A comparison of angiographic CT and multisection CT in lumbar myelographic imaging.
OBJECTIVE
The purpose of this work was to provide an intraindividual comparison of angiographic CT (ACT) and multisection CT (MSCT) in lumbar myelographic imaging and to evaluate possible benefits of ACT, which is a further development of rotational angiography providing image data of high spatial and CT-like contrast resolution.


METHODS
In 26 patients with degenerative lumbar spine disease a lumbar ACT was performed in combination with conventional lumbar myelography and followed by postmyelographic MSCT. Conventional lumbar myelography and lumbar ACT were performed with a flat panel detector-equipped angiographic device. Postmyelographic MSCT was performed with a 16-section CT scanner. Three experienced neuroradiologists rated anonymized sets of multiplanar reformatted CT and ACT images regarding diagnostic and technical parameters. The ratings were repeated after 2 months. Weighted kappa statistics were calculated to describe the levels of intraobserver and interobserver agreement.


RESULTS
The analysis shows that MSCT achieves higher ratings than ACT in all of the parameters asked. An adequate diagnostic quality was only assigned to 80% of the ACT acquisitions compared with 97% of the MSCT acquisitions. All of the mean kappa values were above 0.60, demonstrating a substantial intraobserver and interobserver agreement for MSCT, as well as for ACT.


CONCLUSIONS
Using ACT, radiographic myelography and myelographic CT can be performed at the same imaging system. However, the results of our study show that the current myelographic ACT image quality fails to apply diagnostic standards. We, therefore, cannot recommend ACT as a general alternative to postmyelographic MSCT.
Department of Neuroradiology, University of Goettingen, Goettingen, Germany. jbuhk@gwdg.de
J-H
JH
Buhk
E
E
Elolf
D
D
Jacob
H-H
HH
Rustenbeck
A
A
Mohr
M
M
Knauth
D000368:Aged; D000792:Angiography / Q000379:methods*; D005260:Female; D006801:Humans; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D009192:Myelography / Q000379:methods*; D011856:Radiographic Image Enhancement / Q000295:instrumentation / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013122:Spinal Diseases / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed / Q000295:instrumentation / Q000379:methods*