Multiparametric MRI of Epiphyseal Cartilage Necrosis (Osteochondrosis) with Histological Validation in a Goat Model

Purpose

To evaluate multiple MRI parameters in a surgical model of osteochondrosis (OC) in goats.

Methods

Focal ischemic lesions of two different sizes were induced in the epiphyseal cartilage of the medial femoral condyles of goats at 4 days of age by surgical transection of cartilage canal blood vessels. Goats were euthanized and specimens harvested 3, 4, 5, 6, 9 and 10 weeks post-op. Ex vivo MRI scans were conducted at 9.4 Tesla for mapping the T₁, T₂, T_1ρ, adiabatic T_1ρ and T_RAFF relaxation times of articular cartilage, unaffected epiphyseal cartilage, and epiphyseal cartilage within the area of the induced lesion. After MRI scans, safranin O staining was conducted to validate areas of ischemic necrosis induced in the medial femoral condyles of six goats, and to allow comparison of MRI findings with the semi-quantitative proteoglycan assessment in corresponding safranin O-stained histological sections.

Results

All relaxation time constants differentiated normal epiphyseal cartilage from lesions of ischemic cartilage necrosis, and the histological staining results confirmed the proteoglycan (PG) loss in the areas of ischemia. In the scanned specimens, all of the measured relaxation time constants were higher in the articular than in the normal epiphyseal cartilage, consistently allowing differentiation between these two tissues.

Conclusions

Multiparametric MRI provided a sensitive approach to discriminate between necrotic and viable epiphyseal cartilage and between articular and epiphyseal cartilage, which may be useful for diagnosing and monitoring OC lesions and, potentially, for assessing effectiveness of treatment interventions.     

Muscle tissue changes in vertebrogenic myofascial syndromes

Asymmetrical electrical activity of paired deep segmentary (short) muscles of the back at the level of a vertebra rotation subluxation was found in 50 patients with early neurological thoracic column osteochondrosis (recorded with point electrodes). The proposed experimental simulation of spinal column osteochondrosis (rotation subluxation of the second thoracic vertebra in rabbit) establishes the presence of persistent tonic activity of the deep short paired back muscles at the level of the subluxation and exposes the dynamics of ultrastructural change in the muscle group. Persistent excitation irritation in that segment of the spinal cord and disorganization of deep short back muscle function are associated with over-stretching of richly innervated soft tissues of the same dislocating segment.Scientific-Research Laboratory Center, A. A. Bogomolets Medical Institute, Ukrainian Public Health Ministry, Kiev. Translated from Neirofiziologiya, Vol. 24, No. 3, pp. 298–306, May–June, 1992.     

Differences between horse selection based on two forms of osteochondrosis in fetlock

Horses lose potential opportunities because of health problems. Available breeding strategies are not effective enough, probably also because of the different definition used and its genetic usefulness. The aim of the study was to compare the genetic background estimated by the genome-wide association study (GWAS) for osteochondrosis using two different scaling osteochondrosis (OC)/healthy and osteochondrosis dissecans (OCD)/healthy systems for evaluating the disease status of investigated fetlock joints. Two hundred one Warmblood horses trained for performance tests (87 stallions and 114 mares) were phenotyped and genotyped. Four fetlock x-ray images per horse were collected using the RTG Girth HF 80 and Vet Scan ray 3600. The DNA of each horse was genotyped using the BeadChip 70K. To identify SNPs that significantly affect the probability of osteochondrosis, two different methods were applied: the Cochran-Armitage test based on an additive mode of inheritance and logistic regression. The genetic background for osteochondrosis, expressed in the number of SNPs found with significant associations with osteochondrosis, was higher by evaluation in the scale of OCD/healthy horses (16 SNPs on several chromosomes mainly on the ECA1 and ECA10) than OC/healthy (2 SNPs on the ECA15 and one SNP on the ECA10). Detailed definition of osteochondrosis is needed in breeding and in veterinary practice. The genetic background for osteochondrosis and osteochondrosis dissecans seems not the same. Suggestive SNPs could be the candidate markers for osteochondrosis but should be checked on a larger population before usage.     

Lipomas as an Extremely Rare Cause for Brachial Plexus Compression: A Case Series and Systematic Review

Introduction  Brachial plexus lipomas are extremely rare benign tumors that may cause slow progression of neurological deficits leading to thoracic outlet syndrome. Up to now, surgery remains challenging. The aim of this study is to present our surgical treatment regime and long-term neurological outcome in three cases of giant brachial plexus lipomas and to show results of systematic review. Patients and Methods  Retrospective analysis of our database “peripheral nerve lesion” to identify patients suffering from brachial plexus lipomas between January 1, 2012, and December 31, 2019. Systematic review was performed for literature published until March 31, 2020, analyzing PubMed, Google Scholar, Scopus, and the Cochrane Collaboration Library independently by two authors. Results  Over the past years, three patients suffering from giant brachial plexus lipomas attended to our neurosurgical department. All patients underwent preoperative magnetic resonance imaging (MRI), ultrasound examinations, and electrophysiological testing. Tumors were removed microsurgically via anterior/posterior, supraclavicular/infraclavicular, and combined approaches. The patients were accessed postoperatively by MRI and clinical follow-up. Systematic review of the literature revealed 22 cases, which were analyzed in regard to demographics, surgical treatment, and neurological outcome. Conclusion  Brachial plexus lipomas are an extremely rare cause for brachial plexus compression. Total microsurgical removal with intraoperative electrophysiological monitoring is the treatment of choice with excellent long-term MRI and clinical outcome.     

Atypical vertebral hemangioma: an aggressive form of a benign disease. Case Report and Literature Review

Vertebral hemangiomas are an incidental and relatively common radiological finding and a benign tumor of vascular origin. VH are the most common spine tumors with an estimated incidence of 1.9-27% in the general population. Rarely, vertebral hemangiomas can exhibit extraosseous expansion with resulting compression of the spinal cord. Such lesions are termed aggressive or atypical vertebral hemangiomas (AVH) and account for less than 1% of spinal hemangiomas. A 68-year-old female was referred with progressive walking difficulty and sensory disturbances in her lower extremities. MRI imaging of the thoracic spine revealed a T1- and T2-weighted hyperintense lesion involving the T10 vertebra. Additionally, there was extraosseous extension of the tumor into the spinal canal, located both anterior and posterior to the spinal cord, causing severe spinal cord compression. A combined endovascular and surgical approach (arterial coil embolization and en bloc resection) for treatment was decided. Although vertebral hemangiomas are an incidental and relatively common radiological finding, the findings of our case were consistent with an aggressive hemangioma with atypical MRI and clinical prognostic characteristics. In summary, the present case highlights the need for multidisciplinary approach and in-depth knowledge of this rare pathologic entity.     

Mapping quantitative trait loci for principal components of bone measurements and osteochondrosis scores in a wild boar x large white intercross

Data on osteochondrosis and femur dimensions from 195 F2 pigs from a wild boar x Large White intercross were analysed with the aim of detecting quantitative trait loci (QTLs) for normal and disturbed bone formation. The information from numerous recorded traits was summarized by principal component analysis and analysed by least-squares interval mapping. An increase in the proportion of wild boar alleles across the genome increased length versus width of femur and reduced the prevalence of osteochondrosis. The presence of QTLs with an impact on femur dimensions was indicated on chromosomes 2, 4, 16 and 17 and on osteochondrosis on chromosomes 5, 13 and 15. A substantial effect of the chromosome 5 QTL calls for further studies within commercial populations to evaluate whether marker-assisted selection could be used to reduce the prevalence of osteochondrosis.     

基于磁共振多b值弥散加权成像对严重胸外伤预后的预测

目的:探讨基于磁共振(Magnetic Resonance Imaging,MRI)多b值弥散加权成像(Diffusion Weighted Imaging,DWI)对严重胸外伤预后的预测价值.方法:2018年2月-2020年6月选择在本院诊治的严重胸外伤患者76例(开放性损伤38例,闭合性损伤38例),所有患者都给予...     

儿童胸腔内巨大肿瘤12例分析

目的:总结儿童胸腔内巨大肿瘤的临床特点与外科治疗方式。方法:回顾性分析12例儿童胸腔内巨大肿瘤患儿的临床、病理学资料,外科处理过程,并对治疗效果进行随访。结果:4例前纵隔肿瘤中2例为梭形细胞瘤,另2例来源于胸腺,分别为良性畸胎瘤和恶性神经鞘瘤,肿瘤均被完整切除;5例后纵隔肿瘤均作肿块切除,最终病理结果4例为神经母细胞瘤,1例为神经节细胞瘤;2例术前诊断为肺肿瘤的患者中,1例作了右全肺切除,1例作右肺中下叶切除,病理报告均为胸膜肺母细胞瘤;1例术前诊断为胸腔内巨大肿块患儿行肿块切除后病理报告为间叶性软骨肉瘤。结论:手术指征、手术径路的把握及术后管理决定了胸腔内巨大肿瘤患儿的治疗效果。     

Soft Tissue Artefacts of the Human Back: Comparison of the Sagittal Curvature of the Spine Measured Using Skin Markers and an Open Upright MRI

Soft tissue artefact affects the determination of skeletal kinematics. Thus, it is important to know the accuracy and limitations of kinematic parameters determined and modelled based on skin marker data. Here, the curvature angles, as well as the rotations of the lumbar and thoracic segments, of seven healthy subjects were determined in the sagittal plane using a skin marker set and compared to measurements taken in an open upright MRI scanner in order to understand the influence of soft tissue artefact at the back. The mean STA in the flexed compared to the extended positions were 10.2±6.1 mm (lumbar)/9.3±4.2 mm (thoracic) and 10.7±4.8 mm (lumbar)/9.2±4.9 mm (thoracic) respectively. A linear regression of the lumbar and thoracic curvatures between the marker-based measurements and MRI-based measurements resulted in coefficients of determination, R², of 0.552 and 0.385 respectively. Skin marker measurements therefore allow for the assessment of changes in the lumbar and thoracic curvature angles, but the absolute values suffer from uncertainty. Nevertheless, this marker set appears to be suitable for quantifying lumbar and thoracic spinal changes between quasi-static whole body postural changes.     

Current issues in x-ray diagnosis of cervical osteochondrosis in the course of medical rehabilitation

The results of studying 500 patients with neurological manifestations of cervical osteochondrosis are presented. All the patients underwent in the vertical position X-ray studies in the frontal, lateral, and axial projections, as well as functional spondylography. The development of radiological signs in patients with cervical osteochondrosis and that of the morphological and functional signs of degenerative and dystrophic changes in the cervical spine are discussed. Comprehensive evaluation of osteochondrosis used criteria for cervical motor disorders and impaired disk amortizing and spinal fixing functions. The degree of intradural space compression was also estimated. The studies have yielded a new classification of osteochondrosis and recommendations at the stages of medical rehabilitation.     

髓周动静脉瘘（PMAVF）一例及文献复习

目的:探讨髓周动静脉瘘(perimedullary arteriovenous fistulas,PMAVF)的临床、影像学特征以及治疗方案的选择,以提高对该病的诊断水平。方法:报道1例PMAVF患者的临床诊治经过,并结合相关文献对PMAVF的临床、影像学特征和治疗方法进行总结。结果:1例表现为进行性下肢麻木伴无力的患者,并逐渐出现大小便失禁,胸腰段MRI示第9胸椎水平附近椎管内髓周血管明显迂曲扩张。行脊髓血管造影检查示右侧胸9肋间动脉发出的脊髓前动脉在胸12椎体水平通过分支供应的异常引流静脉走形于脊柱右侧。予Onyx胶栓塞引流静脉及瘘口,术后一年肌力恢复至4级左右。结论:PMAVF早期临床表现多不具有特异性,后逐渐出现进展性脊髓病变表现。脊髓MRI对提示PMAVF诊断具有重要作用,脊髓血管CTA和ceMRA有助术前判断供血动脉和瘘口位置。脊髓血管造影仍是诊断该病的金标准。手术切除和血管内治疗是治疗该病的主要方法。     

64层螺旋CT增强扫描在急诊胸部创伤中的初步应用

目的：探讨64层螺旋CT增强扫描在急诊胸部创伤中的诊断价值及临床意义。方法：18例急诊胸部创伤患者均行胸部64层螺旋CT平扫及增强扫描。采用最大密度投影（MIP）、曲面重建（CPR）和容积再现技术（VR）对胸部大血管进行重建、分析。将CT诊断结果与手术、随访复查结果进行比较。结果：18例中,CT平扫显示胸部主要损伤有：肺挫伤10例（55.56%）,血胸及肋骨骨折各9例（50%）,气胸8例（44.44%）,锁骨骨折6例（33.33%）。CT增强扫描诊断心脏大血管损伤7例,其中锁骨下动脉假性动脉瘤3例,胸主动脉假性动脉瘤2例,胸主动脉夹层和心包破裂各1例。CT增强扫描结果与手术、临床随访结果相吻合。结论：64层螺旋CT增强扫描是全面而准确地诊断急诊胸部创伤的重要影像技术,可以对CT平扫不能确定的心脏、大血管的损伤情况作出明确判断,对临床救治方案的早期确定具有重要的指导意义。     

Genome‐wide association study of osteochondrosis in the tarsocrural joint of Dutch Warmblood horses identifies susceptibility loci on chromosomes 3 and 10

Equine osteochondrosis is a developmental joint disease that is a significant source of morbidity affecting multiple breeds of horse. The genetic variants underlying osteochondrosis susceptibility have not been established. Here, we describe the results of a genome‐wide association study of osteochondrosis using 90 cases and 111 controls from a population of Dutch Warmblood horses. We report putative associations between osteochondrosis and loci on chromosome 3 (BIEC2‐808543; P = 5.03 × 10^?7) and chromosome 10 (BIEC2‐121323; P = 2.62 × 10^?7).     

Refinement of a quantitative trait locus on equine chromosome 5 responsible for fetlock osteochondrosis in Hanoverian warmblood horses

In this report, we provide 29 new informative microsatellites distributed over a region of 21 Mb on horse chromosome (ECA) 5 and refine a quantitative trait locus (QTL) for fetlock osteochondrosis dissecans (OCD) to a genome-wide significant interval between 78.03 and 90.23 Mb on ECA5. Genotyping was performed in 211 Hanoverian warmblood horses from 14 paternal half-sib groups. Within this OCD-QTL, collagen type XXIV alpha 1 was identified as a potential functional candidate gene for equine osteochondrosis. This report is a further step towards unravelling the genes that cause equine osteochondrosis.     

SNP‐based heritability and genetic architecture of tarsal osteochondrosis in North American Standardbred horses

Osteochondrosis is a common developmental orthopedic disease characterized by a failure of endochondral ossification. Standardbred horses are recognized as being predisposed to tarsal osteochondrosis. Prior heritability estimates for tarsal osteochondrosis in European Standardbreds and related trotting breeds have been based on pedigree data and range from 17–29%. Here, we report on genetic architecture and heritability based on high‐density genotyping data in a cohort of North American Standardbreds (n = 479) stringently phenotyped for tarsal osteochondrosis. Whole‐genome array genotyping data were imputed to ~2 million single nucleotide polymorphisms (SNPs). SNP‐based heritability of osteochondrosis in this population was explained by 2326 SNPs. The majority of these SNPs (86.6%) had small effects, whereas fewer SNPs had moderate or large effects (10% and 2.9% respectively), which is consistent with a polygenic/complex disease. Heritability was estimated at 0.24 ± 0.16 using two methods of restricted maximum likelihood analysis, as implemented in gcta (with and without a weighted relatedness matrix) and ldak software. Estimates were validated using bootstrapping. Heritability estimates were within the range previously reported and suggest that osteochondrosis is moderately heritable but that a significant portion of disease risk is due to environmental factors and/or genotype × environment interactions. Future identification of the genes/variants that have the most impact on disease risk may allow early recognition of high‐risk individuals.     

Quantitative trait loci analysis of osteochondrosis traits in the elbow joint of pigs

Osteochondrosis is a growth disorder in the cartilage of young animals and is characterised by lesions found in the cartilage and bone. This study identified quantitative trait loci (QTLs) associated with six osteochondrosis lesion traits in the elbow joint of finishing pigs. The traits were: thickening of the cartilage, lesion in the subchondral bone, irregular cartilage surface, fissure under the cartilage, an irregular sagittal central groove and depression of the proximal edge of the radius. The study comprised 7172 finishing pigs from crossing 12 Duroc boars with 600 crossbred Landrace × Large White sows and included 462 single nucleotide polymorphism markers. The results showed 18 QTLs exceeding the 5% genome-wide threshold. The QTLs associated with lesions in the medial part of the condylus humeri (assumed to be the four main osteochondrosis traits) were, in most cases, at common locations, whereas the QTLs associated with depression of the proximal edge of the radius in general were on the same chromosomes but at separate locations. The detected QTLs explain a large part of the genetic variation, which is promising for incorporating osteochondrosis into a breeding programme using marker-assisted selection.     

Role of magnetic resonance imaging in identifying undiagnosed knee fractures

The purpose of this investigation was to comparatively analyze the results of traditional X-ray study and magnetic resonance imaging (MRI) in traumatic knee injuries. The comparative analysis could reveal diagnostic errors in more than 54% of cases. The early use of MRI to diagnose intraarticular fractures of the distal femur, proximal tibia, and patella favors the right choice of a surgical treatment policy.     

Outcomes of Transsphenoidal Surgery in Cushing Disease Patients with Negative Pituitary Magnetic Resonance Imaging Findings: A Single-Center Experience

Objective: Transsphenoidal surgery (TSS) is a first-line treatment for Cushing disease (CD). However, a subset of patients with CD have no visible adenoma on magnetic resonance imaging (MRI), and whether MRI results affect surgical outcomes is controversial. The aim of this study was to compare the surgical outcomes of CD patients with negative MRI findings to those of patients with positive MRI findings.Methods: The clinical features and outcomes of CD patients who underwent TSS between January 2000 and July 2019 at Peking Union Medical College Hospital were collected from medical records. The clinical, endocrinologic, histopathologic, surgical outcomes, and a minimum 12-month follow-up of 125 consecutive CD patients with negative MRI findings were compared with those of 1,031 consecutive CD patients with MRI-visible adenomas.Results: The total remission rate was 73.3% after TSS, and 11.8% of patients experienced recurrence. Of 1,031 patients with MRI-visible adenomas, postoperative remission was achieved in 762 patients (73.9%), and the recurrence of CD was observed in 94 (12.3%) patients. Of the 125 patients with negative MRI findings, postoperative remission was achieved in 85 (68%) patients, and recurrence was observed in 6 (7.1%) patients. The remission rate and recurrence rate were not significantly different between patients with negative MRI findings and those with positive MRI findings (all P>.05). The remission rate was not significantly different between patients who did or did not undergo bilateral inferior petrosal sinus sampling (BIPSS) in patients with negative MRI findings (P>.05). In the patients with negative MRI findings who underwent BIPSS, the remission rate of patients with positive BIPSS results was not different from that in patients with negative BIPSS results (P>.05). The lack of prior TSS, the detection of a tumor during operation, and pathologic confirmation of adenoma were associated with a higher surgical remission rate in patients with negative MRI findings (all P<.05). Similar results were observed in the patients with positive MRI findings (all P<.05). In addition, the major perioperative complications, including intraoperative cerebrospinal fluid leakage, hypopituitarism, and transient diabetes insipidus, were not related to the MRI results (all P>.05).Conclusion: The remission rate and recurrence rate were not different between patients with negative MRI findings and those with positive MRI findings. If CD is clearly diagnosed according to biochemical tests, radiologic examinations, and BIPSS, we recommend TSS as the first-line treatment for patients, even if the MRI results are negative.     

Imagerie hybride TEMP/TDM de l’épiphysiolyse de hanche

Epiphysiolysis is a slipping of the superior femoral epiphysis under the effect of mechanical stresses. Rare event of end of growth, its incidence tends to increase with the increase of the overweight and the obesity in the child. The slipping can be progressive or acute and evolves spontaneously to fusion without pseudarthrosis or osteonecrosis but at the price of deformation and frequent secondary hip osteoarthritis. The treatment is surgical, with an iatrogenic risk of osteonecrosis if an osteotomy is performed. Although SPECT/CT bone scintigraphy has only a limited role at the initial stage (stage I), its major interest may be to evaluate the vitality of the capital femoral epiphysis, in particular a few weeks after surgery for epiphysiolysis with large displacement, before resuming hip support and/or in case of material MRI artifact resulting in an impossible assessment of vitality.     

Potentialities of low-field magnetic resonance tomography in the diagnosis and treatment of invasive cancer of cervix uteri

The aim of the study was to evaluate the efficiency of low-field (0.14 T) magnetic resonance imaging (MRI) in the diagnosis and treatment of cancer of the cervix uteri. MATERIALS AND METHODS: Low-field MRI was performed in 39 patients with cancer of the cervix uteri to define the stage of the tumor and to follow up the outcomes of their treatment. Particular emphasis was laid on the determination of the size of the tumor and the presence of parametral invasion and on metastatic lesions of lymph nodes. MRI data were compared with clinical, morphological, and surgical staging results. In detecting the stage of cancer of the cervix uteri, the accuracy of MRI was 72% whereas that of clinical study was 51%. In determining parametral invasion, the accuracy of clinical study and low-field MRI was 71 and 90%, respectively. The sensitivity and specificity of MRI were 83 and 92%, respectively. The anterioposterior tumor size was an important prognostic factor in following up the outcomes of treatment as there was its close association and the incidence of tumor recurrences. The present study has indicated that the high efficiency of low-field MRI in detecting the stage of invasive cancer of cervix uteri makes it the method of choice in planning treatment and monitoring the outcomes of combined radiation therapy.