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PurposeIt has been reported that women have higher incidence of Modic changes than men and it may be related to the change of female hormone levels during menopause which leads to osteoporosis and other factors. This paper investigated the relationship between vertebral bone mineral density (BMD) of menopausal female suffering from chronic low pain and lumbar vertebral Modic changes on MRI, to explore the effect of vertebral bone mineral density upon Modic changes.Materials and Methods A total of 205 menopausal women with chronic low back pain were enrolled and underwent vertebral bone mineral density measurement and lumbar MRI examination. The bone mass of vertebral body and bone imaging data were observed. All patients were divided into three groups according to their level of bone mass: group of normal bone mass: 128 cases; osteopenia group: 58 cases; osteoporosis group: 19 cases. The incidence rate of Modic changes was compared among the three groups and the relationship between bone mineral density and vertebral Modic changes was further analyzed.Results Among 205 patients, 128 were with normal bone mass, 44 had Modic changes (type I: 19 cases; type II: 22 cases; type III: 3 cases) and the incidence rate was 34.4%; osteopenia occurred in 58 patients, among whom 34 had Modic changes (type I: 15 cases; type II: 17 cases; type III: 2 cases), which showed that the rate was 58.6%; 19 patients presented osteoporosis, 15 of whom appeared Modic changes (type I: 6 cases, type II: 7 cases;type III: 2 cases), with the rate of 78.9%. There was statistically signiifcant difference in incidence rate of Modic changes among the three groups (χ2=18.995,P0.05).Conclusion Lumbar vertebral bone mineral density is correlated to the incidence of vertebral Modic changes in menopausal women with chronic low back pain. With the loss of vertebral bone mass, the incidence of vertebral Modic changes gradually rise. However, the correlation is rather weak; Modic change is a dynamic process, which is also influenced by other factors except vertebral bone mineral density.
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Objective To evaluate the clinical value of prone flexed posture lumber CT/MRI examination for lumber disc herniation. Methods Supine posture CT/MRI (SPCT/MRI) and prone flexed posture CT/MRI (PFPCT/MRI) examinations were performed on 1200 patients with lumber disc herniation.The imaging findings on SPCT/MRI and PFPCT/MRI of each case were compared. According to the CT/MRI diagnostic criteria for encapsulated lumber disc herniation ( HLDH ), adhered lumber disc herniation (ALDH) and ruptured lumber disc herniation ( RLDH), the 1200 cases were divided into three groups. On the basis of PFPCT/MRI findings, 868 cases were selected for percutaneous lumbar diskectomy (PLD) with half to twelve years follow up. Treatment effects of PLD on HLDH, ALDH and RLDH were analyzed with x2test. Results Among 249 ALDH cases diagnosed by SPCT/MRI 35 were identified as HLDH by PFPCT/MRI. Among 163 RLDH cases diagnosed by SPCT/MRI, 9 HLDH and 17 ALDH were identified by PFPCT/MRI. In 868 cases treated with PLD, the effective rate of HLDH ( n = 832), ALDH ( n = 25 ), RLDH ( n =11 ) were 825/832 (99. 2% ), 13/25, and 1/11 respectively. The effective rate of HLDH is significantly different from that of ALDH and RLDH ( x2 = 369. 69, P ＜ 0. 01 ). Conclusion PFPCT/MRI may change the grouping result of lumber disc herniation made by SPCT/MRI and can be used to objectively select patients for PLD.
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Objective To study the value of diagnosis for internal disc disruption(IDD)with CT discography(CTD).Methods 42 discs of 32 patients showing no disc herniation on CT or MRI,but suffering from chronic low back pain,were undertaken CTD to work out the types of CTD with correlation between contrast medium dosages and the induction of pain.Results CTD demonstrated 4 types of IDD which was individually correlated with the contrast dosages and induced pain.furthermore the dosages for positive and negative disc cases showed significant differece(P
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Objective To study the mechanism of steroid induced necrosis of femoral head. Methods The cell experiment of effect of dexamethasone on the osteoblast in vitro and animal experiment of steroid induced necrosis of femoral head. Results The cell experiment showed that dexamethasone played two roles to bone marrow' mononucleate cells in vitro. The first was that it can prevent the cells from differentiating into the osteoblasts and the second was that it can cause fatty degeneration. The animal experiment showed the number of vacant bony lacunae in femoral head, the average diameter of fat cells in marrow cavity were increased and the number of blood vessles in subchondral areas was decreased with large doses of dexamethasone. Conclusions The mechanism of steroid induced necrosis of femoral head was that dexamethasone can inhibit the grouth of the osteoblasts directely, and cause fatty proliferation of bone marrow resulting in disorder of micro circulation and osteonecrosis in the femoral head.
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Objective To evaluate the clinical efficacy of interventional therapy by direct puncture for the treatment of avascular necrosis of the femoral head. Methods 24 experimental rabbits were undertaken and divided randomly into 3 groups, B, C groups as the models of hormone induced necrosis of femoral head, and A group as the control one. B group was followed up later with interventional therapy by direct puncture. Thromolytic agents, drugs improving microcirculation, and repairing bone tissue were infused directly into the femoral head; and then microscopic observations were conducted to study the pathology. Results The results showed: in group B, the number of vacant bony lacunae in femoral head, the average diameter of fat cells in marrow cavity and the number of blood vessel in subchondral areas showed significant improvement, approaching group A. Conclusions Treatment of femoral head necrosis through interventional method of direct puncture has commenced a solid foundation for clinical therapy.
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Objective To compare MRI wi th CT discography (CTD) for diagnostic assessment of lumbar disc disruption. Methods Paired comparative examination in 16 patients with ch ronic lower back pain without radicular pain and no disc herniation was conducte d using CT or MRI. The standard of CTD classification and positive disc was for mulated and the correlation between the induced lower back pain and dosage used in CTD was observed. Results For a total of 21 discs in the 16 patients, CTD showed the disc as type 2 in 12 discs and type 5 in 1 disc with 13 positive discs, while MRI only showed the high-intensity zone of poster ior annulus in 6 discs as the indirect sign of disc disruption and disc degenera tion in 7 discs. Conclusion CTD was the only method for showing the direct sign of disc disruption. The induced lower back pain was rel ated with the type of disc disruption. MRI can show some of the indirect signs of disc disruption and CTD can show the direct sign of disc disruption.
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Objective To evaluate the clinical application of percutaneous biopsy CT-guided in spine lesions.Methods CT-guided percutaneous biopsy in spine lesions was performed in 53 cases,the final diagnosis was confirmed by operation or following-up. Results The accurate rate was 85 percent for CT -guided percutaneous biopsy in spine lesions without complication.The reason of misdiagnosis was mainly that the biopsied lesions was incorrect. Conclusion The perfect percutaneous needle is the successful key for biopsy in spine lesions, we should coordinate the relationship between imaging diagnosis and percutaneous bone biopsy.
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The dissolution rates of Yiganling Tablets produced by 6 pharmaceutical factories of China and Liganlong Tablets by MAOAUS Factory in German were investigated. As a result, after 30min, the dissolution of all Yiganling is below 30％ and that of Liganlong is 50%. After 120min, the largest dissolution of the former isn't over 43%, and that of the later is about 55％, which indicates that silymarin tablets dissolve more slowly and their bioavailability is lower. The dissolubility can be raised 37, 60 and 27 times, respectively if the silymarin was made into PEG fusion) PVP coprecipitation or ?-CD inclusion compound. The disolution rate (T_(50)) of correspording tablets are 14, 11 and 20min. The largest dissolution after 120min reaches about 80%-103％. There isn't any change observed in the structure of silymarin in solid dispersion when it was identified with UV, IR and TLC. The micropolariscope photograph shows the crystal degree decreased and the dispersity increased.
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Using geometry principle of the spiral CT localization , functional relation was deduced between the bed coordinates and the diagram layers coordinates, i.e.when gantry angle is zero degree, the function relation type is Twm= S190/Cos? + M; Otherwise, it is Twm= S190/Cos? +M. Combined with the actual operation of CT localization, the formula of the CT localization is:Twm=S190/Cos?+M. Finally, the physical meaning and the simplified condition of the formula were discussed.