MYELOGRAPHY AND MYELO-CT IN THE NEURORADIOLOGICAL EVALUATION OF SPINE METASTASES

Myelography and myelo-CT are fast easily performed imaging techniques which are mildly invasive carry little risk and lack major side effects (except for post-myelographic headache), yet provide a wealth of diagnostic information. MR with contrast enhancement is undoubtedly the method of choice to disclose spinal metastases, but myelography coupled with myelo-CT allows rapid screening of the whole spinal cord and spatial assessment of the metastasis for therapeutic purposes. MR has virtually replaced the need for myelography, but this still remains a useful technique in the following cases. - acute myeloradicular symptoms in patients with a known primary tumour; - demonstration of leptomeningeal metastases when MR is nor available or MR findings are inconclusive; - MR cannot be used because of pacemakers or ferromagnetic implants; - fast pre-operative work-up in patients with multiple spinal lesions (control of the relevant levels).