Role of MR imaging in cervical nerve root blocks

To examine whether magnetic resonance [MR] imaging findings of the cervical spine can predict pain relief after selective computed tomography [CT]-guided nerve root block. Sixty consecutive patients with cervical radicular pain were examined with MR imaging and then treated with CT-guided cervical nerve root blocks [CNRBs]. Various MR imaging findings were assessed and compared in terms of associated pain relief after CNRB. Pain relief was graded [0%-100%] by using a visual analogue scale [VAS]. The relationship between MR imaging findings and level of pain relief was tested by using Mann-Whitney U and Kruskal-Wallis tests. The mean percentage of pain reduction at VAS grading was 46%. There was a significant relationship between pain relief level and both location of disk herniation [mean pain reductions of 41% at median or mediolateral locations and 64% at foraminal locations, P = .034] and location of nerve root compromise [mean pain reductions of 19% at intraspinal, 45% at foraminal entrance, and 58% at foraminal locations; P = .019]. There was an inverse relationship between pain relief level and absence or presence of spinal canal stenosis [mean pain reductions of 29% when stenosis present and 53% when stenosis absent, P= .013]. Other parameters were not significantly related to pain relief. MR imaging of the cervical spine assists in the appropriate selection of patients suitable for CNRB. Patients with foraminal disk herniation, foraminal nerve root compromise, and no spinal canal stenosis appear to have the greatest pain relief after this procedure

Complementary imaging of breast lesions contribution of mammography, ultrasonography, fine-needle aspiration biopsy, and MR imaging

Breast cancer is the second most common cancer in the women. Fifty patients with suspected breast mass lesion [40 palpable and 10 nonpalpable] were included in this study. Both mammography and MRI [Plain and Contrast enhanced] were performed in every patient. Ultrasonography and galactorgraphy were performed in few patients whenever required. Following this, fine needle aspiration of the breast mass was done and the materials were studied cytopathologically. For nonpalpable lesions sensitivity of mammography and MRI was 65% and 90%, while the specificity was 25% and 50% respectively. For palpable lesions both methods showed high sensitivity [Mammography 90% and MRI 95%] and MRI demonstrated comparatively higher specificity [Mammography 30% and MRI 50%]. In two mammographically negative patients MRI showed positive result. With the complementary use of MRI, it is possible to increase the sensitivity for detection of breast cancer and multicentric disease. In patients in whom the status of a palpable breast mass remains unclear but where strong clinical suspicion exists, MRI may help to reduce the amount of unnecessary biopsies. This study aimed to assess the value of B-mode, nonenhanced and enhanced power Doppler ultrasonography [US], fine-needle aspiration biopsy [FNAB] and magnetic resonance [MR] imaging as adjunctive tools in breast diagnostics