Mohd Amin Rebuan, Husbani
(2011)
Three dimensional high resolution mri myelography of cervical spine in patients with cervical spondylotic radiculopathy using moderately t2-weighted 3d tse-fs sequence.
Masters thesis, Universiti Sains Malaysia.
Abstract
Introduction: Neck pain is the most frequent cause of consultation in primary care worldwide. The most common cause of neck pain in adult more than 50 years of age is cervical spondylosis. These degenerative changes causing impingement of the nerve root that exit from the foramina producing the patient’s clinical symptoms. MRI myelogram is a non invasive radiation free procedure. Its special sequence is a new technique that can complement conventional MRI in making diagnosis by detecting nerve root impingement. The advantage of this new technique over the conventional MRI is still under investigation. The agreement of the findings between these procedures can give an additional information in the process of making MR myelography as an effective screening tool in the future. Objectives: The objective of this study is to prospectively associate the clinical variables with nerve root impingement in both conventional MRI and MRI myelogram, to determine the agreement of findings (demonstration of foraminal nerve root impingement in cervical spondylotic radiculopathy) between these two procedures and to determine the interobserver variability between the two observers in depicting the nerve root impingement. Materials and method: A randomised cross sectional prospective study to depict the nerve root impingement in patients with clinical diagnosis of cervical spondylotic radiculopathy using both conventional MRI and MRI myelogram of the cervical spine. Images from both two imaging findings of each patient were reviewed by two experienced radiologists. They interpretation of the images were done independently without knowing the symptoms and clinical findings of the involved patients. The agreement of findings between the observers were compared. Results: Cervical spondylotic radiculopathy affects mainly of high productivity age group. There was significant correlation between clinical symptoms and signs with nerve root compression in both imaging techniques. There were moderate agreement of findings between MRI myelogram with conventional MRI and there were moderate agreement of findings between two observers in depicting nerve root impingement. Conclusion: MRI myelogram altered the interpretation of nerve root impingement in 22 cases out of 47 nerve roots (approximately 50% of the cases). This value is very significant that MRI myelogram can be used as a complementary test to conventional MRI in detecting nerve root impingement in patient with cervical spondylotic radiculopathy. MRI myelogram gave additional information (8 nerve roots) that appeared to impinge on MRI myelogram but did not appear on conventional MRI. Even though this value is minimal to make MRI myelogram as an independent imaging technique, it gives a big value to the patients.
Actions (login required)
 |
View Item |
![[img]](http://eprints.usm.my/style/images/fileicons/application_pdf.png)
