms.

Topics: Adult; Brain Neoplasms; Glioma; Humans; Male; Metrizamide; Middle Aged; Myelography; Spinal Cord Neoplasms; Tomography, X-Ray Computed

One case of subarachnoid haemorrhage due to a spinal cord tumor, seen in a child, is reported. This exceptional etiology, whose the look is often misleading must be called to mind when meningeal and rachidian syndromes are associated. Ependymoma of cauda equina is the most common tumor.

Topics: Adolescent; Child; Ependymoma; Humans; Lymphography; Male; Metrizamide; Spinal Cord Neoplasms; Subarachnoid Hemorrhage; Tomography, X-Ray Computed

We compared intrathecal metrizamide-enhanced CT (metrizamide-CT) and magnetic resonance imaging (MRI) in the evaluation of 17 patients with clinical suspicion of lesions at the cervicomedullary junction. MRI was superior in imaging the position of the cerebellar tonsils and the size and extent of mass lesions. MRI and metrizamide-CT were equal in detecting syringomyelia. CT with and without IV contrast enhancement was necessary to detect calcium or defects in the blood-brain barrier within neoplasms.

Topics: Adolescent; Adult; Aged; Arnold-Chiari Malformation; Brain Diseases; Brain Neoplasms; Child; Female; Humans; Magnetic Resonance Spectroscopy; Male; Medulla Oblongata; Metrizamide; Middle Aged; Spinal Cord Diseases; Spinal Cord Neoplasms; Syringomyelia; Tomography, X-Ray Computed

Forty-five patients with a spinal, intraspinal or paraspinal tumour were evaluated by computed tomography. All examinations revealed pathological findings. In 30 cases the extent of the tumour was determined at surgery and in only two cases was there a discrepancy from the CT findings. Twenty-nine patients also underwent conventional myelography, three of which were negative. In the estimation of the extent of extradural tumours or bone involvement, CT was superior to other methods, but the size and localization of intradural tumours were estimated equally well by CT and conventional myelography. In patients with an intramedullary lesion CT was necessary to distinguish a solid neoplasm from a cystic lesion. In CT examinations of intraspinal tumours, intrathecal contrast medium increased the amount of information obtained especially in the thoracic and cervical regions, but was not necessary if myelograms were available. Intravenous contrast medium helped in the evaluation of some intraspinal neoplasms but did not improve the delineation of the paraspinal components.

Topics: Contrast Media; Humans; Metrizamide; Myelography; Spinal Canal; Spinal Cord Neoplasms; Spine; Tomography, X-Ray Computed

Computed tomography (CT) is currently the primary and generally the definitive imaging modality for the diagnosis, evaluation, and management of intracranial neoplasms in children. The value of CT in the postoperative period is discussed. The role of CT and myelography is stressed in the evaluation of cerebrospinal fluid seeding. CT is also important in demonstrating the iatrogenic disturbances of the central nervous system as a result of radiation and chemotherapy. The authors recommend that CT scans with and without contrast be obtained 2 weeks after surgery and before starting any form of adjuvant treatment. CT slices should be contiguous and 5-mm thick. Subsequent scans should be obtained every 3 to 4 months for the first year and every 6 months thereafter. Where necessary, CT scans after the introduction of intrathecal metrizamide may be necessary to evaluate the lower portion of the posterior fossa and brain stem.

Topics: Adolescent; Astrocytoma; Brain Neoplasms; Cerebral Ventricle Neoplasms; Child; Female; Glioma; Humans; Infant; Male; Meningeal Neoplasms; Meningioma; Metrizamide; Myelography; Neoplasm Seeding; Spinal Cord Neoplasms; Tomography, X-Ray Computed

Solitary intramedullary metastasis to the spinal cord is rare and difficult to diagnose clinically. We report a case of lung carcinoma metastasizing to cervical spinal cord with an unusual feature of delayed metrizamide enhancement of the widened portion of the spinal cord. The role of CT in the diagnosis is well demonstrated in this case.

Topics: Carcinoma, Small Cell; Humans; Male; Metrizamide; Middle Aged; Myelography; Spinal Cord Neoplasms; Time Factors; Tomography, X-Ray Computed

Topics: Contrast Media; Diagnosis, Differential; Humans; Intervertebral Disc Displacement; Lumbar Vertebrae; Metrizamide; Myelography; Sacrum; Spinal Canal; Spinal Cord Neoplasms; Spinal Neoplasms; Tomography, X-Ray

A case of familial anterior sacral meningocele associated with a dermoid tumor is reported. This patient presented with recurrent aseptic meningitis. The role of computerized tomography following metrizamide myelography in the diagnosis of this lesion is discussed.

Topics: Adult; Dermoid Cyst; Female; Humans; Meningocele; Metrizamide; Myelography; Sacrococcygeal Region; Spinal Cord Neoplasms; Tomography, X-Ray Computed

In five patients with complete spinal block due to tumor, CT was used to show the upper level of the block. In each case metrizamide myelography demonstrated the lower level of the block, but not enough metrizamide leaked past the block to allow myelographic identification of the upper level. However, the subarachnoid space both below and above the level of the block was clearly outlined by metrizamide on CT in each case.

Topics: Adolescent; Adult; Epidural Space; Female; Humans; Male; Metrizamide; Middle Aged; Myelography; Neoplasm Invasiveness; Spinal Canal; Spinal Cord Compression; Spinal Cord Neoplasms; Subarachnoid Space; Tomography, X-Ray Computed

We describe here a case of holocord subependymoma in an adolescent patient, completely removed with two surgical procedures. We discuss the histological features, the diagnostic difficulties and the surgical techniques used in this case.

Topics: Adolescent; Glioma; Humans; Male; Metrizamide; Myelography; Spinal Cord Neoplasms; Tomography, X-Ray Computed

The normal CT configuration and dimension of the conus medullaris and adjacent spinal cord were determined in 30 patients who had no clinical evidence of conus compression. CT studies were also correlated with anatomic sections in cadavers. The normal conus on CT has a distinctive oval configuration, an anterior sulcus, and a posterior promontory. The anteroposterior diameter ranged from 5 to 8 mm; the transverse diameter from 8 to 11 mm. Intramedullary processes altered both the dimensions and configuration of the conus.

Topics: Astrocytoma; Humans; Metrizamide; Myelography; Radiographic Image Enhancement; Spinal Cord; Spinal Cord Diseases; Spinal Cord Neoplasms; Tomography, X-Ray Computed

Intramedullary spinal cord tumours may present as scoliosis without neurological signs. Those treating spinal deformities should be alert to this possible aetiology. The clinical features of 12 such cases are discussed with reference to early diagnosis and treatment. Patients with a painful scoliosis should be investigated with myelography as well as bone scintigraphy. Many intrinsic spinal cord tumours are now amenable to surgical removal. The prognosis for neurological recovery is poor once a severe deficit becomes established. The importance of early diagnosis and joint orthopaedic and neurosurgical management is emphasised.

Topics: Adolescent; Adult; Astrocytoma; Child; Child, Preschool; Female; Humans; Laminectomy; Male; Metrizamide; Myelography; Retrospective Studies; Scoliosis; Spinal Canal; Spinal Cord Neoplasms; Spinal Fusion; Time Factors; 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

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

Computer-assisted myelography (CAM) is a technique in which computed tomography (CT) is combined with the intrathecal administration of metrizamide to demonstrate the spinal cord and surrounding structures. This retrospective study of 139 CAMs performed at Emory University Hospital included 125 CAMs that were preceded by routine metrizamide myelography (secondary CAM). The remaining 14 CAMs were primary studies without concomitant myelography. These CAMs and conventional myelograms were reviewed to provide indications for the use of CAM as a replacement for other radiodiagnostic studies or as an adjunct to radiological diagnosis. Eighty-one CAMs (58%) were positive for some pathological process. Of the 69 secondary CAMs demonstrating a pathological condition, 46 (67%) revealed some aspect of the lesion not apparent on routine metrizamide myelography. In no case with positive myelography was CAM negative. However, conventional myelography often added valuable diagnostic information. Although high resolution CT has allowed limited visualization of the spinal cord, CAM is often indicated for cases in which diagnosis requires more definition of cervicomedullary, extradural, intradural, extramedullary, and intramedullary lesions. Our clinical review found CAM to be extremely useful in the diagnostic evaluation of pathological conditions involving the spine and spinal cord and suggests clinical indications for the use of CAM based upon selected illustrative cases. Furthermore, CAM seemed to be superior to other radiological procedures in certain instances, such as in cases of spinal dysraphism and in the evaluation of lesions at the foramen magnum. Until more experience is obtained using spinal CT and CAM, CAM should not replace myelography altogether. The present study indicates that, rather than replacing conventional CT and myelography, CAM should be used as a primary study in situations where it has been shown to be superior and as a complementary study when other neurodiagnostic examinations are equivocal or nondiagnostic.

Topics: Adult; Child; Computers; Female; Humans; Intervertebral Disc Displacement; Lumbar Vertebrae; Male; Metrizamide; Myelography; Spinal Cord Compression; Spinal Cord Diseases; Spinal Cord Neoplasms; Syringomyelia; Tomography, X-Ray Computed

A basic and clinical study on the diagnostic value of computed tomographic myelography (CTM) with metrizamide was performed using the GE. CT/T. X-2. A basic study: using the fourth lumbar spine taken from a fresh cadaver and the phantom containing a test tube filled with metrizamide, the optimum window level (W. L.) and window width (W. W.) of the spinal CT and the optimum metrizamide concentration for the CTM were investigated. A clinical study: the relation between the concentration and volume of metrizamide and the timing for performing the CTM after intrathecal injection of metrizamide were examined, then CTM was performed in 82 cases with spinal and spinal cord disorders and 4 cases with normal spinal cords.. 1) Observing the spinal CT and CTM, the optimum W. L. is 50-150 and W. W. is 1,000. 2) The optimum metrizamide concentration of the subarachnoid space for CTM is 6-12 mgI/ml and its CT number is 150-300. This concentration is difficult to recognize in the conventional myelography. 3) It was confirmed that there were two methods to obtain the optimum concentration. One is the CTM after conventional myelography by lumbar puncture; at the cervical or thoracic level CT is performed 1-2 hours after metrizamide myelography with 230-250 mgI/ml and 7-10 ml, and at the lumbar level CT is performed 3-6 hours after myelography with 190-200 mgI/ml and 6-7 ml. The other is the CTM without conventional myelography; at each level, metrizamide with 100 mgI/ml is injected by lumbar puncture and CT is performed 15-40 minutes after injection of 10-15 ml for the cervical or thoracic level, and 3-5 ml for the lumbar level. The CTM obtained under these conditions provides the accurate information about intraspinal canal lesions and, therefore, it is very useful not only for the diagnosis of the lesion but also for the selection of the approach when a surgical treatment is indicated.

Topics: Adolescent; Adult; Aged; Arnold-Chiari Malformation; Cervical Vertebrae; Child; Female; Humans; Lumbar Vertebrae; Lymphoma, Large B-Cell, Diffuse; Male; Metrizamide; Middle Aged; Multiple Myeloma; Myelography; Neural Tube Defects; Scoliosis; Spinal Cord Neoplasms; Spinal Stenosis; Thoracic Vertebrae; 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

Computed tomography (CT) has made a profound impact on the diagnosis and treatment of neuroblastomas and ganglioneuromas. The size, location, calcification, composition, and contiguous spread of the tumors has been well demonstrated by CT. CT is essential for their staging, subsequent treatment, and follow-up. Seventy-seven children were reviewed, 67 with neuroblastoma and 10 with ganglioneuroma seen between 1976 and 1980. Fifty-eight had one or more body CT scans, 22 had metrizamide myelography and/or CT metrizamide myelography, and three patients had cranial CT. Intraspinal extension of tumor occurred in 11 instances, several requiring decompressive surgery. A workup plan for optimal use of CT and CT metrizamide myelography was developed from this experience.

Topics: Adolescent; Brain Neoplasms; Child; Child, Preschool; Female; Ganglioneuroma; Humans; Infant; Infant, Newborn; Male; Metrizamide; Myelography; Neoplasm Metastasis; Neuroblastoma; Retrospective Studies; Spinal Cord Neoplasms; Tomography, X-Ray Computed

Topics: Humans; Intervertebral Disc Displacement; Metrizamide; Myelography; Spinal Cord Diseases; Spinal Cord Neoplasms

Topics: Contrast Media; Ependymoma; Humans; Iopamidol; Iothalamic Acid; Meningeal Neoplasms; Meningioma; Metrizamide; Myelography; Spinal Cord Diseases; Spinal Cord Neoplasms; Spinal Diseases

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: Adolescent; Adult; Arachnoiditis; Child, Preschool; Female; Humans; Lymphoma; Male; Metrizamide; Middle Aged; Myelography; Neurilemmoma; Solubility; Spinal Cord Neoplasms; Water

The non-ionic water-soluble contrast medium Amipaque (metrizamide) shows a lowered neurotoxicity, and therefore it may be used in the entire spinal canal. The better visibility of fine structures compared with oily and gaseous contrast media allows an excellent diagnostic approach to all spinal affections. Our technique of myelography is described and typical examples are given.

Topics: Adolescent; Atrophy; Child; Child, Preschool; Female; Humans; Infant; Infant, Newborn; Male; Meningomyelocele; Metrizamide; Myelography; Spina Bifida Occulta; Spinal Cord; Spinal Cord Neoplasms; Spinal Diseases

In 102 patients, cervical metrizamide myelography was performed using a lateral C1/C2 approach. The procedure is of low risk, is easily performed and provides excellent diagnostic result. The authors hold this method--a few cases excepted--to be best for the investigation of the cervical region.

Topics: Contrast Media; Hematoma, Epidural, Cranial; Humans; Metrizamide; Myelography; Osteochondritis; Spinal Cord Neoplasms

Twenty-six patients with medulloblastoma had complete myelography and spinal fluid cytology and tests for polyamine levels in the evaluation for spinal metastases. The nature and location of abnormalities are presented in this report. Metrizamide was demonstrated to be safe and effective for complete myelography in children. The usefulness of myelography in detecting spinal metastases at the time of initial diagnosis (11%) and at the time of first intracranial recurrence (33%) is discussed.

Topics: Adolescent; Adult; Cerebellar Neoplasms; Child; Child, Preschool; Female; Humans; Infant; Male; Medulloblastoma; Metrizamide; Myelography; Spinal Cord Neoplasms

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

Either EMT Head Scanner, CT 1010 (slice thickness 10mm) or EMI Body Scanner, CT 5005 (slice thickness 13mm) was used. The concentration of metrizamide was 170-250 mgI/microliter and the amount was 7-10 microliters. Either lumbar puncture or lateral C puncture was made.. 26 cases were included in this study. 1) disc disease: 11 cases, 2) spinal cord tumor: 6 cases, 3) Arnold-Chiari malformation: 3 cases, 4) atlantoaxial dislocation: 3 cases, 5) ossification of the posterior longitudinal ligament (associated with ossification of the ligamentum flavum): 2 cases (1 case), 6) spinal foreign body (acupuncture needle): 1 case.. 1) CT metrizamide myelography visualizes the subarachnoid space and makes it possible to know the lesion in the spinal canal in relation to the spinal cord in transverse plane. 2) It is difficult to determine the exact level of the lesion in axial plane. 3) The present technique does not allow to visualize the root sleeves. 4) It is difficult to delineate a compression of the subarachnoid space by small localized lesions (esp., disc diseases) due to overlapping the patent adjacent subarachnoid space within a slice 10 mm to 13 mm thick.

Topics: Astrocytoma; Humans; Meningeal Neoplasms; Meningioma; Metrizamide; Myelography; Neurilemmoma; Spinal Cord Neoplasms; Spinal Diseases; Tomography, X-Ray Computed

Topics: Humans; Metrizamide; Myelography; Spinal Cord Compression; Spinal Cord Neoplasms; Spondylitis; Thoracic Vertebrae

Topics: Adult; Cysts; Humans; Injections; Male; Metrizamide; Middle Aged; Myelography; Spinal Cord Neoplasms

Amipaque (Metrizamide) when injected intrathecally, acts as a drug which may cause side effects and even complications. The adverse effects depend on the amount and concentration of the medium which reach the surface of the brain. The examination of the cervical area carries a risk that undiluted contrast material escapes into the cranial cavity. Knowledge of physical, physiological and pathophysiological properties of the medium is mandatory for proper management of the examination. Careful evaluation of the patient and the diagnostic problem and correct technique of cervical myelography gives perfect diagnostic information, minimal side-effects and no risk of serious complications.

Topics: Contrast Media; Humans; Intervertebral Disc Displacement; Metrizamide; Myelography; Neurilemmoma; Osteoarthritis; Retrospective Studies; Spinal Cord Neoplasms; Spinal Diseases; Syringomyelia

Topics: Adult; Female; Humans; Male; Metrizamide; Myelography; Solubility; Spinal Cord Neoplasms

Topics: Adult; Aged; Female; Humans; Male; Metrizamide; Middle Aged; 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

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

52 metrizamide myelographies practiced with tomodensitometry were studies (23 normal cases); 6 cervicarthrosic myelopathies; 2 intra medullar tumors; 1 extra medullar tumor; 19 syringomyelias). The technical procedures are discussed for the different diseases. This test has proven highly interesting for the study of syringomyelias and tumors. It allows the presence of narrow canals to be demonstrated, but does not yet indicate discal hernias. The role of tomodensitometry, in relation to other exams, is demonstrated.

Topics: Humans; Metrizamide; Myelography; Spinal Cord Neoplasms; Spine; Syringomyelia; Tomography, X-Ray Computed

In order to ascertain how much information Amipaque myelography provides regarding the normal and abnormal anatomy of the spinal arteries, 100 thoracic and/or cervical myelograms were reviewed. Partial demonstration of the anterior spinal system was noted in 78% of the thoraco-lumbar, and in 63% of the cervical myelograms. Where the anterior spinal artery was visible over several segments, it was usually possible to identify its origin. In an extensive arterio-venous angioma with complex vascularity, indirect demonstration of the vessels was definite and clear. Amipaque would seem to be the contrast medium of choice for myelograph of the entire spinal canal, including cervical myelography with puncture at the first or second vertebra. This is particularly true if it is desired to demonstrate the anterior spinal artery system with its tributaries.

Topics: Hemangioma; Humans; Metrizamide; Myelography; Spinal Cord Neoplasms; Spine; Vertebral Artery

Xeroradiography, particularly in addition to conventional tomography, for cervical myelography using water-soluble Metrizamide has been tested. Xerography was done in 30 of a total of 96 examinations and could be compared with conventional X rays. In the sagittal plane there was no advantage, in the lateral plane detail was clearer, especially at the cervico-dorsal junction and in establishing the extent of osteochondrotic changes narrowing the subarachnoid space. Xeroradiography should not be used routinely, but has its merits for certain problems, when higher radiation will be justified.

Topics: Humans; Metrizamide; Middle Aged; Myelography; Neck; Osteochondritis; Spinal Cord Neoplasms; Subarachnoid Space; Tomography, X-Ray; Xeroradiography

The non-ionic water-soluble contrast medium metrizamide (Amipaque) allows the examination of all regions of the spinal canal. Excellent visualization, the low toxicity for nervous tissue, and small side effects make metrizamide the best contrast medium for myelography, even in infants and children. The technique used is described and results are demonstrated.

Topics: Adolescent; Child; Child, Preschool; Female; Humans; Infant; Metrizamide; Myelography; Neural Tube Defects; Spinal Cord Diseases; Spinal Cord Neoplasms

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

Use of a water-soluble contrast medium for cervical spinal diagnosis has become possible with the introduction of Metrizamide (Amipaqque). Injection of contrast at the C.1/2 level by a lateral approach results in excellent visualisation of the cervical theca with previously unobtainable detail. This technique, which is so far not well known, allows a rapid examination and when used with the new, well tolerated contrast media provides optimal diagnostic results.

Topics: Cervical Vertebrae; Chemical Phenomena; Chemistry; Humans; Intervertebral Disc Displacement; Iodobenzoates; Metrizamide; Myelography; Osteochondritis; Posture; Solutions; Spinal Cord Compression; Spinal Cord Neoplasms; Spinal Nerve Roots; Water

A survey is made of the development of water-soluble contrast media and of the experimental and preliminary clinical investigations of the new water-soluble contrast medium metrizamide. The experiences with the medium indicate that its use in the subarachnoid space is safe and reliable.

Topics: Animals; Contrast Media; Humans; Intervertebral Disc Displacement; Metrizamide; Myelography; Neoplasm Metastasis; Neurilemmoma; Spinal Cord Neoplasms; Spinal Neoplasms

Metrizamide seems to be a suitable contrast medium for ventriculography and myelography. This contrast medium is less toxic and far less epileptogenic and spasmogenic than the other water-soluble contrast media in current use. No serious complications were noted in the present series. Transient changes in EEG were recorded, mainly with cervical myelographies. However, it is too early to evaluate the long-term side effects.

Topics: Adolescent; Adult; Aged; Cerebral Aqueduct; Cerebral Ventricle Neoplasms; Cerebral Ventriculography; Child; Child, Preschool; Contrast Media; Humans; Infant; Infant, Newborn; Intervertebral Disc Displacement; Metrizamide; Middle Aged; Myelography; Neoplasm Metastasis; Neurilemmoma; Pineal Gland; Spinal Cord Neoplasms; Teratoma

The radiologic appearances at gas myelography were analysed in 57 metastatic lesions, all histologically verified, or having known primary tumours. Five of these cases were also examined with a water-soluble contrast medium, metrizamide. The results were correlated to the findings at surgery and to tumour pathology. It is concluded that myelographic findings simulating juxtamedullary growth are usually due to local indentation of the dura by the extradural tumour, and not to intradural extension.

Topics: Adolescent; Adult; Aged; Breast Neoplasms; Child; Child, Preschool; Contrast Media; Histiocytosis, Langerhans-Cell; Humans; Infant; Lymphoma, Large B-Cell, Diffuse; Lymphoma, Non-Hodgkin; Metrizamide; Middle Aged; Myelography; Neoplasm Metastasis; Spinal Cord Neoplasms