Doing More with Less: Diagnostic Accuracy of CT in Suspected Cauda Equina Syndrome

Cauda equina syndrome typically requires emergent MR imaging to detect compressive lesions on the cauda equina, which may require surgical decompression. While CT is sometimes performed as a complementary imaging technique to evaluate osseous integrity in patients with cauda equina syndrome, the acc...

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Bibliographic Details
Published in:American journal of neuroradiology : AJNR 2017-02, Vol.38 (2), p.391-397
Main Authors: Peacock, J G, Timpone, V M
Format: Article
Language:English
Subjects:
Accuracy
Adult
Aged
Back
Computed tomography
Decompression
Diagnostic systems
Female
Humans
Image Processing, Computer-Assisted
Impingement
Lesions
Lumbosacral Region - diagnostic imaging
Magnetic Resonance Imaging
Male
Middle Aged
Patients
Polyradiculopathy - diagnostic imaging
Predictive Value of Tests
Reproducibility of Results
Sensitivity
Sensitivity analysis
Spinal cord
Spinal stenosis
Spinal Stenosis - diagnostic imaging
Spine
Spine (lumbar)
Spine - diagnostic imaging
Statistical analysis
Surgery
Surgical instruments
Tomography, X-Ray Computed - methods
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Summary:Cauda equina syndrome typically requires emergent MR imaging to detect compressive lesions on the cauda equina, which may require surgical decompression. While CT is sometimes performed as a complementary imaging technique to evaluate osseous integrity in patients with cauda equina syndrome, the accuracy of CT in detecting significant spinal stenosis and cauda equina impingement is not well-defined in the literature. We hypothesized that percentage thecal sac effacement on CT of the lumbar spine would have high sensitivity and high negative predictive value in evaluating significant spinal stenosis and cauda equina impingement. We analyzed imaging studies for 151 consecutive patients with clinically suspected cauda equina syndrome. The percentage thecal sac effacement (
ISSN:0195-6108
1936-959X
DOI:10.3174/ajnr.A4974