Skeletal radiology
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Comparative Study
Optimization of b value in diffusion-weighted MRI for the differential diagnosis of benign and malignant vertebral fractures.
The objective was to explore the optimal b value in diffusion-weighted imaging (DWI) of MRI for differential diagnosis of benign and malignant vertebral fractures. ⋯ When DWI with multiple b values is used to differentiate benign from malignant vertebral compression fractures, b values within the range of around 300 s/mm2 are recommended, taking into account both SNR and diffusion weighting of water molecules.
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The objective was to assess the prevalence of lumbar facet joint edema in patients with low back pain. ⋯ Sagittal STIR images detect facet joint edema in 14% of patients with low back pain. This fact may be useful for planning treatment including facet joint injections.
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Case Reports
Intramedullary spinal cord abscess complicating thoracic spondylodiscitis caused by Bacteroides fragilis.
Intramedullary spinal cord abscess associated with infectious spondylodiscitis is a rare entity. The case of a 66-year-old man with an intramedullary spinal cord abscess complicating thoracic spondylodiscitis is presented. ⋯ Biopsy of the intervertebral disc was performed and Bacteroides fragilis was isolated. Antibiotic therapy was instituted, and MR imaging of the thoracic spine was performed 6 weeks after the initiation of treatment, showing resolution of the epidural and intramedullary spinal cord abscesses.
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An aortic embolus of cement occurred in a 72-year-old woman after lumbar percutaneous vertebroplasty for breast cancer metastasis. A CT scan during the procedure revealed cement migration into the aorta via the lumbar artery. The cement embolus in the aorta, along with the hook-shaped cement fragment in the lumbar artery, was asymptomatic. ⋯ The patient is free of complaints after 4 months without anticoagulant treatment. This rare complication occurred because the collateral arterial supplies to the breast metastasis and the retrograde migration of cement during the vertebroplasty were not recognized. Proper techniques can minimize the risk of arterial embolism caused by cement during the procedure.