Objective To investigate the technique and effectiveness of CT-guided collagenase injection into prominence of herniated lumbar disc and the surface of prominence in the treatment of lumbar disc herniation. Methods One hundred and fifty-five patients with lumbar disc herniation diagnosed by clinic and CT received CT-guided collagenase injection, with the approaches via intervertebral foramen in L3-4 and L4-5, and the approaches via margo medialis of joint processus articularis in L5-S1. Results Injection was done successfully in all patients (100%), the clinical rate of excellent and good results were 94.2%. The herniation disappeared or significantly reduced as demonstrated by CT scan in 32 of 34 patients (94.1%), the rate of excellent and good results were 100%. No changes existed in 2 cases. There were 2 cases of disc inflammation in our group. Conclusions CT-guided collagenase injection into the prominence of herniated lumbar disc and its surface is a safe and efficient method in the treatment of herniated lumbar disc.

Objective To compare the value of 18 F-labeled deoxyglucose (FDG) PET or PET-CT with MRI in detecting local residue or recurrence of nasopharyngeal carcinoma after radiotherapy, by performing a meta-analysis of relevant trials.Methods A literature search was performed to English original articles about FDG PET or PET-CT and MRI in Medline, Embase and the Cochrane database from January 1995 to August 2009.The reference standard was histopathologic analysis and/or close clinical and imaging follow-up.Two reviewers searched articles and extracted data independently.Sensitivity, specificity,summary receiver operating characteristic curves (SROC), and the Q index for FDG PET or PET-CT and MRI were pooled, respectively.Results Seventeen studies about FDG PET or PET-CT and 10 studies about MRI were included in this meta-analysis.The pooled sensitivity of FDG PET or PET-CT and MRI were 0.935(95% CI= 0.901 -0.964) and 0.792 (95% CI= 0.731 -0.844), separately.The pooled specificity were 0.924 (95 % CI= 0.898 - 0.945) and 0.787 (95 % GI= 0.746 - 0.825), separately.Area under SROC curves of PET-CT or PET (0.966) was significantly larger than that of MRI (0.852) (z =2.29, P < 0.05).The Q * index estimates for PET-CT or PET (0.914) were significantly higher than for MRI (0.783)(z=2.94,P<0.05).Conclusions FDG-PET/PET-CT has higher accuracy than MRI in diagnosing local residue or recurrence of nasopharyngeal carcinoma after radiotherapy.

Objective CT-guided collagenase injection through posterolateral path into the interior and superficial prominence of the herniated lumbar disc in the treatment of L4-5 lumbar disk herniation.Methods The approach of posterolateral path to the prominence through intervertebral foramen and epidural space of L4-5 was established according to the analysis of anatomical features and vertebral medical images. The accuracy and safety of the approach were evaluated by CT scanning after epidural injection with air. CT-guided injection was operated in 66 cases of prolapse of L4-5 intervertebral disc confirmed by CT. Results Technical success was 100%. Followed up for 3 months to 3 years, 62 cases (93%) were markedly suecessfud with the effective rate of 93%. Twenty-three had CT re-examination three months later showed the prominences becoming smaller or disappeared in 22 patients having a resolved rate of 95%.Conclusions CT-guided injection of collagenase is one of the effective methods for the treatment of prolapse of L4-5 intervertebral disc.