Purpose: The purpose of this prospective study was to evaluate the clinical value of 3D-MR-myelography (3D-MRM) in comparison to myelography and intra-operative findings.
Material and methods: 25 patients with suspected lumbar spinal canal stenosis were studied via myelography and 3D-MRM (volume-data set, 3D-FISP sequence, TR 73 ms, TE 21 ms, flip angle 7 degrees, sagittal slices) besides the routinely acquired sagittal and axial T1- and T2-weighted images. Diagnoses were made by two radiologists and one neurosurgeon without knowing the clinical history and symptoms, in two separate sessions. Results were compared to intraoperative findings.
Results: 3D-MRM has the same diagnostic sensitivity (25/25 = 100%) as conventional X-ray myelography (25/25 = 100%) compared to intraoperative findings, but is not invasive and shows more diagnostic details than myelography. Especially in cases of high-grade spinal canal stenosis there is often a lack of intrathecal contrast medium distally of the stenosis.
Conclusion: 3D-MRM is as good as conventional myelography in predicting intraoperative findings in patients with lumbar spinal canal stenosis. This new method is non-invasive and can be performed routinely on an outpatient basis.