1 / 178

ROBERTO CARTOLARI

ROBERTO CARTOLARI. The Axial Loaded Imaging of the Lumbar Spine 18 Years After. Is It Still a Valuable Examination?. U.O.D. DI Neuroradiologia Ospedale “Belcolle” Viterbo – Italy Servizio di Radiologia Ospedale “S. Giovanni” – EOC Bellinzona - Switzerland. AL-CT.

lindsey
Download Presentation

ROBERTO CARTOLARI

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. ROBERTO CARTOLARI The Axial Loaded Imaging of the Lumbar Spine 18 Years After. Is It Still a Valuable Examination? U.O.D. DI Neuroradiologia Ospedale “Belcolle” Viterbo – Italy Servizio di Radiologia Ospedale “S. Giovanni” – EOC Bellinzona - Switzerland

  2. AL-CT In 1992 the idea of Axial Loading

  3. AL-CT Newton’s third law of Conservation of the Momentum

  4. AL-CT Newton’s third law of Conservation of the Momentum

  5. NON-PATHOLOGIC MOTION PATTERN REFERENCE MODEL OF THE SPINE UNDER A PURE AXIAL LOAD

  6. The AxialLoaderis a non-ferromagnetic/x-Raytransparentdevice

  7. The Axial Loader is a non-ferromagnetic/x-Ray transparent device

  8. AL-CT TECHNIQUE • Basal/AL Volumetric acquisition (L2-L3/S1) • MPR (Sagittal plane) • 3D SSD • Basal/AL images cine-loop

  9. AL-MRI TECHNIQUE • Basal acquisition (Sag T1w, Sag T2w, Ax T2w) • AL Volumetric acquisition (Sag T1w, Sag T2w, Ax T2w) • Basal/AL images cine-loop

  10. Axial Images Sagittal Images 3D Images

  11. AL-CT/MRI REMEMBER !!! • only axial loading (the simplest work) • no motion is superimposed • the Patient is SUPINE (it’ s not true orthostatism)

  12. AL-CT/MRI REMEMBER !!! • all the findings are REAL (no distortion artifacts)

  13. AL-CT/MRI FINDINGS CLINICAL SIGN !!! > 90% Patients referred partial to total recurrence of their symptoms during axial loading

  14. AL-CT/MRI: WHEN? THE CLINICAL PICTURE DOESN’ T MATCH THE BASIC IMAGING (X-RAY, CT, MRI)

  15. AL-CT/MRI FINDINGS Elementary Dynamic Modifications Intervertebral Disc Modifications Alterations of Intersomatic Relationships Alteration in Relationships of Articular Processes Narrowing of Spinal Neural Foramina Thickening of Ligamenta Flava Narrowing of Interspinous Spaces and Hypermobility of the Spinous Processes

  16. THE “PARADOXICAL MOTION”

  17. THE “DISC VACUUM SIGN”(“telescoping spine” – J.R.Jinkins, 2002)

  18. THE “ARTICULAR VACUUM SIGN” (CT)/DISPLACEMENT OF INTRARTICULAR FLUID (MRI)

More Related