scholarly journals Magnetic Resonance Imaging and Multidetector Computed Tomography Evaluation of Craniovertebral Junction Abnormalities

2021 ◽  
Vol 8 (10) ◽  
pp. 532-536
Author(s):  
Abhishek Biswas ◽  
Nihar Ranjan Sarkar ◽  
Alak Pandit

BACKGROUND The craniovertebral junction is a complex articulation between occiput, atlas, axis and supporting ligaments enclosing the soft tissue structures of cervicomedullary junction which includes medulla, spinal cord and lower cranial nerves. The incidence of different types of CVJ anomalies varies with demographic environment & ill-defined genetic factors. CVJ anomalies are more frequently found in Indian subcontinent than anywhere else in the world. Even in India, these anomalies are more frequently documented from Bihar, Uttar Pradesh, Rajasthan and Gujarat. The reason for this geographical clustering is more speculative. The CVJ anomalies can be either due to bony or soft tissue anomalies. They are common in all age groups and almost equal in both sex groups. The anomalies can be due to congenital or acquired causes. There has been a renewed interest in the normal anatomy & pathological lesions of CVJ anomalies with dynamic xrays, computed tomography (CT) and magnetic resonance imaging (MRI). The clinical features are often delayed up to 2 nd or 3rd decade, since they are subtle and often missed. Various congenital anomalies and acquired disease processes can affect the craniovertebral junction. They often cause diagnostic dilemmas. Only few studies have been conducted in this regard. This study is an attempt to define importance of precise diagnosis for pre-treatment evaluation and systematic classification of CVJ abnormalities with MRI and multi-detector computed tomography (MDCT). METHODS We conducted this cross-sectional descriptive study with 55 patients, who had been referred to us for CT / MRI from Department of Neurology. 3 Tesla MRI (GE Healthcare) and 16 slice MDCT (Philips) were used in this study. RESULTS In our study, congenital anomalies were the most common type of CVJ abnormality followed by degenerative changes and trauma. MRI proved to be better at detecting soft tissue abnormalities and assessing spinal cord compression, although CT was very much accurate at demonstrating bony lesions with short scan times and ability to reconstruct in three orthogonal planes. CONCLUSIONS CT and MRI cannot be compared in imaging the craniovertebral junction and should be complementary to each other. KEYWORDS Craniovertebral Junction, MRI, MDCT

PEDIATRICS ◽  
1986 ◽  
Vol 78 (2) ◽  
pp. 251-256
Author(s):  
Roger J. Packer ◽  
Robert A. Zimmerman ◽  
Leslie N. Sutton ◽  
Larissa T. Bilaniuk ◽  
Derek A. Bruce ◽  
...  

Correct diagnosis of spinal cord disease in childhood is often delayed, resulting in irreversible neurologic deficits. A major reason for this delay is the lack of a reliable means to noninvasively visualize the spinal cord. Magnetic resonance imaging (MRI) should be useful in the evaluation of diseases of the spinal cord. A 1.5 Tesla MRI unit with a surface coil was used to study 41 children, including eight patients with intrinsic spinal cord lesions, eight patients with masses compressing the cord, 12 patients with congenital anomalies of the cord or surrounding bony structures, three patients with syrinxes, and three patients with vertebral body abnormalities. Intrinsic lesions of the cord were well seen in all cases as intrinsic irregularly widened, abnormally intense cord regions. MRI was helpful in following the course of disease in patients with primary spinal cord tumors. Areas of tumor were separable from syrinx cavities. Extrinsic lesions compressing the cord and vertebral body disease were also well visualized. Congenital anomalies of the spinal cord, including tethering and lipomatous tissue, were better seen on MRI than by any other radiographic technique. MRI is an excellent noninvasive "screening" technique for children with suspected spinal cord disease and may be the only study needed in many patients with congenital spinal cord anomalies. It is also an excellent means to diagnose and follow patients with other forms of intra- and extraspinal pathology.


2017 ◽  
Author(s):  
Emily Alanna Aherne ◽  
Sinchun Hwang

Medical imaging plays a pivotal role in the detection, diagnosis, and clinical management of primary soft tissue tumors. Various imaging modalities have been used, and each modality offers unique advantages in the workup of soft tissue tumors by localizing the lesions in different compartments of the body and characterizing macroscopic tissue composition of the lesions in a noninvasive and safe manner. We review the clinical role and technical aspects of the frequently used imaging modalities, including magnetic resonance imaging (MRI), computed tomography, ultrasonography, positron emission tomography, and plain radiography with an emphasis on MRI as a mainstay imaging modality and a brief discussion of advanced techniques. We also review imaging features of common soft tissue tumors that can be detected and characterized using current imaging techniques. This review contains 54 figures, 1 table and 37 references.   Key words: computed tomography, diffusion-weighted imaging, imaging, magnetic resonance imaging, positron emission tomography, soft tissue, technique, tumor, ultrasonography


1996 ◽  
Vol 6 (3) ◽  
pp. 119-123 ◽  
Author(s):  
D. Lazovic ◽  
J. Franke ◽  
C.J. Wirth

In treatment of congenital dislocation of the hip, a main aim is to achieve concentricity of reduction. Control by plain x-ray lacks accuracy in determining anteroposterior position. Arthrography and sonography cannot be used when a spica cast is in place. After April 1988, therefore, as an alternative in 16 hips, we have used computed tomography to determine femoral head position, acetabular angle, and extent and integrity of posterior rim. However, the presence of any metallic artefacts, unossified cartilage and the general poor-quality imaging of soft tissue associated with the technique reduce its usefulness. Since January 1990, we have instead used magnetic resonance imaging to control treatment. This technique, in 34 hips, proved accurate in determinating the femoral head position. MRI also gave better images than computed tomography of osseous and cartilaginous structures of the acetabulum and the surrounding soft tissue. Spica casting does not affect the quality of imaging. The effect of metal artefacts can be minimized by using, where necessary, implants of titanium alloy.


Neurosurgery ◽  
1990 ◽  
Vol 27 (4) ◽  
pp. 638-640 ◽  
Author(s):  
Patrick L. Valls ◽  
Gill L. Naul ◽  
Steven L. Kanter

Abstract Arachnoid cysts of the spinal canal are relatively common lesions that may be either intra- or extradural. These cysts are usually asymptomatic but may produce symptoms by compressing the spinal cord or nerve roots. We report a case in which an intradural thoracic arachnoid cyst became symptomatic after a routine decompressive lumbar laminectomy for spinal stenosis. Myelography revealed no abnormality, although magnetic resonance imaging and computed tomography after myelography demonstrated a mass within the posterior aspect of the thoracic spinal canal associated with anterior displacement and compression of the spinal cord. A change in the flow dynamics of the cerebrospinal fluid probably allowed the development of spinal cord compression due to one of the following: expansion of the cyst, decreased cerebrospinal fluid buffer between the cord and the cyst, or epidural venous engorgement. A concomitant and more cephalad lesion such as an arachnoid cyst should be considered when myelopathic complications arise after lumbar surgery. Magnetic resonance imaging and computed tomography after myelography are useful to demonstrate the additional pathological processes.


2015 ◽  
Vol 129 (9) ◽  
pp. 852-859 ◽  
Author(s):  
F D Lesser ◽  
S G Derbyshire ◽  
H Lewis-Jones

AbstractBackground:Central skull base osteomyelitis is clinically difficult to distinguish from malignancy.Method:The computed tomography and magnetic resonance imaging scans of six patients with central skull base osteomyelitis were compared with scans from patients with a range of skull base conditions.Results and conclusion:Computed tomography scans of central skull base osteomyelitis show much less bony destruction relative to the magnetic resonance imaging changes, whereas malignancy cases were associated with similar bony destruction on computed tomography and magnetic resonance imaging. In magnetic resonance imaging scans, it was possible to confirm previous findings of clival hypointensity on T1-weighted images relative to normal fatty marrow. In addition, there were signs of pre- and para-clival soft tissue infiltration, with the obliteration of normal fat planes and frank soft tissue masses in all six central skull base osteomyelitis patients. Signal intensity on T2-weighted images of the clivus was high in five central skull base osteomyelitis patients. With intravenous contrast, fascial plane anatomy appeared restored in central skull base osteomyelitis cases, almost in keeping with that of non-involved areas. This was not a feature in any of the malignant conditions.


1990 ◽  
Vol 15 (2) ◽  
pp. 229-232
Author(s):  
R. ADANI ◽  
M. CALÒ ◽  
P. TORRICELLI ◽  
P. B. SQUARZINA ◽  
A. CAROLI

Twenty patients with palpable swellings of the hand were investigated by computed tomography. The results, when compared with the pathological findings, lead us to consider this a technique of considerable value in the assessment of this kind of disease. The importance of angiography and, occasionally of magnetic resonance imaging, are also stressed.


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