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Stellenwert von Myelographie, Myelo-CT und MRT in der Diagnostik der zervikalen Radikulo- und Myelopathie

Imaging cervical myelo- and radiculopathy

  • Freies Thema
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Zusammenfassung

Ziel

Diese Arbeit zieht einen Vergleich zwischen zervikaler Myelographie, CT-Myelographie (CTM) und MRT. Es gilt herauszufinden, welchen Stellenwert jede der oben genannten Methoden in Bezug auf Diagnostik und nachfolgende Therapie hat.

Material und Methoden

Bei insgesamt 25 Patienten mit klinischem Verdacht auf eine zervikale Myelo- oder Radikulopathie wurden sowohl eine MRT-Untersuchung der Halswirbelsäule als auch eine Myelographie durchgeführt.

Ergebnisse

Eine Einengung des Spinalkanals ließ sich sowohl in der CTM als auch MRT darstellen. Bezüglich des Ausmaßes der Spinalkanaleinengung bestand zwischen den T1w-axialen Bildern und den Postmyelo-CT-Bildern kein signifikanter Unterschied.

Schlussfolgerungen

Die MRT ist in der Diagnostik von Myelo- und Radikulopathien der CTM ebenbürtig. Die CT ist zwar in der Differenzierung von weicher und knöcherner Protrusion besser, jedoch bietet die MRT v. a. wegen ihrer fehlenden Invasivität und fehlenden Strahlenbelastung einen entscheidenden Vorteil.

Abstract

Purpose

This article gives an overview of the diagnostic possibilities available in the diagnosis of cervical myelo- and radiculopathy. We compared conventional myelography, CTM, and MRI.

Material and methods

Twenty-five patients with clinical evidence of cervical myelo- or radiculopathy were included. Sagittal and transverse T1-weighted (T1w) TSE and T2-weighted (T2w) TSE sequences were compared with myelography and CTM. Statistical analysis was performed using Wilcoxon’s -test.

Results

Disc herniation could be depicted in CTM as well as in MRI. The extent of herniation did not differ between CTM and T1w. The extent of herniation seemed higher on T2w than on T1w (p <0.001). Foraminal encroachment was easier to diagnose in CTM. When regarding transverse T1w and T2w images simultaneously, a missing root in MRI corresponded to a missing root in CTM and conventional myelography and vice versa. Our data demonstrated the relative inability of MRI to determine whether the compression is by soft tissue or bony structures.

Conclusion

The present study proposes that MRI, when available, should be the imaging method of first choice in patients with suspected radiculo- and myelopathy.

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Authors and Affiliations

  1. Abteilung Neuroradiologie, Universitätsklinikum des Saarlandes Homburg

    C. Roth, P. Papanagiotou, C. Krick, W. Reith &  I. Q. Grunwald

  2. Abteilung Neuroradiologie, Universitätsklinikum des Saarlandes, 66426 , Homburg

    I. Q. Grunwald

Authors
  1. C. Roth
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  2. P. Papanagiotou
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  3. C. Krick
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  4. W. Reith
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  5. I. Q. Grunwald
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Corresponding author

Correspondence to I. Q. Grunwald.

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Roth, C., Papanagiotou, P., Krick, C. et al. Stellenwert von Myelographie, Myelo-CT und MRT in der Diagnostik der zervikalen Radikulo- und Myelopathie. Radiologe 46, 993–1000 (2006). https://doi.org/10.1007/s00117-005-1251-9

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  • DOI: https://doi.org/10.1007/s00117-005-1251-9

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