「画像診断の進歩」脊髄の画像診断の進歩

Abstract

Three decades ago, X-ray was the main procedure for imaging diagnosis. However, it was difficult to diagnose spinal disorders based on X-ray alone because it could not obtain sufficient information from the surrounding bony spinal column. With the advent of magnetic resonance imaging (MRI) and computed tomography (CT), the diagnostic accuracy of spinal disorders has improved significantly regarding their localization and pathological conditions. In this paper, we review the progress in the diagnostic imaging and describe the future prospects. MRI provides a morphological diagnosis based on a range of more invasive to less-invasive techniques, and the production of two-dimensional to three-dimensional images. For example, MR myelography is comparable or superior to conventional myelography and MR cisternography clearly demonstrates the nerves and roots in the spinal canal. In addition, multi-row detector CT (MDCT) systems provide details of bone and soft tissue with multiplanar reconstruction. CT myelography together with MDCT significantly improves image quality and has an advantage for dynamic investigation. CT angiography with 3D reconstruction depicts cervical vascular information. In the near future, functional and metabolic imaging will play an important role in the diagnosis of spinal cord disorders. Duc to the large volume of data obtained with MDCT, it will be necessary to organize the systems for the management of data. To take advantage of these data, it is important to learn about the precise anatomy of the spinal lesion and pathological conditions.