Servikal disk hernisi ve spondilozda konvansiyonel miyelografi ve BT miyelografinin tanı değeri
Date
1990
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Uludağ Üniversitesi
Abstract
Servikal bölge, anatomik ve patolojik özellikleri nedeniyle, nöroradyolojik olarak incelenmesi zor bir kesimdir. Servikal disk hernisi ve spondiloz tanısında, tanı değeri en yüksek yöntemlerden olan Konvansiyonel/ Myelografi (KM) ve Bilgisayarlı Tomografik Miyelogrfinin (BTM) tanıya katkılarını araştırmak amacıyla 40 olgudan oluşan prospektif bir çalışma yaptık. Olguların hepsine KM ve BTM uygulandı. Beş olguda ise önceden düz: BT yapılmıştı. Kırk olguda incelenen 139 seviyenin 80'inde (% 57.5) her iki yöntem eşit derecede bilgi verdi. Elli seviyede (% 36) KM'de lezyon saptanmakla birlikte BTM'de önemli ek bilgi sağlandı. Yedi seviyede (% 5) KM'de lezyon görülmedi halde BTM'de saptandı. İki seviyede ise (% 1.5) KM'de tezyon olmasına karşın BTM normaldi. Beş olguda yapılmış olan düz BT, disk hernilerinin bir kısmı ile kord deformasyonlarını demonstre edemedi. Çalışma sonucunda KM lezyonların seviyesini belirlemekte başarılı bulunmuştur. Ancak, lezyonların yapısının belirlenmesinde ve spinal korddaki değişiklerin gösterilmesinde BTM ye gereksinim duyulmaktadır. Sonuç olarak, servikal disk hernisi ve spondiloz tanısında ilk yöntem olarak KM uygulanmalıdır. KM bulguları klinik tabloyu açıklamıyor veya lezyonların karakterizasyonu gerekiyorsa BTM yapılması uygun olacaktır. Tekal panksiyon yapılamayan olgularda düz BT yararlı bilgiler verebilir.
It is considerably difficult to evaluate the cervical region neuroradiologicaly because of the anatomical and pathological features of this region. We have done prospectif study in 40 cases in order to research the contribution of Computed Tomographic Myelography (CTM) and Conventional Myelography (CM), which have very high diagnostic accuracy, to diagnose cervical disc herniation and spondylosis. CM and CTM were both performed for every case. Five case had previous plain CT studies. Eighty of 139 levels in 40 patients were evaluated and both methods gave same information in these cases (57.5 %). In 50 levels the lesions were detected with CM but CTM gave nıore detailed information (36 %). In seven levels the lesions were not detected with CM. Whereas CTM studies were positive in these cases (5 %). The lesions were seen with CM and not seen with CTM in two levels ( 1.5 %). Plain CT studies in five patients did not demonstrate cord deformation and also some disc herniation. With this study, it is decided that CM is successful to detect level of the lesion. But CTM is necessary to show the changes of the spinal cord and to be the characteristics of the lesion. In the data above it is concluded that CM should be done as a first method to detect cervical disc herniation and spondylosis. CTM can be done when the CM study don't give enough information for clinical sitıtotion or when it is necessary to characterise lesions. CT study can also show some helpful findings when the thecal ponction can 't be done.
It is considerably difficult to evaluate the cervical region neuroradiologicaly because of the anatomical and pathological features of this region. We have done prospectif study in 40 cases in order to research the contribution of Computed Tomographic Myelography (CTM) and Conventional Myelography (CM), which have very high diagnostic accuracy, to diagnose cervical disc herniation and spondylosis. CM and CTM were both performed for every case. Five case had previous plain CT studies. Eighty of 139 levels in 40 patients were evaluated and both methods gave same information in these cases (57.5 %). In 50 levels the lesions were detected with CM but CTM gave nıore detailed information (36 %). In seven levels the lesions were not detected with CM. Whereas CTM studies were positive in these cases (5 %). The lesions were seen with CM and not seen with CTM in two levels ( 1.5 %). Plain CT studies in five patients did not demonstrate cord deformation and also some disc herniation. With this study, it is decided that CM is successful to detect level of the lesion. But CTM is necessary to show the changes of the spinal cord and to be the characteristics of the lesion. In the data above it is concluded that CM should be done as a first method to detect cervical disc herniation and spondylosis. CTM can be done when the CM study don't give enough information for clinical sitıtotion or when it is necessary to characterise lesions. CT study can also show some helpful findings when the thecal ponction can 't be done.
Description
Keywords
Servikal disk hernisi, Spondiloz, BT miyelografi, CT myelography, Cervical disc herniation, Conventional, Myelography, Spondylosis
Citation
Sivri, Z. vd. (1990). ''Servikal disk hernisi ve spondilozda konvansiyonel miyelografi ve BT miyelografinin tanı değeri''. Uludağ Üniversitesi Tıp Fakültesi Dergisi, 17(2), 323-331.