scholarly journals Magnetic resonance imaging predictors of outcome after surgical intervention for cervical spondylotic myelopathy

2020 ◽  
Vol 7 (10) ◽  
pp. 3219
Author(s):  
Sushil Bhogawar ◽  
Prasanth Asher ◽  
Sunilkumar Balakrishnan Sreemathyamma ◽  
Anilkumar Peethambaran
Keyword(s):  
Magnetic Resonance Imaging ◽  
Spinal Cord ◽  
Magnetic Resonance ◽  
Surgical Outcome ◽  
Signal Intensity ◽  
Cervical Spondylotic Myelopathy ◽  
Surgical Intervention ◽  
Resonance Imaging ◽  
Group A ◽  
Group B

Background: Cervical spondylotic myelopathy (CSM) is a commonly seen spinal cord disease. There are no well-defined indications and optimal timing for surgical intervention. Therefore, defining predictors for outcome after surgical intervention will have great advantage in taking decisions for interventions.Methods: A consecutive series of all patients having signs and symptoms of cervical spondylotic myelopathy admitted to Department of Neurosurgery, Medical College, Thiruvananthapuram who underwent decompressive surgery with or without stabilization in one year were studied. Pre-operative magnetic resonance imaging (MRI) findings were correlated with post-operative surgical outcomes (Nurick grade) after 3 months of follow up. The pattern of spinal cord signal intensity was classified as: group A (MRI N/N) - no SI T1WI or T2WI, group B (MRI N/Hi) - no SI T1WI and high SI on T2WI and, group C (MRI Lo/Hi) - low SI T1WI and high SI on T2WI. CSM clinical outcomes were evaluated using Nurick grading system, which was used pre- and post-operatively (pre op and post op).Results: Post operatively improvement was seen in 75% of group A and 61.35 % of group B patients, but among group C only 25% patient improved according to Nurick grading pre op and post op.Conclusions: Patients with high intramedullary signal intensity on T2WI may experience a good surgical outcome. A less favorable surgical outcome is predicted by the presence of low intramedullary signal on T1WI.

Magnetic Resonance Imaging and Cervical Spondylotic Myelopathy

Neurosurgery ◽  
1990 ◽  
Vol 26 (2) ◽  
pp. 217-227 ◽  
Author(s):  
Thomas F. Mehalic ◽  
Roger T. Pezzuti ◽  
Brett I. Applebaum
Keyword(s):  
Magnetic Resonance Imaging ◽  
Spinal Cord ◽  
Magnetic Resonance ◽  
Signal Intensity ◽  
Cervical Spondylotic Myelopathy ◽  
Pathological Condition ◽  
Prognostic Significance ◽  
Resonance Imaging ◽  
T2 Weighted Images

Abstract Nineteen patients were examined for cervical spondylotic myelopathy with magnetic resonance imaging. Pre- and postoperative magnetic resonance scans were obtained in most cases. Surgical confirmation of the pathological condition was obtained for all 19 patients. On the T2-weighted scans, there was increased signal intensity within the spinal cord at the point of maximal compression. The exact cause of the increased signal intensity on the T2-weighted images is not known, but is suspected to represent edema, inflammation, vascular ischemia, myelomalacia, or gliosis. The increased signal intensity diminished postoperatively in the patients who improved clinically, and remained the same or increased in those whose conditions remained unchanged or worsened after decompression. The authors suggest that these T2-weighted images carry prognostic significance.

Central Spinal Cord Injury: Magnetic Resonance Imaging Confirmation and Operative Considerations

Neurosurgery ◽  
1988 ◽  
Vol 22 (2) ◽  
pp. 340-347 ◽  
Author(s):  
John L. Fox ◽  
Louis Wener ◽  
Dale C. Drennan ◽  
Herbert J. Manz ◽  
Daniel J. Won ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Magnetic Resonance ◽  
Signal Intensity ◽  
High Signal ◽  
Proton Density ◽  
Resonance Imaging ◽  
Cord Injury ◽  
Central Cord Syndrome

Abstract A case of central cervical spinal cord injury, confirmed by magnetic resonance imaging (MRI) and treated by myelotomy, is presented. After recovering well from his central cord syndrome and walking with assistance, the patient developed a rapidly progressive myelopathy beginning 2 months after injury. His main injury localized clinically to the C8, T1 level; but central cord abnormalities were identified 3 months after injury at the C6 level by MRI: a high signal intensity on the proton density sequence and a low-signal intensity on the T1-weighted sequence. At operation 4½; months after his injury and 1 month after complete paraplegia, a myelotomy at C6 failed to reveal any cavity (syrinx) but instead disclosed only intense gliosis inside a slightly atrophic spinal cord. Rapid clinical improvement ensued. Secondary syringomyelia may be an endstage condition after spinal cord insults that trigger a progressive, pathophysiological reaction leading to central cord necrosis. In selected cases, myelotomy may interrupt this MRI-identified, nosogenic process before cavitation has occurred. (Neurosurgery 22:340-347, 1988)

scholarly journals Magnetic Resonance Imaging and Dynamic X-ray's correlations with Dynamic Electrophysiological Findings in Cervical Spondylotic Myelopathy: a retrospective cohort study.

2020 ◽  
Author(s):  
Zhengran Yu ◽  
Kaiyuan Lin ◽  
Jiacheng Chen ◽  
Kuan-Hung Chen ◽  
Yuguang Chen ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Spinal Cord ◽  
Magnetic Resonance ◽  
Cervical Spondylotic Myelopathy ◽  
T Test ◽  
Resonance Imaging ◽  
Segmental Instability ◽  
X Ray ◽  
Clinical Assessments ◽  
Radiographic Parameters

Abstract Background: Dynamic somatosensory evoked potentials (DSSEP) can be used to disclose abnormalities of ascending sensory pathways at dynamic positions and diagnose cervical spondylotic myelopathy (CSM). However, radiographic tests including magnetic resonance imaging (MRI) and dynamic X-ray are used much more widely in the management of CSM. Our study aims to clarify the correlations between several radiographic parameters and the DSSEP results, and further determine their reliability with clinical data.Methods: We retrospectively enrolled 38 CSM patients with surgical intervention. DSSEP tests were performed before surgery. Amplitude ratios of DSSEP N13 and N20 waves at extension and flexion were calculated and recorded as N13_E, N20_E, N13_F, N20_F respectively. Baseline severity was evaluated with the modified Japanese Orthopedic Association (mJOA) score and the Nurick grades. Prognosis was evaluated based on the 2-year recovery rate. Sagittal diameter and transverse areas of the cord and canal were measured and the Spinal cord/Canal Area Ratio were calculated. The compressive ratios at the compressed site (Compression_Ratio), central (Central_Ratio) and 1/4-lateral points (1/4-Lateral_Compression_Ratio), and intramedullary T2 hyperintensity patterns (Ax-CCM types) were also collected from MRI axial images. Dynamic X-rays were used to test for segmental instability of the cervical spine. The correlations between radiologic findings, DSSEP data, and clinical assessments were investigated.Results: We found that DSSEP N13_E and N13_F correlated with the Compression_Ratio, Central_Ratio, 1/4-Lateral_Compression_Ratio (Pearson, p<0.05) and Ax-CCM types (ANOVA, p<0.05) in MRI axial images and cervical segmental instability in dynamic X-ray (t-test, p<0.05). Apart from the 1/4-Lateral_Compression_Ratio, these radiographic parameters above also correlated with the baseline clinical assessments (Spearman or ANOVA or t-test, p<0.05) and postoperative recovery rate (Pearson or ANOVA or t-test, p<0.05).Conclusions: We found that the preoperative Compression_Ratio, Central_Ratio and 1/4-Lateral_Compression_Ratio in MRI and cervical segmental instability in dynamic X-ray could reflect the dynamic neural dysfunction of the spinal cord. Different Ax-CCM types corresponded to different DSSEP results at extension and flexion, suggesting divergent pathophysiology. These radiographic parameters could help evaluate disease severity and predict postoperative prognosis.Trial registration: The trial "动态诱发电位对脊髓型颈椎病诊断和预后评估(Dynamic Somatosensory Evoked Potentials for the diagnostic and prognostic evaluation for Cervical Spondylotic Myelopathy)" was retrospectively registered on April 30th, 2020 and the registration number is "伦审[2020]151号".

Application of Gold Nanoparticles in Magnetic Resonance Imaging for Targeted Diagnosis and Treatment of Breast Cancer

2021 ◽  
Vol 13 (9) ◽  
pp. 1595-1602
Author(s):  
Yuli Wu ◽  
Junwei Song ◽  
Shengcui Liu ◽  
Xianglei Wei ◽  
Weiwei Chen
Keyword(s):  
Breast Cancer ◽  
Magnetic Resonance Imaging ◽  
Targeted Therapy ◽  
Magnetic Resonance ◽  
Diagnosis And Treatment ◽  
Control Group ◽  
Breast Cancer Patients ◽  
Resonance Imaging ◽  
Group A ◽  
Group B

This study aimed to explore the application of super paramagnetic gold magnetic nanoparticles (Au-M-NPs) in the magnetic resonance imaging (MRI) images for targeted diagnosis and treatment of breast cancer. The reducibility of ethylene glycol to ferric chloride (FeCl3) was adopted to synthesize the Au-M-NPs by solvothermal method by taking acetic acid as the base source and trisodium citrate as the stabilizer. Besides, the synthesized Au-M-NPs were applied in the MRI images for targeted therapy of breast cancer. Patients from a blank group (group A), a control group (group B), and an experimental group (group C) received the traditional clinical diagnosis treatment, MRI diagnosis, and Au-M-NPs targeted therapy with MRI in turn. The results showed that the prepared Au-M-NPs were featured with small particle size and good dispersibility, and were monodispersive after surface modification. The intraoperative blood loss of patients from group A (115.3±9.33 mL) and group B (94.6±9.72 mL) was obviously higher than the loss of group C (68.4±8.7 mL) (P < 0.05). The drainage volume of patients from group B (162.4±12.3 mL) and group C (131.9±11.8 mL) decreased sharply after surgery compared with group A (193.7±11.8 mL), and that in group C was the lowest (P < 0.05). The proportion of local recurrence in patients from group B (12.3%) and group C (6.4%) dropped steeply in contrast to the proportion of group A (13.2%) (P < 0.05). The proportion of tumor metastasis in patients from group B (11.2%) and group C (8.4%) was greatly lower than that of group A (14.8%) (P < 0.05). In conclusion, the application of Au-M-NPs in the diagnosis and treatment of breast cancer with MRI could effectively reduce the incidence of intraoperative and postoperative adverse reactions.

Prognostic value of changes in spinal cord signal intensity on magnetic resonance imaging in patients with cervical compressive myelopathy

2014 ◽  
Vol 14 (8) ◽  
pp. 1601-1610 ◽  
Author(s):  
Kenzo Uchida ◽  
Hideaki Nakajima ◽  
Naoto Takeura ◽  
Takafumi Yayama ◽  
Alexander Rodriguez Guerrero ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Spinal Cord ◽  
Magnetic Resonance ◽  
Signal Intensity ◽  
Prognostic Value ◽  
Resonance Imaging ◽  
Cervical Compressive Myelopathy ◽  
Compressive Myelopathy
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