Differentiation of Cervical Spine Osteoradionecrosis and Bone Metastasis After Radiotherapy Detected by Bone Scan in Patients With Nasopharyngeal Carcinoma: Role of Magnetic Resonance Imaging

The present method comparison study was carried out in the Radiology and Imaging Department of Dhaka Medical College & Hospital, Dhaka during the period of January 2012 to December 2013 to evaluate the role of Magnetic Resonance Imaging in the diagnosis of cervical disc herniation. A total of 40 patients having clinical features of cervical disc herniation with neck pain referred to the Department of Radiology & Imaging for MRI of their cervical spine were included in the study. At first all the patients were evaluated by detail history and clinical examination with special emphasis on clinical features. Then subsequently MRI of cervical spine was performed in all cases. The MRI report was checked by a competent radiologist of the department of Radiology and imaging DMCH. Among these 40 patients 11 were operated in department of neurosurgery, DMCH and 29 were operated in spine surgery unit, Department of Orthopaedic, BSMMU, Dhaka. The MRI and peroperative findings of these 40 patients were analyzed for the study. MRI findings correlated well in most of the cases with preoperative findings. Sensitivity, specificity, positive predictive value, negative predictive value and accuracy of MRI in the diagnosis of cervical disc herniation were 94.12%, 83.33%, 96.97%, 71.43% and 92.5% respectively. Therefore it can be concluded that MRI may be used as a reliable tool with which we can assess the level, type and position of cervical disc herniation and can plan the subsequent appropriate management in majority of cases.DOI: http://dx.doi.org/10.3329/cmoshmcj.v13i2.21071

Download Full-text

The role of cross-sectional imaging in suspected nasopharyngeal carcinoma

Annals of The Royal College of Surgeons of England ◽

10.1308/rcsann.2019.0025 ◽

2019 ◽

Vol 101 (5) ◽

pp. 325-327 ◽

Cited By ~ 4

Author(s):

A Shayah ◽

L Wickstone ◽

E Kershaw ◽

F Agada

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Nasopharyngeal Carcinoma ◽

Histological Finding ◽

Endoscopic Examination ◽

Resonance Imaging ◽

Cross Sectional ◽

Cross Sectional Imaging ◽

Sectional Imaging

Introduction Nasopharyngeal carcinoma is a rare neoplasm in the UK. The current gold standard for detection is endoscopic examination under anaesthesia of the nasopharynx with biopsy. Many clinicians are now advocating cross-sectional imaging as the primary investigation. The objective of this study is to evaluate the role of cross-sectional imaging in detecting nasopharyngeal carcinoma and ultimately to avoid unnecessary biopsy. Material and methods This is a retrospective uncontrolled case series review of patients who were investigated for suspected nasopharyngeal carcinoma between 2009 and 2017 at York Teaching Hospital NHS Foundation Trust. At present, any suspected nasopharyngeal carcinoma requires biopsy. Search terms used were ‘endoscopic biopsy of nasopharynx’, ‘endoscopic examination + biopsy nasopharynx’. The main outcome measures are reported histological and radiological features of malignancy. Only patients who had imaging prior to the biopsy were included. Results A total of 144 patients had endoscopic examination under anaesthesia of the nasopharynx with biopsy. Approximately one-third of these patients had cross-sectional imaging before the biopsy. The study revealed that magnetic resonance imaging had 100% sensitivity and 84% specificity; however, the endoscopic examination under anaesthesia and biopsy had only 88% sensitivity. This is due to a negative histological finding despite radiological characteristics of nasopharyngeal carcinoma in some patients. However, the specificity was 100%. Conclusion The study supports magnetic resonance imaging as the primary investigation in patients with suspected nasopharyngeal carcinoma followed by endoscopic examination under anaesthesia and biopsy in cases with suspicious findings on imaging only.

Download Full-text

The Role of Magnetic Resonance Imaging in the Management of Traction Injuries to the Adult Brachial Plexus

Journal of Hand Surgery (European Volume) ◽

10.1054/jhsb.1999.0234 ◽

1999 ◽

Vol 24 (5) ◽

pp. 550-555 ◽

Cited By ~ 60

Author(s):

T. E. J. HEMS ◽

R. BIRCH ◽

T. CARLSTEDT

Keyword(s):

Magnetic Resonance Imaging ◽

Cervical Spine ◽

Magnetic Resonance ◽

Brachial Plexus ◽

Spinal Canal ◽

Root Avulsion ◽

Resonance Imaging ◽

Additional Information ◽

Magnetic Resonance Imaging Mri

Magnetic resonance imaging (MRI) of the cervical spine and brachial plexus was performed on 26 consecutive patients presenting with traction injuries of the brachial plexus during 1996 and 1997. These included T1 and T2 weighted coronal, sagittal and axial images of the cervical spine and coronal images of the brachial plexus. The results were compared with surgical findings, intraoperative neurophysiology, and subsequent clinical progress. Operations for exploration and repair have been performed in 23 and 26 patients scanned. Evidence of root avulsion was seen in 11 patients in the form of displacement or oedema of the spinal cord, haemorrhage or scarring within the spinal canal, absence of roots in the intervertebral foramena, and meningoceles. Characteristic abnormalities were evident in the MR scans of all cases where exploration confirmed some root avulsions. There were no false positives. MRI underestimated the number of individual roots avulsed; sensitivity was 81%. Post-ganglionic lesions were seen as swelling on T1 images associated with increasing signal on T2 images. It was usually possible to define the level of the injury within the plexus. This study suggests that MR imaging, performed early after traction injury to the brachial plexus, provides useful additional information towards establishing the level of the lesion. It also provides information about injury to the plexus outside the spinal canal.

Download Full-text

The role of magnetic resonance imaging in acute trauma of the cervical spine in children

Medical Visualization ◽

10.24835/1607-0763-2018-6-105-115 ◽

2019 ◽

Vol 22 (6) ◽

pp. 105-115

Author(s):

I. A. Korneev ◽

T. A. Akhadov ◽

I. A. Mel'nikov ◽

O. S. Iskhakov ◽

N. A. Semenova ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Spinal Cord ◽

Cervical Spine ◽

Magnetic Resonance ◽

Diagnostic Method ◽

Cervical Spine Trauma ◽

Spine Trauma ◽

Resonance Imaging ◽

Acute Trauma

Aim.To evaluate the role of magnetic resonance imaging (MRI) as a diagnostic method in children with acute trauma of the cervical spine and spinal cord, to compare the correspondence of MRI results with neurologic symptoms in accordance with the ASIA scale.Materials and methods.156 children with acute trauma of spine and spinal cord at the age from 6 months up to 18 years were studied. MRI was performed on a Phillips Achieva 3T scanner. The standard protocol included MYUR (myelography) in coronal and sagittal projections, STIR and T2VI FS SE in sagittal projection, T2VI SE or T2 * VI FSGE (axial projection), 3D T1VI FSGE before and after contrast enhancement. Contrast substance was injected intravenously in the form of a bolus at the rate of 0.1 mmol/kg (equivalent to 0.1 ml/kg) at a rate of 3 to 4 ml.Results.The causes of cervical spine blunt trauma were: road accidents (55), catatrauma (60), “diver” trauma (21), blunt trauma (20). Intramedullary lesions of the spinal cord were detected: concussion (49), bruising / crushing (27), hematomia (34), disruption with divergence of segments (21), accompanied by edema (141); extramedullary lesions: epi- and subdural, intralesive and sub-connective and soft tissues hematomas (68), ruptures of bundles (48), fractures (108), dislocation and subluxation of the vertebrae (35), traumatic disc herniation (37), spinal cord compression and/or rootlets (63), statics violation (134), instability (156).Conclusion.MRI is the optimal method for spinal cord injury diagnostics. In the acute period of injury this technique has limited application, but it can however serve as a primary diagnostic method in these patients. MRI should be performed no later than the first 72 hours after injury. The most optimal for visualization of cervical spine trauma and spinal cord are T2VI SE and STIR in sagittal projection with suppression of signal from fat. MRI results correlate with neurologic symptoms at the time of performance according to the ASIA scale, and therefore MRI should be performed in all patients with acute cervical spine trauma, whenever possible.

Download Full-text