Iterative reconstruction combined with low dose CT in diagnosis of lumbar intervertebral disc hernia / 中国医学影像技术

Objective To explore the value of iteration algorithm (AIDR 3D) and filter-back projection (FBP) combined with CT low dose scanning in evaluation of lumbar intervertebral disc hernia.Methods Totally 150 patients with lumbar degenerative osteoarthropathy were randomly divided into A＞E groups,with 30 cases in each group.Scanning parameters of A＞D groups were 120 kV of tube voltage,and 100 mAs,50 mAs,30 mAs,as well as 20 mAs of tube current.While parameters of group E were 80 kV of tube voltage and 100 mAs of tube current.Each group was reconstructed with FBP and AIDR 3D,respectively,and their noises,SNRs and CNRs of groups were compared.And 3-point evaluation method was used to score the imaging,while score ≥2 were acceptable image quantity for clinical imaging.Results Under different radiation doses,AIDR 3D reconstruction images were superior to FBP in noise,SNR,CNR and display of intervertebral disc hernia.Under the same reconstruction technology,with the reduction of dose,noise increased,SNR and display of intervertebral disc hernia decreased.Except for slightly lower in AIDR 3D reconstruction with 50 mAs than that with 30 mAs,CNR decreased with the reduction of dose.Two reconstruction technologies under the same dose,image quality of reducing the tube current were better than that of lowering the tube voltage.Conclusion It is valuable of AIDR 3D combined with CT low dose scanning in evaluation on lumbar intervertebral disc hernia.

Clinical investigation of complaint of chronic gluteal pain / 中国基层医药

Objective To investigate the pathogenesis of chronic gluteal pain.Methods 79 cases with chronic gluteal pain were provided in series of strict clinical examination to make sure their final diagnosis.Results 67 cases were identified with lumbar disc herniation,7 cases were of sacroiliac joint disease,2 cases of L5 isthmic spondyloisthesis,2 eases of avaseular necrosis of the femoral head,1 case of compressive fracture of thoracolumbar re- gion.Meantime 2 other concealed factors ought to be noted:ankylosing spondylitis and 12th intercostals neuritis. Conclusion Most cases of chronic gluteal pain were resulted from lumbar disc herniation,next from sacroiliac joint disturbances and probably a few cases from hip ioint disease.

Further knowledge on Schmorl′s node formation:a case report / 第二军医大学学报

Objective:To further study the pathogenesis of classic Schm orl′s nodes based on clinical practice.Methods:A patient with severe low back pain was found that the irregularity of the endplates and the presence of Schm orl′s nodes in L2 - 3 and L3- 4spaces in lumbar radiographs.Two painful intervertebral discs with Schm orl′s nodes in their superior or inferior endplates were identified by discography and pain provocation.Two foci of Schnorl′s nodes were rem oved in en bloc via a retroperitoneal approach for histological examination.Meanwhile,anterior intervetebral body fusion of painful discs were undertaken.Results:The radiographic manifestation of Schmorl′s nodes was the end- plate indentation.Schmorl′s nodes in CT scan was shown as a round- like or multicystic irregular zone of bone density with an indistinct sclerotic margin beneath the cartilaginous endplate,which was sim ilar to the typical CT changes of osteonecrosis.The histological examinations of en bloc slices of Schm orl′s nodes revealed subchondral osteonecrosis.Conclusion:The current study indicate classic Schm orl′s node shown in radiograph is osteonecrosis zone beneath cartilaginous endplate,suggesting the necessity of further study on Schmorl′s node form ation. [