Magnetic Resonance Imaging for Diagnosis and Analysis of Bone Tumors and Bone Tuberculosis

The purpose of the study is to explore the diagnostic value of magnetic resonance imaging in bone tuberculosis and bone tumors.Firstly,148 patients with bone tumor and bone tuberculosis were selected,74 cases in each group.Perform magnetic resonance imaging(MRI)examinations on all patients,relevant parameters were set and the changes in the value of the dispersion system were recorded to obtain T1-weighted imaging and T2-weighted imaging.The results showed that among 74 patients,41 cases were bone damage,38 cases were joint swelling,27 cases were sparse bone,10 cases were bone hyperplasia and 5 cases were dead bone and calcification.The imaging manifestations of bone tumors were 45 cases of fractures,26 cases of surrounding soft tissue infiltration,10 cases of hip duct enlargement and 11 cases of sacral foramen enlargement.After MRI diagnosis,the accuracy of diagnosing 74 cases of bone tumor was 100%,and the accuracy of diagnosing 65 cases of bone tuberculosis was 87.84%.The difference between the two groups was statistically significant(P<0.05).The diffusion sensitivity coefficient of MRI weighted imaging was 150 s/mm2,and there was no significant difference in ADC values between the two groups(P>0.05).When the diffusion sensitivity coefficient is 300 s/mm2,and the difference between the two groups was statistically significant(P<0.05).Therefore,MRI had a certain diagnostic value for bone tuberculosis and bone tumors,and MRI had a higher diagnostic value and richer information for bone tumors.Corresponding treatment can be performed to improve the prognosis.

Prediction of transitional lumbosacral anatomy on magnetic resonance imaging of the lumbar spine

AIM: To evaluate two simple angle measurements for predicting lumbosacral transitional vertebra (LSTV) in magnetic resonance imaging (MRI) studies of the spine. METHODS: The lumbar spine MRI studies of 50 subjects with LSTV and 50 subjects with normal lumbosacral anatomy were retrospectively evaluated. In each study, the mid-sagittal T2-weighted image was used to measure the angle formed by a line parallel to the superior surface of the sacrum and a line perpendicular to the axis of the scan table (A-angle), as well as the angle formed by a line parallel to the superior endplate of the L3 vertebra and a line parallel to the superior surface of the sacrum (B-angle). RESULTS: The total study population consisted of 100 subjects (46 males, 54 females, 51 ± 16 years old). There were no differences in age and sex between the two groups. Both A-angle and B-angle were significantly increased in subjects with LSTV compared to controls (P < 0.05). The optimal cut-off values of A-angle and B-angle for the prediction of LSTV were 39.8° (sensitivity = 80%, specificity = 80%, accuracy = 83%; 95% confidence interval = 74%-89%, P = 0.0001) and 35.9° (sensitivity = 80%, specificity = 54%, accuracy = 69%; 95% confidence interval = 59%-78%, P = 0.0005), respectively. CONCLUSION: On sagittal MR images of the lumbar spine, an increased A-angle and/or B-angle should alert the radiologist to the presence of LSTV.

High-resolution,three-dimensional magnetic resonance imaging axial load dynamic study improves diagnostics of the lumbar spine in clinical practice

BACKGROUND The response to axial physiological pressure due to load transfer to the lumbar spine structures is among the various back pain mechanisms.Understanding the spine adaptation to cumulative compressive forces can influence the choice of personalized treatment strategies.AIM To analyze the impact of axial load on the spinal canal’s size,intervertebral foramina,ligamenta flava and lumbosacral alignment.METHODS We assessed 90 patients using three-dimensional isotropic magnetic resonance imaging acquisition in a supine position with or without applying an axial compression load.Anatomical structures were measured in the lumbosacral region from L1 to S1 in lying and axially-loaded magnetic resonance images.A paired t test atα=0.05 was used to calculate the observed differences.RESULTS After axial loading,the dural sac area decreased significantly,by 5.2%on average(4.1%,6.2%,P<0.001).The intervertebral foramina decreased by 3.4%(2.7%,4.1%,P<0.001),except for L5-S1.Ligamenta flava increased by 3.8%(2.5%,5.2%,P<0.001),and the lumbosacral angle increased.CONCLUSION Axial load exacerbates the narrowing of the spinal canal and intervertebral foramina from L1-L2 to L4-L5.Cumulative compressive forces thicken ligamenta flava and exaggerate lumbar lordosis.

Extraspinal Incidental Findings at Lumbar Spine Magnetic Resonance Imaging in Two Hospitals:Prevalence and Clinical Importance

Objective: To assess the importance of incidental extraspinal findings on Magnetic Resonance Imaging of the lumbar spine in two hospital facilities. Materials and Methods: It was a descriptive and retrospective study from November 2015 to March 2016. The records of patients who had done a Magnetic Resonance Imaging (MRI) scan of the lumbar spine were re-read in search of incidental findings. The incidental findings found were classified using Colonography Reporting and Data System(C-RADS) classification of extracolonic lesions to assess clinical significance. The prevalence of incidental findings was calculated for each facility, as well as the distribution according to age, the organs involved and the clinical importance. A non-detection rate was calculated by confronting the findings of the study with the original reports. Results: The prevalence of incidental findings was respectively 33% (19 out of 36) in Jordan Medical Center (JMC) in Yaounde and 27.74% (106 out of 292) in Jacques Monod Hospital. The extraspinal incidental findings were classified mainly as extracolonic 2 (E2): 58% in each facility. The percentage detection of incidental findings was 5% at JMS and 1.7% at Jacques Monod Hospital. Conclusion: Extraspinal incidental findings are frequent in both hospitals. However, the rate of detection remains very low.

Correlation of lumbar lateral recess stenosis in magnetic resonance imaging and clinical symptoms

AIM To assess the correlation of lateral recess stenosis(LRS) of lumbar segments L4/5 and L5/S1 and the Oswestry Disability Index(ODI).METHODS Nine hundred and twenty-seven patients with history of low back pain were included in this uncontrolled study.On magnetic resonance images(MRI) the lateral recesses(LR) at lumbar levels L4/5 and L5/S1 were evaluated and each nerve root was classified into a 4-point grading scale(Grade 0-3) as normal,not deviated,deviated or compressed.Patient symptoms and disability were assessed using ODI.The Spearman's rank correlation coefficient was used for statistical analysis(P < 0.05).RESULTS Approximately half of the LR revealed stenosis(grade 1-3;52% at level L4/5 and 42% at level L5/S1) with 2.2% and 1.9% respectively reveal a nerve root compression.The ODI score ranged from 0%-91.11% with an arithmetic mean of 34.06% ± 16.89%.We observed a very weak statistically significant positive correlation between ODI and LRS at lumbar levels L4/5 and L5/S1,each bilaterally(L4/5 left:rho < 0.105,P < 0.01;L4/5 right:rho < 0.111,P < 0.01;L5/S1 left:rho 0.128,P < 0.01;L5/S1 right:rho < 0.157,P < 0.001).CONCLUSION Although MRI is the standard imaging tool for diagnosing lumbar spinal stenosis,this study showed only a weak correlation of LRS on MRI and clinical findings.This can be attributed to a number of reasons outlined in this study,underlining that imaging findings alone are not sufficient to establish a reliable diagnosis for patients with LRS.

Magnetic resonance imaging-based interpretation of degenerative changes in the lower lumbar segments and therapeutic consequences

Intervertebral disc degeneration and facet joint osteoarthritis of the lumbar spine are, among others, wellknown as a cause of low back and lower extremity pain. Together with their secondary disorders they set a big burden on health care systems and economics worldwide. Despite modern imaging modalities, such as magnetic resonance imaging, for a large proportion of patients with low back pain(LBP) it remains difficult to provide a specific diagnosis. The fact that nearly all the lumbar structures are possible sources of LBP, may serve as a possible explanation. Furthermore, our clinical experience confirms, that imaging alone is not a sufficient approach explaining LBP. Here, the Oswestry Disability Index, as the most commonly used measure to quantify disability for LBP, may serve as an easy-toapply questionnaire to evaluate the patient's ability to cope with everyday life. For therapeutic purposes, among the different options, the lumbar facet joint intraarticular injection of corticosteroids in combination with an anaesthetic solution is one of the most frequently performed interventional procedures. Although widely used the clinical benefit of intra-articular steroid injections remains controversial. Therefore, prior to therapy, standardized diagnostic algorithms for an accurate assessment, classification and correlation of degenerative changes of the lumbar spine are needed.

Cardiac functional magnetic resonance imaging at 7T:Image quality optimization and ultra-high field capabilities

BACKGROUND 7T cardiac magnetic resonance imaging(MRI)introduces several advantages,as well as some limitations,compared to lower-field imaging.The capabilities of ultra-high field(UHF)MRI have not been fully exploited in cardiac functional imaging.AIM To optimize 7T cardiac MRI functional imaging without the need for conducting B1 shimming or subject-specific tuning,which improves scan efficiency.In this study,we provide results from phantom and in vivo scans using a multi-channel transceiver modular coil.METHODS We investigated the effects of adding a dielectric pad at different locations next to the imaged region of interest on improving image quality in subjects with different body habitus.We also investigated the effects of adjusting the imaging flip angle in cine and tagging sequences on improving image quality,B1 field homogeneity,signal-to-noise ratio(SNR),blood-myocardium contrast-to-noise ratio(CNR),and tagging persistence throughout the cardiac cycle.RESULTS The results showed the capability of achieving improved image quality with high spatial resolution(0.75 mm×0.75 mm×2 mm),high temporal resolution(20 ms),and increased tagging persistence(for up to 1200 ms cardiac cycle duration)at 7T cardiac MRI after adjusting scan set-up and imaging parameters.Adjusting the imaging flip angle was essential for achieving optimal SNR and myocardium-toblood CNR.Placing a dielectric pad at the anterior left position of the chest resulted in improved B1 homogeneity compared to other positions,especially in subjects with small chest size.CONCLUSION Improved regional and global cardiac functional imaging can be achieved at 7T MRI through simple scan set-up adjustment and imaging parameter optimization,which would allow for more streamlined and efficient UHF cardiac MRI.

Magnetic resonance imaging findings of redundant nerve roots of the cauda equina

BACKGROUND Redundant nerve roots(RNRs)of the cauda equina are often a natural evolutionary part of lumbar spinal canal stenosis secondary to degenerative processes characterized by elongated,enlarged,and tortuous nerve roots in the superior and/or inferior of the stenotic segment.Although magnetic resonance imaging(MRI)findings have been defined more frequently in recent years,this condition has been relatively under-recognized in radiological practice.In this study,lumbar MRI findings of RNRs of the cauda equina were evaluated in spinal stenosis patients.AIM To evaluate RNRs of the cauda equina in spinal stenosis patients.METHODS One-hundred and thirty-one patients who underwent lumbar MRI and were found to have spinal stenosis between March 2010 and February 2019 were included in the study.On axial T2-weighted images(T2WI),the cross-sectional area(CSA)of the dural sac was measured at L2-3,L3-4,L4-5,and L5-S1 levels in the axial plane.CSA levels below 100 mm^2 were considered stenosis.Elongation,expansion,and tortuosity in cauda equina fibers in the superior and/or inferior of the stenotic segment were evaluated as RNRs.The patients were divided into two groups:Those with RNRs and those without RNRs.The CSA cut-off value resulting in RNRs of cauda equina was calculated.Relative length(RL)of RNRs was calculated by dividing the length of RNRs at mid-sagittal T2WI by the height of the vertebral body superior to the stenosis level.The associations of CSA leading to RNRs with RL,disc herniation type,and spondylolisthesis were evaluated.RESULTS Fifty-five patients(42%)with spinal stenosis had RNRs of the cauda equina.The average CSA was 40.99±12.76 mm^2 in patients with RNRs of the cauda equina and 66.83±19.32 mm^2 in patients without RNRs.A significant difference was found between the two groups for CSA values(P<0.001).Using a cut-off value of 55.22 mm^2 for RNRs of the cauda equina,sensitivity,specificity,positive predictive value(PPV),and negative predictive value(NPV)values of 96.4%,96.1%,89.4%,and 98.7%were obtained,respectively.RL was 3.39±1.31(range:0.93-6.01).When the extension of RNRs into the superior and/or inferior of the spinal canal stenosis level was evaluated,it was superior in 54.5%,both superior and inferior in 32.8%,and inferior in 12.7%.At stenosis levels leading to RNRs of the cauda equina,29 disc herniations with soft margins and 26 with sharp margins were detected.Disc herniation type and spondylolisthesis had no significant relationship with RL or CSA of the dural sac with stenotic levels(P>0.05).As the CSA of the dural sac decreased,the incidence of RNRs observed at the superior of the stenosis level increased(P<0.001).CONCLUSION RNRs of the cauda equina are frequently observed in patients with spinal stenosis.When the CSA of the dural sac is<55 mm^2,lumbar MRIs should be carefully examined for this condition.

Association between Magnetic Resonance Imaging and the Result of Medial Branch Blocks

The aim of this retrospective practice audit was to assess the correlation between painful zygapophysial joints and changes seen in magnetic resonance imaging (MRI). Patients with unilateral pain were tested with controlled medial branch blocks. The MRI scans of patients with a positive response were compared blinded with normal MRI scans. The dimensions of the joint were assessed and osteoarthritis was graded. Fifteen symptomatic patients and 15 asymptomatic patients were included and evaluated. Comparison of the joints showed that the maximum diameter of symptomatic joints was significantly larger, and the grading of osteoarthritis was significantly higher for symptomatic joints. No healthy patient was assigned a grade 3. Grades 2 and 3 were found significantly more often in symptomatic patients. Only one symptomatic joint was assigned grade 0. Grade 0 was found significantly more often in asympto-matic patients. The presented MRI technique has limited value as a diagnostic test for lumbar zygapophysial joint pain. It is not possible to detect a single symptomatic joint. However, the osteoarthritis grading for the lumbar zyg-apophysial joints might be helpful for finding predictors for negative response if the results of the rating are grade zero. Therefore, unnecessary medial branch blocks might be avoided.

Magnetic Resonance Imaging of Central Nervous System Lesions in HIV/AIDS: About 35 Cases in Libreville (Gabon)

Background: Sub-Saharan Africa is the region most affected by the Human Immunodeficiency Virus (HIV) with an increasing prevalence of related cognitive impairments. Magnetic Resonance Imaging (MRI) plays an important role in the early detection of lesions. This work aimed to describe the MRI aspects of different brain lesions occurred in HIV positive patients in our practice. Methods: This was a descriptive cross-sectional study that took place from June 2014 to July 2016 in the medical imaging department of the EL RAPHA private Polyclinic in Libreville, Gabon. It included all patients referred for imaging for the exploration of a Central Nervous System (CNS) lesions at MRI, based on clinical and/or paraclinical arguments. Results: Among the 39 patients included, 19 (48.7%) had a previous brain CT scan, 11 of which were normal (28.2%). Thirty-five (89.74%) patients had a pathological MRI. The main etiologies found were toxoplasmosis (37.14%), tuberculosis (17.14%), cerebral atrophy (17.14%) and HIV encephalitis (14.28%). Among the eleven patients with a normal Computer Tomography scan, the MRI found 7 abnormalities including 1 case of toxoplasmosis, 3 cases of HIV encephalitis and 3 cases of Progressive Multifocal Leukoencephalopathy (PML). Conclusion: MRI played an important role in the diagnosis of CNS disorders in HIV-infected individuals. It can be used to differentiate and characterize various brain lesions. Improving its accessibility in sub-Saharan Africa should contribute to better care for people living with HIV.

Imaging Diagnosis of Monostotic Fibrous Dysplasia in Thoracic and Lumbar Spine Vertebrae

The X-ray radiograph, CT scan and MRI appearance of 5 patients with pathologically proven fibrous dysplasia in thoracic and lumbar spine vertebrae were retrospectively analyzed. Plain radiographs, CT scans and MR images showed the presentation of eccentric lesion with intact cortex bone and marginal sclerosis in vertebral bodies without involvement of vertebral appendix and ex- traosseous soft tissue. The lesion masses were round （one being oval-shaped） and radiolucent in plain radiographs and CT scans. Homogeneous long signal was observed on Tl weighted image and strongly enhanced when gadolinium was administered. On T2 weighted MRI, short signal was found in the anterior part of the mass, long signal in the posterior part, and short and slight long signal in the middle part, without partitioning and laminating change. There was a good correlation between radiological features and surgical findings. These findings may be useful to diagnose fibrous dysplasia m spree.

Imaging of the spine: Where do we stand?

The number of patients presenting with spine-related problems has globally increased, with an enormous growing demand for the use of medical imaging to address this problem. The last three decades witnessed great leaps for diagnostic imaging modalities, including those exploited for imaging the spine. These developments improved our diagnostic capabilities in different spinal pathologies, especially with multi-detector computed tomography and magnetic resonance imaging, via both hardware and software improvisations. Nowadays,imaging may depict subtle spinal instability caused by various osseous and ligamentous failures, and could elucidate dynamic instabilities. Consequently,recent diagnostic modalities can discern clinically relevant spinal canal stenosis.Likewise, improvement in diagnostic imaging capabilities revolutionized our understanding of spinal degenerative diseases via quantitative biomarkers rather than mere subjective perspectives. Furthermore, prognostication of spinal cord injury has become feasible, and this is expected to be translated into better effective patient tailoring to management plans with better clinical outcomes.Meanwhile, our confidence in diagnosing spinal infections and assessing the different spinal instrumentation has greatly improved over the past few last decades. Overall, revolutions in diagnostic imaging over the past few decades have upgraded spinal imaging from simple subjective and qualitative indices into a more sophisticated yet precise era of objective metrics via deploying quantitative imaging biomarkers.

MR Imaging Features of Solitary Plasmacytoma of the Spine

OBJECTIVE To evaluate the MR imaging features of solitary plasmacytomas of the spine. METHODS The MR images of 7 patients with histologically proven solitary plasmacytomas of the spine were reviewed. RESULTS All tumors showed predominantly isoto hypointensity relative to muscle on Tl-weighted MR images and intermediate signal intensity between muscle and fat on T2- weighted images. Curvilinear low signal intensity structures were seen within the lesions on T1 and T2-weighted images in five tumors. Moderate to strong enhancement was seen in all 6 tumors that underwent contrast enhanced MR examination. All tumors showed areas of high signal intensity on T2-weighted images and heterogeneous enhancement, except the 2 largest tumors without pathologic fracture in the sacrum. Intervertebral discs were preserved in all tumors. CONCLUSION The MR imaging features that suggest plasmacytorna of the spine include predominant intermediate signal intensity on T2-weighted images, curvilinear low signal intensity structures, moderate to strong enhancement, relatively homogeneous appearance if there are no pathologic fracture and preservation of the intervertebral discs.

The Comparison of the Manifestation of the Clinical Imageology and Pathology between the Brucellar Spondylitis and the Spine Turberculosis

Objective: To improve the clinical differential diagnosis level, the clinical manifestation of the brucellar spondylitis and the spine turberculosis were discussed in this paper. Method: The study was completed in the No. 1 Affiliated Hospital of Hebei North University in Zhangjiakou City, Hebei Province, China, from January 2001 to December 2013 by Analyzing the X-ray, CT scanning and MRI of 257 cases of the brucellar spondylitis retrospectively and comparing with the clinical imageology and pathology 332 cases of turberculosis of the spine diagnosed finally. Results: The brucellar spondylitis: The focuses usually locate in the lumbar vertebra and L4, 5 has the highest occurrence rate. The focuses are often small but multiple, and limited to the edge of the vertebra. Hyperostosis and osteoscterosis are usually found in the tissuses around the focuses. There are often new focuses in the newborn bones, and the destruction of intervertebral discs is usually slight. Hyperostosis and osteoscterosis might be found in the surfaces of the joints. The densites of the bones close to the focuses become high. There were less or no paravertebral abscesses but inflammational granuloma can be found frequently. Turberculosis of the spine: The focuses are usually located in the thoracic and lumbar vertebra, and are characterized by the destruction of the vertebra and the intervertebral discs, accompanied by the appearance of dead bones. In most cases, paravertebral abscesses and osteoporosis might be found. Conclusions: The specific manifestation of the clinical imageology can help to differentiate the brucelar spondylitis from the turberculosis of the spine.

Imaging characteristics of a rare case of monostotic fibrous dysplasia of the sacrum:A case report

BACKGROUND Fibrous dysplasia(FD)is a common benign intramedullary fibro-osseous lesion.Involvement of the spine is rare,with the literature including only case reports,and cases of monostotic FD(MFD)in the sacrum are extremely rare.A correct preoperative diagnosis of spinal MFD is important for clinicians to select proper treatment.CASE SUMMARY We retrospectively assessed a case report of MFD in the sacrum.This patient was examined by computed tomography(CT)and magnetic resonance imaging(MRI),and the diagnosis was confirmed by pathology.A review of the literature was performed to analyze the imaging characteristics and differential diagnoses of spinal MFD.For our patient,the CT scan showed the lesion to be expansile,with ground glass opacity and a sclerotic rim.On MRI,the lesion showed iso-low signal intensity on T1WI and iso-high signal intensity on T2WI.A low signal rim was found on T1WI and T2WI.Our patient was treated by posterior focal excision,decompression,bone grafting,fusion and pedicle screw fixation.A satisfactory result was achieved,with pain disappearance.No complications had occurred at the 1-year follow up.CONCLUSION MFD is an expansile osteolytic change.Ground glass opacity and a sclerotic margin are obvious characteristics.The lesion often involves the vertebral body and posterior element.Knowledge of these imaging characteristics of spinal FD could be helpful for diagnosis and prevent unnecessary procedures.

The clinicpathologic features and MRI manifestations of the thoracic lumbar tuberculosis

Objective: To explore the clinicpathologic features and MRI manifestations of the thoracic lumbar tuberculosis by underwenting MRI and pathological examinations. Methods: 34 cases of Thoracic lumbar tuberculosis were collected which underwent MRI examination and confirmed by pathology or treatment of anti-TB drugs, the clinical cure from June 2008 to June 2012 in our hospital. The first MRI was performed on all patients, to determine the MRI findings, and surgical treatment for pathological examination in order to determine the pathological features. Results: 34 patients with 81 vertebral involvement, in which two adjacent vertebral involvement is the common, accounting for 72.25%, vertebral showed uneven long T1, long T2 signal. Intervertebral disc abnormalities accounted for 90.17%, the performance showed long T1, long T2 signal changes in the intervertebral disc damage, often accompanied by disc space narrowing or disappear. Paraspinal abscess accounted for 90.67%, often more than vertebra, up and down across one or more vertebral bodies showed long T1, long T2 signal. The vertebrae were damaged kyphosis or (and) the posterior longitudinal ligament abscess caused by the dural sac and spinal column with pressure accounted for 74.72%. In enhanced scan, vertebrae, intervertebral discs showed heterogeneous enhancement, paraspinal abscess was curved or ring enhancement. The pathological diagnosis may be obvious to confirm the degree of swelling and lesions. Conclusion: By doing the MRI and pathologic examinations, it can determine the clinical and pathological features and MRI findings of spinal tuberculosis patients with Thoracic lumbar spinal tuberculosis, and lay a reliable foundation for the treatment of the subsequent treatment.

23例肾上腺结核的MRI特征分析

目的观察肾上腺结核的MRI特征,并评估MRI诊断该病的应用价值。方法回顾性分析并对比23例确诊的肾上腺结核患者(病变组)与23例肾上腺转移瘤患者(对照组)的MRI信号特征。结果23例肾上腺结核患者共42个腺体受侵,双侧19例,单侧4例,40个腺体增大,2个萎缩;40个增大腺体中23个为不规则肿块状,17个保留原有轮廓。共检出49个病灶,病灶长径0.9~4.9cm。肿块样病变T1WI呈均匀稍低、等信号,T2WI呈高低混杂信号,中心见片状稍低信号,DWI呈稍低、等或高信号。增强扫描7个均匀强化,40个不均匀强化,包括环形强化和分隔样强化,延迟扫描病灶实质成分范围扩大,2个无强化。肾上腺结核中均匀强化结节、强化环壁的ADC值分别为(1.28±0.26)×10^(-3)mm^(2)/s、(1.06±0.10)×10^(-3)mm^(2)/s,均高于转移瘤,非强化中心ADC值为(1.23±0.16)×10^(-3)mm^(2)/s,低于转移瘤的坏死区。结论MRI成像可反映肾上腺结核病理变化并用于评估其活动性。

脊椎骨内神经鞘瘤的CT、MRI表现(附11例报道及文献复习)

目的探讨脊椎骨内神经鞘瘤(Intraosseous Schwannoma,IOS)的特征性影像学表现,以与其他脊椎溶骨性病变区别开。方法回顾性分析上海交通大学医学院附属第九人民医院经手术病理证实的脊椎IOS的临床资料及CT、MRI等影像学资料。该文收集了11例脊椎IOS患者,其中男性7例,女性4例,年龄23~74岁[平均年龄(51±17)岁]。所有患者均行CT和MRI检查。由两名高年资骨关节系统放射科医师对所有影像学征象进行评估,并复习了近几年来文献报告的脊椎IOS影像学征象。结果病变累及部位包括颈椎3例(3/11,27.3%),胸椎1例(1/11,9.1%),腰椎5例(5/11,45.5%),腰骶椎2例(2/11,18.2%),最大径(5.8±2.85)cm,形态均为不规则形。CT显示偏心性膨胀性溶骨性骨质破坏,密度不均匀,平扫CT值为(43.0±11.55)HU。增强后不均匀轻度强化,CT值为(70.3±12.22)HU,病灶边界清晰,有硬化缘,未见骨膜反应,病灶易沿着椎间孔向椎管内外延伸。在MRI上,与肌肉组织相比,病灶在T1WI上呈等稍低信号,在T2WI上呈混杂稍高信号,压脂后呈混杂高信号,DWI未见弥散受限,ADC值为(1.25±0.176)×10-3mm2/s,增强后不均匀明显强化,时间-信号强度曲线为I型,7例患者病灶内发生囊性变。结论脊椎IOS是一种罕见的良性肿瘤,影像学表现具有一定的特征性,在鉴别诊断边界清晰的具有异质性的脊椎溶骨性病变时应予以考虑。

磁共振AIR-魔毯线圈在胸椎结核扫描中的应用价值

目的探讨联合应用AIR-魔毯线圈磁共振成像(MRI)对胸椎结核扫描图像信噪比(signal to noise ratio,SNR)、对比噪声比(contrast to noise ratio,CNR)和脂肪抑制成像效果的价值。方法选取我院80例经手术病理证实为胸椎结核患者,按1:1随机分为两组,应用常规线圈(脊柱相控阵线圈,头颈联合线圈)、常规线圈联合AIR魔毯线圈对两组患者分别进行扫描。扫描序列包括胸椎矢状位T_(2)WI,T_(1)WI,T_(2)FLEX,进一步测量、比较SNR,CNR及脂肪抑制效果,分析MRI多序列诊断胸腰椎结核的准确率、特异度和灵敏度。结果常规线圈联合AIR-魔毯线圈扫描组,胸椎矢状位图像的SNR、CNR及压脂效果优于常规线圈组。结论联合应用AIR-魔毯线圈的图像SNR、CNR得到提高,脂肪抑制效果稳定良好。

人工智能在颈椎影像学中的研究进展

人工智能(AI)可通过影像智能检测、分割、分类等技术赋能临床诊疗及预后。AI与颈椎影像学的结合在自动分割颈椎结构,检测颈椎骨折、脊髓型颈椎病,识别颈椎后纵韧带骨化,自动测量颈椎前凸等病变以及评估颈椎成熟度等方面性能优越。就AI技术在颈椎影像学中的研究现状及展望予以综述。