[Recurrent postoperative sciatica. Prospective evaluation of magnetic resonance imaging and x-ray computed tomography with iodine injection]. / Sciatique post-opératoire récidivée. Evaluation prospective de l'imagerie par résonance magnétique et de la tomodensitométrie avec injection iodée.

The respective performance of MRI and CT were studied prospectively in 80 cases. Surgery was indicated in 56 patients after MRI examination and 21 patients after CT; the 21 patients were included in the 56. Among these patients, 45 were reoperated and 11 preferred the medical treatment. Surgery confirmed the diagnosis for 44 patients (from the 45), and the only discordance was the presence of ligament calcification, associated to a disc protrusion not seen on MRI. Surgery confirmed also the diagnosis for the 21 cases diagnosed by CT after iodine injection. However, among the 24 cases of fibrosis diagnosed by CT after i.v. injection were found: 19 recurrent disc protrusions, 4 disc protrusions with fibrosis, and 1 disc protrusion at a level above the operated disc.

Recurrent postoperative sciatica: evaluation with MR imaging and enhanced CT.

Magnetic resonance (MR) imaging and computed tomography enhanced with intravenous iodine injection (ECT) were prospectively compared in 80 patients in the diagnosis of recurrent postoperative sciatica. Diagnostic accuracy was determined with surgical verification. Isolated fibrosis was considered a contraindication to surgery. A decision to operate was made in 56 of the 80 patients on the basis of MR imaging findings; in 21 of the 56, the decision was also made on the basis of ECT findings. Of the 80 patients, 45 underwent surgery, In all but one of these patients, the diagnosis made on the basis of MR imaging findings was confirmed with surgical analysis. The only surgical finding that did not agree with MR imaging findings was a calcification of the common posterior ligament. The 21 diagnoses of disk herniation based on ECT findings were confirmed surgically, but among the 24 diagnoses of fibrosis made with the help of ECT, there were actually 19 recurrent herniations, four herniations with fibrosis, and one herniation at the level above the previously resected disk. MR imaging seems to be the investigation of choice in diagnosing the cause of recurrent postoperative sciatica.

MRI anatomy of the nerves of the upper limb.

In view of the good anatomic definition of the images obtained by magnetic resonance imaging (MRI), we have defined MRI sections allowing study of the nerves of the upper limb.

[Role of MRI in the study of the Achilles tendon and patellar tendon]. / Place de l'IRM dans l'étude du tendon d'Achille et du tendon rotulien.

The possibilities of MRI and radiography with mammogram to diagnose mechanical tendinitis have been prospectively evaluated in thirty sportsmen. Sixteen had Achilles tendon lesion, fourteen had patellar ligament lesion. Each patient included in the study was programmed for radiography with mammogram and MRI of the pathologic tendon and the controlateral tendon. These examinations were separately interpreted by two reviewers who had no knowledge of pain location. The number of tendinitis diagnosis based on X-ray and MRI was approximatively the same. But the microtearings were more often diagnosed on MRI data than on X-ray data (10/1). Eight patients underwent an operation. The surgery findings always confirmed the MRI diagnoses. MRI seems to be the examination of choice to evaluate the tendon injuries and particularly microtearings before surgery.

[Comparison of MRI and scanning coupled with myelography in the diagnosis of cervicobrachial neuralgia]. / Comparaison de l'IRM et du scanner couplé à la myélographie dans le diagnostic des névralgies cervico-brachiales.

A prospective study was undertaken to compare the accuracy of surface coil magnetic resonance imaging (MRI) and computed tomography with myelography (CTM) in the determination of cervical radiculopathy with or without myelopathy. Twenty five patients underwent both imaging studies. The separately imaging diagnosis and the surgical findings were the basis of this study. The based-MRI and based-CTM predictions were not significant. MRI predicted two disc herniations that CTM did not predict. CTM predicted a combination of disk herniation and stenosis and one more lateral stenosis that MRI did not predict. Among the fourteen patients who underwent surgery, one underwent surgery only on based-MRI prediction, it was a disc herniation; one patient was operated on only on based-CTM prediction, it was a stenosis. In these operated patients, the predictive value of the both imaging modalities was not significant. In this report the diagnostic assessment of MRI and CTM was overall the same. The major advantages of MRI were its ability to display all the cervical spine, to study the disk pathology and to delineate a signal alteration within cord substance but the disadvantage was the difficulty to characterize the osteophytes made of cortical bone which did not give signal.

[A new diagnostic method of spondylodiscitis. Magnetic resonance imaging]. / Une nouvelle méthode diagnostique de la spondylodiscite. L'imagerie par résonance magnétique.

Twenty four patients who were hospitalized for a suspicion of spondylodiscitis were prospectively evaluated with magnetic resonance imaging (MRI), radiology and radionuclide studies. Fifteen patients had an infectious spondylodiscitis, four had a vertebral degenerative disease, four had a rheumaticus spondylodiscitis, one had a chemical spondylodiscitis. The microbiological examinations and the clinical development bore the diagnosis out. Seven patients underwent Indium 111 scanning. The results of this scanning were correlated with MRI results. The MRI was performed with a 0.35 T whole body superconducting unit using spin echo technique. All patients were studied in the sagittal plane with two pulse sequences and more often with a surface-coil: TR 500 msec./TE 28 msec. and TR 2,000 msec./TE 60 msec. In all cases of true infectious spondylodiscitis the MRI results finding were characteristics. On the image obtained with the TR 500 msec./TE 28 msec., there was a confluent decreased signal intensity from the vertebral bodies and the intervertebral disk space. On the image obtained with TR 2,000 msec./TE 60 msec. there was an increased signal intensity from the vertebral bodies and the intervertebral disk space. The other spondylodiscitis have given a different MRI imaging, it was a confluent decreased signal intensity from the vertebral bodies and the intervertebral disk space on the twice pulse sequences. different images were obtained during the evolution of the infectious: first we observed a modification of the vertebral signal then the typical image that we described then a normal signal of the vertebral bodies with a pathological signal from the intervertebral disk space at last a degenerative intervertebral disk.(ABSTRACT TRUNCATED AT 250 WORDS)

[Value of magnetic resonance imaging in the diagnosis of recurrent postoperative lumbosciatica]. / Intérêt de l'imagerie par résonance magnétique dans le diagnostic des lombosciatiques récidivantes post-opératoires.

Twelve patients who had a subsequent lumbar sciatica after surgery were evaluated with computerized tomography (C.T.) and magnetic resonance imaging (M.R.I.). The M.R.I. was performed with a 0.35 T whole body superconducting unit using spin echo technique. Two pulse sequences were realized varying the repetition time (TR) from 500 to 2,000 ms and the echo time (TE) from 28 to 60 ms. For the longer pulse, the twice echo were interpreted. The slide obtained with a surface-coil were performed in sagittal plane for the twice pulse sequences and in transaxial plane for the shorter pulse sequence. In seven cases, the results obtained with C.T. and M.R.I. were correlated. In two cases, the C.T. showed a scar formation, the M.R.I. showed a recurrent disk herniation. In three times, C.T. was unable to differentiate clearly between recurrent disk herniation and scar formation, the M.R.I. showed unequivocally on one case a scar formation and on two cases a recurrent disk herniation.

[B27-negative spondylarthritis. Results of 3 familial surveys, with monozygotic twins in one]. / Les spondylarthrites B27 négatives. Résultats de trois enquêtes familiales dont une avec jumeaux monozygotes.

With the typing of the major histocompatibility complex (HLA, A, C, B, Bf, C4, DR, GLO), the authors study three (3) family investigations of patients suffering from primary ankylosing spondylarthritis, B27 negative, including one concerning a discordant pair of monozygotic female twins. The possible links between the patient's haplotypes and the phenotypic expression of their ankylosing spondylarthritis, B27 negative, is discussed: a complotype (C4 A4 B2) and 2 antigens (B18 and Bw62) from the group B35 CREG over-represented in ankylosing spondylarthritis (Family n degree 1): presence of antigen B40 of B7 CREG in the patient of Family n degree 2, contrasting with the presence of antigen B27 in 2 first-degree parents, apparently healthy; presence of antigen B7 from the B7 CREG and the possible role of an environmental factor in the discordant monozygotic female twins (Family n degree 3). The results are compared to the studies of families with ankylosing spondylarthritis, B27 negative, of monozygotic twins and discordant ankylosing spondylarthritis-antigen B27 reported in the literature. Pathogenetic implications are discussed (linked gene hypothesis, direct role and/or heterogeneity of B27).