Diagnostic Value of Computed Tomography in Recurrent Pain after Discectomy

Neurosurgery ◽  
1987 ◽  
Vol 20 (2) ◽  
pp. 302-309 ◽  
Author(s):  
Gerald R. Schell ◽  
Luciano M. Modesti ◽  
Edwin D. Cacayorin
Keyword(s):  
Computed Tomography ◽  
Disc Herniation ◽  
Scar Tissue ◽  
Diagnostic Value ◽  
Herniated Disc ◽  
Recurrent Pain ◽  
Clinical Criteria ◽  
Recurrent Disc Herniation ◽  
Contrast Enhanced Ct ◽  
Enhanced Ct

Abstract Intravenously enhanced computed tomography (CT) was used in patients in whom the differential diagnosis between recurrent herniated disc and postoperative scar was considered. Enhanced CT images demonstrated postoperative herniated discs more accurately than clinical criteria, myelography, or plain or postmetrizamide CT. The scar tissue shows contrast enhancement, but recurrent disc herniation does not. Therefore, contrast-enhanced CT is considered to be a valuable aid in distinguishing between recurrent disc herniation and hypertropic scar formation.

Computed tomographic and histological findings of Hansen type I intervertebral disc herniation in dogs

2013 ◽  
Vol 26 (05) ◽  
pp. 379-384 ◽  
Author(s):  
C. L. Vitale ◽  
S. C. Essman ◽  
P. Pithua ◽  
J. R. Coates ◽  
K. Kuroki
Keyword(s):  
Intervertebral Disc ◽  
Disc Herniation ◽  
Imaging Modality ◽  
Thoracolumbar Spine ◽  
Herniated Disc ◽  
Intervertebral Disc Herniation ◽  
Type I ◽  
Contrast Enhanced Ct ◽  
Contrast Enhanced ◽  
Enhanced Ct

SummaryObjective: To evaluate whether noncontrast-enhanced computed tomography (CT) as a stand-alone imaging modality can be used to define the Hansen type I intervertebral disc herniation (IVDH) lesion and also whether the Hounsfield unit (HU) value of herniated disc is relevant to clinical duration and to histopathological chronicity of extruded disc material.Methods: Information from a series of CT studies performed on 45 dogs with a presumptive diagnosis of Hansen type I IVDH was used. Clinical duration of IVDH was estimated based on time from onset of signs per owner communication to time of surgical intervention. Hansen type I IVDH was confirmed at surgery. Retrieved herniated disc was histologically examined. The HU values were analyzed to correlate the clinical duration and histopathological chronicity of the disc lesion.Results: Non-contrast-enhanced CT provided sufficient diagnostic information to plan surgery in 42 of 45 dogs (93%). The value of the HU was significantly higher in clinically chronic cases (n = 12) compared to peracute cases (n = 11) (p <0.05). The HU values were significantly correlated with clinical duration (r = 0.482, p = 0.0008) and histopathological chronicity of the herniated disc (r = 0.408, p = 0.0056).Conclusion: Consistent with the previous reports, the use of non-contrast-enhanced CT alone was sufficient for the diagnosis and surgical planning in most patients with Hansen type I IVDH in the thoracolumbar spine. In addition, the present study suggested that HU values on CT images may be useful in the evaluation of disease chronicity of IVDH.

scholarly journals Anterior lumbar discectomy and fusion for acute cauda equina syndrome caused by recurrent disc prolapse: report of 3 cases

2017 ◽  
Vol 27 (4) ◽  
pp. 352-356
Author(s):  
Kimberly-Anne Tan ◽  
Mathew D. Sewell ◽  
Yma Markmann ◽  
Andrew J. Clarke ◽  
Oliver M. Stokes ◽  
...  
Keyword(s):  
Disc Herniation ◽  
Cauda Equina Syndrome ◽  
Cauda Equina ◽  
Scar Tissue ◽  
Lumbar Discectomy ◽  
Neurological Injury ◽  
Herniated Disc ◽  
Disc Prolapse ◽  
Recurrent Disc Herniation ◽  
Previously Treated

There is a lack of information and consensus regarding the optimal treatment for recurrent disc herniation previously treated by posterior discectomy, and no reports have described an anterior approach for recurrent disc herniation causing cauda equina syndrome (CES). Revision posterior decompression, irrespective of the presence of CES, has been reported to be associated with significantly higher rates of dural tears, hematomas, and iatrogenic nerve root damage. The authors describe treatment and outcomes in 3 consecutive cases of patients who underwent anterior lumbar discectomy and fusion (ALDF) for CES caused by recurrent disc herniations that had been previously treated with posterior discectomy. All 3 patients were operated on within 12 hours of presentation and were treated with an anterior retroperitoneal lumbar approach. Follow-up ranged from 12 to 24 months. Complete retrieval of herniated disc material was achieved without encountering significant epidural scar tissue in all 3 cases. No perioperative infection or neurological injury occurred, and all 3 patients had neurological recovery with restoration of bladder and bowel function and improvement in back and leg pain. ALDF is one option to treat CES caused by recurrent lumbar disc prolapse previously treated with posterior discectomy. The main advantage is that it avoids dissection around epidural scar tissue, but the procedure is associated with other risks and further evaluation of its safety in larger series is required.

scholarly journals Prospective Study on the Performance of 18F-DOPA Positron Emission Tomography/Computed Tomography in Patients with Medullary Thyroid Carcinoma

2022 ◽  
Author(s):  
Inés Califano ◽  
Fabian Pitoia ◽  
Roxana Chirico ◽  
Alejandra de Salazar ◽  
Maria Bastianello
Keyword(s):  
Computed Tomography ◽  
Positron Emission Tomography ◽  
Distant Metastases ◽  
Emission Tomography ◽  
Medullary Thyroid ◽  
Contrast Enhanced Ct ◽  
Positron Emission ◽  
Contrast Enhanced ◽  
Pet Ct ◽  
Enhanced Ct

Abstract Purpose 18F-DOPA Positron Emission Tomography/Computed Tomography (18F-DOPA PET/CT) is a sensitive functional imaging method (65-75%) for detecting disease localization in medullary thyroid cancer (MTC). We aimed: i) to assess the clinical usefulness of 18F-DOPA PET/CT in patients with MTC and elevated calcitonin (Ctn) and CEA levels and, ii) to evaluate changes in disease management secondary to the findings encountered with this methodology. Methods thirty-six patients with MTC and Ctn levels ≥150 pg/ml were prospectively included. Neck ultrasound, chest contrast-enhanced CT, liver magnetic resonance imaging/ abdominal 3-phase contrast-enhanced CT and bone scintigraphy were carried out up to 6 months before the 18F DOPA PET/CT. Results 77.7% were female and 27% had hereditary MTC. Median Ctn level was 1450 pg/ml [150-56620], median CEA level 413 ng/ml [2.9-7436]. Median Ctn DT was 37.5 months [5.7-240]; median CEA DT was 31.8 [4.9-180]. 18F-DOPA PET/CT was positive in 33 patients (91.6%); in 18 (56%) uptake was observed in lymph nodes in the neck or mediastinum, in 7 cases (22%) distant metastases were diagnosed, and in 8 additional patients (24%) both locoregional and distant sites of disease were found. Ctn and CEA levels were higher in patients with ≥ 3 foci of distant metastases. In 14 patients (38.8%), findings on 18F-DOPA PET/CT led to changes in management; surgery for locoregional lymph nodes was the most frequent procedure in 8 patients (22%). Conclusion 18F-DOPA PET/CT was useful for the detection of recurrent disease in MTC and provided helpful information for patient management.

scholarly journals Assessment Of Third Ventricular Parameters in Computed Tomography of Head: A Pilot Study in Tertiary Level Hospital

2020 ◽  
Vol 42 (3) ◽  
pp. 82-86
Author(s):  
Umesh P Khanal ◽  
Keshav Sah ◽  
Ram B Chand
Keyword(s):  
Computed Tomography ◽  
Third Ventricle ◽  
Cross Sectional Study ◽  
University Teaching ◽  
Cross Sectional ◽  
Contrast Enhanced Ct ◽  
Contrast Enhanced ◽  
Upper Limits ◽  
Gender And Age ◽  
Enhanced Ct

Introduction Measurement of ventricles of the brain is important for evaluating changes due to growth, ageing, intrinsic and extrinsic pathologies. The aim of this study was to determine the various parameters of the third ventricle and to assess their association with gender and age using computed tomography (CT) scans of head. MethodsThis retrospective, quantitative, cross sectional study was performed in the Department of Radiology and Imaging, Tribhuvan University Teaching Hospital from July to October 2019 (4 months) on images of 100 patients (50 males and 50 females) whose age group were 18-87 years, who underwent non-contrast and contrast enhanced CT scan of head. ResultsThe total mean of width of third ventricle was found to be 0.33±0.09 cm, 0.35±0.10 cm in male and 0.31±0.06 cm in female. Third ventricle width (TVW) showed statistically significant correlation with male and also with Age. Mean of third ventricle sylvian fissure distance index was 0.41±0.67 cm, 0.42±0.65 cm in male and 0.39±0.06 cm in female respectively. Mean of third ventricle ratio was 0.03±0.09 cm, 0.03±0.09 cm in male and 0.02±0.09 in female respectively. The value were slightly higher in male. ConclusionThe third ventricle width in CT in this study was 0.33±0.09 cm. CT was very useful to determine the upper limits of normal value and its variation with age.

scholarly journals Misdiagnosis of Rectus Abdominis Abscess Owing to Delayed Contrast-Enhanced Computed Tomography

2021 ◽  
Author(s):  
Yuichiro Nagase ◽  
Yukinori Harada
Keyword(s):  
Computed Tomography ◽  
Laboratory Tests ◽  
Rectus Abdominis ◽  
Rectus Abdominis Muscle ◽  
Contrast Enhanced Ct ◽  
Contrast Enhanced ◽  
Enhanced Ct ◽  
The Right ◽  
Enhanced Computed Tomography ◽  
Contrast Enhanced Computed Tomography

A 77-year-old man, who was on anticoagulation, presented with a painful lump on the right abdominal wall. Laboratory tests showed slight anaemia and elevated inflammatory markers. Abdominal plain computed tomography (CT) revealed a mass in the right rectus abdominis muscle. He was admitted with a diagnosis of primary rectus abdominis haematoma. However, on the next day, the diagnosis was corrected to primary rectus abdominis abscess, following contrast-enhanced CT of the abdomen. This case illustrates the importance of considering primary rectus abdominis abscess in patients with suspected primary rectus abdominis haematoma, and contrast should be used when performing CT.

scholarly journals Sex difference in aortic valve fibrosis assessed by contrast-enhanced computed tomography in severe aortic stenosis

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
V Myasoedova ◽  
E Fraschini ◽  
G Mostardini ◽  
L Bonfanti ◽  
M Chiesa ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Aortic Valve ◽  
Aortic Stenosis ◽  
Sex Difference ◽  
Severe Aortic Stenosis ◽  
Aortic Valve Area ◽  
Men And Women ◽  
Contrast Enhanced Ct ◽  
Contrast Enhanced ◽  
Enhanced Ct

Abstract Background Aortic stenosis (AS) is characterized by fibro-calcific remodeling of aortic valve leaflets. Progressive aortic valve calcification (AVC) occurs in both sexes and cardiac computed tomography (CT) is recognized as a high-quality technique for AVC evaluation. To date, sex-specific CT thresholds of AVC have been implemented in clinical practice since it is now recognized that women have less AVC burden than men. In addition, recent evidences indicate that women have more fibrotic remodeling of aortic valve leaflet compared to men. Purpose Aortic valve fibrosis (AVF) being a significant contributor to valve gradient, we sought to evaluate the difference in AVF burden between men and women with severe AS using contrast-enhanced CT. Methods We included 56 patients matched for age and sex with severe AS. All patients underwent Doppler echocardiography and cardiac CT before intervention. Contrast attenuation values (Hounsfield Units, HU) and contrast-to-noise ratio were measured at the level of the ascending aorta. Total AVF was assessed based on HU ranging between 30 and 350, adjusting the upper threshold by increments of 25 HU in either direction until blood pool was not highlighted. Indexed contrast-enhanced CT calcium volume (iAVC) and fibrosis volume (iAVF) were calculated dividing the volumes by the aortic annular area. Fibro-calcific ratio was calculate dividing iAVF by iAVC volumes. Results There was no difference between men and women in major cardiovascular risk factors, valve phenotype (bicuspid vs. tricuspid), nor pharmacological treatment. Men had higher body surface area than women (1.89±0.14 vs. 1.67±0.17 m2, respectively; p&lt;0.001), while women had lower aortic valve area than men (AVA; 0.74±0.2 vs. 0.91±0.2 cm2, respectively; p=0.007) but similar indexed AVA (0.44±0.15 vs. 0.48±0.12 cm2/m2, respectively; p=0.262). Women had significantly lower iAVC compared to men (36 [36–72] vs. 72 [67–123] mm3/cm2, respectively; p=0.03). However, iAVF was significantly higher in women compared to men (83 [78–123] vs. 63 [58–83] mm3/cm2, respectively; p=0.006). Finally, the fibro-calcific ratio, which indicates the predominance of valve fibrosis if &gt;1.0, was significantly higher in women compared to men (2.57 [2.14–7.02] vs. 0.78 [0.84–2.02], respectively; p=0.003). Conclusions Our study highlights for the first time a sex difference in the fibrotic content of severe AS evaluated by contrast-enhanced CT. These findings might be valuable to promote further studies on the role of sex-specific tissue composition in AS progression and outcomes. FUNDunding Acknowledgement Type of funding sources: Foundation. Main funding source(s): Fondazione Gigi e Pupa Ferrari ONLUS

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