Sequential changes of traumatic vertebral compression fracture on MR imaging

The purpose of this study was to evaluate the sequential signal intensity changes in post-traumatic vertebral compression fractures of varying ages. Sixty-six patients with 115 post-traumatic vertebral compression fractures underwent MR imaging. The ages of fractures at the time of MR images ranged from 1 day to 6 years. Sequential follow-up MR imagings were obtained in 4 patients for 2 years after initial MR examination. The fracture sites in all 52 fractures with traumatic events less than 3 months prior were hypointense on T1-weighted images and hyperintense on T2-weighted images (type I). A type I fracture could be subdivided into 3 patterns depending on its morphologic appearance: diffuse (type Ia); patchy (type Ib); and bandlike (type Ic). In 12 fractures of 3 to 5 months after trauma, six showed focal hypointensity (type II) in all pulse sequences, and six showed isointensity (type IV). Four of 51 fractures with trauma over 5 months showed focal hyperintensity on T1-weighted images and isointensity on T2-weighted images (type III); and the remaining 47 fractures showed isointensity on all sequences (type IV). In conclusion, MR imaging is useful in predicting the age of known traumatic compression fractures, so familiarity with these sequential MR findings would be helpful in distinguishing benign from malignant fractures.

Clinical Report of 46 Intracranial Tumors with LINAC Based Stereotactic Radiosurgery / 대한치료방사선과학회지

Between July 1988 and December 1992, we treated 45 patients who had deep seated inoperable or residual and/or recurrent intracranial tumors using LINAC based stereotactic radiosurgery at the Department of Therapeutic Radiology, Kangnam St. Mary's Hospital, Catholic University Medical College. Treated intracranial tumors included pituitary tumors(n=15), acoustic neurinomas(n=8), meningiomas(n=7), gliomas(n=6), craniopharyngiomas(n=4), pinealomas(n=3), hemangioblastomas(n=2), and solitary metastatic tumor from lung cancer (n=1). The dimension of treatment field varied from 0.23 to 42.88 cm3(mean ; 7.26 cm3). The maximum tumor doses ranging from 5 to 35.5 Gy (mean; 29.9 Gy) were given, and depended on patients' age, target volume, location of lesion and previous history of irradiation. There were 22 male and 23 female patients. The age was varied from 5 to 74 years of age(a median age; 43 years). The mean duration of follow-up was 35 months (2~55 months). To date, 18(35.1%) of 46 intracranial tumors treated with SRS showed absent or decrease of the tumor by serial follow-up CT and/or MRI and 16(34.8%) were stationary, e.g. growth arrest. From the view point of the clinical aspects, 34(73.9%) of 46 tumors were considered improved status, that is, alive with no evidence of active tumor and 8(17.4%) of them were stable, alive with disease but no deterioration as compared with before SRS. Although there showed slight increase of the tumor in size according to follow-up imagings of 4 cases(pituitary tumor 1, acoustic neurinomas 2, pinealoma 1), they still represented clinically stable status. Clinically, two(4.4%) patients who were anaplastic astrocytoma(n=1) and metastatic brain tumor(n=1) were worsened following SRS treatment. So far, no serious complications were found after treatment. The minor degree headache which could be relieved by steroid or analgesics and transient focal hair loss were observed in a few cases. There should be meticulous long term follow-up in all cases.