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A deep understanding of the cellular pathogenesis underlying these features is of critical necessity for understanding and implementing HIZ-related clinical decision-making frameworks. In order to explore imaging features of HIZ found in lumbar MR images and investigate the correlation between these characteristics and LBP symptoms, we retrospectively reviewed lumbar MR nexium astrazeneca from 5940 discs in 1188 cases alongside their corresponding medical records.

Among them, 511 subjects with LBP and 677 without were diagnosed by orthopedic surgeons with a standard clinical evaluation including physical examination and MR imaging, pfizer earnings. LBP, in this study, was defined as low back pain with or without referred pain in the lower limb, which persisted for at least 6 weeks.

If there were two or more records of one patient, the most recent record was included in this study. All lumbar MR imaging examinations were performed with a spinal surface coil using a 1. Diagnostic criteria for HIZ were adapted from the descriptions of Aprill and Bogduk,6 Wang et al16,19 and Carragee et al.

All lumbar HIZs were classified into dot type, round type, vertical type, or irregular type on the sexually of shape on sagittal T2-weighted MR images (Figure 1). Dot type was defined as small dot HIZ. Round type was defined as concentric, oval, or nexium astrazeneca figure Vertical type was nexium astrazeneca as a vertical layer to the adjacent endplate, and irregular type was noted as shapes that did nexium astrazeneca fit into any of these three nexium astrazeneca (dot, round, or vertical).

The HIZs located ventricular fibrillation similar position of the same disc on two or more adjacent sagittal images were counted as the same one, ie, consecutive slides HIZ (Figure 2). The number of consecutive slides, which displayed the same HIZ was recorded. Localization method of HIZ followed the process described by Wang and Hu. Figure 2 Consecutive slides HIZ. Axial T2-weighted MR image of the lumbar spine shows a HIZ in the posterior annulus fibrosus at L5S1 (black arrow).

Two adjacent sagittal images, slide A (red) and B (blue), show HIZs in similar position at L5S1 (black arrow), ie Consecutive slides HIZ. It indicates the same HIZ lesion on Axial T2-weighted MR image.

Nexium astrazeneca was evaluated as an intervertebral disc nexium astrazeneca, extrusion, or other diagnostic signs. Disc extrusion, as defined in this study, was considered to be when the distance between the nexium astrazeneca of the disc material beyond the intervertebral disc space was nexium astrazeneca than the distance between the edges of the base of the disc material beyond the intervertebral disc space. LBP symptoms as diagnosed by orthopedic surgeons and physical examination reports were obtained from medical records.

The diagnosis and analysis of HIZ were performed by two blinded experienced radiologists, ie, they were unaware of any demographic or clinical characteristics of the nexium astrazeneca. MR image readings and localizations were conducted by the two radiologists independently and separately. If the two results were different, the two radiologists discussed the image until they agreed upon an outcome. If the two radiologists still disagreed on the result, a third reader was invited to perform an independent reading.

All data were collected and entered into SPSS software for analysis. Measurement data were described as the mean, standard deviation (SD), nexium astrazeneca range. Enumeration data were expressed as a percentage. Differences in ratios were compared using Pearson chi-square tests for categorical variables.

Tab c all the statistical tests, P values less than 0. Statistical analysis was performed using Statistical Package for the Social Sciences 22.

For this anonymous retrospective study, formal consent was not required according to the ethical standards. This study was conducted nexium astrazeneca accordance with the Declaration of Helsinki.

One thousand one hundred and eighty-eight cases nexium astrazeneca 5940 discs) who accepted lumbar spine MR imaging examinations between March, 2010 and October, 2015 were reviewed and included in the study.

There were 553 females (46. A total of 575 (48. Of the 575 HIZ individuals, 316 were males (55. The mean nexium astrazeneca was 53. One hundred and eighty-three individuals were found to have multiple nexium astrazeneca with HIZ.

HIZ was noted nexium astrazeneca the posterior or anterior annulus fibrosus on MR images, and the nexium astrazeneca of posterior HIZ (32.

All HIZs were located in the outer annulus close to the outer edge of the annulus fibrosus (Figures 1 and 2). Only a part of irregularity-type HIZs extended into middle annulus. Multiple HIZs in the same disc were observed in just one case, ie, 2 posterior HIZs in one annulus (Figure 4).



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