Sciatica may result from pathologies affecting the nerve both in its intraspinal and extraspinal course. In daily routine, the vast majority of cases are caused by herniation of the lumbar discs compressing the neural roots. Extraspinal causes of sciatic pain are usually underestimated and the imaging study may be completed after reporting the lumbar MRIs. However, early diagnosis of the exact etiology of sciatica is paramount for both relieving the symptoms and preventing any additional neurologic injury. In this pictorial assay, some relatively rare causes of sciatic neuralgia along the route of the sciatic nerve after leaving the sacral foramen will be displayed.
{"title":"Siatic nerve: beyond the sacral foramen.","authors":"H. Sanal","doi":"10.5152/DIR.2016.16068","DOIUrl":"https://doi.org/10.5152/DIR.2016.16068","url":null,"abstract":"Sciatica may result from pathologies affecting the nerve both in its intraspinal and extraspinal course. In daily routine, the vast majority of cases are caused by herniation of the lumbar discs compressing the neural roots. Extraspinal causes of sciatic pain are usually underestimated and the imaging study may be completed after reporting the lumbar MRIs. However, early diagnosis of the exact etiology of sciatica is paramount for both relieving the symptoms and preventing any additional neurologic injury. In this pictorial assay, some relatively rare causes of sciatic neuralgia along the route of the sciatic nerve after leaving the sacral foramen will be displayed.","PeriodicalId":50582,"journal":{"name":"Diagnostic and Interventional Radiology","volume":"22 6 1","pages":"574-579"},"PeriodicalIF":2.1,"publicationDate":"2016-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5152/DIR.2016.16068","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71007050","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. Spiliopoulos, P. Kitrou, N. Christeas, D. Karnabatidis
PURPOSE Direct superficial femoral artery (SFA) antegrade puncture is a valid alternative to common femoral artery (CFA) access for peripheral vascular interventions. Data investigating vascular closure device (VCD) hemostasis of distant SFA 6F access are limited. We aimed to investigate the safety and effectiveness of the Starclose SE® VCD for hemostasis, following direct 6F antegrade SFA access distal to the femoral head. METHODS This prospective, single-center study included patients who were not suitable for CFA puncture and were scheduled to undergo peripheral endovascular interventions using direct antegrade SFA 6F access, at least 2 cm below the inferior edge of femoral head. Hemostasis was obtained with the Starclose SE® VCD (Abbott Laboratories). Primary endpoints were successful hemostasis rate and periprocedural (30-day) major complication rate. Secondary endpoint was the rate of minor complications. Clinical and Doppler ultrasound follow-up was performed at discharge and at one month. RESULTS Between September 2014 and August 2015, a total of 30 patients (21 male; 70.0%) with a mean body mass index of 41.2 kg/m2 were enrolled. Mean age was 72±9 years (range, 67-88 years). Most patients suffered from critical limb ischemia (87.1%) and diabetes (61.3%). Calcifications were present in eight cases (26.6%). Reason for direct SFA puncture was obesity (100%). Successful hemostasis was achieved in 100% of the cases. No major complications were noted after one-month follow-up. Minor complications included two <5 cm hematomas (6.6%) not necessitating treatment. CONCLUSION In this prospective study, Starclose SE® VCD was safe and effective for hemostasis of antegrade direct SFA puncture. Uncomplicated hemostasis was achieved even in cases of puncturing 2 to 7 cm below the inferior edge of the femoral head.
{"title":"Starclose SE® hemostasis after 6F direct antegrade superficial femoral artery access distal to the femoral head for peripheral endovascular procedures in obese patients.","authors":"S. Spiliopoulos, P. Kitrou, N. Christeas, D. Karnabatidis","doi":"10.5152/DIR.2016.15614","DOIUrl":"https://doi.org/10.5152/DIR.2016.15614","url":null,"abstract":"PURPOSE\u0000Direct superficial femoral artery (SFA) antegrade puncture is a valid alternative to common femoral artery (CFA) access for peripheral vascular interventions. Data investigating vascular closure device (VCD) hemostasis of distant SFA 6F access are limited. We aimed to investigate the safety and effectiveness of the Starclose SE® VCD for hemostasis, following direct 6F antegrade SFA access distal to the femoral head.\u0000\u0000\u0000METHODS\u0000This prospective, single-center study included patients who were not suitable for CFA puncture and were scheduled to undergo peripheral endovascular interventions using direct antegrade SFA 6F access, at least 2 cm below the inferior edge of femoral head. Hemostasis was obtained with the Starclose SE® VCD (Abbott Laboratories). Primary endpoints were successful hemostasis rate and periprocedural (30-day) major complication rate. Secondary endpoint was the rate of minor complications. Clinical and Doppler ultrasound follow-up was performed at discharge and at one month.\u0000\u0000\u0000RESULTS\u0000Between September 2014 and August 2015, a total of 30 patients (21 male; 70.0%) with a mean body mass index of 41.2 kg/m2 were enrolled. Mean age was 72±9 years (range, 67-88 years). Most patients suffered from critical limb ischemia (87.1%) and diabetes (61.3%). Calcifications were present in eight cases (26.6%). Reason for direct SFA puncture was obesity (100%). Successful hemostasis was achieved in 100% of the cases. No major complications were noted after one-month follow-up. Minor complications included two <5 cm hematomas (6.6%) not necessitating treatment.\u0000\u0000\u0000CONCLUSION\u0000In this prospective study, Starclose SE® VCD was safe and effective for hemostasis of antegrade direct SFA puncture. Uncomplicated hemostasis was achieved even in cases of puncturing 2 to 7 cm below the inferior edge of the femoral head.","PeriodicalId":50582,"journal":{"name":"Diagnostic and Interventional Radiology","volume":"22 6 1","pages":"542-547"},"PeriodicalIF":2.1,"publicationDate":"2016-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5152/DIR.2016.15614","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71006360","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
J. Son, H. K. Jung, J. Song, H. Baek, K. Doo, Woogyeong Kim, Yeon Mee Kim, Woon-won Kim, Jung Sun Lee, E. Y. Cho
With the increasing use of computed tomography (CT), incidental breast lesions are detected more frequently. When interpreting chest CT findings, it is important for radiologists to carefully review the breast to recognize any abnormal findings that could affect patient management. The purpose of this study is to discuss incidental breast lesions on chest CT with ultrasonography correlation that may be encountered in routine clinical practice.
{"title":"Incidentally detected breast lesions on chest CT with US correlation: a pictorial essay.","authors":"J. Son, H. K. Jung, J. Song, H. Baek, K. Doo, Woogyeong Kim, Yeon Mee Kim, Woon-won Kim, Jung Sun Lee, E. Y. Cho","doi":"10.5152/DIR.2016.15539","DOIUrl":"https://doi.org/10.5152/DIR.2016.15539","url":null,"abstract":"With the increasing use of computed tomography (CT), incidental breast lesions are detected more frequently. When interpreting chest CT findings, it is important for radiologists to carefully review the breast to recognize any abnormal findings that could affect patient management. The purpose of this study is to discuss incidental breast lesions on chest CT with ultrasonography correlation that may be encountered in routine clinical practice.","PeriodicalId":50582,"journal":{"name":"Diagnostic and Interventional Radiology","volume":"22 6 1","pages":"514-518"},"PeriodicalIF":2.1,"publicationDate":"2016-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5152/DIR.2016.15539","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71006420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Vural, R. Gocmen, K. Oguz, M. Topcuoglu, E. Arsava
PURPOSE Prominent hypointense cerebral vessels on susceptibility-weighted imaging (SWI) and the hyperintense vessel sign (HVS) on fluid-attenuated inversion recovery (FLAIR) imaging are considered as markers of compromised tissue perfusion in cerebral ischemia. In this study, we aimed to identify the correlation between HVS on FLAIR and hypointense vessels on SWI, and to determine whether these imaging features provide independent prognostic information in patients with ischemic stroke. METHODS We retrospectively analyzed consecutive ischemic stroke patients with proximal middle cerebral artery (MCA) occlusion who underwent SWI and FLAIR within 24 h of symptom onset. The presence of hypointense vessels on SWI and hyperintense vessels on FLAIR in >4 of 10 slices encompassing the MCA territory were considered to represent prominent hypoperfusion. RESULTS Among 50 patients, 62% had a prominent HVS on FLAIR and 68% had prominent hypointense vessels on SWI. There was a moderate but significant correlation between the number of slices with HVS on FLAIR and prominent hypointense vessels on SWI (r=0.425, P = 0.002). In multivariate analyses, the prominence of hypointense vessels on SWI, but not HVS on FLAIR, was significantly associated with a higher discharge NIHSS score (P = 0.027), mRS score (P = 0.021), and lesion growth (P = 0.050). CONCLUSION The significant, albeit moderate, correlation between markers of compromised tissue perfusion on FLAIR and SWI suggests that these imaging features reflect different but interrelated aspects of cerebral hemodynamics during ischemic stroke. Our findings highlight that while HVS on FLAIR denotes the presence of leptomeningeal collaterals, hypointense vessels on SWI signify the sufficiency of cerebral blood flow at the tissue level and are therefore more critical in terms of prognosis.
{"title":"Bright and dark vessels on stroke imaging: different sides of the same coin?","authors":"A. Vural, R. Gocmen, K. Oguz, M. Topcuoglu, E. Arsava","doi":"10.5152/dir.2015.15271","DOIUrl":"https://doi.org/10.5152/dir.2015.15271","url":null,"abstract":"PURPOSE\u0000Prominent hypointense cerebral vessels on susceptibility-weighted imaging (SWI) and the hyperintense vessel sign (HVS) on fluid-attenuated inversion recovery (FLAIR) imaging are considered as markers of compromised tissue perfusion in cerebral ischemia. In this study, we aimed to identify the correlation between HVS on FLAIR and hypointense vessels on SWI, and to determine whether these imaging features provide independent prognostic information in patients with ischemic stroke.\u0000\u0000\u0000METHODS\u0000We retrospectively analyzed consecutive ischemic stroke patients with proximal middle cerebral artery (MCA) occlusion who underwent SWI and FLAIR within 24 h of symptom onset. The presence of hypointense vessels on SWI and hyperintense vessels on FLAIR in >4 of 10 slices encompassing the MCA territory were considered to represent prominent hypoperfusion.\u0000\u0000\u0000RESULTS\u0000Among 50 patients, 62% had a prominent HVS on FLAIR and 68% had prominent hypointense vessels on SWI. There was a moderate but significant correlation between the number of slices with HVS on FLAIR and prominent hypointense vessels on SWI (r=0.425, P = 0.002). In multivariate analyses, the prominence of hypointense vessels on SWI, but not HVS on FLAIR, was significantly associated with a higher discharge NIHSS score (P = 0.027), mRS score (P = 0.021), and lesion growth (P = 0.050).\u0000\u0000\u0000CONCLUSION\u0000The significant, albeit moderate, correlation between markers of compromised tissue perfusion on FLAIR and SWI suggests that these imaging features reflect different but interrelated aspects of cerebral hemodynamics during ischemic stroke. Our findings highlight that while HVS on FLAIR denotes the presence of leptomeningeal collaterals, hypointense vessels on SWI signify the sufficiency of cerebral blood flow at the tissue level and are therefore more critical in terms of prognosis.","PeriodicalId":50582,"journal":{"name":"Diagnostic and Interventional Radiology","volume":"22 3 1","pages":"284-90"},"PeriodicalIF":2.1,"publicationDate":"2016-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5152/dir.2015.15271","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71005366","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
PURPOSE We aimed to evaluate the safety and effectiveness of a novel catheter-based mechanical thrombectomy device, XCOILTM, as a first line therapy to restore patency of thrombosed dialysis grafts and fistulae. METHODS In 2010, 18 consecutive/sequential patients (11 male, 7 female; median age, 52 years; age range, 32-69 years) with occluded arteriovenous grafts (n=15) or fistulae (n=3) were treated with XCOILTM (NexGen Medical Systems Inc.) without adjunctive thrombolytic drugs. XCOILTM was advanced distal to the thrombus within the outflow vein as well as distal to the arterial inflow platelet thrombin plug, using a 4F angiographic catheter. The percentage of thrombus cleared, primary patency, procedure time, and XCOILTM performance were documented. RESULTS Thrombosis occurred 1-30 days prior to the procedure. Thrombosed segments of graft/fistula measured 10-50 cm. Pre- and postprocedure angiography demonstrated that in 15 of 18 cases (83%) XCOILTM removed 80%-100% of the venous outflow thrombus. In 11 of 14 cases (79%), the platelet thrombin plug was also removed. Thrombectomy procedure time averaged 8 min, with one to three passes with the XCOILTM required. No evidence of distal embolization or graft/vessel injury was found on angiography following clot removal. In four cases in whom patency was not restored with XCOILTM, subsequent use of other clot removal devices also failed to restore patency. In one case with severe venous stenosis, the device failed to deploy and the thrombus was not captured. No intraprocedural complications related to XCOILTM use occurred. CONCLUSION XCOILTM is an effective and safe first-line therapy option for the treatment of thrombosed hemodialysis grafts/fistulae. Rapid removal of intact thrombus and platelet thrombin plug can be achieved without adjunctive thrombolytics.
目的:我们旨在评估一种新型导管机械取栓装置XCOILTM作为恢复血栓性透析移植物和瘘管通畅的一线治疗方法的安全性和有效性。方法2010年，18例连续/序贯患者(男性11例，女性7例;平均年龄52岁;年龄范围，32-69岁)闭塞的动静脉移植物(n=15)或瘘管(n=3)使用XCOILTM (NexGen Medical Systems Inc.)治疗，无辅助溶栓药物。采用4F血管造影导管将XCOILTM推进到流出静脉内血栓的远端以及动脉流入血小板凝血酶栓的远端。记录血栓清除率、初级通畅度、手术时间和XCOILTM性能。结果术前1 ~ 30天血栓形成。移植物/瘘管的血栓段测量为10-50厘米。术前和术后血管造影显示，18例患者中有15例(83%)XCOILTM清除了80%-100%的静脉流出血栓。14例中有11例(79%)的血小板凝血酶栓也被移除。取栓手术时间平均为8分钟，需要使用XCOILTM进行1至3次检查。在去除血块后的血管造影中没有发现远端栓塞或移植物/血管损伤的证据。在4例未使用XCOILTM恢复通畅的病例中，随后使用其他凝块清除装置也未能恢复通畅。在一个严重静脉狭窄的病例中，该装置未能部署，血栓未被捕获。无XCOILTM术中并发症发生。结论xcoiltm是治疗血栓性血液透析移植物/瘘管的有效、安全的一线治疗选择。快速去除完整的血栓和凝血酶栓可以实现不辅助溶栓。
{"title":"Initial clinical use of a novel mechanical thrombectomy device, XCOILTM, in hemodialysis graft and fistula declot procedures.","authors":"W. Monsky, R. Latchaw","doi":"10.5152/dir.2015.15158","DOIUrl":"https://doi.org/10.5152/dir.2015.15158","url":null,"abstract":"PURPOSE\u0000We aimed to evaluate the safety and effectiveness of a novel catheter-based mechanical thrombectomy device, XCOILTM, as a first line therapy to restore patency of thrombosed dialysis grafts and fistulae.\u0000\u0000\u0000METHODS\u0000In 2010, 18 consecutive/sequential patients (11 male, 7 female; median age, 52 years; age range, 32-69 years) with occluded arteriovenous grafts (n=15) or fistulae (n=3) were treated with XCOILTM (NexGen Medical Systems Inc.) without adjunctive thrombolytic drugs. XCOILTM was advanced distal to the thrombus within the outflow vein as well as distal to the arterial inflow platelet thrombin plug, using a 4F angiographic catheter. The percentage of thrombus cleared, primary patency, procedure time, and XCOILTM performance were documented.\u0000\u0000\u0000RESULTS\u0000Thrombosis occurred 1-30 days prior to the procedure. Thrombosed segments of graft/fistula measured 10-50 cm. Pre- and postprocedure angiography demonstrated that in 15 of 18 cases (83%) XCOILTM removed 80%-100% of the venous outflow thrombus. In 11 of 14 cases (79%), the platelet thrombin plug was also removed. Thrombectomy procedure time averaged 8 min, with one to three passes with the XCOILTM required. No evidence of distal embolization or graft/vessel injury was found on angiography following clot removal. In four cases in whom patency was not restored with XCOILTM, subsequent use of other clot removal devices also failed to restore patency. In one case with severe venous stenosis, the device failed to deploy and the thrombus was not captured. No intraprocedural complications related to XCOILTM use occurred.\u0000\u0000\u0000CONCLUSION\u0000XCOILTM is an effective and safe first-line therapy option for the treatment of thrombosed hemodialysis grafts/fistulae. Rapid removal of intact thrombus and platelet thrombin plug can be achieved without adjunctive thrombolytics.","PeriodicalId":50582,"journal":{"name":"Diagnostic and Interventional Radiology","volume":"22 3 1","pages":"257-62"},"PeriodicalIF":2.1,"publicationDate":"2016-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5152/dir.2015.15158","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71005509","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ö. Nas, M. F. Inecikli, K. Hacıkurt, R. Büyükkaya, G. Özkaya, F. Özkalemkaş, R. Ali, C. Erdoğan, B. Hakyemez
PURPOSE We aimed to assess the effectiveness, benefits, and reliability of percutaneous vertebroplasty (PV) in patients with vertebral involvement of multiple myeloma. METHODS PV procedures performed on 166 vertebrae of 41 patients with multiple myeloma were retrospectively evaluated. Most of our patients were using level 3 (moderate to severe pain) analgesics. Magnetic resonance imaging was performed before the procedure to assess vertebral involvement of multiple myeloma. The following variables were evaluated: affected vertebral levels, loss of vertebral body height, polymethylmethacrylate (PMMA) cement amount applied to the vertebral body during PV, PMMA cement leakages, and pain before and after PV as assessed by a visual analogue scale (VAS). RESULTS Median VAS scores of patients decreased from 9 one day before PV, to 6 one day after the procedure, to 3 one week after the procedure, and eventually to 1 three months after the procedure (P < 0.001). During the PV procedure, cement leakage was observed at 68 vertebral levels (41%). The median value of PMMA applied to the vertebral body was 6 mL. CONCLUSION Being a minimally invasive and easily performed procedure with low complication rates, PV should be preferred for serious back pain of multiple myeloma patients.
{"title":"Effectiveness of percutaneous vertebroplasty in patients with multiple myeloma having vertebral pain.","authors":"Ö. Nas, M. F. Inecikli, K. Hacıkurt, R. Büyükkaya, G. Özkaya, F. Özkalemkaş, R. Ali, C. Erdoğan, B. Hakyemez","doi":"10.5152/dir.2016.15201","DOIUrl":"https://doi.org/10.5152/dir.2016.15201","url":null,"abstract":"PURPOSE\u0000We aimed to assess the effectiveness, benefits, and reliability of percutaneous vertebroplasty (PV) in patients with vertebral involvement of multiple myeloma.\u0000\u0000\u0000METHODS\u0000PV procedures performed on 166 vertebrae of 41 patients with multiple myeloma were retrospectively evaluated. Most of our patients were using level 3 (moderate to severe pain) analgesics. Magnetic resonance imaging was performed before the procedure to assess vertebral involvement of multiple myeloma. The following variables were evaluated: affected vertebral levels, loss of vertebral body height, polymethylmethacrylate (PMMA) cement amount applied to the vertebral body during PV, PMMA cement leakages, and pain before and after PV as assessed by a visual analogue scale (VAS).\u0000\u0000\u0000RESULTS\u0000Median VAS scores of patients decreased from 9 one day before PV, to 6 one day after the procedure, to 3 one week after the procedure, and eventually to 1 three months after the procedure (P < 0.001). During the PV procedure, cement leakage was observed at 68 vertebral levels (41%). The median value of PMMA applied to the vertebral body was 6 mL.\u0000\u0000\u0000CONCLUSION\u0000Being a minimally invasive and easily performed procedure with low complication rates, PV should be preferred for serious back pain of multiple myeloma patients.","PeriodicalId":50582,"journal":{"name":"Diagnostic and Interventional Radiology","volume":"22 3 1","pages":"263-8"},"PeriodicalIF":2.1,"publicationDate":"2016-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5152/dir.2016.15201","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71006254","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
V. Lehman, R. Murphy, L. Schenck, R. Carter, G. Johnson, A. Kotsenas, Jonathan M. Morris, M. Nathan, J. Wald, T. Maus
PURPOSE We compared signal change on magnetic resonance imaging (MRI) with fat suppression and bone scan activity of lumbar facet joints to determine if these two imaging findings are correlated. METHODS We retrospectively identified all patients who underwent imaging of the lumbar spine for pain evaluation using both technetium-99m methylene disphosphonate single-photon emission computed tomography/computed tomography (99mTc-MDP SPECT/CT) and MRI with at least one fat-suppressed T2- or T1-weighted sequence with gadolinium enhancement within a 180-day interval, at our institution between 1 January 2008 and 19 February 2013. Facet joint activity on 99mTc-MDP SPECT/CT and peri-facet signal change on MRI were rated as normal or increased. Agreement between the two examination types were determined with the κ and prevalence-adjusted bias-adjusted κ (PABAK) statistics. RESULTS This study included 60 patients (28 male, 47%), with a mean age of 49±19.7 years (range, 12-93 years). The κ value indicated no agreement between 99mTc-MDP SPECT/CT and MRI (κ=-0.026; 95% confidence interval: -0.051, 0.000). The PABAK values were fair to high at each spinal level, which suggests that relatively low disease prevalence lowered the κ values. Together, the κ and PABAK values indicate that there is some degree of intermodality agreement, but that it is not consistent. CONCLUSION Overall, facet joint signal change on fat-suppressed MRI did not always correlate with increased 99mTc-MDP SPECT/CT activity. MRI and 99mTc-MDP SPECT/CT for facet joint evaluation should not be considered interchangeable examinations in clinical practice or research.
{"title":"Comparison of facet joint activity on 99mTc-MDP SPECT/CT with facet joint signal change on MRI with fat suppression.","authors":"V. Lehman, R. Murphy, L. Schenck, R. Carter, G. Johnson, A. Kotsenas, Jonathan M. Morris, M. Nathan, J. Wald, T. Maus","doi":"10.5152/dir.2015.15203","DOIUrl":"https://doi.org/10.5152/dir.2015.15203","url":null,"abstract":"PURPOSE\u0000We compared signal change on magnetic resonance imaging (MRI) with fat suppression and bone scan activity of lumbar facet joints to determine if these two imaging findings are correlated.\u0000\u0000\u0000METHODS\u0000We retrospectively identified all patients who underwent imaging of the lumbar spine for pain evaluation using both technetium-99m methylene disphosphonate single-photon emission computed tomography/computed tomography (99mTc-MDP SPECT/CT) and MRI with at least one fat-suppressed T2- or T1-weighted sequence with gadolinium enhancement within a 180-day interval, at our institution between 1 January 2008 and 19 February 2013. Facet joint activity on 99mTc-MDP SPECT/CT and peri-facet signal change on MRI were rated as normal or increased. Agreement between the two examination types were determined with the κ and prevalence-adjusted bias-adjusted κ (PABAK) statistics.\u0000\u0000\u0000RESULTS\u0000This study included 60 patients (28 male, 47%), with a mean age of 49±19.7 years (range, 12-93 years). The κ value indicated no agreement between 99mTc-MDP SPECT/CT and MRI (κ=-0.026; 95% confidence interval: -0.051, 0.000). The PABAK values were fair to high at each spinal level, which suggests that relatively low disease prevalence lowered the κ values. Together, the κ and PABAK values indicate that there is some degree of intermodality agreement, but that it is not consistent.\u0000\u0000\u0000CONCLUSION\u0000Overall, facet joint signal change on fat-suppressed MRI did not always correlate with increased 99mTc-MDP SPECT/CT activity. MRI and 99mTc-MDP SPECT/CT for facet joint evaluation should not be considered interchangeable examinations in clinical practice or research.","PeriodicalId":50582,"journal":{"name":"Diagnostic and Interventional Radiology","volume":"22 3 1","pages":"277-83"},"PeriodicalIF":2.1,"publicationDate":"2016-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5152/dir.2015.15203","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71005403","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
PURPOSE We aimed to investigate the prevalence of lumbar multifidus muscle (LMM) atrophy in patients having mechanical low back pain with and without disc hernia. METHODS In total, 2028 lumbar magnetic resonance imaging scans of low back pain patients (age range, 18-88 years) were re-evaluated retrospectively. LMM atrophy was visually assessed in axial sections of L4-L5 and L5-S1 levels. RESULTS LMM atrophy prevalence at both levels was significantly higher in subjects ≥40 years compared with younger adults (P < 0.001). LMM atrophy was significantly more frequent in women than in men (P < 0.001). Among patients with low back pain without hernia, LMM atrophy was significantly more frequent than normal muscle (n=559 vs. n=392; P < 0.001). Frequency of LMM atrophy in low back pain patients without disc hernia was 13%. Hernia was more frequent in patients with LMM atrophy compared with patients without atrophy (P < 0.001). CONCLUSION LMM atrophy is more common in women; its prevalence and severity are observed to increase with advancing age, and disc hernia is found more frequently in individuals with LMM atrophy.
{"title":"Age and sex-based distribution of lumbar multifidus muscle atrophy and coexistence of disc hernia: an MRI study of 2028 patients.","authors":"E. Ekin, Hülya Kurtul Yıldız, H. Mutlu","doi":"10.5152/dir.2015.15307","DOIUrl":"https://doi.org/10.5152/dir.2015.15307","url":null,"abstract":"PURPOSE\u0000We aimed to investigate the prevalence of lumbar multifidus muscle (LMM) atrophy in patients having mechanical low back pain with and without disc hernia.\u0000\u0000\u0000METHODS\u0000In total, 2028 lumbar magnetic resonance imaging scans of low back pain patients (age range, 18-88 years) were re-evaluated retrospectively. LMM atrophy was visually assessed in axial sections of L4-L5 and L5-S1 levels.\u0000\u0000\u0000RESULTS\u0000LMM atrophy prevalence at both levels was significantly higher in subjects ≥40 years compared with younger adults (P < 0.001). LMM atrophy was significantly more frequent in women than in men (P < 0.001). Among patients with low back pain without hernia, LMM atrophy was significantly more frequent than normal muscle (n=559 vs. n=392; P < 0.001). Frequency of LMM atrophy in low back pain patients without disc hernia was 13%. Hernia was more frequent in patients with LMM atrophy compared with patients without atrophy (P < 0.001).\u0000\u0000\u0000CONCLUSION\u0000LMM atrophy is more common in women; its prevalence and severity are observed to increase with advancing age, and disc hernia is found more frequently in individuals with LMM atrophy.","PeriodicalId":50582,"journal":{"name":"Diagnostic and Interventional Radiology","volume":"22 3 1","pages":"273-6"},"PeriodicalIF":2.1,"publicationDate":"2016-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5152/dir.2015.15307","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71005690","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
G. Durhan, S. Diker, A. Has, J. Karakaya, Asli Tuncer Kurne, K. Oguz
PURPOSE Cigarette smoking has been associated with increased occurrence of multiple sclerosis (MS), as well as clinical disability and disease progression in MS. We aimed to assess the effects of smoking on the white matter (WM) in patients with clinically isolated syndrome (CIS) using diffusion tensor imaging. METHODS Smoker patients with CIS (n=16), smoker healthy controls (n=13), nonsmoker patients with CIS (n=17) and nonsmoker healthy controls (n=14) were included. Thirteen regions-of-interest including nonenhancing T1 hypointense lesion and perilesional WM, and 11 normal-appearing white matter (NAWM) regions were drawn on color-coded fractional anisotropy (FA) maps. Lesion load was determined in terms of number and volume of WM hyperintensities. RESULTS A tendency towards greater lesion load was found in smoker patients. T1 hypointense lesions and perilesional WM had reduced FA and increased mean diffusivity to a similar degree in smoker and nonsmoker CIS patients. Compared with healthy smokers, smoker CIS patients had more extensive NAWM changes shown by increased mean diffusivity. There was no relationship between diffusion metrics and clinical disability scores, duration of the disease and degree of smoking exposure. CONCLUSION Smoker patients showed a tendency towards having greater number of WM lesions and displayed significantly more extensive NAWM abnormalities.
{"title":"Influence of cigarette smoking on white matter in patients with clinically isolated syndrome as detected by diffusion tensor imaging.","authors":"G. Durhan, S. Diker, A. Has, J. Karakaya, Asli Tuncer Kurne, K. Oguz","doi":"10.5152/dir.2015.15415","DOIUrl":"https://doi.org/10.5152/dir.2015.15415","url":null,"abstract":"PURPOSE\u0000Cigarette smoking has been associated with increased occurrence of multiple sclerosis (MS), as well as clinical disability and disease progression in MS. We aimed to assess the effects of smoking on the white matter (WM) in patients with clinically isolated syndrome (CIS) using diffusion tensor imaging.\u0000\u0000\u0000METHODS\u0000Smoker patients with CIS (n=16), smoker healthy controls (n=13), nonsmoker patients with CIS (n=17) and nonsmoker healthy controls (n=14) were included. Thirteen regions-of-interest including nonenhancing T1 hypointense lesion and perilesional WM, and 11 normal-appearing white matter (NAWM) regions were drawn on color-coded fractional anisotropy (FA) maps. Lesion load was determined in terms of number and volume of WM hyperintensities.\u0000\u0000\u0000RESULTS\u0000A tendency towards greater lesion load was found in smoker patients. T1 hypointense lesions and perilesional WM had reduced FA and increased mean diffusivity to a similar degree in smoker and nonsmoker CIS patients. Compared with healthy smokers, smoker CIS patients had more extensive NAWM changes shown by increased mean diffusivity. There was no relationship between diffusion metrics and clinical disability scores, duration of the disease and degree of smoking exposure.\u0000\u0000\u0000CONCLUSION\u0000Smoker patients showed a tendency towards having greater number of WM lesions and displayed significantly more extensive NAWM abnormalities.","PeriodicalId":50582,"journal":{"name":"Diagnostic and Interventional Radiology","volume":"69 1","pages":"291-6"},"PeriodicalIF":2.1,"publicationDate":"2016-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71005894","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Serkan Guneyli, Emily V M Ward, Stephen H. Thomas, Ambereen Yousuf, Igor Trilisky, Yahui Peng, T. Antic, A. Oto
Benign prostatic hyperplasia (BPH) is a common condition in middle-aged and older men and negatively affects the quality of life. An ultrasound classification for BPH based on a previous pathologic classification was reported, and the types of BPH were classified according to different enlargement locations in the prostate. Afterwards, this classification was demonstrated using magnetic resonance imaging (MRI). The classification of BPH is important, as patients with different types of BPH can have different symptoms and treatment options. BPH types on MRI are as follows: type 0, an equal to or less than 25 cm3 prostate showing little or no zonal enlargements; type 1, bilateral transition zone (TZ) enlargement; type 2, retrourethral enlargement; type 3, bilateral TZ and retrourethral enlargement; type 4, pedunculated enlargement; type 5, pedunculated with bilateral TZ and/or retrourethral enlargement; type 6, subtrigonal or ectopic enlargement; type 7, other combinations of enlargements. We retrospectively evaluated MRI images of BPH patients who were histologically diagnosed and presented the different types of BPH on MRI. MRI, with its advantage of multiplanar imaging and superior soft tissue contrast resolution, can be used in BPH patients for differentiation of BPH from prostate cancer, estimation of zonal and entire prostatic volumes, determination of the stromal/glandular ratio, detection of the enlargement locations, and classification of BPH types which may be potentially helpful in choosing the optimal treatment.
{"title":"Magnetic resonance imaging of benign prostatic hyperplasia.","authors":"Serkan Guneyli, Emily V M Ward, Stephen H. Thomas, Ambereen Yousuf, Igor Trilisky, Yahui Peng, T. Antic, A. Oto","doi":"10.5152/dir.2015.15361","DOIUrl":"https://doi.org/10.5152/dir.2015.15361","url":null,"abstract":"Benign prostatic hyperplasia (BPH) is a common condition in middle-aged and older men and negatively affects the quality of life. An ultrasound classification for BPH based on a previous pathologic classification was reported, and the types of BPH were classified according to different enlargement locations in the prostate. Afterwards, this classification was demonstrated using magnetic resonance imaging (MRI). The classification of BPH is important, as patients with different types of BPH can have different symptoms and treatment options. BPH types on MRI are as follows: type 0, an equal to or less than 25 cm3 prostate showing little or no zonal enlargements; type 1, bilateral transition zone (TZ) enlargement; type 2, retrourethral enlargement; type 3, bilateral TZ and retrourethral enlargement; type 4, pedunculated enlargement; type 5, pedunculated with bilateral TZ and/or retrourethral enlargement; type 6, subtrigonal or ectopic enlargement; type 7, other combinations of enlargements. We retrospectively evaluated MRI images of BPH patients who were histologically diagnosed and presented the different types of BPH on MRI. MRI, with its advantage of multiplanar imaging and superior soft tissue contrast resolution, can be used in BPH patients for differentiation of BPH from prostate cancer, estimation of zonal and entire prostatic volumes, determination of the stromal/glandular ratio, detection of the enlargement locations, and classification of BPH types which may be potentially helpful in choosing the optimal treatment.","PeriodicalId":50582,"journal":{"name":"Diagnostic and Interventional Radiology","volume":"22 3 1","pages":"215-9"},"PeriodicalIF":2.1,"publicationDate":"2016-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5152/dir.2015.15361","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71005829","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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