Marco Perri1, Giuseppe Grattacaso2, Valeria di Tunno3, Claudia Marsecano4, Antonio Gennarelli5, Giulia Michelini6, Alessandra Splendiani7, Ernesto Di Cesare8, Carlo Masciocchi9, Massimo Gallucci10. 1. Department of Biotechnological and Applied Clinical Sciences, Division of Radiology, University of L'Aquila, 67100, L'Aquila, Italy. marco-perri@tiscali.it. 2. Department of Biotechnological and Applied Clinical Sciences, Division of Radiology, University of L'Aquila, 67100, L'Aquila, Italy. Giuseppe.grattacaso@hotmail.it. 3. Department of Biotechnological and Applied Clinical Sciences, Division of Radiology, University of L'Aquila, 67100, L'Aquila, Italy. valeria.ditunno@yahoo.it. 4. Department of Biotechnological and Applied Clinical Sciences, Division of Radiology, University of L'Aquila, 67100, L'Aquila, Italy. claudia.marsecano@gmail.com. 5. Department of Biotechnological and Applied Clinical Sciences, Division of Radiology, University of L'Aquila, 67100, L'Aquila, Italy. antoniogennarelli@alice.it. 6. Department of Biotechnological and Applied Clinical Sciences, Division of Radiology, University of L'Aquila, 67100, L'Aquila, Italy. giulia.mik@libero.it. 7. Department of Biotechnological and Applied Clinical Sciences, Division of Neuroradiology, University of L'Aquila, 67100, L'Aquila, Italy. alessandra.splendiani@univaq.it. 8. Department of Biotechnological and Applied Clinical Sciences, Division of Radiology, University of L'Aquila, 67100, L'Aquila, Italy. Ernesto.dicesre@cc.univaq.it. 9. Department of Biotechnological and Applied Clinical Sciences, Division of Radiology, University of L'Aquila, 67100, L'Aquila, Italy. carlo.masciocchi@cc.univaq.it. 10. Department of Biotechnological and Applied Clinical Sciences, Division of Neuroradiology, University of L'Aquila, 67100, L'Aquila, Italy. Massimo.gallucci@cc.univaq.it.
Abstract
PURPOSE: To evaluate the discal morpho-structural changes as predictive sign in the clinical outcome after Ozone Therapy in lumbar disc herniation using the T2 shine-through effect in DWI. METHODS:One hundred and fifty-four patients suffering from lumbosciatica (89 men and 65 women; range 23-62 years) were included in previous MR study performed with FSE-T2 and T2-fat, SE-T1 and DWI sequences and were randomly assigned to two groups. Seventy-seven patients (Control Group) underwent conservative treatment with intraforaminal injection of steroid and anesthetic. The remaining 77 patients (Study Group) underwent the same treatment with the addiction of oxygen-ozone (O2-O3). During the coming 6 months, an MRI follow-up with the same sequences was performed. An intervertebral disc volumetric analysis (IDVA), DWI signal score and post treatment clinical outcome evaluation were performed for an assessment of hernia reduction. χ (2) test, Student's t test and analysis of covariance were used for comparison of variables. RESULTS: In the Study Group, 58 over 77 patients had a successful outcome (Responders). In the Responders group, DWI T2 shine-through effect was present during MRI follow-up and in particular in 53 of 77 patients in the 6 months of follow-up (P < 0.05). Moreover, in the same group was present a statistically significant discs' shrinkage in the sixth month of follow-up (P < 0.05) as showed by IDVA. CONCLUSIONS: T2 shine-through effect in DWI is present before morphological disc reduction and moreover could be considered as a predictive sign of response to oxygen-ozone treatment.
RCT Entities:
PURPOSE: To evaluate the discal morpho-structural changes as predictive sign in the clinical outcome after Ozone Therapy in lumbar disc herniation using the T2 shine-through effect in DWI. METHODS: One hundred and fifty-four patients suffering from lumbosciatica (89 men and 65 women; range 23-62 years) were included in previous MR study performed with FSE-T2 and T2-fat, SE-T1 and DWI sequences and were randomly assigned to two groups. Seventy-seven patients (Control Group) underwent conservative treatment with intraforaminal injection of steroid and anesthetic. The remaining 77 patients (Study Group) underwent the same treatment with the addiction of oxygen-ozone (O2-O3). During the coming 6 months, an MRI follow-up with the same sequences was performed. An intervertebral disc volumetric analysis (IDVA), DWI signal score and post treatment clinical outcome evaluation were performed for an assessment of hernia reduction. χ (2) test, Student's t test and analysis of covariance were used for comparison of variables. RESULTS: In the Study Group, 58 over 77 patients had a successful outcome (Responders). In the Responders group, DWI T2 shine-through effect was present during MRI follow-up and in particular in 53 of 77 patients in the 6 months of follow-up (P < 0.05). Moreover, in the same group was present a statistically significant discs' shrinkage in the sixth month of follow-up (P < 0.05) as showed by IDVA. CONCLUSIONS: T2 shine-through effect in DWI is present before morphological disc reduction and moreover could be considered as a predictive sign of response to oxygen-ozone treatment.
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Authors: Alessandra Splendiani; Marco Perri; Giuseppe Grattacaso; Valeria Di Tunno; Claudia Marsecano; Luca Panebianco; Antonio Gennarelli; Valentina Felli; Marco Varrassi; Antonio Barile; Ernesto Di Cesare; Carlo Masciocchi; Massimo Gallucci Journal: Radiol Med Date: 2015-07-28 Impact factor: 3.469
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