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Low dose cervical CT myelography. How acceptable are adverse effects at this juncture?
H Wang1, A E Rosenbaum, M L Updike
1Russell L. Morgan Department of Radiology and Radiological Science, Johns Hopkins Medical Institutions, Baltimore, Maryland.
Abstract:
When cervical myelography is required, the highest incidence of adverse effects usually supervenes. These effects are particularly important in patients with metastatic disease, post-cervical trauma and out-patients. Low dose hydrosoluble CT myelography imaging (300-500 mg I, total dose) can be accomplished by injecting the contrast medium when the patient is in the CT scanner via C1-2 puncture with a small needle (e.g. 25 gauge). Our method of accomplishing this was to use C-arm fluoroscopy performed with the patient either supine or prone and to transfer the patient with the needle in situ to the scanner. This was done with the patient on a portable exchangeable CT table top. Remarkably few adverse effects (transient mild headache in 2 of 22 patients) would appear to render this technique safe and useful.