Coincidental Lesions that have been seen in Patients with Lumbar Discopathy at Spinal MR Examination

Abstract

Introduction: The present Study has been made in order to investigate and examine the prevalence and type of the coincidental findings seen in patients with lumbar discopathy subjected to Lumbar Spinal Magnetic Resonance Imaging (MRI).

Tools and Method: 613 patients who were thought to have been Lumbar discopathy and who were subjected to Lumbar MRI have been examined. Lumbar MRIs were reported by musculoskeletal radiologists. Vertebra hemangiomas, tarlov cysts, Renal cysts, schmorl nodules, liver cysts were included in this study.  

Findings: Total 613 patients (male-female rate, 354: 259; age range, 16-79 years of age) were assessed. Vertebra Hemangiomas at 5.7% of the patients (n=35) vertebra hemangioma, at 3.5% of patients (n=22) tarlov cyst, at 2.2% (n=14) kidney cyst, at 1.4% (n=9) schmorl nodule, at 0.3% (n=2) of the patients liver cyst were found.

Conclusion: Detected coincidental findings have seen quite common at the examination of MRI of the patients with lumbar discopathy. Although the most of the coincidental findings which were detected at MRI of Lumbar Spine have been benign, the awareness of their prevalence is helpful in diagnosing the lesions which are not related with the symptoms. 

Keywords

• Lumbar,MRI,Discopathy,Tarlov Cyst

Kaynakça

1. 1. Park H-J, Jeon Y-H, Rho M-H, et al. Incidental findings of the lumbar spine at MRI during herniated intervertebral disk disease evaluation. AJR Am J Roentgenol. 2011;196:1151-5.
2. 2. Suri P, Hunter DJ, Joueve C, et al. Inciting events associated with lumbar disc herniation. Spine J 2010;10:388–95.
3. 3. Cieszanowski A, Maj E, Kulisiewicz P, et al. Non-contrast-enhanced whole-body magnetic resonance imaging in the general population: the incidence of abnormal findings in patients 50 years old and younger compared to older subjects. PLoS One. 2014;9(9).
4. 4. Kamath S, Jain N, Goyal N, Mansour R, Mukherjee K. Incidental findings on MRI of the spine. Clin Radiol 2009;64:353-61.
5. 5. Wagner SC, Morrison WB, Carrino JA, Schweitzer ME, Nothnagel H. Picture archiving and communication system: effect on reporting of IF. Radiology 2002;225:500–5.
6. 6. Quattrocchi CC, Giona A, Di Martino AC, Errante Y, Scarciolla L, Mallio CA. Extra-spinal incidental findings at lumbar spine MRI in the general population: a large cohort study. Insights Imaging. 2013;4:301-8.
7. 7. Sobhan M, Samiee M, Asgari Y, Mansour A. Incidental Findings of the Lumbar Spine at MRI in Patients Diagnosed with Discopathy International Journal of Medical Imaging 2016;4:44-7.
8. 8. Green L. PACS: Effect on incidental findings. Radiol Manage 2004;26:26-9.

9. 9. Barzin M, Maleki I. Incidence of vertebral hemangioma on spinal magnetic resonance imaging in Northern Iran. Pak J Biol Sci. 2009;15;12:542-4.
10. 10. Kulshrestha M, Byrne P. Multiple primary haemangiomas of bone mimicking vertebral metastases. R Soc Med 1997;90:632-4.
11. 11. Templin CR, Stambough JB, Stambough JL. Acute spinal cord compression caused by vertebral hemangioma. Spine J 2004;4:595-600.
12. 12. Hadjipavlou A, Tosounidis T, Gaitanis I, Kakavelakis K, Katonis P. Balloon kyphoplasty as a single or as an adjunct procedure for the management of symptomatic vertebral haemangiomas. J Bone Joint Surg (Br) 2007;89:495-502.
13. 13. Fukuta S, Miyamoto K, Masuda T, Hosoe H, Kodama H, Nishimoto H. Unusual back pain caused by intervertebral disc degeneration associated with schmorl node at Th11/12 in a young athlete, successfully treated by anterior interbody fusion: a case report. Spine (Phila Pa 1976). 2009;1;34:195-8.
14. 14. Zehra U, Flower L, Robson-Brown K, Adams MA, Dolan P. Defects of the vertebral end plate: implications for disc degeneration depend on size. Spine J. 2017;17:727-7.
15. 15. Park H J, Kim S, Lee S W, et al. Two cases of symptomatic perineural cysts (Tarlov Cysts) in one family- case report. J Korean Neurosurg Soc 2008;44:174-7.
16. 16. Mitra R, Kirpalani D, Wedemeyer M. Conservative management of perineural cysts. Spine 2008;16:565-8.
17. 17. Nabors MW, Pait TG, Byrd EB, AI et al. Updated assessment and current classification of spinal meningeal cysts. J Neurosurg. 1988;68:366-77.
18. 18. Paulsen RD, Call GA, Mertagh FR. Prevalence and percutaneous drainage of cysts of the sacral nerve root sheath (Tarlov cysts). AJNR 1994;15:293-7.
19. 19. Mortele KJ, Ros PR. Cystic focal liver lesions in the adult: differential CT and MR imaging features. Radiographics 2001;21:895-910.
20. 20. Macedo FI. Current management of noninfectious hepatic cystic lesions: A review of the literature. World J Gastroenterol 2013;27:462-9.
21. 21. Tuncel SA, Cagli B, Tekatas , et al. Extraspinal Incidental Findings on Routine MRI of Lumbar Spine: Prevalence and Reporting Rates in 1278 Patients. Korean J Radiol. 2015;16:866-73.
22. 22. Lee SY, Landis MS, Ross IG, Goela A, Leung AE. Extraspinal findings at lumbar spine CT examinations: prevalence and clinical importance. Radiology 2012;263:502-9.
23. 23. Terada N, Arai Y, Kinukawa N, Yoshimura K, Terai A. The 10-year natural history of simple renal cysts. Urology. 2008;71:7–12.
24. 24. McHugh K, Stringer DA, Hebert D, Babiak CA. Simple renal cysts in children: diagnosis and follow-up with US. Radiology 1991;178:383-5.
25. 25. Laucks Jr SP, McLachlan MSF. Aging and simple renal cysts of the kidney. Br J Radiol 1981;54:12-4.
26. 26. Konnak JW, Grossman HB. Renal cell carcinoma as an incidental finding. Journal of Urology 1985;134:1094-6.