1.Application value of magnetic resonance sequences in diagnosis of early spinal metastatic tumor.
Li-Xia WANG ; Xiang-Quan KONG ; He-Shui SHI ; Ding-Xi LIU ; Yin XIONG
Chinese Medical Sciences Journal 2007;22(1):9-12
OBJECTIVETo investigate the clinical value of different magnetic resonance (MR) pulse sequences in diagnosis of spinal metastatic tumor.
METHODSFifteen patients with clinically suspected spinal metastatic tumor were included in this study. These patients were with documented primary tumors. Four MR pulse sequences, T1-weighted spin echo (T1WI SE), T2-weighted fast spin echo (T2WI FSE), short time inversion recovery (STIR), and gradient echo 2-D multi echo data imaging combination (GE Me-2D) were used to detect spinal metastasis.
RESULTSFifteen vertebral bodies were entire involvement, 38 vertebral bodies were section involvement, and totally 53 vertebral bodies were involved. There were 19 focal infections in pedicle of vertebral arch, 15 metastases in spinous process and transverse process. Fifty-three vertebral bodies were abnormal in T1 WI SE and GE Me-2D, 35 vertebral bodies were found abnormal in T2WI FSE, and 50 vertebral bodies were found abnormal in STIR. The verges of focal signal of involved vertebral bodies were comparatively clear in T1WI SE, comparatively clear or vague in T2WI FSE, vague in STIR, and clear in GE Me-2D.
CONCLUSIONSGE Me-2D may be the most sensitive technique to detect metastases. So three sequences (T1WI SE, T2WI FSE, GE Me-2D) can demonstrate the early changes of spinal metastasis roundly.
Cervical Vertebrae ; diagnostic imaging ; Coccyx ; diagnostic imaging ; Humans ; Lumbar Vertebrae ; diagnostic imaging ; Magnetic Resonance Imaging ; methods ; Neoplasm Metastasis ; pathology ; Radiography ; Sacrum ; diagnostic imaging ; Sensitivity and Specificity ; Spinal Neoplasms ; pathology ; secondary ; Spine ; diagnostic imaging ; Thoracic Vertebrae ; diagnostic imaging
2.Normative values of cervical sagittal alignment according to the whole spine balance: Based on 126 asymptomatic Chinese young adults.
Yan Chao TANG ; Wen Kui ZHAO ; Miao YU ; Xiao Guang LIU
Journal of Peking University(Health Sciences) 2022;54(4):712-718
OBJECTIVE:
To explore the normal distribution of cervical sagittal alignment and the relationship between cervical alignment and global spine balance in asymptomatic young adults.
METHODS:
A cohort of 272 asymptomatic Chinese adults (including 161 males and 111 females, with an average age of (23.2±4.4) years, ranging from 18 to 45 years) were prospectively recruited from November 2011 to December 2014. The C0-C2 angle, disk angles from C2-C3 to C6-C7, vertebral angles from C3 to C7, T1 slope, thoracic kyphosis (TK), lumbar lordosis (LL), pelvic incidence (PI), sacral slope (SS), C2-C7 sagittal vertical axis (C2-C7SVA), center of gravity of head to C7SVA (CGH-C7SVA), C7-S1SVA were measured and statistically analyzed. All the subjects were categorized with the Roussouly classification and the cervical morphologies were evaluated as lordotic, straight, sigmoid or kyphotic. Spinal sagittal alignment parameters were compared between different sexes and Roussouly classifications with independent student t test, analysis of variance (ANOVA) or Chi-square test. Correlations between cervical sagittal alignment and global spine sagittal alignment were calculated using the Pearson and Spearman correlation coefficient. Linear regression analysis was performed.
RESULTS:
Sixty-seven males and 59 females aged from 18 to 30 years old were included in the study. The mean value of C0-C7 was 26.0°±12.8°, composed of 15.2°±6.7° for C0-C2, 9.1°±12.1° for sum of disk angles from C2-C3 to C6-C7, and 1.4°±10.2° for sum of vertebral angles from C3 to C7. C2-C7SVA [(18.6±7.9) mm] and CGH-C7SVA [(22.9±12.3) mm]were offset ideally by C7-S1SVA [(-21.6±31.0) mm]. Males had a larger T1 slope (P < 0.05) and accordingly, a larger cervical lordosis C2-C7 (P < 0.01) and C0-C7 angle (P < 0.01) than females. Males had a smaller C7-S1SVA (P < 0.01) and accordingly, a smaller CGH-C7SVA (P=0.165) than females. Significant difference was found between cervical alignment of different Roussouly types (P < 0.01). In general, a larger LL was consistent with a set of larger TK, C2-C7angle, C0-C7 angle, and vice versa. There was no significant correlation between cervical morphology and the Roussouly classification (Chi-square=10.548, P=0.308). There was significant correlation between cervical alignment and T1 slope (P < 0.01), TK (P < 0.01). There was significant correlation between adjacent segmental angles from T1 slope up to C0-C2 angle (P < 0.05).
CONCLUSION
Normative values of each vertebral angle and disk angle were established. The cervical lordosis occurred mainly at C0-C2 and disk levels, which was influenced by parameters of other parts of the spine, such as T1 slope, TK and the Roussouly classification. There was significant correlation between adjacent disk angles.
Adolescent
;
Adult
;
Cervical Vertebrae/diagnostic imaging*
;
China
;
Female
;
Humans
;
Kyphosis
;
Lordosis/diagnostic imaging*
;
Male
;
Thoracic Vertebrae
;
Young Adult
3.Assessment of the Original Height of L1~2 after Vertebral Compression Fracture.
Pei Pei ZHUO ; Mao Wen WANG ; Xiao Ying YU ; Lei WAN ; Si Lei TAN ; Jie Min CHEN ; Wen Tao XIA
Journal of Forensic Medicine 2018;34(4):359-362
OBJECTIVES:
To explore the assessment method of original height of L1-2 after vertebral compression fracture and its application value in forensic clinical practice.
METHODS:
A total of 154 normal thoracic and lumbar X-ray films were collected, and 140 cases were used as experimental group while 14 cases as validation group. The heights of anterior (Ha) and posterior (Hp) vertebral body of T₁₂-L₃ vertebrae in each X-ray image were measured. In the experimental group, the correlation analysis between HaL₁ and HaT₁₂, HpT₁₂, HpL₁, HaL₂ and HpL₂ was carried out, and regression equation was established via fitting. The correlation analysis between HaL₂ and HaL₁, HpL₁, HpL₂, HaL₃, HpL₃ was performed, and the regression equation was also established via fitting. The difference between the predicted and measured values of HaL₁ and HaL₂ in validation group was compared.
RESULTS:
In the 140 normal subjects, HaL₁ (y₁) was well correlated with HaT₁₂ (x₁) and HaL₂(x₂), and the multiple linear regression equation was y₁=2.545+0.423 x₁+0.486 x₂ (determining coefficient R²=0.712, P<0.05; F=169.206, P<0.05). There was no significant difference between the predicted and actual measured values of HaL₁ in the validation group ( P>0.05). HaL₂ (y₂) was well correlated with HaL₁ (x₃) and HaL₃ (x₄), and the multiple linear regression equation was y₂=4.354+0.530 x₃+0.349 x₄ (determining coefficient R²=0.689, P<0.05; F=151.575, P<0.05). There was no significant difference between the predicted and actual measured values of HaL₂ in the validation group ( P>0.05).
CONCLUSIONS
It is more appropriate to evaluate the original height of L₁ or L₂ single vertebrae by comparing with the height of the anterior edge of the upper and lower adjacent vertebral bodies.
Aged
;
Fractures, Compression
;
Humans
;
Lumbar Vertebrae/diagnostic imaging*
;
Middle Aged
;
Spinal Fractures/surgery*
;
Thoracic Vertebrae/diagnostic imaging*
4.Sex Estimation of Typical Adult Vertebrae Morphology in Central China Based on CT Technique.
Dai Ang LIU ; Li YANG ; Zhen Hua DENG ; Dong GAO ; Xin LI ; Ying ZHANG ; Lan WANG ; Yun Feng CHANG
Journal of Forensic Medicine 2020;36(5):654-659
Objective The morphological data of the second thoracic vertebra and the third lumbar vertebra were measured by computerized tomography (CT). The sex differences were analyzed and the discrimination equation was obtained. Methods The data of 274 adults (203 cases from experimental group and 69 cases from validation group) from central China were collected. Four linear data (maximum transverse length of vertebral body, maximum longitudinal length of vertebral body, maximum transverse length of vertebral foramen, maximum longitudinal length of vertebral foramen), one angle data (angle between spinous processes) and two area (vertebral foramen area, total cross-sectional area of vertebral body) data of the second thoracic vertebra and the third lumbar vertebra were collected, respectively. Then three ratios [maximum transverse length/ maximum longitudinal length of vertebral body, maximum transverse length/ maximum longitudinal length of vertebral foramen, vertebral foramen area/ (total cross-sectional area of vertebral body-vertebral foramen area)] and one angle (angle between spinous processes) were obtained. The discriminant equation was established for sexual discriminant analysis. Results The morphology of the second thoracic vertebra and the third lumbar vertebra was related with gender. Four single index discriminant formulae and eleven multi-index discriminant formulae were established. The 69 validation group samples were substituted into the formula for testing, and the maximum discriminant accuracy rate of the single-index discriminant formula was 75%. The maximum discriminant accuracy rate of multi-index discriminant formula was 83%. Conclusion It is feasible to conduct individual sex analysis by the morphological indexes of second thoracic vertebra and the third lumbar vertebra. The indexes have important application values in practice.
China
;
Female
;
Lumbar Vertebrae/diagnostic imaging*
;
Male
;
Thoracic Vertebrae/diagnostic imaging*
;
Tomography, X-Ray Computed
;
Vertebral Body
5.The influence of thoracic kyphosis on sagittal balance of the lumbosacral spine in thoracic idiopathic scoliosis patients.
Yong QIU ; Gang YIN ; Xing-Bing CAO
Chinese Journal of Surgery 2008;46(16):1237-1240
OBJECTIVESTo evaluate the influence of thoracic kyphosis to sagittal alignment and balance of the lumbosacral vertebrae in thoracic adolescent idiopathic scoliosis patients.
METHODSStanding posteroanterior and lateral x-rays of a cohort of 55 patients with thoracic adolescent idiopathic scoliosis were obtained. The patients were classified according to their thoracic kyphosis, the first group TK < 10 degrees and the second group 10 degrees < or = TK < or = 40 degrees . The following parameters were measured: lumbar lordosis (LL), upper and lower arc of lumbar lordosis, sagittal vertical axis, sacral slope (SS), pelvic incidence (PI), pelvic tilt (PT). Sagittal plane parameters were analyzed using t-test between two groups, with significance set at P < 0.05. Linear correlations between parameters were calculated using Pearson correlation coefficients, with significance set at P < 0.01.
RESULTSThere were smaller LL and upper arc of lumbar lordosis in the first group. Significant linear correlations were found between each single adjacent shape parameter. Significant correlations were also found between TK, LL and upper arc of lumbar lordosis, as well as between PT, SS and PI.
CONCLUSIONSSagittal alignment and balance of the lumbosacral vertebrae may influence the thoracic kyphosis in AIS patients. The mechanism of this influence may through the adaptation of upper arc of lumbar lordosis. This influence must be considered in thoracic adolescent idiopathic scoliosis patients who undergo selective posterior thoracic fusion.
Adolescent ; Adult ; Female ; Humans ; Kyphosis ; complications ; pathology ; Lumbar Vertebrae ; diagnostic imaging ; pathology ; Male ; Radiography ; Sacrum ; diagnostic imaging ; pathology ; Scoliosis ; complications ; pathology ; Thoracic Vertebrae ; diagnostic imaging ; pathology
6.Vertebra morphology measurement in adolescent idiopathic scoliosis population.
Li-xiang DING ; Yong LIU ; Yi-peng WANG ; Jian-guo ZHANG ; Jian-hua HU ; Fu-hui DONG ; Gui-xing QIU
Chinese Journal of Surgery 2009;47(17):1327-1331
OBJECTIVETo measurement the vertebra morphology using multi-planar reformations method of multi-slice spiral CT (MSCT) in AIS girls, and To compare with age and gender-matched controls in order to affirm the morphology results of abnormal development of the anterior and posterior elements in AIS.
METHODSThoracic and lumbar spine multi-slice spiral CT was undertaken on 52 girls with AIS between the age of 10 and 18 years from June 2004 to May 2008 in Peking Union Medical College Hospital and Beijing Shijitan Hospital, and 54 age and gender-matched non-IS controls. Multiple measurements (including the anterior column and posterior column) of each thoracic and lumbar vertebra were obtained using the 3D-MPR technique. The patients and control were divided into 10-14 years old group and 15-18 years old group. The corresponding vertebral anterior height, vertebral posterior height, transverse distance, vertebra central width, vertebra anterior-posterior distance, area of pedicle, pedicle height, pedicle width, and upper-lower facet distance were compared.
RESULTSCompared with the controls, the 10-14 years old group girls' spine had longer anterior column height, relative shorter posterior column (there are difference from thoracic 2-11 and lumbar 1-3, P < 0.05), relative longer anterior-posterior vertebral distance, vertebral wedging changes in vertebral, distinct vertebral and pedicle asymmetry on the concave and convex side, and upper-lower facet distance asymmetry on the concave and convex side. The difference between the anterior and the posterior column ratio was significantly different from that in the controls (P < 0.01). But there hadn't the same difference in 15 - 18 years old group.
CONCLUSIONSThere are differences in coronal plane vertebra wedging changes in AIS patient. There are high vertebra height, relative shorter posterior column, relative longer anterior-posterior vertebral distance, and relative slender vertebra in 10 - 14 years old AIS patients. This may lead to the initial and progression of scoliosis.
Adolescent ; Case-Control Studies ; Child ; Female ; Humans ; Lumbar Vertebrae ; diagnostic imaging ; Scoliosis ; diagnostic imaging ; surgery ; Thoracic Vertebrae ; diagnostic imaging ; Tomography, X-Ray Computed
7.Radiological features of traumatic vertebral endplate fracture: an analysis of 194 cases with 263 vertebral fractures.
Xiao-Rong WANG ; Fei-Rong XU ; Qiu-Li HUANG ; Yì Xiáng J WÁNG
Chinese Medical Journal 2020;133(22):2696-2702
BACKGROUND:
The importance of identifying osteoporotic vertebral endplate or/and cortex fracture (ECF), which primarily includes endplate fracture (EPF) and vertebral anterior cortex buckling, has been recognized. However, some old traumatic ECFs with healing process in the elderly may be mistaken as osteoporotic. This study analyzes the radiological features of traumatic EPF.
METHODS:
This was a retrospective analysis of 194 spine trauma patients with 263 vertebral fractures (mean age: 42.11 ± 9.82 years, 118 males and 76 females). All patients had traumatic EPF identified by X-ray/CT/MRI.
RESULTS:
The involved vertebra was mostly L1 (29.7%), followed by T12 and L2. Except EPFs involved both superior and inferior endplates (12.6%), only 1.9% involved inferior endplate alone, with the majority involved superior endplate. If each endplate was divided into five segments of equal lengths (from anterior to posterior: a1, a2, m, p2, p1), the most depressed point of superior EPFs was mostly at segment-a2 (approximately 45%), followed by segment-a1 (approximately 20%) or segment-m (approximately 20%), and very rarely at segment-p1. The upper 1/3 of anterior vertebral wall was more likely to fracture, followed by middle 1/3 of anterior wall. For posterior vertebral wall fracture, 68.5% broke the bony wall surrounding the basivertebral vain. 58.6%, 30.0%, and 11.4% of vertebral fractures had <1/5, 1/5-1/3, and >1/3 vertebral body height loss. As the extent of vertebral height loss increased, the chance of having both superior and inferior EPFs also increased; however, the chance of having inferior EPF alone did not increase.
CONCLUSION
Traumatic EPF features are characterized, which may help the differentiation of traumatic and osteoporotic EPFs.
Adult
;
Aged
;
Female
;
Fractures, Bone
;
Humans
;
Lumbar Vertebrae/diagnostic imaging*
;
Male
;
Middle Aged
;
Osteoporotic Fractures/diagnostic imaging*
;
Radiography
;
Retrospective Studies
;
Spinal Fractures/diagnostic imaging*
;
Thoracic Vertebrae
8.The anatomic and radiographic morphometry of thoracic pedicle rib unit.
Xing WEI ; Jian-jun HE ; Shu-xun HOU ; Ya-min SHI ; Yu-peng ZHANG ; Xiao-ning WANG ; Bing-yao CHEN
Chinese Journal of Surgery 2010;48(17):1313-1316
OBJECTIVESTo investigate the spatial structure of pedicle rib units in normal thoracic human spines and to compare the dimensions of the pedicle rib unit with corresponding dimensions.
METHODSThoracic spine specimens in four fresh adult cadaveric were used. Computerized tomographic (CT) images (including two-dimensional, three-dimensional reconstruction) of the thoracic spines were obtained. Measurement parameters include:the width, the height, the chord length and the sagittal angles of the pedicle rib unit compared with pedicle, especially for the pedicle-rib overlapping height.
RESULTSThe pedicle rib unit was not a simple two-dimensional structure but a three-dimensional structure. The shortest height of pedicle rib unit was (12.6 ± 0.8) mm (T(1)), while the longest was (16.9 ± 1.1) mm (T(11)). The shortest height of pedicle-rib overlap was (7.2 ± 0.3) mm (T(1)), while the longest was (11.8 ± 1.0) mm (T(10)). The height of pedicle rib unit and the height of pedicle were significantly larger than that of the pedicle-rib overlap (P < 0.05), while there was no significantly difference between the height of pedicle rib unit and the height of pedicle (P > 0.05).
CONCLUSIONSThe pedicle rib unit is a complicated spatial structure, and the longitudinal height of pedicle-rib overlap should be taken as the real height of the unit.
Adult ; Bone Screws ; Humans ; Male ; Radiography ; Ribs ; anatomy & histology ; diagnostic imaging ; Thoracic Vertebrae ; anatomy & histology ; diagnostic imaging ; surgery
9.Classification of thoracic pedicle according to the transverse diameters in thoracic idiopathic scoliosis patients and its clinical significance.
Yong QIU ; Gang YIN ; Bin WANG ; Feng ZHU ; Xu SUN ; Guang-quan SUN ; Wen-jun LIU
Chinese Journal of Surgery 2010;48(5):353-357
OBJECTIVESTo explore the clinical significance of the transverse thoracic pedicle diameters measurement and thoracic pedicles classification in thoracic adolescent idiopathic scoliosis patients.
METHODSThirty thoracic idiopathic scoliosis patients who were hospitalized during October 2008 and July 2009 and 20 non-scoliosis adolescents who were adopted during August 2008 and July 2009 were included in this study. Successive CT thoracic vertebrae scanning of all subjects were obtained. All participants' transverse pedicle diameters of the thoracic vertebrae were measured with the software of PACS Client. Classified the pedicle into 4 types according to the transverse pedicle diameters. In control group, the transverse pedicle diameters of bilateral thoracic vertebrae were compared using paired-t test. In AIS group, the transverse pedicle diameters of concave and convex side thoracic vertebrae were compared using paired-t test. The distribution of pedicle types were compared using Chi-Square test between the control group and AIS group.
RESULTSThe transverse pedicle diameters showed a decreasing trend from T(1) to T(4) followed by an increasing trend from T(5) to T(12) in both groups. The bilateral transverse pedicle diameters had no significant difference in the control group. The transverse pedicle diameters of the concave side at the apex of thoracic curve were found to be significantly thinner than those of convex side. The ratio of Type 4 was higher in thoracic adolescent idiopathic scoliosis patients than the controls, and the ratio of Type 1 was smaller in thoracic adolescent idiopathic scoliosis patients than the controls.
CONCLUSIONSThe thoracic pedicles in thoracic adolescent idiopathic scoliosis patients are often rather thinner. Preoperative CT measurement of thoracic pedicle in the treatment of idiopathic scoliosis is suggested helpful in deciding the correct strategy of pedicle screw insertion and decreasing the risk of clinically relevant neurovascular complications.
Adolescent ; Child ; Female ; Humans ; Male ; Radiography ; Scoliosis ; diagnostic imaging ; pathology ; surgery ; Thoracic Vertebrae ; diagnostic imaging ; pathology ; surgery ; Young Adult