Using imaging to diagnose lipomatous ganglioneuroma: a case report and literature review.

We report a case of a well-defined lesion in an asymptomatic patient with lipomatous ganglioneuroma (LG) located close to the left thoracic spine. Its intensity was heterogeneous with adipocytes. The lesion extended into the spinal canal through the enlarged left intervertebral without bony erosion. The imaging, clinical, and pathological features of the tumor are analyzed. Contrast-enhanced magnetic resonance imaging (MRI) revealed that the lesion was moderate enhanced. 18-F-fluoro-2-deoxyglucose-positron emission tomography/computed tomography (18FDG-PET/CT) demonstrated high 18-F-fluoro-2-deoxyglucose (18FDG) uptake of the tumor lesion. The finial preoperative diagnosis from our radiologists was that the tumor may be a liposarcoma or neurogenic tumor, but pathology showed that this was incorrect. Some related literatures were reviewed for reference to summarize imaging characteristics of this disease and to assist radiologists in making more accurate diagnoses. All of the lesions had adipocytes in reviewed literature, and the fat-suppressed images showed that there was some low signal intensity within the lesions, some lesions had widened neural foramina and extended into the spinal canal, and some lesion had calcifications. LG is an extremely rare variant of ganglioneuroma. Using the correct measurement of the CT value, applying MRI for fat-suppressed images, using in phase, out phase and contrast-enhanced sequences, using FDG-PET/CT, mastering LG imaging diagnostics characteristics, and combining all of this with clinical, morphological characteristics and pathology results can help clinical workers decrease the misdiagnosis rate of LG.

Genetic polymorphism of the estrogen receptor alpha gene and susceptibility to osteoarthritis: evidence based on 15,022 subjects.

OBJECTIVE: Several lines of evidence suggest that estrogen receptor alpha (ER-α) gene polymorphism may influence the development of osteoarthritis (OA). However, the results are inconsistent. The aim of this study was to explore using a meta-analysis whether rs2234693 (ER-α PvuII T/C) polymorphism confers significant susceptibility to OA. METHODS AND RESULTS: A systematic search of all relevant studies published through 17 August 2014 was conducted using the PubMed, Web of Science, Embase, Cochrane database, Current Controlled Trials, Clinicaltrials.gov, Chinese Clinical Trial Registry, CBMdisc, CNKI and Google Scholar. All statistical analyses were done with Review Manager 5.1.4. Twelve articles involving 15 studies were included in the final meta-analysis, which contained 6417 OA cases and 8605 controls. Overall, no significant association was found between the rs2234693 polymorphism and OA risk when all studies were pooled into the meta-analysis (for C allele vs. T allele: OR = 0.99, 95% CI = 0.94-1.04, p = 0.63; for C/C vs. T/T: OR = 0.97, 95% CI = 0.87-1.08, p = 0.53; for C/C vs. T/C + T/T: OR = 0.96, 95% CI = 0.88-1.06, p = 0.43; for C/C + T/C vs. T/T: OR = 1.00, 95% CI = 0.89-1.14, p = 0.94). In the subgroup analysis, significant association was found between the rs2234693 polymorphism and the OA risk in the knee osteoarthritis (KOA) group (for C/C + T/C vs. T/T: OR = 1.15, 95% CI = 1.02-1.29, p = 0.02). CONCLUSIONS: The present meta-analysis suggests that the rs2234693 polymorphism is associated with an increased KOA risk. Additional well designed genome-wide association studies are required to confirm the result.

[Correlation studies between MRI and the symptom scores of patients with LDH before and after manipulative therapy].

OBJECTIVE: To study the correlation between the MRI and some symptom scores of the patients with lumbar disc herniation (LDH), such as VAS (visual analogue scale), JOA (Japanese orthopedic association scale),and SLR (straight leg raising test) before and after manipulative therapy. METHODS: From June to December in 2007, 70 patients with LDH were selected in the study. Among the patients, 40 patients were male and 30 patients were female, ranging in age from 21 to 56 years (averaged 39 years). MRI was used to measure the size and position of the protruded nucleus pulposus (size of disc protrution, the angle between nerve root canal and disc protrution). Correlation study was conducted between the MRI and VAS, JOA, and SLR before and after therapy. The correlation between the changes of MRI and that of the quantified clinical indexes of LDH patients was also analyzed. RESULTS: There were significant differences before and after therapy in some quantified indexes for the clinical manifestation of the patients, such as VAS, JOA,and SLR. There were no significant changes in the shape and size of protrude nucleus pulposus after 20 days' therapy by CT or MR recheck. Correlation study between the quantified indexes of clinical manifestation (JOA) and MRI before and after the treatment showed that there was no significant correlation. CONCLUSION: The study proves again that the shape and size of protrude nucleus pulposus has no paralleled relation with the patient's clinical manifestation,which is demonstrated by the recheck of MRI after a successful spinal manipulative treatment in the study.