Rai, Santosh and *, Santosh K and Chakraborti, Shrijeet and Pai , Shivananda and *, Ishwara Keerthi and Pai, Muralidhar K (2014) A blast from the past!: The value of adding single slice magnetic resonance myelography sequence to magnetic resonance imaging of the spine; a flashback to the conventional myelography of the past. Surgical Neurology International, 5 (Sup 15). S523-S528. ISSN 2229-5097

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Abstract

Background: The study was undertaken to determine whether a single slice magnetic resonance (MR) myelogram sequence improves the interpretation and diagnostic yield for magnetic resonance imaging (MRI) of the spine. Methods: A total of 100 cases with positive findings were retrospectively reviewed. All patients had initial imaging with sagittal T1‑weighted (T1‑W) and T2‑weighted (T2‑W) scans, followed by axial T2‑W images. Subsequently, a heavily T2‑W single slice MR myelogram sequence was acquired in coronal and sagittal planes. The MR myelogram images were evaluated initially by a radiologist, and, further independently reviewed, by a neurologist, neurosurgeon, and spine surgeon. The utility of the MR myelogram in establishing the diagnosis was graded on a 4‑point scale. Results: Out of 100 cases, 53% showed degenerative spine or disc disease, 14% space occupying lesions, 13%, congenital lesions, 7% infection, and 7% other conditions. The MR myelogram contributed additional information in 50-74% cases. The intraclass correlation coefficient showed overall good agreement between observers in grading the utility of MR myelogram. Conclusion: Single slice MR myelography is noninvasive avoiding the complications associated with lumbar punctures/intrathecal contrast injections, while image acquisition takes only an added 6-8 s. Although MR myelogram has no value as a stand‑alone sequence, its inherent advantage is that it completes the overview of the spinal pathology in entirety, and adds vital three‑dimensional information in 50-74% of cases.

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