[骨髓造影-仍然是最新的吗?]
Wolfgang Reith1, Anne Kettner2, Michael Kettner2
1Klinik für diagnostische und Interventionelle Neuroradiologie, Universitätsklinikum des Saarlandes, Kirrbergerstraße, 66424, Homburg, Deutschland. Wolfgang.Reith@uks.eu.
Radiologie (Heidelberg, Germany)
|October 17, 2025
概括
骨髓学可视化脊髓和神经根. 先进的技术,如动态CT-myelography对于诊断脑脊液泄漏至关重要,有助于有效的治疗.
科学领域:
- 神经辐射学神经辐射学
- 诊断成像 诊断成像 诊断成像
背景情况:
- 骨髓学可视化脊髓和神经根通过内对比或MRI.
- 从历史上看,光镜骨髓学是黄金标准,CT和MR成像现在很常见.
- 尽管有进步,骨髓图仍然对不清楚的MRI发现和诊断脑脊液 (CSF) 泄漏至关重要.
研究的目的:
- 为了突出神经放射学中骨髓图学的持续重要性.
- 强调其在诊断脊髓大脑脊髓液 (CSF) 泄漏中的作用.
- 讨论特定的骨髓学技术,用于CSF泄漏局部化.
主要方法:
- 在脊柱下关节空间 (SAS) 内注射对比剂.
- 使用X射线光学或计算机断层扫描 (CT) 的图像引导注射.
- 非侵入性磁共振成像 (MR) 使用重 T2 权重序列.
主要成果:
- 骨髓造影仍然是补充MRI发现的必要条件.
- 动态CT-骨髓图 (CTM),数字减去骨髓图 (DSM) 和动态光镜骨髓图是可视化CSF泄漏的关键.
- 当保守措施失败时,准确地定位脊髓中核液泄漏对于手术治疗至关重要.
结论:
- 骨髓造影,特别是动态CT骨髓造影,对于诊断和定位脊髓脑脊髓液泄漏是不可或缺的.
- 这种技术对于自发性内低血压 (SIH) 患者至关重要,这些患者对初始治疗没有反应.
- 对脑液泄漏诊断的重新关注强调了骨髓学在临床实践中的持久价值.
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