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Biomedical subjects

John A Carrino

Publications and source records attributed to John A Carrino.

At least 19 recordsLinked to original sources
PubMed2007

Prospective evaluation of contrast-enhanced MR imaging after uncomplicated lumbar discography.

OBJECTIVE: Postdiscography infection is an uncommon complication. Magnetic resonance (MR) imaging is often the modality of choice for evaluating spinal infection. Discography entails disc access and fluid injection that could alter the baseline MR imaging appearance of the spine and be confounded for infection. Our purpose was to describe the MR imaging findings of the lumbar spine subsequent to uncomplicated discography and to determine if this may mimic infection. DESIGN AND PATIENTS: In a prospective cohort study of eight adults (age 22-64 years, mean 45 years) with 22 intradiscal injections, all subjects underwent routine unenhanced and contrast-enhanced MR imaging during the 2-3 week interval postdiscography. A subset of four returned for additional MR imaging during the 4-8 week interval postdiscography. MR images were reviewed for intradiscal, endplate, marrow, and epidural findings and then compared with prediscography examinations. Infection was excluded by clinical documentation. RESULTS: Postdiscography MR imaging showed that almost all levels were similar to baseline prediscography examinations. No levels developed new vertebral marrow edema, fluid-like intradiscal signal, endplate irregularity, or epidural abnormality. Two subjects simulated potential discitis, but these findings were unchanged from prediscography and were related to prior surgery. CONCLUSIONS: Uncomplicated lumbar spine discography does not cause MR imaging changes that simulate discitis.

Adult↗
PubMed2006

Long-term magnetic resonance imaging evaluation of bioresorbable anterior cervical plate resorption following fusion for degenerative and traumatic disk disruption.

STUDY DESIGN: A retrospective magnetic resonance imaging (MRI) review of a series of patients who underwent a single-level anterior cervical discectomy and fusion followed by anterior plate stabilization using an anterior cervical resorbable mesh plate and screw system. OBJECTIVE: MRI evaluation of the long-term implant resorption properties of a bioresorbable anterior cervical plate and the adjacent peri-implant soft tissue environment. SUMMARY OF BACKGROUND DATA: The use of bioresorbable anterior cervical plates for immediate cervical stabilization following an anterior cervical discectomy and fusion presents several distinct advantages over metallic instrumentation. Bioresorbable polymers may diminish, by their resorbability, implant-related complications such as loosening, migration, and failure of instrumentation, as well as stress shielding of the underlying fusion. Information on the intermediate and long-term bony and soft tissue reaction to the resorption byproducts of these biomaterials is limited. METHODS: There were 9 consecutive patients who underwent single-level anterior cervical decompression and fusion using allograft cortical bone, followed by bioresorbable polylactide anterior mesh plate and screw fixation. Following institutional review board approval, 5 of the 9 patients agreed to postoperative MRI assessment of the peri-implant area. An independent radiologist then characterized implant degradation, and the presence of soft tissue inflammation and swelling during the resorption phase of the bioresorbable plate. RESULTS: At an average follow-up of 32 months, MRI assessment showed no evidence of soft tissue swelling or inflammation related to the resorption of a bioresorbable anterior plate in any of the 5 patients. In addition, none of the patients complained of any dysphagia or phonation difficulties. CONCLUSIONS: Based on MRI assessment, these devices, at more than 2-year follow-up, did not indicate any local chronic inflammation or swelling resulting from their degradation. Clinical symptoms of dysphagia or dysarthria, a common reported problem following anterior cervical spine procedures, were not observed in any patient.

Absorbable Implants↗
PubMed2006

Unsuspected lower extremity deep venous thrombosis simulating musculoskeletal pathology.

OBJECTIVE: The purpose of this study was to highlight the critical role that MRI may play in diagnosing unsuspected lower extremity deep venous thrombosis and to stress the importance of scrutinizing MRI studies of the lower extremity showing apparently non-specific muscle edema for any evidence of intramuscular venous thrombosis. DESIGN AND PATIENTS: The imaging studies of four patients in whom deep venous thrombosis was unsuspected on clinical grounds, and first diagnosed on the basis of MRI findings, were reviewed by two musculoskeletal radiologists in consensus. In all four patients the initial clinical suspicion was within the scope of musculoskeletal injuries (gastrocnemius strain, n=3; ruptured Baker cyst, n=1), explaining the choice of MRI over ultrasound as the first diagnostic modality. RESULTS: All patients showed marked reactive edema in the surrounding soft tissues or muscles. Three patients showed MR evidence of branching rim-enhancing structures within intramuscular plexuses characteristic of venous thrombosis (gastrocnemius, n=1; sural, n=2); one patient showed a distended popliteal vein. Ultrasound was able to duplicate the MRI findings in three patients: one patient showed above-the-knee extension on ultrasound; neither of the two patients with intramuscular thrombosis demonstrated on ultrasound showed extension to the deep venous trunks. CONCLUSION: Intramuscular venous thrombosis can present as marked edema-like muscle changes on MRI, simulating primary musculoskeletal conditions. In the absence of clinical suspicion for deep venous thrombosis, only the identification of rim-enhancing branching intramuscular tubular structures will allow the correct diagnosis to be made.

Diagnosis, Differential↗
PubMed2006

High-signal T2 changes of the bone marrow of the foot and ankle in children: red marrow or traumatic changes?

BACKGROUND: High-signal T2-weighted bone marrow changes can be found in both bone marrow edema and hematopoietic marrow and are often seen on pediatric MR images of the feet and ankle. OBJECTIVE: To evaluate whether high-signal T2 changes of the bone marrow seen on pediatric MRI of feet and ankles represent residual hematopoietic marrow. MATERIALS AND METHODS: A total of 402 bones in 41 pediatric MRI studies of feet and ankles (34 children, 1-18 years) were reviewed by two observers who were blinded to the patients' ages. The studies were reviewed for the presence of high-signal changes of the bone marrow on sagittal fluid-sensitive images. The frequency and location of these foci were correlated with the patients' ages. RESULTS: High-signal T2 changes of the bone marrow were seen in 45/402 bones (11%) and in 24/41 patients younger than 16 years (59%). The changes were most commonly located in the calcaneus (54%), followed by the talus (35%) and navicular bone (35%), invariably at the endosteal surface. In 16 ankles, such foci were seen in the feet but not in the distal tibia/fibula. Symmetric presence (two ankles) or absence (four ankles) of high-signal marrow were seen in six of seven patients with bilateral ankles. CONCLUSION: High-signal T2 changes of the bone marrow in pediatric feet and ankle MRIs have a symmetric, fairly consistent pattern and disappear after the age of 15 years. We believe that these high-signal areas are normal and represent residual hematopoietic marrow.

Adolescent↗
PubMed2006

Bone augmentation: past, present, and future.

Painful skeletal and vertebral conditions caused by degeneration, fractures, infection, and neoplasm are common and associated with high morbidity and mortality. Since the introduction of modern orthopedic surgery these conditions have been treated with a multitude of techniques. Bone augmentation and grafting have emerged as integral parts of orthopedic reconstructive, reparative, and palliative surgery. As imaging-guided therapy has developed, image-guided procedures to achieve bone augmentation have also emerged. It is important for the radiologist to understand the materials and methods used to achieve bone augmentation. A variety of materials are available for the application of hone augmentation. Methods used to accomplish bone augmentation often are performed under image guidance. Applications in the axial skeleton include vertebroplasty, kyphoplasty (balloon-assisted vertebroplasty), sacroplasty, and acetabuloplasty. This article discusses the development, current trends, and possible future directions of bone augmentation.

Bone Transplantation↗
PubMed2006

Magnetic resonance--guided musculoskeletal interventional radiology.

As an imaging modality, magnetic resonance (MR) guidance has great potential to direct diagnostic and therapeutic procedures performed in the musculoskeletal region and influence patient management. MR-guided interventional procedures involving bone, soft tissue, intervertebral discs, and joints are safe and sufficiently effective for use in clinical practice. This article discusses and illustrates the procedural characteristics and techniques when performing MR-guided musculoskeletal interventions. Biopsy procedures are similar to other modalities for bone and soft tissue lesions. MR guidance is advantageous if the lesion is not visible by other modalities and for regions adjacent to hardware and implants, subselective targeting, intra-articular locations, and periarticular cyst aspiration. MR guidance has also been used for a host of spine injections and pain management procedures such as sacroiliac joint injections, discography, transforaminal epidural injection, selective nerve block, sympathetic block, celiac plexus block, and facet joint cryotherapy neurotomies. Future directions of clinical applications include tumor ablation and multimodality procedure suites. MR-guided musculoskeletal procedures will continue to be a growth area particularly for the diagnosis and treatment of bone and soft tissue neoplasia.

Humans↗
PubMed2006

Flexor carpi radialis tendinopathy: spectrum of imaging findings and association with triscaphe arthritis.

OBJECTIVE: To present the spectrum of pathology affecting the flexor carpi radialis (FCR), and its anatomical, functional and clinical relationship with conditions affecting the triscaphe or scapho-trapezium-trapezoid (STT) compartment, and particularly osteoarthritis. DESIGN: The study comprised two men and four women aged between 23 and 79 years (mean age, 49 years). Two musculoskeletal radiologists in consensus evaluated MRI findings. RESULTS: Five of the patients showed evidence of triscaphe osteoarthritis. One of the patients showed synovitis and reactive marrow edema at the triscaphe joint without more specific findings of osteoarthritis. Five patients showed evidence of FCR tenosynovitis. Partial-thickness tears were noted in three patients. Two patients showed complete discontinuity of the FCR; one of them had undergone prior tendon harvesting for interposition arthroplasty after trapezectomy. One patient showed a ganglion cyst in connection to the FCR tendon sheath. CONCLUSION: The FCR tendon courses over the volar surfaces of the scaphoid and trapezium in a separate fibro-osseous tunnel. This anatomical and functional relationship explains the coexistence of FCR tendinopathy and STT arthritis demonstrated by MR imaging.

Adult↗
PubMed2006

Posterior longitudinal ligament status in cervical spine bilateral facet dislocations.

OBJECTIVE: It is generally accepted that cervical spine bilateral facet dislocation results in complete disruption of the posterior longitudinal ligament. The goal of this study was to evaluate the integrity of numerous spine-stabilizing structures by MRI, and to determine if any associations between injury patterns exist with respect to the posterior longitudinal ligament status. DESIGN: Retrospective case series. PATIENTS: A retrospective review was performed of 30 cervical spine injury subjects with bilateral facet dislocation. Assessment of 1.5T MRI images was carried out for: intervertebral disc disruption, facet fracture, and ligamentous disruption. Statistical analyses were performed to evaluate for associations between various injury patterns and posterior longitudinal ligament status. RESULTS: The frequency of MRI abnormalities was: anterior longitudinal ligament disruption (26.7%), disc herniation or disruption (90%), posterior longitudinal ligament disruption (40%), facet fracture (63.3%) and disruption of the posterior column ligament complex (97%). There were no significant associations between injury to the posterior longitudinal ligament and other structures. Compared to surgical reports, MRI was accurate for determining the status for 24 of 26 ligaments (three of three anterior longitudinal ligament, seven of nine posterior longitudinal ligament, and 14 of 14 posterior column ligament complex) but generated false negatives in two instances (in both MRI showed an intact posterior longitudinal ligament that was torn at surgery). CONCLUSIONS: In contradistinction to the existing concept, the posterior longitudinal ligament can remain intact in a substantial proportion of hyperflexion injuries that produce bilateral cervical facet dislocation. Posterior longitudinal ligament integrity is not associated with any other injury pattern related to the anterior longitudinal ligament, intervertebral disc or facet fracture.

Adult↗
PubMed2006

High-resolution MR imaging of the proximal zone of the lunotriquetral ligament with a microscopy coil.

OBJECTIVE: To evaluate high-resolution MRI of the proximal zone of the lunotriquetral ligament (LTL) using a microscopy surface coil with a 1.5 T scanner. DESIGN AND SUBJECTS: The proximal zone of the LTL was reviewed in 90 subjects (23 asymptomatic normal volunteers and 67 patients with suspicion of triangular fibrocartilage complex injury) with high-resolution MRI using a 47-mm microscopy surface coil. High-resolution MR images were obtained with gradient recalled echo (GRE) T2*-weighted sequence and short tau inversion recovery imaging, with a 1- to 1.5-mm slice thickness, a 50-mm field of view, an imaging matrix of 140-224x512 using zero fill interpolation, and 3-4 excitations. As a qualitative analysis, the LTL was classified in shape and signal intensity. RESULTS: The triangle-shaped low-signal-intensity LTL was identified in 77 of 90 subjects (85.6%) on GRE images. The triangle was classified as regular (41.1%), broad-based (20.0%), narrow-based (6.7%), or asymmetrical (17.8%). The bar-shaped ligament was seen in one patient, and unclassified ligaments were seen in 12 patients. All volunteers showed triangle-shaped LTL. The MR signal intensity of the proximal zone in the LTL was characterized as homogeneously low intensity (type 1; 33.8%), linear intermediate or high signal intensity traversing the distal surface of the LTL (type 2; 45.5%), and linear intermediate or high intensity traversing both distal and proximal surfaces of LTL (type 3; 20.8%). CONCLUSION: The proximal zone of the LTL showed a broad spectrum of normal variations in shape and signal intensity on high-resolution MR images with a microscopy coil.

Adolescent↗
PubMed2006

Picture archiving and communication system and its impact on image viewing in physical therapy practice.

Imaging plays an increasing role in physical therapy (PT) practice. We sought to determine if picture archiving and communication system (PACS) deployment would increase the proportion of imaging studies viewed by physical therapists (PTs) at the point of care and to assess PTs' perception of the value of access to imaging information. The study was performed in a 720-bed urban teaching hospital where an average of 2,000 rehabilitation visits per month are performed by 12 PTs. We compared the proportion of imaging studies viewed by PTs before and after PACS implementation. We surveyed PTs to assess their perception on the value of access to imaging studies. Film library records pre-PACS and web server audit trail post-PACS implementation were reviewed to measure access. Chi-square was used to compare proportions and trends. During the 3-month period before PACS usage, PTs viewed 1% (6/505) of imaging studies, citing time as the primary barrier. Post-PACS, the proportion of imaging studies viewed rose from 28% (95/344, second month) to 84% (163/192, fifth month) (p < 0.0001, chi-square). Most PTs believed that access to imaging studies has high value and has a positive impact on clinical practice. Physical therapists rarely viewed imaging studies before PACS due to time barriers. They viewed more imaging studies (84%) post-PACS and felt that access to imaging studies has a positive impact on clinical practice. Further studies are needed to assess whether PACS enhances PTs' clinical decision making and improves patient outcomes.

Attitude of Health Personnel↗
PubMed2006

Statistical combination schemes of repeated diagnostic test data.

RATIONALE AND OBJECTIVES: When diagnostic tests are repeated and combined, a number of schemes may be adopted. Guidelines for their interpretations are required. MATERIALS AND METHODS: Three combination schemes, "and" (A), "or" (O), and "majority" (M), are considered. To evaluate these schemes, dependency by specifying kappa values quantifying repeated test agreement was structured. In a pilot study, the combined accuracies of magnetic resonance imaging using six different pulse sequences of medial collateral ligaments of the elbows of 28 cadavers, with eight having lesions artificially created surgically, were examined. Images were evaluated simultaneously by using a five-point ordinal scale. For each pulse sequence, individuals for whom the diagnosis varied from once to three repetitions were considered. RESULTS: Scheme M improves diagnostic accuracy when sensitivity and specificity of a single test exceed 0.5, with maximal improvement at 0.79. Under scheme A, sensitivity decreases to 0.38-0.59. Under scheme O, sensitivity increases to 0.53-0.79. Scheme M yields a small improvement, reaching 0.50-0.71. Under scheme A, specificity increases to 0.95-0.98. Under scheme O, specificity decreases to 0.91-0.98. Scheme M also yields a small improvement, reaching 0.94-0.98. CONCLUSION: Scheme A is recommended for ruling in diagnoses, scheme O is recommended for ruling out diagnoses, and scheme M is neutral. Consequently, different schemes may be used to optimize the target diagnostic accuracy.

Algorithms↗
PubMed2006

Usefulness of 18F-FDG PET-directed skeletal biopsy for metastatic neoplasm.

RATIONALE AND OBJECTIVES: Technium-99m methylene diphosphonate (99mTc-MDP) bone scintigraphy and 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET) are useful imaging modalities to detect skeletal metastases. Several other conditions such as infection, fractures, and arthritis can cause false-positive results with either modality. However, PET is felt to be more specific than bone scintigraphy for malignancy. Our objective was to investigate the value of PET scan compared with bone scintigraphy for directing biopsies in patients with suspected metastatic bone lesions. MATERIALS AND METHODS: Retrospective case series of subjects with undergoing skeletal biopsy of suspected metastases detected by 99mTc-MDP scintigraphy or 18F-FDG PET scan. Reference standards were pathologic reports and follow-up for 6 months. The diagnostic test performance measures of true positive (TP), false positive (FP), and positive predictive value (PPV) were calculated for each group. The PPV with 95% confidence intervals (CI) was compared using the Fisher exact test. RESULTS: There were a total of 68 subjects. PET-directed skeletal biopsies (n = 39) showed 35 TP, 4 FP, and an 89.7% PPV (95% CI: 75.7-97.1%). Bone scintigraphy directed biopsies (n = 29) had 21 TP, 8 FP, and 72.4 % PPV (95% CI: 52.7-82.7%). The PPV was not significantly different between the groups (P = .10). CONCLUSION: This study supports that PET can be used to effectively direct bone biopsies to confirm metastatic neoplasm and suggests that PET may provide incremental improvement to diagnostic yield over bone scintigraphy. The role of PET compared with bone scintigraphy for directing skeletal biopsies warrants further verification.

Biopsy↗
PubMed2006

Incidental vertebral fractures on chest radiographs. Recognition, documentation, and treatment.

BACKGROUND: Recognition of incidental vertebral fractures may be an important opportunity for identifying and treating osteoporosis. OBJECTIVE: To assess osteoporosis documentation rates in patients with vertebral fractures, and to define patient and hospitalization characteristics associated with osteoporosis management. DESIGN: Hospital and outpatient records were abstracted for patients with vertebral fractures on inpatient radiograph reports. The primary outcome of interest was discharge summary fracture documentation. Covariates associated with fracture documentation and treatment were examined with multivariate regression models. Secondary outcomes included osteoporosis documentation and management 6 months following discharge. PATIENTS: Women > or =50 years hospitalized at an academic medical center. RESULTS: Among 10,291 women with chest radiographs, 142 (1.4%) had vertebral fractures reported. Among patients with a reported fracture, 58 (41%) had their fracture noted in the findings section but not in the final impression. Only 23 (16%) discharge summaries documented a vertebral fracture. Factors associated with documentation of the fracture in the discharge summary included notation of the fracture in the impression section (odds ratio [OR] 3.7, 95% confidence interval [CI] 1.0 to 13.1), tobacco use (OR 3.7; 95% CI 1.1 to 12.2), discharge from a medical service (OR 7.6; 95% CI 0.9 to 66.2) and glucocorticoid use (OR 3.7; 95% CI 0.8 to 17.0). Only 36% of patients were using any osteoporosis medications at discharge. Fracture notation in the impression section was associated with fracture documentation in subsequent outpatient notes (OR 3.6, 95% CI 0.9 to 13.8). Discharge summary fracture documentation was associated with an increased likelihood of starting an osteoporosis medication by 6 months (OR 2.8; 95% CI 0.8 to 9.2). CONCLUSIONS: Incidental vertebral fractures from inpatient chest radiographs may represent a missed opportunity for osteoporosis management.

Aged↗
PubMed2006

Neuropathic arthropathy of the foot with and without superimposed osteomyelitis: MR imaging characteristics.

PURPOSE: To determine retrospectively the magnetic resonance (MR) findings associated with pedal neuropathic arthropathy with and without superimposed osteomyelitis and to identify any useful discriminating features. MATERIALS AND METHODS: Investigational review board approval was obtained and allowed review of records and images without informed consent. HIPAA compliance was observed. Contrast-enhanced MR images in patients with diabetic neuropathic arthropathy of the foot were examined by two reviewers in consensus. Affected joints were examined for marrow, articular, periarticular, and soft-tissue findings. Presence of superimposed osteomyelitis was documented. A subgroup that had undergone MR before infection was evaluated for comparison; chi(2) and t tests were used to evaluate the associations. RESULTS: Of 128 neuropathic joints in 63 patients (24 female, 39 male; aged 31-78 years), 43 had superimposed osteomyelitis. Effusion was common in all neuropathic joints, but thin rim enhancement was more common in noninfected joints (62% vs 21%, P < .001) and diffuse joint fluid enhancement was more common with infection (47% vs 26%, P = .052). Subluxation, bone proliferation, fragmentation, and erosion were seen in both groups, but intraarticular bodies were more common in noninfected joints (53% vs 12%, P < .001). In the periarticular soft tissues, edema, enhancement, and ulceration were common in both groups. Fluid collections in the soft tissues were more commonly associated with infected joints (95% vs 48%, P < .001) and, when present next to an infected joint, were larger than those next to noninfected neuropathic joints (2.6 cm(2) [range, 0.3-8.6 cm(2)] vs 1.6 cm(2) [range, 1.0-2.4 cm(2)]). Soft-tissue fat replacement (68% vs 36%, P = .002) and sinus tracts (84% vs 0%, P < .001) were also more common with infection. In the marrow, periarticular signal intensity abnormality was common in both groups, but the extent was greater with infection. Subchondral cysts were seen almost exclusively in noninfected joints (76% vs 2%, P < .001). Similar results were obtained in the subgroup of 21 joints (15 patients) with both pre- and postinfection MR images. CONCLUSION: Sinus tract, replacement of soft-tissue fat, fluid collection, and extensive marrow abnormality are MR imaging features indicating superimposed infection. Thin rim enhancement of effusion, presence of subchondral cysts, or intraarticular bodies indicate absence of infection.

Adult↗
PubMed2006

Osteochondral lesions of the talus: change in MRI findings over time in talar lesions without operative intervention and implications for staging systems.

BACKGROUND: MRI findings are used in several staging systems to help determine appropriate treatment. The purposes of this study were to evaluate longitudinal changes in MRI characteristics of osteochondral lesions of the talus (OLT) and to evaluate published staging systems in a cohort of nonoperatively treated patients. METHODS: Twenty-nine patients were identified; MR images were reviewed for location, size, and interface signal of OLT as well as cysts, marrow edema and osteoarthritis. Lesions were classified as unchanged, progressed, or improved based on changes in size or interface signal. Each lesion was assigned a stage based on four different staging systems. RESULTS: Of the 29 lesions, 13 progressed, seven improved, and nine were unchanged over an average followup of 13.7 months. In the 13 that progressed, marrow edema remained present in ten and developed in two. Four had persistent cysts and four developed new cysts. Two had progression of osteoarthritis and two developed it anew. In the seven that improved, six had some degree of marrow edema that persisted and one had a persistent cyst. Initial staging changed for at least one classification system in 16 (55%) of the 29 lesions at followup. Change in stage was primarily due to development (four of 16) or disappearance of cysts or progression of the lesion in the extent of bone marrow edema (five of 16). CONCLUSIONS: OLT did not invariably progress over the short-term without operative intervention. Because some cysts and bone marrow edema resolved on MRI, they may not be reliable signs of lesion severity nor show progression of degenerative changes. Since these findings determine the stage and severity of OLT in some staging systems, they may require reconsideration and adjustment of the current staging systems.

Adolescent↗
PubMed2005

Reactive endplate marrow changes: a systematic morphologic and epidemiologic evaluation.

PURPOSE: To evaluate the morphology and location of vertebral endplate changes, and to analyze their association with age, gender, and body mass index (BMI). DESIGN AND PATIENTS: At 1.5 T (T1-weighted, T2-weighted/STIR) 100 lumbar spines were evaluated separately by three observers. The readers classified the endplate bone marrow abnormalities on sagittal MR images according to the definitions of Modic et al. Findings were localized by disc segment; whether in the upper and/or lower endplate; and within each endplate divided into 15 segments. Disc space narrowing, as well as disc desiccation, was also noted at each vertebral level. In addition, endplate changes were correlated with age, gender, and BMI (weight(kg)/height(m)2). RESULTS: A total of 15,000 data points were studied and 422 total changes recorded. A total of 99 vertebral levels were affected in 58 patients. Of these, 171 were of type I, 242 were of type II, and 9 were of type III. L4-L5 and L5-S1 vertebral levels were most commonly involved, having (142, 4.73%) and (116, 3.87%) changes respectively (P<0.0001). The upper and lower aspects of the endplate were affected similarly. Changes most frequently occurred at the anterior aspect of the endplate (P<0.0001). Endplate marrow changes were associated with increasing age (P<0.0001) and, surprisingly, male gender (P<0.0001). Endplate changes were not associated with BMI. CONCLUSION: The fatty pattern was most common, with the sclerotic pattern being rare. Endplate marrow changes most often occurred at the anterior aspect of the endplate, particularly at L4--L5 and L5--S1 levels. Modic changes occur more frequently with aging, evidence of their degenerative etiology. They were, however, not related to body habitus, but to weight and male gender.

Adolescent↗
PubMed2005

Development of radiology prediction models using feature analysis.

RATIONALE AND OBJECTIVES: This article provides an introduction to prediction models and their application in diagnostic imaging research. Prediction models capitalize on the different degrees of association among variables to make a prediction of a health state, formulate a rule, or quantify individual contributions of various predictor variables. The purpose of this article is to elucidate the rationale, implication, and interpretation of prediction models using imaging features. MATERIALS AND METHODS: The techniques and challenges of developing, testing, and implementing prediction models are described. Prediction model development methods are similar to data-mining techniques. RESULTS: Learning objectives are to review prediction rule (model) methods, learn how prediction models may be applied to feature analysis, and understand the challenges of developing, testing, and implementing prediction models.

Decision Support Techniques↗