Magnetic Resonance Imaging Of Thoracolumbar Spine Research Articles

Prevalence of gastroesophageal reflux in dogs undergoing MRI for a thoracolumbar vertebral column pathology.

The aims of the study were to investigate the prevalence and extent of gastroesophageal reflux, and the prevalence of regurgitation in dogs undergoing thoracolumbar spine magnetic resonance imaging, and to explore possible associations of reflux and regurgitation with signalment (breed, age, sex, neuter status), bodyweight, body condition score and drugs used in the anaesthetic protocol. The thoracic part of the oesophagus was retrospectively assessed for presence and quantification of fluid on two T2 weighted sequences. Patient breed, age, sex, neuter status, weight and body condition score were recorded. Anaesthetic records were reviewed for the presence of regurgitation and detailed anaesthetic protocols. Fifty percent (95% confidence interval: 45 to 57%) of included dogs had evidence of gastroesophageal reflux. Reflux was not associated with the individual breed, age, sex, neuter status or body weight. Brachycephalic dogs did not demonstrate significantly higher rates of reflux compared to non-brachycephalic dogs. A larger volume of reflux was associated with a higher chance of regurgitation. Gastroesophageal reflux is a common finding in dogs undergoing thoracolumbar spine magnetic resonance imaging. Dogs which regurgitated had higher volumes of reflux. Early detection and quantification of the volume of reflux is helpful as it may allow the anaesthetist to take measures which may reduce the risk of associated complications.

Prevalence and Clinical Significance of Incidental Vertebral Marrow Signal Abnormality in Thoracolumbar Spine MRI.

A cross-sectional study. This study investigates the prevalence of incidental vertebral marrow signal abnormality (VMSA) in thoracolumbar spine magnetic resonance imaging (MRI) ordered for the evaluation of back and/or leg pain and assess the clinical work-up for VMSAs. Patients presenting with back pain are often referred for spine MRI for diagnostic evaluation. VMSA is most frequently found in the lumbar spine and is of clinical concern because it can represent malignancy. Standardized procedures for reporting and managing VMSAs do not exist. The radiology database at the Oregon Health & Science University health system was queried to identify patients with thoracolumbar spine MRI scans performed between January 2014 and June 2016. Patients 16 years or older with MRIs ordered by providers at a multidisciplinary spine specialty clinic for the diagnostic evaluation of back and/or leg pain were included. Radiology reports were searched for keywords pertaining to VMSAs, such as "malignancy." Medical records of these patients were further reviewed for the clinical work-up and final diagnoses pertaining to the VMSA. The study sample included 1503 individual patients, of whom 65 (4%) had MRI radiology reports that described a VMSA. Thirty-one (48%) of the 65 patients with VMSAs had further evaluation recommended by radiology. Ten (32%) of these 31 patients were followed clinically without further diagnostic testing for the VMSA. Of the 65 patients with VMSAs, only one was diagnosed with malignancy (multiple myeloma). While VMSAs are not frequently found on thoracolumbar MRIs ordered to evaluate back and/or leg pain, there is a large amount of heterogeneity in how these abnormalities are documented and managed. This may indicate the need for clinical guidelines for the reporting and management of VMSAs detected on spine MRI and for improvement in communication between radiologists and ordering providers. 3.

Surgeon Survey Shows No Adverse Events With MRI in Patients With Magnetically Controlled Growing Rods (MCGRs)

Study DesignSurgeon survey. ObjectivesTo determine if magnetic resonance imaging (MRI) following implantation of magnetically controlled growing rods (MCGRs) is associated with any adverse events. Summary of Background DataMagnetically controlled growing rods have been shown to reduce the need for repeated surgical procedures and improve costs when compared to traditional growing rods, but concerns about MRI compatibility exist. MRIs are often clinically indicated in the EOS population. MethodsPediatric spine surgeons who are members of the Growing Spine Study Group, Children's Spine Study Group, and early international users of this technology were surveyed regarding MRI use after performing MCGR surgery. ResultsA total of 118 surgeons were surveyed. Four surgeons reported that 10 patients had an MRI with an implanted MCGR. Loss of fixation (0%, 0/10), movement of implants (0%, 0/10), unintended lengthening/shortening (0%, 0/10), or noticeable heating of MCGR (0%, 0/10) were not observed. No problems were observed with function of the MCGR following MRI, and a mean of 2.1 mm was obtained at the next lengthening (range, 0.5-3.0 mm). Two patients had brain MRIs, both of which could be interpreted. All cervical spine MRIs could be interpreted without excessive artifact (100%, 7/7). Six patients had MRIs of the thoracic or lumbar spine, but these were considered uninterpretable as a result of artifact from the MCGR device (0%, 0/6). ConclusionThese are the first reported cases of MRI use in humans with MCGR. There were no adverse events observed. MCGR rods lengthened as expected following MRI. MRIs of the brain and cervical spine were able to be interpreted, but MRIs of the thoracolumbar spine could not be interpreted because of MCGR artifact. MRIs can be safely performed in patients with MCGRs; however, MRIs of thoracic and thoracolumbar spine may be of limited clinical benefit because of artifact. Level of EvidenceLevel IV, case series.

Primary Ewing sarcoma of the vertebral column: Case report and literature review

We describe a rare case of the spinal cord compression by a primary Ewing sarcoma of the thoracolumbar spine. A 16-year-old boy was admitted with back pain for 2 month and inability to walk for 15 days. At the presentation, he had paraparesis and bilateral hypoesthesia below the T12 level, without sphincter dysfunction. Thoracolumbar spine magnetic resonance imaging showed an involved vertebral body mass of the L1 extending in the epidural space with an extension into the prevertebral area. The mass was totally removed by the anterolateral approach. Histopathological examination revealed Ewing sarcoma. Although his infrequency, such a primary Ewing sarcoma of the vertebral column should be suspected for lesion causing a spinal cord compression particularly in the children and adolescent that the treatment protocol included a three main modalities: surgery, radiotherapy and chemotherapy.

Evaluation of dual-source parallel RF excitation technology in MRI of thoraco-lumbar spine at 3.0 T

High-field 3 T magnetic resonance imaging (MRI) has entered standard clinical practice over the past decade, and its advantages have already been suggested in areas such as neural, musculoskeletal, pelvic and angiographic imaging. However, high-field systems still pose challenges in terms of their specific absorption rate (SAR) and radiofrequency (RF) excitation uniformity. Thus, the aim of the present study was to evaluate the impact, on both these factors, of standard quadrature against parallel RF transmission technology (dual-source parallel RF excitation [DSPE]) in spinal examination at 3 T. The thoracolumbar spine was examined with three different sequences: T1-weighted (T1w); T2-weighted (T2w); and T2w short tau inversion recovery (STIR). Each was acquired with and without DSPE. The manufacturer's implementation of this technology has been associated with optimized handling of patient SAR exposure, resulting in a 38.4% reduction in acquisition time. On comparing sequences with equal repetition times (TRs), the acquisition time reduction was 44.4%. Thus, DSPE allows a reduction in acquisition time. This gain is accompanied by augmentation of the whole-body SAR and diminution of the local SAR. Image quality improvement due to more homogeneous effective transmit B1 was mainly observed at the junction of the thoracolumbar spine.

Malignant Lymphoma in an Atomic-bomb Survivor

Atomic bomb survivors outside of Japan are few and often hard to follow-up. Spinal malignant lymphoma among these survivors is rare in established studies from Japan or the United States. Here, we report an 81-year-old woman, who experienced the atomic bomb explosion in Nagasaki when she was 19 years old, who presented with papillary thyroid carcinoma when she was 70 years old. Both follicular lymphoma over the right elbow region and vertebral malignant lymphoma were found when she turned 81 years old. Bone scan did not show any increased uptake of isotope. However, thoracolumbar spine magnetic resonance imaging showed multiple infiltrative soft tissue masses involving vertebral bodies at the T10-11 level. Computed tomography-guided biopsy further showed lymphocyte infiltration. Fortunately, the neurological deficit was improved after chemotherapy. The diagnosis of malignant lymphoma in atomic bomb survivors should be more careful and aggressive, even when their bone scan results show negative findings. In addition, the authors suggest that atomic bomb survivors should be followed-up carefully throughout their entire life.

Post-traumatic findings of the spine after earlier vertebral fracture in young patients: clinical and MRI study.

A study comparing magnetic resonance imaging findings of degenerative changes in intervertebral discs in young patients with previous wedge-shaped compression fracture and age-matched and sex-matched control subjects. To find out the role of fractures in disc degeneration and to assess the clinical outcome of the patients. Several experimental studies have postulated that trauma is one of the major reasons for disc degeneration. Wedge compression fractures in vertebrae of children have been considered insignificant, but this has not been verified in the literature. Fourteen patients 8.8 to 20.8 years of age (mean, 15.5 years) with a history of wedge-shaped vertebral compression fracture at least 1 year previously (mean, 3.8 years) and asymptomatic healthy control subjects were studied by thoracolumbar spine magnetic resonance imaging. The patients also underwent a clinical examination. Eight (57%) of the 14 patients had disc degeneration, and seven of them had it at the trauma level. Of these 7 subjects, 6 also had endplate damage at this level. The association between endplate damage and adjacent intervertebral disc degeneration was significant (P < 0.01). Only 2 of the patients were symptomatic. In the control group, only 1 subject had disc degeneration with endplate changes and disc herniation. The patients had more disc degeneration than did those in the control group. Endplate injury was strongly associated with disc degeneration. No correlation between previous vertebral fracture and back pain was seen in this study.