CT and Myelography of the Spine and Cord: Techniques, by Holger Pettersson MD, PhD, Derek C. F. Harwood-Nash MB, ChB,
By Holger Pettersson MD, PhD, Derek C. F. Harwood-Nash MB, ChB, FRCP(C) (auth.)
To learn the phenomenon of affliction with out books is to sail an uncharted sea. whereas to review books with out sufferers isn't to visit sea in any respect. Sir William Osler Over a interval of 5 years, the influence of computed tomography (CT) on pediatric neuroradiology on the clinic for ill youngsters, Toronto, has been, as anticipated, within the overview of the mind and its abnormalities. Concurrent with this software was once the advent of Metrizamide (Amipaque, Nyegaard & Co. AS, Oslo, Norway), a water-soluble CSF distinction medium, used basically as a myelog raphic agent. the following software of the wide-aperture CT scanner to imaging of the backbone in childrens supplied amazing advances within the medical administration of spinal disorder considering that CT is way extra actual than ordinary neuroradiologic strategies. The com bination of CT and Metrizamide additional one other size to the imaging of the backbone and of the spinal wire and nerve roots. Such spinal CT and CT Metrizamide myelography in teenagers now occupies an important a part of day by day pediatric neuroradiologic perform. they've got dramatically improved our figuring out of the conventional anatomy and pathologic entities of the backbone and its contents in young children; have altered and more advantageous the surgical administration of such ailments; and feature considerably enhanced the scientific deal with ment of such ailments within the specialties of neurosurgery, orthopedic surgical procedure, and genito-urinary surgical procedure . .
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Additional resources for CT and Myelography of the Spine and Cord: Techniques, Anatomy and Pathology in Children
Normal thoracic spine. (a) T9 in a newborn girl. The neurocentral synchondrosis is wide. The spinal canal is slightly larger in the transverse diameter than the ossified part of the vertebral body. (b) T8 in an 11 year old boy. The neurocentral synchondrosis is closed, and there is a dense area at the site of the junction. The spinal canal is small compared with the vertebral body. The pedicles are thin. infancy and during the first years of life, the heavy buttressing of these structures appearing at about the age of 5.
Lamina becomes longer and thinner in later childhood. In the thoracic region the pedicles are longer than the lamina (Fig. 4), in contrast to the lumbar spine, where the pedicles are thick and of the same length as the lamina (Fig. 5). The ossified parts of the pedicles and lamina in the sacrum are quite small in Fig. 3. Normal cervical spine. In a 2-year-old boy the neurocentral synchondrosis of C4 as well as the junction between the posterior arches is very narrow. The foramina transversaria are almost completely surrounded by bone.
The CTMM examination reveals a large intramedullary tumor, often with irregular margins and partially adherent to the dura (Fig. 1). The astrocytoma may be cystic or solid, which might be differentiated by the differing attenuation values. , 1978). Fig. 1. Astrocytoma. Girl, 8 years, T12. The cord is irregularly enlarged. The attenuation value is 20 Hounsfield units. As the tumor appeared in a patient with dysraphism, the differentiation between astrocytoma, ependymoma, and dermoid is difficult.