PURPOSE: To assess the frequency and pattern of disc enhancement of lumbar spine on enhanced MR images and to determine whether enhanced MR images are useful for locating internal disc lesions. MATERIALS AND METHODS: MR images of a total of 225 discs from 45 patients were reviewed. Fifteen discs from 15 patients who had previously undergone an operation were excluded and 210 discs were therefore studied. T1-, T2-, and gadolinium-enhanced T1-weighted images were obtained after intravenous injection of Gd-DTPA(0.2 ml/kg). Findings were analyzed retrospectively. RESULTS: Sixty-nine(32.6%) of 210 discs showed enhancement. The pattern of enhancement was intradiscal(linear or nodular) or extradiscal. Of 165 morphologically normal discs, 34(20.6%) discs were enhanced; 32 showed linear and two showed nodular enhancement. All of six ruptured discs were enhanced. Six patients were operated on after MRI study ; one case of intradiscal linear enhancement revealed a bulging disc, three of five patients were confirmed on surgery as having ruptured discs in view of the extradiscal enhancement and the other two patients were confirmed having protruded discs. CONCLUSION: The pattern of disc enhancement is classifiedinto intradiscal and extradiscal. The former is further classified into linear and nodular. Gd-DTPA enhanced MRimages may be helpful in diagnosing ruptured discs and in detecting pathologic conditions in those patients whose discs appear to be morphologically normal before enhancement.
Gadolinium DTPA* ; Humans ; Injections, Intravenous ; Magnetic Resonance Imaging* ; Spine

PURPOSE: To evaluate the radiologic findings of carotid-vertebrobasilar anastomosis and associated anomalies. MATERIALS AND METHODS: Thirteen patients with fourteen cases of carotid-vertebrobasilar anastomosis collectedfrom January 1992 to December 1997 were reviewed. Clinical diagnosis refered for cerebral angiography werecerebral infarction(n=3), intracranial hemorrhage(n=2), subarachnoid hemorrhage(n=1), brain tumor(n=3),arteriovenous malformation(n=3) and trigeminal neuralgia(n=1). Cerebral angiograms and clinical symptoms wereretrospectively analyzed. RESULTS: The fourteen carotid-vertebrobasilar anastomsis consisted of eleven cases ofpersistent trigeminal artery and three cases of type I proatantal intersegmental artery. Persistent trigeminalarteries were associated with anterior communicating artery aneurysm(n=1), posterior fossa arteriovenousmalformation(n=2) and persistent trigeminal artery variant(n=5). Type I proatantal intersegmental arteries wereassociated with hypoplastic vertebral arteries(n=2) : only proximal segment in one, and proximal and distalsegments in one case. Only one patient had clinical symptom related to the carotid-vertebrobasilar anastomosiswhich was trigeminal neuralgia. CONCLUSION: Knowledge of the anatomical and radiologic findings ofcarotid-vertebrobasilar anastomosis and associated anomalies will aid in the accurate diagnosis of neurovasculardisease and prevent possible complications during surgical and interventional procedures.
Arteries ; Brain ; Cerebral Angiography ; Diagnosis ; Humans ; Trigeminal Neuralgia

PURPOSE: To observe the MR findings of cerebral palsy by evaluating cerebral damage resulting from hypoxic ischemic injury and other variable causes and to compare the findings between preterm and full-term patients. MATERIALS AND METHODS: We reviewed the MR findings of 102 cerebral palsy patients (71 full-term and 31 preterm). These were analysed with regard to deep and peripheral white matter, gray matter, basal ganglia, the thalamus, brainstem, cerebellum, corpus callosum and ventricles, according to the pattern of injury such as hypoxic ischemic injury, migration anomaly and early intrauterine injury, the findings of full-term and preterm patients were then compared. RESULTS: MR findings of preterm patients (n=31) were as follows ; hypoxic ischemic injury (n=26), normal (n=2), and migration anomaly (n=3), while those of full-term patients (n=71) were hypoxic ischemic injury (n=41), normal (n=24), migration anomaly (n=4), early uterine injury (n=2), and perirolandic ischemic injury (n=6); in 5 patients, this latter condition was combined with status marmoratus. Periventricular leukomalacia was the most common finding in both preterm patients and full-term patients; selective neuronal necrosis, parasagittal injury and perirolandic injury were observed only in full-term patients. CONCLUSION: On MRI, variable findings of cerebral palsy were clearly observed; periventricular leukomalacia was the most common finding in both preterm and full-term patients.
Basal Ganglia ; Brain Stem ; Cerebellum ; Cerebral Palsy* ; Corpus Callosum ; Humans ; Infant, Newborn ; Leukomalacia, Periventricular ; Magnetic Resonance Imaging ; Movement Disorders ; Necrosis ; Neurons ; Thalamus

OBJECTIVE: This study aimed to examine clinical practice patterns in the management of pregnant women admitted with threatened preterm labor (TPL) in Korea. METHODS: Data from women admitted with a diagnosis of TPL were collected from 22 hospitals. TPL was defined as regular uterine contractions with or without other symptoms such as pelvic pressure, backache, increased vaginal discharge, menstrual-like cramps, bleeding/show and cervical changes. Data on general patient information, clinical characteristics at admission, use of tocolytics, antibiotics, and corticosteroids, and pregnancy outcomes were collected using an online data collections system. RESULTS: A total of 947 women with TPL were enrolled. First-line tocolysis was administered to 822 (86.8%) patients. As a first-line tocolysis, beta-agonists were used most frequently (510/822, 62.0%), followed by magnesium sulfate (183/822, 22.3%), calcium channel blockers (91/822, 11.1%), and atosiban (38/822, 4.6%). Of the 822 women with first-line tocolysis, second-line tocolysis were required in 364 (44.3%). Of 364 with second-line, 199 had third-line tocolysis (37.4%). Antibiotics were administered to 29.9% of patients (284/947) with single (215, 22.7%), dual (26, 2.7%), and triple combinations (43, 4.5%). Corticosteroids were administered to 420 (44.4%) patients. Betamethasone was administered to 298 patients (71.0%), and dexamethasone was administered to 122 patients (29.0%). CONCLUSION: Practice patterns in the management of TPL in Korea were quite various. It is needed to develop standardized practice guidelines for TPL management.
Adrenal Cortex Hormones ; Anti-Bacterial Agents ; Back Pain ; Betamethasone ; Calcium Channel Blockers ; Dexamethasone ; Diagnosis ; Female ; Humans ; Korea ; Magnesium Sulfate ; Muscle Cramp ; Obstetric Labor, Premature* ; Physician's Practice Patterns ; Pregnancy ; Pregnancy Outcome ; Pregnant Women ; Premature Birth ; Retrospective Studies* ; Tocolysis ; Tocolytic Agents ; Uterine Contraction ; Vaginal Discharge