CT-Myelografie: klinische Indikationen und Bildgebungsbefunde

Trotz der unbestreitbaren Vorteile der MRT bleibt die CT-Myelografie eine wichtige diagnostische Methode zur Darstellung der Wirbelsäule, etwa bei Lokalisation einer Erkrankung im intraduralen extramedullären Raum oder wenn aus patientenbezogenen Gründen die MRT nicht eingesetzt werden kann. Deshalb gehen die Autoren auf einige Indikationen der CT-Myelografie ein und zeigen ihren Nutzen bei verschiedenen Wirbelsäulenerkrankungen.

Abstract

CT myelography is an important imaging modality that combines the advantages of myelography and the high resolution of CT. It provides a detailed delineation of pathologic spine conditions, especially those involving the thecal sac and its contents. However, the role of CT myelography has dramatically and appropriately decreased with the advent of MRT, which provides a noninvasive method to demonstrate pathologic spine conditions with high signal intensity in soft tissues. At the present time, CT myelography is often performed in patients who require evaluation of the thecal sac but have a contraindication to undergoing MRI. However, there remain many situations in which CT myelography is indicated and plays a critical role in patient treatment. The authors review common and uncommon indications for CT myelography and demonstrate various pathologic conditions in which CT myelography plays a vital role in patient treatment in this modern era of MRI.

Kernaussagen

• Mit der CT-Myelografie lassen sich die Prozesse, die das Rückenmark, die Nervenwurzeln und den Duralsack berühren, einengen oder verschieben, am besten darstellen.

• Große Vorteile der CT-Myelografie gegenüber der MRT sind ihre Dynamik und die Möglichkeit, verzögerte Bilder aufzunehmen.

• Gegenwärtig wird die CT-Myelografie häufig bei Patienten und Patientinnen durchgeführt, die eine Beurteilung des Duralsacks benötigen, bei denen jedoch eine Kontraindikation für eine MRT besteht.

• Die Möglichkeit, die zu untersuchende Person während der CT-Myelografie auf verschiedene Weise zu lagern, ist ein weiterer Vorteil gegenüber der MRT.

• Die Extravasation des intrathekalen Kontrastmittels in den extrathekalen Raum hilft, die genaue Austrittsstelle zu identifizieren.

• Obwohl die MRT insgesamt eine bessere Kontrastauflösung bietet, sorgt das intrathekale Kontrastmittel in der CT-Myelografie für eine hervorragende Kontrastauflösung zwischen den Liquorräumen und dem angrenzenden Weichgewebe.

Schlüsselwörter

CT-Myelografie - Wirbelsäule - Indikationen - Bildgebungsbefunde

Keywords

CT myelography - spine, indications - imaging findings

Publikationsverlauf

Artikel online veröffentlicht:
02. August 2022

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