Magnetic Resonance Imaging Analysis of the Spread of Local Anesthetic Solution after Ultrasound-guided Lateral Thoracic Paravertebral Blockade

2013 ◽  
Vol 118 (5) ◽  
pp. 1106-1112 ◽  
Author(s):  
Daniela Marhofer ◽  
Peter Marhofer ◽  
Stephan C. Kettner ◽  
Edith Fleischmann ◽  
Daniela Prayer ◽  
...  

Abstract Background: This study was designed to examine the spread of local anesthetic (LA) via magnetic resonance imaging after a standardized ultrasound-guided thoracic paravertebral blockade. Methods: Ten volunteers were enrolled in the study. We performed ultrasound-guided single-shot paravertebral blocks with 20 ml mepivacaine 1% at the thoracic six level at both sides on two consecutive days. After each paravertebral blockade, a magnetic resonance imaging investigation was performed to investigate the three-dimensional spread of the LA. In addition, sensory spread of blockade was evaluated via pinprick testing. Results: The median (interquartile range) cranial and caudal distribution of the LA relative to the thoracic six puncture level was 1.0 (2.5) and 3.0 (0.75) [=4.0 vertebral levels] for the left and 0.5 (1.0) and 3.0 (0.75) [=3.5 vertebral levels] for the right side. Accordingly, the LA distributed more caudally than cranially. The median (interquartile range) number of sensory dermatomes which were affected by the thoracic paravertebral blockade was 9.8 (6.5) for the left and 10.7 (8.8) for the right side. The sensory distribution of thoracic paravertebral blockade was significantly larger compared with the spread of LA. Conclusions: Although the spread of LA was reproducible, the anesthetic effect was unpredictable, even with a standardized ultrasound-guided technique in volunteers. While it can be assumed that approximately 4 vertebral levels are covered by 20 ml LA, the somatic distribution of the thoracic paravertebral blockade remains unpredictable. In a significant percentage, the LA distributes into the epidural space, prevertebral, or to the contralateral side.

2020 ◽  
Vol 10 (1) ◽  
pp. 14
Author(s):  
Cezary Grochowski ◽  
Kamil Jonak ◽  
Marcin Maciejewski ◽  
Andrzej Stępniewski ◽  
Mansur Rahnama-Hezavah

Purpose: The aim of this study was to assess the volumetry of the hippocampus in the Leber’s hereditary optic neuropathy (LHON) of blind patients. Methods: A total of 25 patients with LHON were randomly included into the study from the national health database. A total of 15 patients were selected according to the inclusion criteria. The submillimeter segmentation of the hippocampus was based on three-dimensional spoiled gradient recalled acquisition in steady state (3D-SPGR) BRAVO 7T magnetic resonance imaging (MRI) protocol. Results: Statistical analysis revealed that compared to healthy controls (HC), LHON subjects had multiple significant differences only in the right hippocampus, including a significantly higher volume of hippocampal tail (p = 0.009), subiculum body (p = 0.018), CA1 body (p = 0.002), hippocampal fissure (p = 0.046), molecular layer hippocampus (HP) body (p = 0.014), CA3 body (p = 0.006), Granule Cell (GC) and Molecular Layer (ML) of the Dentate Gyrus (DG)–GC ML DG body (p = 0.003), CA4 body (p = 0.001), whole hippocampal body (p = 0.018), and the whole hippocampus volume (p = 0.023). Discussion: The ultra-high-field magnetic resonance imaging allowed hippocampus quality visualization and analysis, serving as a powerful in vivo diagnostic tool in the diagnostic process and LHON disease course assessment. The study confirmed previous reports regarding volumetry of hippocampus in blind individuals.


2001 ◽  
Vol 49 (3) ◽  
pp. 275-284
Author(s):  
Zs. Petrási ◽  
R. Romvári ◽  
G. Bajzik ◽  
B. Fenyves ◽  
I. Repa ◽  
...  

A dynamic magnetic resonance imaging (MRI) method was developed for in vivo examination of the pig heart. Measurements were carried out on 15 meat-type pigs of different liveweight using a 1.5 T equipment. Inhalation anaesthesia was applied, then data acquisition was synchronised by ECG gating. Depending on the heart rate and heart size, in each case 8 to 10 slices and in each slice 8 to 14 phases were acquired prospectively according to one heart cycle. During the post-processing of the images the left and the right ventricular volumes were determined. The values measured at 106 kg liveweight are 2.5 times higher than those obtained at 22 kg, while the ejection fractions are equal. The calculated cardiac output values were 3.5 l (22 kg, 132 beats/min.), and 6.0 l (106 kg, 91 beats/min.), respectively. After measuring the wall thickness, the contraction values were also determined for the septum (70%), and for the anterior (61%), posterior (41%) and lateral (54%) walls of the left ventricle. Three-dimensional animated models of the ventricles were constructed. Based on the investigations performed, the preconditioning, the anaesthetic procedure, the specific details of ECG measurement and the correct MR imaging technique were worked out.


Author(s):  
Hongzhang Zhu ◽  
Shi-Ting Feng ◽  
Xingqi Zhang ◽  
Zunfu Ke ◽  
Ruixi Zeng ◽  
...  

Background: Cutis Verticis Gyrata (CVG) is a rare skin disease caused by overgrowth of the scalp, presenting as cerebriform folds and wrinkles. CVG can be classified into two forms: primary (essential and non-essential) and secondary. The primary non-essential form is often associated with neurological and ophthalmological abnormalities, while the primary essential form occurs without associated comorbidities. Discussion: We report on a rare case of primary essential CVG with a 4-year history of normal-colored scalp skin mass in the parietal-occipital region without symptom in a 34-year-old male patient, retrospectively summarizing his pathological and Computer Tomography (CT) and magnetic resonance imaging (MRI) findings. The major clinical observations on the CT and MR sectional images include a thickened dermis and excessive growth of the scalp, forming the characteristic scalp folds. With the help of CT and MRI Three-dimensional (3D) reconstruction techniques, the characteristic skin changes could be displayed intuitively, providing more evidence for a diagnosis of CVG. At the 5-year followup, there were no obvious changes in the lesion. Conclusion: Based on our observations, we propose that not all patients with primary essential CVG need surgical intervention, and continuous clinical observation should be an appropriate therapy for those in stable condition.


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