Feasibility and potential value of flat-panel detector-based computed tomography in myelography after spinal surgery.
OBJECTIVE
The purpose of this study was to assess the value of myelography using flat-panel detector-based computed tomography (fpCT) in 5 patients in whom the image quality of multislice CT (MSCT) or MR imaging was limited by metal artifacts.


METHODS
The application of fpCT to myelographic imaging of the lumbar spine and cervicothoracic junction after surgery was feasible. Multiplanar, preferably sagittal, and 3D reconstructions adequately depicted disc space implants and provided high resolution images of osseous structures.


RESULTS
The images obtained with fpCT allowed evaluation of anatomical details such as single nerve roots and proved especially valuable in a patient with impaired MR imaging results caused by metal artifacts from an intraoperative abrasion. In a case of recurrent disc herniation, imaging results of myelographic fpCT and MSCT scanning were in good agreement.


CONCLUSIONS
The novel imaging technique the authors describe yielded adequate results in patients with a history of spinal surgery, may be superior to MSCT scanning in depicting osseous structures and metallic implants, and has the potential to provide multilevel spinal images. Myelographic fpCT scanning may be the preferred modality in patients with expected or known metal artifacts on myelographic MSCT scans and/or MR images.
Kau
Thomas
T
Institute of Diagnostic and Interventional Radiology, General Hospital of Klagenfurt, Austria. t.kau@gmx.at
Rabitsch
Egon
E
Celedin
Stefan
S
Jeschofnig
Barbara
B
Illiasch
Herbert
H
Eicher
Wolfgang
W
Uhl
Eberhard
E
Honl
Matthias
M
Hausegger
Klaus Armin
KA
D000328:Adult; D016477:Artifacts; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D007405:Intervertebral Disc Displacement / Q000000981:diagnostic imaging* / Q000601:surgery*; D017116:Low Back Pain / Q000000981:diagnostic imaging / Q000601:surgery; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009192:Myelography; D011183:Postoperative Complications / Q000000981:diagnostic imaging; D013131:Spine / Q000000981:diagnostic imaging*; D013904:Thoracic Vertebrae / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed