The efficacy of quantitative magnetic resonance imaging in the diagnosis of unstable L4/L5 degenerative spondylolisthesis.

Lumbar degenerative spondylolisthesis (LDS) is a common degenerative disease that particularly affects the elderly. LDS can occur in any segment of the spine but is most commonly found in the L4/L5 segment. In the present study, a quantitative study of lumbar MRI measurements was conducted to identify predisposing factors indicative of spinal instability in patients with L4/L5 LDS. In total, 81 patients [58 patients in the stable group (SG) and 23 patients in the unstable group (UG)] who were diagnosed with L4/L5 LDS on X-ray and MRI between January 2021 and January 2022 were included in this study. Disk height, disk signal intensity on T1-weighted (T1W) and T2-weighted (T2W) images, facet joint fluid thickness, and ligamentum flavum thickness were measured on MRI, and the differences in these parameters between the two groups were evaluated. The receiver operating characteristic curve was generated, and the area under the curve (AUC), cut-off value, sensitivity (Se), specificity (Sp), positive predictive value (PPV), and negative predictive value (NPV) were calculated for parameters found to be significantly different between the two groups. The facet joint fluid was significantly thicker in the UG than in the SG (P<0.01), and a cut-off value of 1.45 mm was found to have an AUC of 0.77 and an SE, SP, PPV, and NPV of 73.9, 67.2, 69.3, and 69.77%, respectively. No significant differences were identified between the two groups for mean disk height, ligamentum flavum thickness, or disk signal intensity on T1W or T2W images. The facet joint fluid thickness on axial T2W images may represent a useful predictor of spinal instability in patients with LDS. Therefore, spinal instability should be assessed, and additional evaluation methods, such as standing lateral flexion-extension radiographs, should be performed when facet fluid is detected on lumbar MRI.

Primary intraperitoneal solitary fibrous tumor in mesentery: How does it present?

Intra-abdominal solitary fibrous tumor (SFT), also known as hemangiopericytoma, is rare, especially for those with a mesenteric location, and only a few cases have been reported. Distinguishing a hemangiopericytoma from other intra-abdominal benign or malignant tumors can be difficult, as they have similar presentations on both computed tomography and magnetic resonance imaging. In the present study, the records for a 31-year-old Vietnamese woman who underwent abdominal surgery for greater omental tumor resection and received histopathological results revealing SFT are retrospectively reviewed. The case is discussed and similar reported cases are reviewed. Due to the aggressive behavior and high rate of postoperative recurrence associated with SFT, a thorough understanding of the radiologic and histopathological features of the disease is necessary to achieve an appropriate diagnosis and treatment.

Gastric rupture following multiple blunt trauma.

Gastric injury due to trauma is a rare complication that occurs in approximately 0.04%-1.2% of all instances of abdominal trauma. When imaging trauma cases, certain areas can be obscured by several inevitable reasons. Despite its rarity, the high mortality rate of a gastric injury requires an early and accurate diagnosis. We present the case of an 18-year-old male who suffered a gastric rupture of the greater curvature following a road traffic collision before providing a brief review of the literature.

A Computed Tomographic Study of Vietnamese C1-C2 Morphology for Atlantoaxial Crew Fixation Techniques.

OBJECTIVES: This study aimed to define variations in radiological C1 and C2 measurements among Vietnamese subjects and to determine the feasibility of implementing C1-2 fixation techniques. MATERIAL AND METHODS: From October 2017 to April 2018, 120 patients underwent thin slide computed tomography (CT) scans of the cervical spine, in our hospital. Various dimensions of the C1 and C2 were analyzed, using axial and sagittal reconstructions of CT images. Differences in characteristics between the two sides and between sexes were investigated, using Student's t-test, with significance at P < 0.05. RESULTS: The mean anteroposterior dimension and the transverse width of the C1 lateral mass were 19.7 ± 2.1 mm and 12.2 ± 1.7 mm, respectively. The mean angles of the screw, directed to the maximal medial, lateral, cranial, and caudal directions, were 36.6 ± 2.8°, 28.2 ± 3.0°, 49.6 ± 4.1°, and 26.4 ± 5.5°, respectively. The average isthmus height, internal height, and pedicle width of the C2 were 5.8 ± 1.0 mm, 4.8 ± 1.3 mm, and 5.0 ± 1.3 mm, respectively. No significant differences were observed for any parameters, between the left and right side of the C1 or C2 or between the two sexes. CONCLUSION: This study revealed that the morphology of the C1 and C2 did not differ between genders in the studied subjects, but morphologic variations exist between Vietnamese subjects and other populations. Pre-operative anatomy evaluations based on CT data are essential be performed for screw placement and trajectory planning to avoid neurovascular complications and to enhance the treatment outcome.

Vietnamese Case Series of Hirayama Disease.

BACKGROUND/AIM: Hirayama disease, a rare neurological disorder, is characterized by progressive, asymmetric muscle atrophy of the forearm and hand in young male patients. CASE REPORT: We noted two cases of Hirayama disease that appeared in the right upper limb and identified the cervical neutral and flexion position magnetic resonance imaging (MRI) characteristics. CONCLUSION: In the flexion posture, the cervical MRI allows early diagnosis of Hirayama disease and should be considered in patients with the typical clinical symptoms.

Value of Diffusion Weighted MRI with Quantitative ADC Map in Diagnosis of Malignant Thyroid Disease.

Thyroid nodule is a common disease in clinical practice. The diagnosis of malignant thyroid tumors determines the treatment strategy. Among a number of methods have claimed to help evaluating thyroid nodules, ultrasound is a usable one in spite of several disadvantages (dependent on the physician/technician, incomparable, etc.) and magnetic resonance imaging (MRI) accompanied by quantitative apparent diffusion coefficient (ADC) is a promising diagnostic tool. This study was designed to investigate the usefulness of ADC cut-off values and the protocol of thyroid MRI derived from quantitative diffusion weighted imaging (DWI) in differentiating benign and malignant thyroid nodules. The study was conducted on 93 patients with 128 thyroid nodules, diagnosed and underwent surgery at Hanoi Medical University Hospital. All the patients took thyroid MRI with different b levels (from 200 to 800). ADC value was calculated to each b level, and the statistical tests were conducted with the Statistical Package for Social Sciences (SPSS-Windows and Mac version 20) and STATA 12. The mean ADC with all the b ranging from 200 to 800 of malignant groups was significantly higher than the group of benign lesions (p from <0.001 to 0.01). We chose b = 500 as a standard b-value in the protocol of thyroid MRI. The ADC cut-off point for distinguishing malignant from benign thyroid lesions: 1.7 × 10-3 mm2/s with high accuracy (87.1%, 95% CI: 79.59-92.07%). The study revealed that quantitative diffusion weighted MRI with ADC measurement could potentially quantitatively differentiate between benign and malignant thyroid nodules.