• Title/Summary/Keyword: Lumbar images

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Determination of Adequate Entry Angle of Lumbar Sympathetic Ganglion Block in Korean

  • Kim, Won-Ho;Kim, Sang-Kwon;Lee, Chul-Joong;Kim, Tae-Hyeong;Sim, Woo-Seok
    • The Korean Journal of Pain
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    • v.23 no.1
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    • pp.11-17
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    • 2010
  • Background: The target of lumbar sympathetic ganglion block is the anterolateral surface of the L2, 3 and 4 vertebral bodies, where the lumbar sympathetic ganglion usually lies. In most cases, a block-needle is inserted approximately 5-8 cm lateral to spinous process on the skin and directed to the anterolateral surface of vertebral body obliquely. The purpose of this study is to determine the safe entry angle and entry point in Korean by using the abdominal CT scan images. Methods: The abdominal CT images of eighty five patients were recruited to this study. The minimal angle aimed at the lumbar sympathetic ganglion that can pass through the lateral aspect of body and maximal angle that avoids puncturing the kidney, ureter or retroperitoneal space were measured. The distance from midline to skin entry point was also measured. Results: There was no significant difference in entry angle among L2, 3, and 4 level. The entry angle was similar in the right and left side, and in males and females. The entry angle of old age group was significantly smaller than that of young age group. The calculated safe entry angle was $30.5{\pm}0.4^{\circ}$ and entry point was $7.7{\pm}0.2\;cm$ and $6.7{\pm}0.1\;cm$ lateral from midline in males and females respectively. Conclusions: These measurements can be used as a reference for lumbar sympathetic ganglion block and radiofrequency lesioning. Prior to performing the lumbar sympathetic ganglion block for cancer patients, the abdominal CT scan should be reviewed to prevent complications.

Discal Cyst of the Lumbar Spine

  • Hwang, Jae-Ha;Park, In-Sung;Kang, Dong-Ho;Jung, Jin-Myung
    • Journal of Korean Neurosurgical Society
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    • v.44 no.4
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    • pp.262-264
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    • 2008
  • Discal cysts are rare lesions that can cause radiating leg pain. Because they are very rare, their natural history and the details of the therapeutic guidelines for the treatment of these cysts are still unknown. A 30-year-old male patient presented to our institute with radiating pain in his left leg and mild back pain. Magnetic resonance imaging (MRI) revealed an intraspinal extradural cystic mass with low signal intensity on T1-weighted images and high signal intensity on T2-weighted images at the L5-S1 level. The partial hemilaminectomy and cyst resection were performed. We report a patient with low back pain and radiating leg pain caused by a lumbar discal cyst and discuss the treatment of this cyst.

Ultrasound-guided Intervention in Lumbar Spine (요추부 초음파 유도하 중재술)

  • Moon, Sang Ho
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • v.6 no.2
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    • pp.81-93
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    • 2013
  • This review was described to investigate the feasibility of using ultrasound as an image tool for interventions of lumbar spine. This article will first provide an overview of lumbosacral spine surface anatomy and sonoanatomy. A detailed understanding of anatomy is critical for interpretation of ultrasound and procedural performance at spine. Fluoroscopy is most commonly used in interventional spine procedures, but radiation exposure is the major concern when obtaining fluoroscopic images. Ultrasound is radiation-free, is easy to use, and can provide real-time images with high accuracy. Also this device can be used in virtually any clinical setting. Ultrasound guidance offers a reliable alternative to fluoroscopy or computed tomography for lumbar interventions and can be safely performed without radiation exposure.

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Magnetic Resonance Imaging Follow-up Study on Two Cases of Lumbar intervertebral Disc Sequestration Patients Treated with Oriental Medicine Treatment (한방 요법으로 호전된 부골화된 요추 추간판 탈출증 환자에서의 영상의학적 변화)

  • Lee, Ki-Su;Hong, Kwon-Eui
    • Journal of Pharmacopuncture
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    • v.14 no.3
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    • pp.99-107
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    • 2011
  • Objectives : The purpose of this study is to report the image changes of two cases of Lumbar intervertebral Disc Sequestration after oriental medical treatment. Methods : We examined 2 patients with Lumbar intervertebral Disc Sequestration who showed changes on MRI images before/after the treatment. And we assessed clinical symptoms by using numeric rating scale(NRS) and straight leg raising test(SLRT). Results & Conclusions : In this study, the first MRI examination of Lumbar intervertebral Disc Sequestration patients was performed at the first visit and re-examination of MRI was done after treatment. In each case, the size of the disc sequestration was considerably reduced in MRI image. And both patients represented effective improvment in NRS score and SLRT test angle.

Spine Computed Tomography to Magnetic Resonance Image Synthesis Using Generative Adversarial Networks : A Preliminary Study

  • Lee, Jung Hwan;Han, In Ho;Kim, Dong Hwan;Yu, Seunghan;Lee, In Sook;Song, You Seon;Joo, Seongsu;Jin, Cheng-Bin;Kim, Hakil
    • Journal of Korean Neurosurgical Society
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    • v.63 no.3
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    • pp.386-396
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    • 2020
  • Objective : To generate synthetic spine magnetic resonance (MR) images from spine computed tomography (CT) using generative adversarial networks (GANs), as well as to determine the similarities between synthesized and real MR images. Methods : GANs were trained to transform spine CT image slices into spine magnetic resonance T2 weighted (MRT2) axial image slices by combining adversarial loss and voxel-wise loss. Experiments were performed using 280 pairs of lumbar spine CT scans and MRT2 images. The MRT2 images were then synthesized from 15 other spine CT scans. To evaluate whether the synthetic MR images were realistic, two radiologists, two spine surgeons, and two residents blindly classified the real and synthetic MRT2 images. Two experienced radiologists then evaluated the similarities between subdivisions of the real and synthetic MRT2 images. Quantitative analysis of the synthetic MRT2 images was performed using the mean absolute error (MAE) and peak signal-to-noise ratio (PSNR). Results : The mean overall similarity of the synthetic MRT2 images evaluated by radiologists was 80.2%. In the blind classification of the real MRT2 images, the failure rate ranged from 0% to 40%. The MAE value of each image ranged from 13.75 to 34.24 pixels (mean, 21.19 pixels), and the PSNR of each image ranged from 61.96 to 68.16 dB (mean, 64.92 dB). Conclusion : This was the first study to apply GANs to synthesize spine MR images from CT images. Despite the small dataset of 280 pairs, the synthetic MR images were relatively well implemented. Synthesis of medical images using GANs is a new paradigm of artificial intelligence application in medical imaging. We expect that synthesis of MR images from spine CT images using GANs will improve the diagnostic usefulness of CT. To better inform the clinical applications of this technique, further studies are needed involving a large dataset, a variety of pathologies, and other MR sequence of the lumbar spine.

Spinal Lymphoma in a Cat (고양이에서 척수림프종의 발생례)

  • 권오경;홍성혁
    • Journal of Veterinary Clinics
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    • v.17 no.1
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    • pp.279-284
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    • 2000
  • A 3.5kg, 3-year-old castrated male Japanese domestic cat withpelvic limb ataxia and dysuria was referred to the Veterinary Medical Center of the Tokyo University. On the neurologic examination findings, both pelivic had a LMN paresis. The cat was FeLV positive and FIV negative. Radiographic findings did not identify the spinal lesions. In magnetic resonance images(MRI) of the lumbar spinal cord, the cat had the lesions in the lumbar(L) 1 and L3, characterized by hyperintensity on a transverse T2-weighted and T1-weighted images, and contrast enhancement was evident. The mass removed by dorsal laminectomy. Histopathological examination of the mass revealed spinal lymphoma. Three weeks after the surgery, the cat administered chemotherapy protocol for lymphoma by current protocol. Two weeks after chemotherapy, the cat had a metastasis to bone marrow and died.

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Finite Element Analysis of Lumbar Spine under Surgical Condition (척추 수술시 요추의 유한요소해석)

  • Kim D. H.;Cho S. H.;Jang D. P.;Hwang W;Chung W. K;Oh S. H.;Kim Y. S.
    • Proceedings of the Korean Society For Composite Materials Conference
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    • 2004.04a
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    • pp.210-213
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    • 2004
  • We study the fracture behavior of the lumbar No.4 and No.5 vertebra subjected to posteroanterior (PA) forces, a three dimensional finite element method (FEM). The lumbar spine was modeled 3-dimensionally using commercial software based on the principle of convert stacked two dimensional CT scan images into three dimensional shapes. Determination of the boundary conditions corresponding to actual surgical conditions was not easy, so that the simplified spine beam analyses were performed. The results were used in three dimensional finite element (FE) analysis. This FE analysis, indicates that the fracture loads of the lumbar No.4 and No.5 vertebra are respectively 1550 N and 1500 N. These fracture loads are for static loading, but in actual conditions the load on the lumbar spine varies dynamically. We found that the fracture load of lumbar No.4 vertebra is larger than that of lumbar No.5 vertebra, as a result of the total stress difference by the moment.

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Effects of Therapeutic Exercise on Pain, Physical Function, and Magnetic Resonance Imaging Findings in a Patient with Multilevel Lumbar Disc Herniation: A Case Report

  • Kim, Ahram;Lee, Hoseong
    • Journal of International Academy of Physical Therapy Research
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    • v.10 no.1
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    • pp.1725-1733
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    • 2019
  • Background: In some clinical guidelines followed in clinical practice, nonsurgical treatments are recommended as the primary intervention for patients with lumbar disc herniation (LDH). However, the effect of a therapeutic exercise program based on stabilization of the lumbar spine for treatment of multilevel LDH has not been evaluated thoroughly. Objective: To investigate the effects of therapeutic exercise on pain, physical function, and magnetic resonance imaging (MRI) findings in a patient with multilevel LDH. Design: Case Report Methods: A 43-year-old female presented with low back pain, radicular pain and multilevel LDH (L3-L4, L4-L5, L5-S1). The therapeutic exercise program was conducted. in 40-min sessions, three times a week, for 12 weeks. Low back and radicular pain, lumbar disability, and physical function were measured before and after 6 and 12 weeks of the exercise program. MRI was performed before and after 12 weeks of the program. Results: After 6 and 12 weeks of the therapeutic exercise, low back and radicular pain and lumbar disability had decreased, and lumbar range of motion (ROM) was improved bilaterally, compared with the initial values. Also improved at 6 and 12 weeks were isometric lumbar strength and endurance, and the functional movement screen score. The size of disc herniations was decreased on MRI obtained after 12 weeks of therapeutic exercise than on the pre-exercise images. Conclusions: We observed that therapeutic exercise program improved spinal ROM, muscle strength, functional capacity, and size of disc herniation in LDH patient.

The Value of Additional Cervicothoracic Spine Sagittal T2-weighted Images Included in Routine Lumbar Spine MR Imaging (요추 MR영상에 포함된 경흉추 시상T2강조영상의 효용성 평가)

  • Seo, Jiwoon;Park, So Young;Lee, Joon Woo;Lee, Guen Young;Kang, Heung Sik
    • Investigative Magnetic Resonance Imaging
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    • v.17 no.2
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    • pp.91-100
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    • 2013
  • Purpose : To evaluate the usefulness of cervicothoracic spine sagittal T2-weighted images (CT SAG T2WIs) included in routine lumbar spine MRI. Materials and Methods: Institutional review board approval was obtained and informed consents were waived for this retrospective study. The study group comprised 2,113 patients who underwent lumbar spine MRI from January 2005 to December 2005. CT SAG T2WIs were added in the routine lumbar spine MRIs. Radiologic reports were reviewed retrospectively for pathologic lesions on CT SAG T2WIs by one radiologist. Information of additional cervical or thoracic spine MRI and/or CT for further evaluation of positive findings on CT SAG T2WIs and their treatment were collected by retrospectively reviewing medical records. Results: The CT SAG T2WIs revealed 142 pathologic lesions in 139 (6.58%) of the 2,113 patients. They were easily obtained without positional change in a scan time of less than 2 minutes. Additional cervical or thoracic spine MRI and/or CT for positive findings on CT SAG T2WIs were performed in 13 patients. Seven patients underwent surgical treatment. Conclusion: CT SAG T2WIs included in routine lumbar spine MRI were useful in finding the pathologic lesions in cervicothoracic spine for the patients who assumed to have lesions in lumbar spine.

A Study of Radiographic Methods to X-ray Study of Patients with Spinal Scoliosis and Vertebrae Bone Fracture of Lumbar Spine (척주측만증과 허리뼈 골절 수술 환자의 엑스선 촬영법 연구)

  • Ahn, Byung-Ju;Lee, Jun-Haeng
    • Journal of the Korean Society of Radiology
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    • v.13 no.3
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    • pp.425-431
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    • 2019
  • The Study In order to obtain images of overlap of the two iron cores in the spinal cord simple x-ray scan after surgery of patients with ulcer lateral sclerosis and a fractured backbone, the researcher conducted a subjective evaluation on five radiographers of the university hospital's imaging department for more than 10 years. The results of the experiment showed that the lateral shot of lateral scoliosis of the spinal cord was taken with the middle face of the IR plane, and then the X-ray tube angle was taken vertically with the vertical spinal column fan-tom position, resulting in two overlapping images and high scores in the subjective evaluation. In addition, lateral shots of the lumbar dislocation fractured lumbar vertebrae were taken with the forehead aligned with the center of the IR plane and then with the X-ray angle perpendicular to the fourth waistline and the angle of the spinal cord perpendicular to the fourth waistline, the image of the two iron cores could be obtained from the radiographer.