The evaluation of disc and extra-disc pathologies with MDCT

Öz

The evaluation of disc and extra-disc pathologies with MDCTPurpose: The aim of this study is to evaluate the diagnostic value of MDCT for lumbar spine pathologiesin routine abdominal CT examinations. Materials and Methods: 50 cases those performed abdominal CTexamination for any complaint were taken to investigation and evaluated to determine lumbar spinepathologies . In our study, all abdominal CT examined patients were studied by lumbar MR. AbdominalCT examination was performed by MDCT with four canal. IV contrast medium was administered to allpatients that were going to examined by CT. After examination, all images were transferred to workstationand they were evaluated in sagittal, coronal and axial plans. Lumbar spine pathologies were classified infour groups as disc pathologies, axis pathologies, bone lesions and other degenerative changes. All patologieswere identified by MDCT. MR evaluations were made by same radiologist at different time. CT and MRIfindings of each patient in lumbar spine patologies had been revealed. The MDCT findings of as a goldstandart MR are accepted in lumbar spine patologies were compared with MR findings of the same patients.Thus, we evaluated the rate of accuracy of MDCT in lumbar spine patologies. Results: Posterior bulging %46.4, posterior disc herniation % 100, axis pathologies % 100, bone lesions % 66.7, narrow canal and narrownoral foramen % 66.7 and schmorl nodul % 87 were detected with MDCT accuracy. Disc calsification andvacum fenomen were only detected by CT. Discussion: We can use MDCT for the evaluation of many lumbarspine patology safely. Sagittal and coronal images are a feature of MDCT that have very important diagnosticvalue in lumbar spine pathologies. Lumbar spine pathologies should be specify at abdominal CT reports

Anahtar Kelimeler

• MDCT
• MRI and lumbar disc pathology

Rutin abdominal ÇDBT incelemelerinde disk ve disk dışı patolojilerin değerlendirilmesi

Öz

Amaç: Bu çalýþmanýn amacý ÇDBT ile yapýlan rutin abdomen BT incelemelerinin lomber omurga patolojileriaçýsýndan tanýsal önemini deðerlendirmektir. Gereç ve Yöntem: Herhangi bir nedenle abdomen BT çekilenve bu tetkiklerde lomber omurga patolojileri açýsýndan deðerlendirme yapýlan 50 olgu çalýþmaya dahil edildi.BT incelemeyi takiben tüm hastalar lomber disk patolojilerine yönelik lomber MRG inceleme ile deðerlendirildi.Abdomen BT incelemesi 4 kanallý BT ile gerçekleþtirildi. Tüm hastalara IV kontrast madde uygulandý.Çekimden sonra tüm görüntüler iþ istasyonuna gönderilerek sagittal, koronal ve aksiyel planlarda incelendi.Lomber spinal patolojiler disk patolojileri, aksis patalojileri, kemik lezyonlarý ve diðer dejeneratif deðiþikliklerolarak dört sýnýfa ayrýldý. Tüm patalojiler ÇDBTde tanýmlandý. MRG deðerlendirmeleri farklý bir zamandaayný radyolog tarafýndan yapýldý. Her hastanýn lomber spinal patolojiler açýsýndan BT ve MRG bulgularýyorumlandý ve her iki tetkikteki bulgularý karþýlaþtýrýldý. Sonuç olarak lomber spinal patolojilerde ÇDBTnindoðruluk oranlarý deðerlendirildi. Bulgular: ÇDBTde posterior disk taþmasý (PDT) % 46.4, posterior diskherniasyonu (PDH) % 100, aksis patolojileri % 100, kemik lezyonlarý % 66.7, dar kanal ve dar nöral foramen% 66.7 ve schmorl nodülü % 87 doðruluk oranýyla saptandý. Disk kalsifikasyonu ve vakum fenomeni sadeceBT de saptandý. Sonuç: Lomber spinal patolojilerin deðerlendirilmesinde ÇDBT yi güvenle kullanabiliriz.ÇDBTnin sagittal ve koronal görüntü özellikleri lomber spinal patolojileri deðerlendirmede oldukça önemlidir.Lomber spinal patolojiler abdomen BT raporlarýnda belirtilmelidir

Anahtar Kelimeler

• ÇDBT
• MRG
• lomber disk patolojileri

Kaynakça

1. Pauster DM, Modic MT, Masaryk TJ. Magnetic Resonance Ýmaging of the spine: applications and limitations, Radiol Clin North Am 1985; 23 : 551-563.
2. Differential Diagnosis in Magnetic Resonance Imaging. Francis A. Burgener Steven P. Meyers Raymond K. Tan Wolfgang Zaunbauer 2002 Thime Sturtgart New York
3. Klingebiel R, Bohner G, Zimmer C, Rogalla P, Masuhr F, Lehmann R. Using multislice spiral CT in neuroradiologic imaging, Nervenarzt. Aug, 2002; 73 : 729-35.
4. Rabassa AE, Guinto FC, Crow WN, Chaljub G, Wright GD, Storey GS. BT of the spine: value of reformatted images. AJR Am J Roentgenol Dec. 1993; 161: 1223- 1227.
5. Eur Radiol (2008) 18: 1696 1702 /DOI 10.1007/s00330- 008-0920-2.
6. Significance of sagittal reformations in routine thoracic and abdominal multislice CT studies for detecting osteoporotic fractures and other spine abnormalities
7. Pearce J, Moll JM. Conservative treatment and natural history of acute lumbar disc lesions. J Neurol Neurosurg Psychiatry, 1967; 30:13-17.
8. Forristall RM, Marsh HO, Pay NT. Magnetic resonance imaging and contrast BT of the lumbar spine. Comparison of diagnostic methods and correlation with surgical findings, Spine 1988; 13: 1049-1054.

9. Hasan Kamil Sucu, Hamdi Bezircioðlu, Füsun Demirçiv, Þevket Tektaþ. Lomber Disk Hernilerinde Lezyon Özellikleri ve Semptomatoloji Ýliþkisi Ýnönü Üniversitesi Týp Fakültesi Dergisi, 2002; 9. 179-183.
10. Cerrahoðlu L, Þenel K, Aydýn M et al: Bel aðrýlý vakalarda etyolojik ve tomografik deðerlendirme. KSIV. Ulusal Fizik Tedavi ve Rehabilitasyon Kongresi. Özet Kitabý. 1993; 135.
11. Wegener OH. Whole body Computerized Tomography. Second Edition, Germany, 1992; 519-526.
12. Krämer J. Disk Degeneration In: Intervertebral Disk Disease. Causes, Diagnosis, Treatment 2nd ed. Georg Thieme Verlag Stuttgart Newyork 1990; 41-51.
13. Elster AD, Jensen KM. Computed tomography of spondylolisthesis: patterns of associated pathology. J Comput Assist Tomogr, 1985; 9 : 867-874.
14. Farsetti P, Tudisco C, Caterini R, Ippolito E. Juvenile and idiopathic kyphosis. Long-term follow-up of 20 cases. Arch Orthop Trauma Surg, 1991; 110 : 165-168.
15. Tümer Y, Bel ve sýrt. In: Ege R, ed. Ortopedi ilkeleri ve uygulamalarý. Ankara, Yargýçoðlu matbaasý, 1980; 1382-1530.
16. Winter RB, Hall JE. Kyphosis in childhood and adolescence, Spine 1978; 3 : 285-308.
17. Yorgancýgil H, Özerdemoðlu RA, Aydýnlý U. Skolyoz, Okul taramalarý ile erken taný, takip ve tedavi. Fizik. Týp Rehabil Derg, 1997; 22 : 39-43.
18. Skinner HB. Scolliosis Skinner HB (E). Current diag- nosis & treatment in orthopedics. Appleton & Lange, ConneBTicu. 1995; 190-204.
19. Tezeren G, Özlü K, Aydemir A, Ayaþlý A, Kahraman Y, Dülgeroðlu D. School screening for scoliosis in Ankara. J Turk Spin Surg, 1993; 4 : 92-94.
20. Benameur S, Mignotte M, Parent S, Labelle H, Skalli W. De Guise J.3D/2D registration and segmentation of scoliotic vertebrae using statistical models. Comput Med Imaging Graph, 2003; 27 : 321-327.
21. Foks MW, Onofrio BM. The natural history and management of symptomatic and asymptomatic vertebral hemangiomas. Smith TP. Transarterial embolization of vertebral hemangioma. J Neurosurg, 1993; 78 : 36-45.
22. Christian WA,. Pfirrmann MD, Donald Resnick. Schmorl Nodes of the Thoracic and Lumbar Spine: Radiographic-Pathologic Study of Prevalence, CharaBTerization, and Correlation with Degenerative Changes of 1,650 Spinal Levels in 100 Cadavers. Radiology, 2001; 219 : 368-374.
23. Schmorl G. Über knorpelknötchen an den wirbelbandscheiben. Rofo Fortschr Geb Rontgenstr Neuen Bildgeb Verfahr, 1928; 38 : 265-279.
24. Fritz JM, Delitto A, Welch WC, Erhard RE. Lumbar spinal stenosis: A review of current concepsts in evaluation, management, and outcome measurements. Arch Phys Med Rehabil, 1998; 79 : 700-708.
25. Kent DL, Haynor DR, Larson EB, Deyo RA. Diagnosis of lumbar spinal stenosis in adults: a metaanalysis of the accuracy of BT, MR and myelography. AJR Am J Roentgenol, 1992; 158 : 1135-1144.
26. Hall S, Bartleson J, Onofrio BM, Baker HL, et al. Lumbar spinal stenosis: Clinical features, diagnostic procedures, and results of surgical treatment in 68 patients. Annals of Internal Medicine, 1985; 103 : 271- 275.
27. Acosta FL, Quinones-Hinojosa A, Schmidt MH. Weinstein PRDiagnosis and management of sacral Tarlov cysts. Case report and review of the literature. Neurosurg Focus, Aug, 2003; 15:;15.
28. Bartolozzi C, Bartolozzi A, Lizzadro G, Dal Pozzo G. Magnetic resonance in the study of spondylodiscitis. Radiol Med. 1989; 78 : 153-157.
29. Weinberger A, Myers AR. Intervertebral disc calcification in adults: a review. Semin Arthritis Rheum. 1987; 8 : 69-75.
30. Hamze B, Leaute F, Wybier M, Laredo JD. Vertebral vacuum phenomena. Ann Radiol, 1995; 38 : 186-191.
31. Lafforgue PF, Chagnaud CJ, Daver LM, Daumen- Legre VM, Peragut JC, Kasbarian MJ, Volot F,
32. Acquaviva PC. Intervertebral disk vacuum phenomenon
33. secondary to vertebral collapse: prevalence and
34. significance. Radiology, 1994; 193 : 853-858.