Radiology, Vol 146, 79-86, Copyright © 1983 by Radiological Society of North America
The value of computed tomographic metrizamide myelography in the neuroradiological evaluation of the spine
AB Dublin, JP McGahan and MH Reid
The diagnostic value of plain film metrizamide myelography (PFMM) was
compared with computed tomographic metrizamide myelography (CTMM) in a
study of 106 individuals who had undergone high-resolution computed
tomographic scanning of the spine. CTMM provided more significant
information than PFMM in 42 of 106 cases (40%), but showed no advantage
over PFMM in 63 of 106 cases (59%). In 19 of the 42 cases (45%), PFMM was
useful in directing the CT analysis to the appropriate region of pathology.
In one patient, PFMM revealed a mobile herniated disc that had not been
visualized with CTMM. In 30 of 106 cases in which plain CT scans of the
spine were also obtained, the addition of intrathecal metrizamide
demonstrated additional pathology in ten individuals. In general, CTMM was
useful in the delineation of a variety of pathologic entities, especially
neoplasms and congenital abnormalities. Low-dose CTMM (3 ml of a 150 ml/mg
concentration) was performed as an outpatient procedure and found to be a
useful adjunct to plain CT in two patients. A schema for the radiological
evaluation of pathology of the spine is presented.
