By Holger Pettersson MD, PhD, Derek C. F. Harwood-Nash MB, ChB, FRCP(C) (auth.)
To research the phenomenon of ailment with out books is to sail an uncharted sea. whereas to review books with no sufferers isn't to visit sea in any respect. Sir William Osler Over a interval of 5 years, the impression of computed tomography (CT) on pediatric neuroradiology on the health facility for ailing teenagers, Toronto, has been, as anticipated, within the evaluate of the mind and its abnormalities. Concurrent with this software used to be the creation of Metrizamide (Amipaque, Nyegaard & Co. AS, Oslo, Norway), a water-soluble CSF distinction medium, used basically as a myelog raphic agent. the following program of the wide-aperture CT scanner to imaging of the backbone in young ones supplied outstanding advances within the scientific administration of spinal ailment on account that CT is much extra exact than general neuroradiologic strategies. The com bination of CT and Metrizamide extra an extra measurement to the imaging of the backbone and of the spinal twine and nerve roots. Such spinal CT and CT Metrizamide myelography in little ones now occupies an important a part of daily pediatric neuroradiologic perform. they've got dramatically more advantageous our knowing of the conventional anatomy and pathologic entities of the backbone and its contents in kids; have altered and stronger the surgical administration of such ailments; and feature considerably enhanced the medical deal with ment of such illnesses 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
In the infant, however, until about the age of 6 months, the subarachnoid space and cord are more rounded throughout the cervical region (Fig. 1). At the cervico-thoracic junction the cord is still centrally placed in the subarachnoid space, but becomes relatively smaller. At the level of T3 and below, the dural sac is slightly oval, the large diameter in the sagittal plane, and the cord, still smaller, situated close to the anterior wall of the sac (Fig. 10). This is due to Fig. 10. Normal' thoracic cord.
3. The alteration with age of the shape and size of the spinal canal at different levels relative to the vertebral body at the corresponding level. Shape of the Spinal Column The infant's spine is relatively straight from occiput to coccyx. When the child begins to sit and walk, the cervical and lumbar lordosis as well as the thoracic kyphosis appear. This is important to bear in mind when choosing the gantry angles for the CTMM examination. Thus, in the small child the CT sections perpendicular to the table will be perpendicular to the spine, while in the older child the normal lordosis and kyphosis must be considered and CT sections perpendicular to each vertebra obtained, as has been described in Chap.
34 CT and Myelography of the Spine and Cord Fig. 14. Normal cauda equina. L3 in a 4-year-old boy. The nerve roots are arranged in a symmetric V or crescentic shape and the filum terminale is clearly visible in the midline (arrow) . The sacral roots are aligned medial to the lumbar roots. Recently, Seibert et al. (1981) have shown experimentally that the window level greatly influences the measurement values of th~ size of the cord, whereas the window width does not. The appropriate window level for size measurements is the mean between the attenuation values for the Metrizamide in the subarachnoid space and fdr the cord.
CT and Myelography of the Spine and Cord: Techniques, Anatomy and Pathology in Children by Holger Pettersson MD, PhD, Derek C. F. Harwood-Nash MB, ChB, FRCP(C) (auth.)