What stroke image do we want? European survey on acute stroke imaging and revascularisation treatment

IntroductionThe evolution of stroke treatment has been geared toward thrombolysis and thrombectomy, which requires quick imaging assessment. Various imaging and treatment options are available and current evidence suggests European differences in stroke care. We aimed to describe the patterns of stroke imaging and acute revascularisation therapy and examine variations across countries.MethodsA web-based clinician survey was developed and circulated to clinicians through email distribution lists and websites of European professional societies. Statistical analyses were performed.ResultsWe received responses from Sweden (21), the UK (16), Hungary (15), Germany (12) and Europe (47). Large variations are observed in revascularisation treatment: German respondents report that 81% of their ischaemic stroke patients diagnosed with a large vessel occlusion within 4.5 h receive intravenous thrombolysis and thrombectomy, compared to 12% reported by the UK-respondents. For patients diagnosed with an extensive ischaemic stroke within 2 h from onset, 75% of UK-respondents state thrombectomy as their preferred revascularisation treatment, but only 13% report to use it. Computed Tomography (CT) is reported as the most widely used first imaging test (for 81% to 93% of patients across geographic areas), while Magnetic Resonance Imaging (MRI) is a distant second.ConclusionThe diagnostic workup and, to a greater extent, the revascularisation treatments of typical stroke patients vary considerably across European countries. This study reinforces the need to compare the quality of stroke care in terms of process and outcomes between countries. Research is also needed to investigate the cost-effectiveness of second-line imaging strategies in acute stroke care.     

Short time effects of a low-frequency,high intensity magnetic field in the treatment of chronic neck and low back pain

IntroductionNeck and back pain afflicts millions of people. Magnetotherapy has shown to have anti-inflammatory effects that could act on pain generation, but the literature lacks provide a precise therapeutic protocol.MethodsA high-intensity electromagnetic field with a dedicated applicator was administered to 38 patients with low-back pain and 30 patients with neck pain. The device provides 60 mT and a frequency of 50 Hz for 30 minutes, the session was repeated 4 times.ResultsThe mean VAS of the low-back pain group decreased from 6.56 to 4.54, with a significant reduction of 30.8%. The mean VAS of the neck pain group decreased from 6.51 to 1.96, with a significant reduction of 69.9%.DiscussionThe treatment used showed good results in both groups of the patient, without side effects. The therapeutic protocol adopted is safe, provide rapid relief from the pain and is not time demanding. This treatment could represent an effective non-pharmacologic physical therapy option in the treatment of low-back pain and cervical pain.     

美国磁共振设备使用报告中患者安全事件分析及启示

目的分析美国磁共振设备使用报告中患者安全事件相关数据，为降低此类事件发生率提出建议。方法检索美国FDA MAUDE数据库，获取2017年1月1日—2021年12月31日报告的磁共振设备相关安全事件，应用Excel表格进行分类分析。结果纳入的388份患者安全事件报告中，灼伤是最常见的伤害类型（56.44%），其次分别为听觉伤害（16.49%），机械性损伤（14.18%），抛射（10.82%），图像错误（1.55%），外周神经刺激（0.26%）及窒息（0.26%）。结论磁共振设备使用安全不容忽视。建议做好患者检查时的肢体隔离措施，重视对患者听力保护，加强对患者随身金属物品检测，关注患者体位摆放，特别避免患者乳腺扫描时肋骨骨折，以确保患者磁共振检查安全。     

浅谈磁共振成像系统的质量控制参数与测量

磁共振成像技术是临床医学不可缺少的诊断手段,保证磁共振成像系统的质量是关系到临床诊断水平的重要问题。本文主要介绍磁共振成像系统的常用的质量控制参数及其影响因素和测试。     

A missed unstable cervical vertebra fracture in a patient with ankylosing spondylitis

A 53-year-old man with a 13-year history ofankylosing spondylitis presented to the emergency clinic of another hospital because of neck pain after a fall from a low stepladder. The patient was put at ease and discharged after physical examination and X-ray of the cervical spine revealed nothing out of the ordinary. Because his neck pain persisted, the patient contacted his rheumatologist. New cervical X-rays revealed fractures of the body and articular process of CVI and CVII. The patient was referred to our hospital for orthopaedic treatment. The fractures healed during 2.5 months' treatment with halotraction and a halovest. All patients with ankylosing spondylitis with neck pain after trauma have an unstable cervical fracture until proven otherwise. Cervical fractures should be excluded in all cases and other diagnostic tools (CT-scan or MRI) must be used whenever necessary.     

弥散张量成像检测脊髓损伤

脊髓损伤后胶质瘢痕的形成影响轴突再生。核磁共振成像方法作为无创伤手段,已经被普遍应用于脊髓损伤的临床实践和研究中。本文主要针对弥散张量成像方法在脊髓损伤的应用作简要的综述。     

MRI对卵巢上皮癌分期的价值

目的探讨MRI对卵巢上二皮癌分期的价值。方法选取68例卵巢上皮癌患者，分析评估其MRI征象，包括：肿瘤的特性，单、双侧病变，邻近器官侵袭情况，肿瘤种植病灶，淋巴结肿大，腹水，囊壁、间隔及乳头投影。并对本组病例进行MRT分期，与临床病理分期比较分析。结果MRI对卵巢上皮癌分期：MRI分期与临床病理分期相比，整体准确牢为88．2％。结论MRI分期与临床病理分期相比，MRI能准确评估卵巢癌的分期。     

A mobile traction device for MR and CT imaging

The development of a spinal traction device for use in Magnetic Resonance Imaging (MRI) and Computed Tomography (CT) imaging is described. Such a device has arisen from the need to apply continuous traction to patients having suffered acute cervical spine trauma. Previous traction techniques have proven unsuitable for use in the MRI scanner, particularly as they lack stability, are awkward to implement and prove quite cumbersome to manage. Traction may be applied to a patient for periods of time in excess of 1 hour with a minimum of discomfort. Materials are used which have a negligible proton density and a low atomic number, yielding no detectable magnetic resonance and very small x-ray cross sections respectively. Calibrated traction may be applied to patients via tongs or a head harness, the latter rendering the device suitable for general transport of injured patients with traction applied. The device is compact, light and strong and contains no ferrometallic parts. Thus far in excess of 40 patients have been scanned, most in a FONAR beta-3000M .3 Tesla electromagnetic MR imager and some also in a GE 9800 Quickscan CT scanner. No artefact has been demonstrated in any of the images to date for any of the MR pulse sequences or CT kVp. Modifications likely include refinement of the tensioning mechanism, inclusion of x-ray cassette facilities and improvement of aesthetic design.     

Magnetic resonance imaging of the thorax

We examined thirty-five patients with various chest diseases with cardiac gated Magnetic Resonance Imaging (MRI) at 1.5 tesla. Major advantages of MRI of the thorax are its abilities to display sagittal and coronal planes and to disclose vessels clearly without contrast media. We conclude MRI is useful in evaluating, 1) masses at the lung apex or base, 2) chest wall invasion, 3) hilar and mediastinal lymphadenopathy, 4) aortic aneurysm, and 5) bronchogenic cyst.     

Integrating MRI facility design and risk management

Magnetic Resonance Imaging (MRI) has become a valuable diagnostic tool but the high‐strength electromagnets that enable cutting‐edge clinical images also present significant hazards to patients, staff and equipment. Managing these hazards has fallen almost exclusively under the domain of the clinical staff since the inception of MRI, yet accidents in the MRI suite continue to occur. New strategies for building safety into the design and construction of the MRI suite will further minimize the hazards to patients, staff and health care institutions.     

Health-related quality-of-life status in Veterans with spinal disorders

Purpose

To measure the impact of spinal disorders on health-related quality of life (HRQOL) among Veterans, to describe demographic patterns of Veterans with spinal disorders, and to quantify HRQOL scores as they relate to demographics, medical comorbidities, pain severity, and depressive symptoms.

Methods

From 2009 to 2010, 112 lumbar and 56 cervical spinal disorder patients completed SF-12, Oswestry Disability Index, visual analog pain scale, and Beck Depression Inventory surveys. Multivariate analysis identified predictors of HRQOL, disability, and depressive symptoms.

Results

A total of 168 patients completed surveys for this study. The median age of all patients was 60. Nearly 30% of lumbar and 16% of cervical patients were aged 65 or older. Approximately 96% of patients were men. Sixty percent of patients were currently receiving or had pending disability compensation. Nearly 60% of patients were current smokers, approximately 26% reported alcoholism or intravenous drug use, and 26% self-reported post-traumatic stress disorder. The most common lumbar spine diagnoses were disk herniation (36.6%) and stenosis (34.8%), and most common cervical spine diagnoses were stenosis (50.0%) and disk herniation (23.2%). Back pain was reported by 93.8% of lumbar patients and leg pain by 83.0%. Neck pain was reported by 96.4% of cervical patients and arm pain by 69.6%. Median SF-12 physical component scores were more than two standard deviations below the US average. Ninety percent of patients had at least moderate physical disability. Sixty-four percent met criteria for depressive symptoms. Visual analog pain score was the strongest predictor of SF-12 physical (β = ?1.32, P < 0.001) and mental (β = ?1.63, P < 0.001) HRQOL and was the prime determinant of depressive symptoms (β = 1.52, P < 0.001) and disability index score (β = 4.39, P < 0.0001). Charlson Comorbidity Score and smoking status had no significant impact on HRQOL or disability scores. Age was negatively correlated with depressive symptoms and positively correlated with SF-12 mental component scores.

Conclusions

Spinal disorders have a severe impact on both physical and emotional HRQOL of Veterans and are associated with severe disability and an unusually high prevalence of depressive symptoms. Therapeutic interventions should be targeted to reduce pain, which is a prime determinant of HRQOL, disability, and depressive symptoms. Given high prevalence of multiple risk factors for poor outcomes, studies of spine surgery outcomes in Veterans are needed.     

Brain ventricular size in female alcoholics: an MRI study

The brains of ten alcohol-dependent women between the ages of 21 and 65 were studied with Magnetic Resonance Imaging (MRI) techniques. All women had MRI scans twice during the withdrawal period. Only one of the ten women had abnormally enlarged ventricles. At the time of the second scan there were no significant changes in ventricular size from the first scan. No correlations were found between age and ventricular size, or years of alcohol abuse and ventricular size.     

Physical capacity in relation to low back, neck, or shoulder pain in a working population

Aims

To investigate the longitudinal relation between physical capacity (isokinetic lifting strength, static endurance of the back, neck, and shoulder muscles, and mobility of the spine) and low back, neck, and shoulder pain.

Methods

In this prospective cohort study, 1789 Dutch workers participated. At baseline, isokinetic lifting strength, static endurance of the back, neck, and shoulder muscles, and mobility of the spine were measured in the pain free workers, as well as potential confounders, including physical workload. Low back, neck, and shoulder pain were self‐reported annually at baseline and three times during follow up.

Results

After adjustment for confounders, Poisson generalised estimation equations showed an increased risk of low back pain among workers in the lowest sex specific tertile of performance in the static back endurance tests compared to workers in the reference category (RR = 1.42; 95% CI 1.19 to 1.71), but this was not found for isokinetic trunk lifting strength or mobility of the spine. An increased risk of neck pain was shown for workers with low performance in tests of isokinetic neck/shoulder lifting strength (RR = 1.31; 95% CI 1.03 to 1.67) and static neck endurance (RR = 1.22; 95% CI 1.00 to 1.49). Among workers in the lowest tertiles of isokinetic neck/shoulder lifting strength or endurance of the shoulder muscles, no increased risk of shoulder pain was found.

Conclusions

The findings of this study suggest that low back or neck endurance were independent predictors of low back or neck pain, respectively, and that low lifting neck/shoulder strength was an independent predictor of neck pain. No association was found between lifting trunk strength, or mobility of the spine and the risk of low back pain, nor between lifting neck/shoulder strength or endurance of the shoulder muscles and the risk of shoulder pain.     

Vitamin D,bone mineral density and body mass index in eating disorder patients

AimTo investigate associations of vitamin D with BMD and BMI in ED patients.MethodsVitamin D, BMD and BMI for 50 patients admitted to a specialised ED inpatient unit were measured. Patients were aged 15–54 years with BMI 8–25 kg/m².ResultsOf the patients, 18% were vitamin D deficient. There was a significant linear relationship between vitamin D and BMD T-score at the lumbar spine (p = 0.029), femoral neck (p < 0.001) and total hip (p = 0.001). There was no relationship between vitamin D and BMI. There was a significant linear relationship between BMI and BMD T-score at the lumbar spine (p < 0.001), femoral neck (p = 0.008) and total hip (p = 0.001).ConclusionsLow vitamin D and low BMI are associated with low BMD in ED patients. Despite widespread belief that it is not necessary, our findings suggest it is appropriate to measure vitamin D in ED patients. It should not be assumed ED patients take supplements.     

Value of proton spin tomography in the diagnosis of intra-articular pathological disorders of the knee]

Magnetic resonance imaging (MRI) of the knee was performed in 50 patients with unilateral knee problems with clinical suspicion of a meniscal tear or degeneration of the cartilage. The findings of the MRI examination were compared with previously performed arthrography and the diagnosis was subsequent confirmed arthroscopically. MRI detected degenerative changes in 69 out of 100 menisci and signs of a meniscal tear in 31 of the menisci. The diagnostic accuracy of MRI for a tear in the medial or the lateral meniscus was 91%. MRI was accurate in the detection of 8/11 ruptures of the anterior cruciate ligament and in 6/13 cases with degenerative changes of the patella.     

数字化磁共振谱仪的设计

谱仪是磁共振成像系统（MRI）中的核心部件。介绍了一种新型的数字化谱仪的设计方法，它使用PXI平台下的通用数据采集板卡和高分辨率定时器，通过编写软件实现谱仪的功能。详细讨论了该软件的结构和设计细节，并介绍了实验结果。     

核磁共振成像系统的质量保证与质量控制

本文概括介绍了核磁共振成像系统在安装前后和使用过程中实行质量测试的重要性和具体方法步骤。主要包括系统验收测试、日常检查、基本测试,以及年度系统评估。建立一个完整合理的质量保证、质量控制方案,并能按时全面执行这一方案,对于保证磁共振成像系统的高质、高效运行,提高临床和科研能力起到十分重要的作用。     

弥散张量成像检测脊髓损伤

脊髓损伤后胶质瘢痕的形成影响轴突再生。核磁共振成像方法作为无创伤手段,已经被普遍应用于脊髓损伤的临床实践和研究中。本文主要针对弥散张量成像方法在脊髓损伤的应用作简要的综述。     

深圳市中学生日常行为习惯与其肩颈腰背健康状况的关系

目的 探讨深圳市中学生日常行为习惯与其肩颈、腰背健康的相关性,为更好地预防中学生肩颈、腰背症状提供理论依据。方法 采取分层整群抽样方法,抽取深圳市10个区10所中学的3 952名学生进行脊柱健康状况及日常行为习惯的问卷调查,调查数据采用SPSS 23.0软件进行分析。结果 深圳市中学生中有肩颈症状和腰背症状的分别为20.3%和15.2%;有肩颈症状的女生（25.3%）多于男生（16.2%）,高中生（24.5%）多于初中生（15.5%）,住校生（24.4%）多于非住校生（17.6%）;有腰背症状的女生（17.9%）多于男生（13.0%）,差异均有统计学意义（P<0.05）。多因素logistic结果分析显示,性别、学校类型、午休趴在桌子上睡觉、因学习或玩电脑熬夜、自评学习压力、持续长时间做作业、玩手机、看电视和使用电脑与学生肩颈症状相关（P<0.05）;性别、午休趴在桌子上睡觉、因学习或玩电脑熬夜、自评学习压力、持续长时间做作业、玩手机、看电视与学生腰背症状相关（P<0.05）。结论 深圳市中学生肩颈、腰背症状不容忽视,学习压力、长时间静坐行为和不良的睡眠习惯均对脊柱健康有影响。     

MR水成像技术在四肢血管瘤诊断中的应用价值

目的：研讨磁共振水成像技术（MRH）在四肢血管瘤诊断中的价值。方法：选取2013年1-5月因血管瘤在四川省肿瘤医院影像科做磁共振成像（MRI）检查的20例患者资料,分别进行MRI检查,分析图像质量及对诊断与手术的价值。结果：20例患者经手术证实：蔓状血管瘤7例、海绵状血管瘤9例、毛细血管瘤4例。结论：MRI对蔓状血管瘤成像效果最佳;襻状瘤体成像清晰,对比度高,吻合瘤体的动静脉亦可同时显影,经三维-最大信号强度投影（3D-MIP）重建后可以达到磁共振血管造影（MRA）的效果,有较大的手术指导价值;海绵状血管瘤成像为散在分布的高信号影,易与关节积液混淆,诊断特异性不高;毛细血管瘤基本不显影。