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CT of extraarachnoid metrizamide instillation
AJR. American Journal of Roentgenology
|September 1, 1986
Summary
Computed tomography (CT) of spinal extraarachnoid metrizamide collections can be misleading. This review identified key CT findings to help diagnose these potentially confusing subdural collections.
Area of Science:
- Radiology
- Neuroradiology
- Medical Imaging
Background:
- Metrizamide, a water-soluble contrast agent, is used for myelography.
- Post-myelography computed tomography (CT) can reveal extraarachnoid contrast collections.
- These collections can mimic intrinsic spinal pathology, leading to misdiagnosis.
Purpose of the Study:
- To characterize the CT appearance of spinal extraarachnoid metrizamide collections.
- To identify diagnostic clues for differentiating these collections from other spinal abnormalities.
Main Methods:
- Retrospective review of post-metrizamide CT scans from 425 patients.
- Identification and analysis of patients with extraarachnoid metrizamide collections.
Main Results:
- Eight patients (1.9%) had extraarachnoid metrizamide collections.
- Seven patients had subdural collections, often appearing as masses on the subarachnoid space.
- Three subdural collections were hypodense, simulating soft-tissue disease like tumors or arteriovenous malformations.
Conclusions:
- Spinal extraarachnoid metrizamide collections can be misleading on CT.
- Diagnostic CT clues include preserved dural/epidural interface, metrizamide islands within masses, epidural collections, and absence of vertebral destruction.