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AJNR - American Journal of Neuroradiology

Published ahead of print on December 7, 2007
doi: 10.3174/ajnr.A0853

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A Comparison of Angiographic CT and Multisection CT in Lumbar Myelographic Imaging

J.-H. Buhk^a, E. Elolf^a, D. Jacob^a, H.-H. Rustenbeck^a, A. Mohr^a and M. Knauth^a

^a From the Department of Neuroradiology, University of Goettingen, Goettingen, Germany

View larger version (152K): [in this window] [in a new window]   Fig 1. Images from a 58-year-old woman with persistent back pain. The left lateromedial prolapsed intervertebral disk in the segment L2/3 is equally well visible in both ACT (A and C) and MSCT (B and D) images. ACT images in the left posterior oblique position are displayed as 3D-MIP (E) and 3D-VRT (F). G, The myelographic projection was derived by transferring the position of the 3D volume from the workstation to the C-arm. Hence, no additional fluoroscopy was necessary to determine the optimal angles for projection myelographies.

View larger version (77K): [in this window] [in a new window]   Fig 2. Images from a 62-year-old man with symptoms of spinal claudication. Coronal MPR planes of ACT (A) and MSCT (B) are of equal quality. C, A curved coronal reconstruction of the ACT provides an appropriate depiction of the segmental nerve roots.

View larger version (79K): [in this window] [in a new window]   Fig 3. MPR images from a 75-year-old woman with persistent back pain after multisegmental laminectomy. In the sagittal sections (A, ACT; B, MSCT), the relevant degenerative changes can be depicted equally well: ligamental hyperplasia in the segment L1/2, ventral osteochondrosis in the segment L2/3, and the slight listhesis in the segment L4/5. A, Note the loss of detail and the enhanced image noise in the ACT section at the level from L5 to S2 due to the high attenuation of contrast media in the thecal sac. The transverse sections through the vertebral body of L4 (C, ACT; D, MSCT) show the hypertrophic facet joints and the thecal sac herniating into the laminectomy site. Both techniques show a well-defined L4 nerve root of the right side and an increase of tissue around the L4 nerve root of the contralateral side.