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MRI Contribution in the Diagnosis of Non-Traumatic Medular compressions at the Mali Hospital of about 179 Cases

Open Journal of Medical Imaging 2020年第4期10卷 186-195页

作者： Mody Abdoulaye Camara Mamadou N’Diaye Mamadou Bakary Coulibaly Mohamed Maba Traore Hawa Diarra Boubacar Mama Toure Abourahman Abdillahi Nour Salia Coulibaly Ilias Guindo Madani Ouologuem Sounkalo Traore Mahamane Mariko Aphou Sallé Kone Moussa Konate Siaka Sidibe Medical Imaging Department of Mali Hospital Bamako Mali Radiology Unit of the Bamako Infirmary Hospital Bamako Mali Gynecology Department of Mali Hospital Bamako Mali Medical Imaging Department at Kati University Hospital Bamako Mali Neurology Unit of the Bamako Infirmary Hospital Bamako Mali Radiology Unit of the Reference Health Center of the Commune V Bamako Mali Medical Imaging Department of CHME Luxembourg Bamako Mali Radiotherapy Department of Mali Hospital Bamako Mali Radiology Department of CHU POINT G Bamako Mali

Slow spinal compressions are due to the development of an expansive process in the spinal canal. It is a very common pathology, the diagnosis of which is mainly clinical. However, magnetic resonance imaging occupies an essential place in the site diagnosis and etiological research in the management. Non-traumatic spinal cord compression is a diagnostic and therapeutic emergency, requiring early and appropriate management. MRI is the benchmark imaging examination for this pathology. No similar previous MRI study in Mali. We undertook this work with the aim to determine the place of MRI in the diagnosis of spinal cord compressions in Mali hospital. Method and Patients: This was a descriptive retrospective study, carried out at the hospital’s medical imaging department from January 1, 2017 to December 31, 2018 (02 years). It involved all patients, regardless of sex and age, sent for an MRI examination of the spine, and in whom spinal cord compression was diagnosed. We used a 0.35T low-field MRI machine with solid-state antennas. Results: We collected 179 cases of spinal cord compression MRI out of 585 spinal MRI performed, (frequency of 30.59%). The average age was 53.5 years with a male predominance (sex ratio 3.7). Motor disorders were the most common reason for examination (41%). We used the T1 T2 sagittal and T2 axial sequences. IV injection of gadolinium was performed in 48% of patients. The topographic lesions were: cervical (54.7%), thoracic (31.3%) and several segments (9.5%). The lesions concerned the compartments: extradural (79.3%), intradural (4.5%), and intramedullary (16.2%). The processes were degenerative (57.5%). tumorous (29.6%), infectious (12.3%) and vascular (0.6%). Conclusion: MRI is the benchmark imaging test for the management of non-traumatic spinal cord injury. Myelo-CT can be an alternative in the absence or in case of MRI contraindication.

关键词： spinal cord compression Non Traumatic MRI Mali Hospital

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Single-stage en bloc resection using a posterior approach for sacral tumors

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Oncology and Translational Medicine 2016年第2期2卷 65-68页

作者： Zhong Fang Wei Wu Wei Xiong Guanghui Li Hui Liao Jun Xiao Fengjing Guo Anmin Chen Feng Li Department of Orthopaedic Surgery Tongji Hospital Tongji Medical College Huazhong University of Science and Technology

Objective This study aims to investigate the surgical results of single-stage en bloc resections using a posterior approach for sacral tumors and evaluate its benefit for these tumors.Methods A total of 32 cases involving patients with sacral tumors who were treated with single-stage en bloc resection by posterior approach from April 2004 to January 2010 were reviewed. The patient cohort included 20 males and 12 females. The average patient age was 49.1 years old(range, 18 to 75 years old). Twenty-seven patients suffered from primary sacral tumors, including 17 patients with chordomas, 5 patients with giant cell tumors of the bone, 3 patients with chondrosarcoma, 1 patient with sarcoma of the nerve fibers, and 1 patient with neurofibromatosis. Five patients were diagnosed with sacral metastatic tumors, including 2 cases of breast cancer, 1 case of renal carcinoma, 1 case of thyroid cancer, and 1 case of lung cancer. According to the Frankel grading system, there were 3 Grade B tumors, 4 Grade C tumors, 10 Grade D tumors, and 15 Grade E tumors. Results The operation took 265 min on average(range, 130–360 min), and blood loss was 1676 m L on average(range, 800–1800 m L) during the operation. The follow-up period ranged from 6 months to 6.2 years. All patients had pain prior to operation. Twenty-eight patients experienced complete pain-relief, and 4 patients experienced partial pain-relief after their operations. In all patients, neurological function was improved more than one grade using the Frankel grading system. Up to now, 5 patients experienced local recurrence after operation, and 2 patients were deceased. The remaining patients are still alive without recurrence. Conclusion Single-stage en bloc resection through a posterior approach for sacral tumors is feasible, safe, and effective. It has many advantages, such as controlling local recurrence, thorough decompression of the spinal cord, relieving pain, improving quality of life, and prolonging survival.

关键词： sacrum tumor en bloc resection spinal cord compression reconstruction

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