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Diagnostic imaging of the cervical disc diseases. Kazuo MIYASAKA 1 , Kunio TASHIRO 2 1Department of Radiology, Hokkaido University School of Medicine 2Department of Neurology, Hokkaido University School of Medicine pp.267-276
Published Date 1993/4/10
DOI https://doi.org/10.11477/mf.1431900327
  • Abstract
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 Many imaging modalities are currently available for the diagnosis of the cervical disc diseases. Myelography has been the examination of choice in cervical disc diseases for a long time, especially using non-ionic water soluble contrast agent. With the advent of high resolution CT, coupled with or without contrast material, the diagnostic accuracy has been greatly improved. Furthermore, recent revolution of MRI with a high-field magnet, highly sensitive coil and motion suppression technique has given great advantages for the evaluation of the disc diseases.

 What is important in evaluating the cervical disc diseases is; first, to delineate disc protrusion and osteophyte suitably; second, to understand the associated findings with disc diseases including congenital or developmental narrow canal, OPLL, subluxation and dynamic changes of cervical spine on neck flexion and extension, and intramedullary changes secondary to extrinsic spinal cord compression; and third, to correlate the image findings to neurological sign. Identification of protruded disc and osteophyte is directly made by CT and MRI. On T1 weighted image herniated disc is seen as intermediated signal intensity while on T2 weighted image it is high signal intensity. In the patient with myelopathy and radiculomyelopathy MRI is superior to CT since MRI dipicts disc material and its location, deformity of the spinal cord, intramedullary change within the material and its location, dynamic change of the cervical spine non-invasively. However, MRI is not always better than CT in evaluating patients with radiculopathy. It is especially ture in the cases with bony changes such as osteophyte, OPLL and narrow canal. Some disc materials above C6 level may be better appreciated by CT. When there are spondylotic changes at multiple levels and a responsible lesion for the patient symptoms is not conclusive, myelographic study will be performed, and followed by CT myelography.


Copyright © 1993, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1243 印刷版ISSN 0001-8724 医学書院

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