Digital myelography of spinal dysraphism in infancy: preliminary results.

Digital techniques are becoming well established as costeffective for vascular imaging in neuroradiology [1, 2]. Pediatric application of this technology is also under development [3]. Futhermore, there has been increasing use of more efficient, less invasive methods of evaluating pediatric spine problems through newer-generation computed tomography (CT), including scanned-projection radiography, in an attempt to achieve the high contrast resolution of film-screen myelography [4, 5]. For the past 2 years, we have used metrizamide myelography with simple, thick-section poly tomography (myelotomography) to evaluate patients with spinal dysraphism. This technique has provided separation of simultaneously imaged bone and neural landmarks in standard surgical planes, while directing CT for specific transaxial plane imaging. It also allows reduction in metrizamide dosage and total radiation exposure as compared with previously used myelographic procedures employing multiple plain filming plus complex thinsection tomography. Further, myelotomography produces high-contrast-resolution imaging superior to CT with reformatting [6]. For further reductions in risk and cost, digital fluorographic techniques are currently being explored. We describe our preliminary experience with digital myelography in the evaluation of spinal dysraphism in infancy.