MRI of difficult discs

Waindim, F.; Crim, J.

doi:10.1016/j.crad.2022.11.009

Cited by 4 publications

(6 citation statements)

References 30 publications

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“…Interestingly, 1 recent radiological series describing MRI characteristics of different disc herniations showed a left L2–3 sequestered foraminal disc herniation that was also isointense on T1-weighted imaging and hyperintense on T2-weighted imaging that was suspicious for breast metastasis given the patient’s prior history of breast cancer. 11 Despite being rarer, this example highlights that upper lumbar spine disc herniations can be misdiagnosed as tumors but may be underreported in the literature.…”

Section: Discussionmentioning

confidence: 92%

“…Migratory disc herniations can travel to various locations, including epidural, intradural, intraneural, lateral (intraforaminal or extraforaminal), or retroperitoneal spaces. [5][6][7][8][9][10][11] Because these fragments can separate from the parent defect, they can present as isolated distinct lesions and appear differently than typical disc herniations on imaging. These variations in imaging characteristics can make diagnosing far lateral disc herniations challenging.…”

Section: Discussionmentioning

confidence: 99%

“…Despite its less frequent occurrence in the upper lumbar spine at the L1-2 and L2-3 levels, far lateral disc herniations can occur in these segments and imitate peripheral nerve sheath tumors radiographically. 5,6,8,11,16 Previous case reports and a literature review described lateral disc herniations in the lower lumbar spine and lumbosacral plexuses that mimicked a nerve sheath tumor (Table 1). [5][6][7][8]17 Cases 1 and 2 are the first known reported cases of an L1-2 and L2-3 far lateral disc herniation mimicking a peripheral nerve sheath tumor.…”

Section: Discussionmentioning

confidence: 99%

“…Migratory disc fragments are usually hypointense or isointense on T1-weighted MRI and hyperintense on T2-weighted MRI due to residual water content or water gain from inflammation. 11 , 12 Gadolinium contrast can help differentiate herniated disc material from tumors, postoperative scar tissue, or abscesses. Generally, disc material is avascular and thus does not enhance with intravenous contrast, while tumors usually extensively enhance with contrast.…”

Section: Discussionmentioning

confidence: 99%

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Upper lumbar spine far lateral disc herniations masquerading as peripheral nerve sheath tumors: illustrative cases

Sun

Muftuoglu

et al. 2023

Journal of Neurosurgery: Case Lessons

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BACKGROUND Migratory disc herniations can mimic neoplasms clinically and on imaging. Far lateral lumbar disc herniations usually compress the exiting nerve root and can be challenging to distinguish from a nerve sheath tumor due to the proximity of the nerve and characteristics on magnetic resonance imaging (MRI). These lesions can occasionally present in the upper lumbar spine region at the L1–2 and L2–3 levels. OBSERVATIONS The authors describe 2 extraforaminal lesions in the far lateral space at the L1–2 and L2–3 levels, respectively. On MRI, both lesions tracked along the corresponding exiting nerve roots with avid postcontrast rim enhancement and edema in the adjacent muscle tissue. Thus, they were initially concerning for peripheral nerve sheath tumors. One patient underwent fluorodeoxyglucose positron emission tomography–computed tomography (FDG PET-CT) screening and demonstrated moderate FDG uptake on PET-CT scan. In both cases, intraoperative and postoperative pathology revealed fibrocartilage disc fragments. LESSONS Differential diagnosis for lumbar far lateral lesions that are peripherally enhancing on MRI should include migratory disc herniation, regardless of the level of the disc herniations. Accurate preoperative diagnosis can aid in decision making for management, surgical approach, and resection.

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Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Upper lumbar spine far lateral disc herniations masquerading as peripheral nerve sheath tumors: illustrative cases

Sun

Muftuoglu

et al. 2023

Journal of Neurosurgery: Case Lessons

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“…IAAA does not present with serious symptoms in the early stages, and back pain is the main complaint in 44% cases; therefore, orthopedicians are likely to be involved. However, in cases of lower back pain without the primary complaint of fever, abdominal examinations and blood investigations are rarely performed, and orthopedic surgeons tend to focus only on their area of expertise in diagnostic imaging 13,14 . Focusing on the spine and spinal cord, without paying attention to the soft tissues that appear in the imaging, can lead to overlooking serious diseases such as IAAA.…”

Section: *Outcome and Follow-upmentioning

confidence: 99%

Imminent rupture of infected aortic aneurysm presenting as lower back pain in an older patient

Takashima

Morimoto

Hirata

et al. 2023

Preprint

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This a preprint and has not been peer reviewed. Data may be preliminary.Furthermore, we believe that there are lessons to be learned from the clinical course of our patient and that this paper will be of interest to the readers of your journal. We hope that the takeaway message will serve as a reminder to physicians regarding consideration of diagnosis of infectious aneurysms when patients present with lower back pain. A delayed diagnosis can have serious consequences and may lead to unsatisfactory clinical outcomes. We hope that the information provided in this report will aid in early detection and treatment of this disease.

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Current Advances in Viral Nanoparticles for Biomedicine

Sun,

Tian,

Lian

et al. 2024

ACS Nano

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Viral nanoparticles (VNPs) have emerged as crucial tools in the field of biomedicine. Leveraging their biological and physicochemical properties, VNPs exhibit significant advantages in the prevention, diagnosis, and treatment of human diseases. Through techniques such as chemical bioconjugation, infusion, genetic engineering, and encapsulation, these VNPs have been endowed with multifunctional capabilities, including the display of functional peptides or proteins, encapsulation of therapeutic drugs or inorganic particles, integration with imaging agents, and conjugation with bioactive molecules. This review provides an in-depth analysis of VNPs in biomedicine, elucidating their diverse types, distinctive features, production methods, and complex design principles behind multifunctional VNPs. It highlights recent innovative research and various applications, covering their roles in imaging, drug delivery, therapeutics, gene delivery, vaccines, immunotherapy, and tissue regeneration. Additionally, the review provides an assessment of their safety and biocompatibility and discusses challenges and future opportunities in the field, underscoring the vast potential and evolving nature of VNP research.

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MRI of difficult discs

Cited by 4 publications

References 30 publications

Upper lumbar spine far lateral disc herniations masquerading as peripheral nerve sheath tumors: illustrative cases

Upper lumbar spine far lateral disc herniations masquerading as peripheral nerve sheath tumors: illustrative cases

Imminent rupture of infected aortic aneurysm presenting as lower back pain in an older patient

Current Advances in Viral Nanoparticles for Biomedicine

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