Presentation on myelography

1. BMIT 4th sem

2.  Objectives
 Introduction
 Anatomy
 Indications
 Contraindications
 Patient Preparation
 Needle Placement and Injection Process
 Procedures
 Radiographic Positioning
 Post Procedure Care
 Types of Myelography
 Conclusion
 References

3.  To List the common indications and contraindications
of Myelography
 To describe the procedures and imaging technique for
Myelography
 To compare Myelography with CT Myelography, and
MR Myelography.
 To summarize Imaging of the Spine and Anatomical
Features

4.  A myelogram is a radiographic study in which contrast
medium is injected into the subarachnoid space to study
the structural details of spinal cord, conus medullaris ,
nerve roots and spinal canal

6.  Suspected mass lesions with or without any
compressive myelopathy
 Disc lesions
 Congenital lesions
 Spinal canal Stenosis
 Degenerative diseases
 Injury -fractures
 Localised lesion at any level of spinal cord
 Back pain radiating to the limb

7. The following are contraindications to myelography:
 Blood in the cerebrospinal fluid (CSF)
 Arachnoiditis
 Increased intracranial pressure
 Recent lumbar puncture (within 2 weeks of the current
procedure)

8.  Four hours fasting prior to the procedures
 Plenty of oral fluids on the previous day
 The type of premedication used are determine by the
radiologist
 Before the examination, the procedures must be explain
to the patient

11.  Adults
 Children
Region Dose
Lumbar 10-15ml
Thoracic 10 ml
Cervical 10 ml
Age Dose
Less than 2 years 2-6ml
Between 2-6 years 4-8 ml
More than 6 years 6-12ml

17. RADIOGRAPHIC MYELOGRAPHY POSITIONING:
CERVICAL REGION

18. 2)Swimmer’s Lateral Horizontal Beam

19. THORACIC REGION
1)Right Lateral Decubitus Position—AP or PA
Projection with Horizontal Beam

20. 2)Left Lateral Decubitus Position—AP or PA
Projection with Horizontal Beam

21. 3)Right or Left Lateral—Vertical Beam

22. LUMBAR REGION
Semi erect Lateral—Horizontal Beam

25.  CT Myelography: After the physician has evaluated the
spinal cord adequately under fluoroscopy, the patient is
transferred to CT for further imaging
 Fig: Cyst
(arrow)

26.  MR Myelography: using heavily T2-weighted fast spin-
echo pulse sequences imaging with fat suppression,
enhances the signal intensity of CSF with subtraction of
the surrounding background signal. Krudy first
described the technique.