Magnetic resonance imaging: a valuable method for diagnosing chronic lumbago caused by lumbar muscle strain and monitoring healing process / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Magnetic resonance imaging (MRI) is the most sensitive technique for evaluating the healing process and should be performed before the patients return to their exercise routines. The aim of this research was to diagnose chronic lumbago associated with lumbar muscle strain and to monitor healing process by MRI.</p><p><b>METHODS</b>Sixty-fve symptomatic cases of chronic lumbago caused by lumbar muscle strain were collected from March 2009 to October 2011. MRI was used to examine, diagnose and monitor the healing process. The control group included 65 random cases of asymptomatic volunteers. MRI methods included routine sequences of GRE T1WI, TSE T2WI and special sequences of T2-STIR-FS, combined with DWI. We compared the MRI characteristics of symptomatic cases before and after healing and with asymptomatic controls.</p><p><b>RESULTS</b>The important MRI characteristics of chronic lumbago with lumbar muscle strain included: (1) The low back muscle showed edema. (2) The low back intermuscular spaces showed edema and/or fluid. (3) The low back spaces beside the spinous process showed edema and/or fluid. (4) The low back vertebral articular process fossae or transverse process fossae showed fluid. Of these image characteristics, the intermuscular space edema provided the best diagnostic sensitivity, Se = 83%, with YI = 0.63, p = 74%. The low back muscle edema provided the best diagnostic specificity, Sp = 100%, with YI = 0.66, Π = 83%. And the spaces edema beside the spinous process provided the best diangnostic accuracy, Π = 86%, with YI = 0.71, Se = 80%, Sp = 91%. The diagnosis accurate could be improved by combining multiple MRI characteristics. The diagnostic accuracy could achieve Π = 93%, with YI = 0.86, Se = 100% and Sp = 86% when two characteristics were combined. After rehabilitation care, the edema disappeared on the repeated MRI.</p><p><b>CONCLUSIONS</b>MRI may well be a useful diagnostic method for lumbago with lumbar muscle strain. Combining routine sequences with T2-STIR-FS and DWI sequences could demonstrate the pathological changes of lumbar muscle strain and monitor the healing.</p>

Changes of cranial hemodynamic after trauma by phase-contrast cine MR imaging / 中华神经医学杂志

Objective To evaluate the application of phase-contrast (PC) cine MR imaging in monitoring the changes of cranial hemodynamics after trauma.Methods The 2D PC cine MR imaging was performed on 40 patients with cerebral trauma,admitted to our hospital from September 2010 to December 2010 and considered to have changes of cranial hcmodynamics,and 40 healthy volunteers; and the mean flow velocity,peak systolic velocity and time-averaged mean velocity of cranial segment in the jugular vein,carotid artery and vertebral artery were compared.Results The bilateral mean flow velocity in the jugular vein of patient group was significantly higher than that in the healthy volunteers (P＜0.05); and no significant differences were noted in the peak systolic velocity and time-averaged mean velocity of eranial segment in the jugular vein between the 2 groups (P＞0.05).And no obvious differences in the mean flow velocity,peak systolic velocity and time-averaged mean velocity of cranial segment in the carotid artery and vertebral artery were noted between the 2 groups (P＞0.05).Conclusion The 2D PC cine MR imaging can quantitatively monitor the changes of cranial hemodynamic after trauma in prophase,providing evidence for clinical treatment.