Bryc, S.; Zelazny, S.; Losicki, M.; Orzedala, E.; Woznica, J. [Akademia Medyczna, Lublin (Poland)
The authors compared the agreement between clinical, radiological and surgical diagnoses in 33 cases of nucleus pulposus prolapse. A complete agreement of diagnosis was obtained in 88% of cases. The mechanism and incidence of different signs and their importance for the diagnosis of nucleus pulposus prolate are discussed. It should be stressed that the compression of nerve roots recognized on radiculography is not pathognomonic sign of prolapse and may be due to such process as development of marginal osteophyles in the degenerative disc disease, thickening of the posterior longitudinal ligament, hypertrophy of radicular processes or necks of vertebral archess. In the light of own experiences and data from the literature the authors consider radiculography with Amipaque and computer tomography as the method of choice in cases with suspected disc herniation in the lumbar region. (author). 27 refs, 5 figs.
A series of lumbar myelographies -- 105 in 98 patients - was carried out with water-soluble Metrizamid (Amipaque R) in a concentration of 170 mg I/ml and showed side-effects in 32% and a quality of contrast similar to that of other water-soluble contrast media used before. The side effects were mild, of short duration and needed no treatment. There were no epileptic fits, tonic or clonic carried out 1 - 12 months later showed no signs of arachnoiditis. Dangers of more serious complications appeared to increase, the higher the level of injection into the spinal canal. A short survey of contrast media used in myelography and earlier experience of experimental or clinical side effects caused by Medtrizamid in myelography follows.
Cernoch, Z.; Sercl, M.; Heger, L.; Parizek, J. (Karlova Univ., Hradec Kralove (Czechoslovakia). Lekarska Fakulta)
Computer tomography was used in 42 patients for the exploration of ventricular and subarachnoidal spaces following intraventricular, lumbar or suboccipital injections of 3 to 5 ml Amipaque using the kind of manoeuvre to permit optimum filling of the region concerned. This type of CT ventriculo- or cisternography is a significant supplement to plain CT examination particularly because it supplies data on the causes of CSF passage blocks. Thus, in two female patients it proved possible to localize cysts in the 3rd ventricle, the density of which was no different from that of CSF. As regards benign stenoses of the aqueduct, it is likely to yield less information than conventional specific ventriculography. On the other hand, the technique gives perfect visualization of all possible communications between pathological intracranial cavities and the ventricular system. CT cisternography proved useful for the identification of small-size isodense growths in the region of the sella turcica, and brought convincing evidence of the causes of profuse liquorrhea by demonstrating the presence of nasal meningocele. It was also found helpful in the analysis of the craniocervical region, otherwise difficult to survey.