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BACKGROUND: The long-term effect of repetitive trauma by military parachuting on the lumbar spine is not well investigated. Therefore, the purpose of this study was to examine the development of lumbar degenerative changes during a 30-year follow-up in Japanese Ground Self Defense Forces (JGSDF) parachute infantry soldiers with normal lumbar radiographs at entry by comparison with those with non-parachute infantry soldiers. METHODS: 79 non-parachutists and 65 parachutists were included for radiological examination and questionnaires for low back pain (LBP). All subjects were non-commissioned officers with similar socioeconomic status and life styles. The number of parachuting descent during the 30-year in the parachute group ranged from 208 to 630, with an average of 322. RESULTS: The mean age of the subjects was 18.3±0.5 years at entry and 48.5±0.3 years at follow-up. LBP had been experienced by 37% in the non-parachute group and 25% in the parachute group with no significant difference. The nature of their LBP was judged as mild. The prevalence rate of degenerative changes was similar in both groups. Disc space narrowing was detected 37 subjects (47%) in non-parachute group an 23 subjects (35%) in parachute group without significant difference. Vertebral osteophytes were detected in 52 subjects (67%) in non-parachute group and 47 subjects (72%) in parachute group without significant difference. CONCLUSIONS: This study did not identify any significant differences in the development of lumbar degenerative changes between the parachutists and non-parachutists over a 30-year follow-up, suggesting that military parachuting itself does not accelerate the development of intervertebral disc degeneration. Further studies are needed using large cohorts assessed by MRI as well as plain X-ray.

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An Intradiscal gas collection, referred to as the vacuum disc phenomenon (VDP) is a relatively common finding on radiographic studies of the lumbar spine, whereas gas-containing lumbar disc hernia is rarely observed. We report a case of a patient with left leg pain, provoked by a radiographically and surgically documented L4-5 gas containing disc hernia.

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A rare case of transitional cell carcinoma (TCC) with extension into the renal vein and inferior vena cava (IVC) is presented. Computed tomography, magnetic resonance imaging, and angiography successfully delineated tumor thrombus in the right renal vein and IVC. TCC should be included in the differential diagnosis of renal tumors that can cause IVC thrombosis.

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CT findings of 10 cases of transitional cell carcinoma with renal parenchymal involvement were reviewed. CT showed a low-density mass with varying degrees of renal parenchymal involvement. Intrarenal transitional cell carcinomas were characterized by preserved renal contour with abnormalities of the collecting system such as obliteration, entrapment in the tumor, dilatation, and intraluminal mass. Obliteration of the renal sinus fat and poorly defined tumor margin were other characteristic CT features. This study indicated that CT is useful for differentiating transitional cell carcinomas with renal parenchymal involvement from renal cell carcinomas.

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Wall thickening and intimal changes obtained by enhanced CT are early findings of aortic sclerosis. These findings are often detected in the lower abdominal aorta and middle thoracic descending aorta of normal subjects over 30 years of age, as predictors of atherosclerosis. Arterial calcification is a useful sign for evaluating atherosclerosis, especially, in the coronary arteries. The sensitivity and specificity of CT-detected coronary calcification in coronary stenosis by CAG were 76% and 80%, respectively, in our study. In the patients with atherosclerosis, MRI demonstrates wall thickening, intimal projection and narrowing of the lumen in the aorta and large arteries. MRA can be applied to more peripheral arteries, particularly, in the head and extremities, and will be available for screening of atherosclerotic disease in the near future.

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The authors evaluated the ability of magnetic resonance imaging (MRI) at 1.5 T to characterize 33 adrenal masses, using visual analysis and the following quantitative variables: signal intensity ratios of tumor/liver, tumor/muscle, and (tumor--muscle)/(fat--muscle) on T2- and T1-weighted images, and the calculated T2 relaxation time of the adrenal masses. All 15 tumors of less than 3 cm in diameter were visually homogeneous on all pulse sequences, whereas the other 18 tumors of over 3 cm appeared to be inhomogeneous. The signal intensity ratios of tumor/liver and tumor/muscle and the calculated T2 relaxation time were not helpful in distinguishing tumors from one another. The ratios of tumor/fat and (tumor--muscle)/(fat--muscle) were useful in distinguishing pheochromocytoma and myelolipoma from other tumors on T2- and T1-weighted images, respectively. However, differentiation among other adrenal tumors appeared to be difficult. The authors concluded that, although MRI might have considerable potential in characterizing adrenal masses, the use of conventional MRI in such analysis is still quite limited.

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The CT and clinical features of six patients with congenital renal arteriovenous malformation (RAVM) were reviewed to determine the characteristics of this condition. The most common symptom was hematuria. The CT images were characterized by masses of vascular density located in the renal sinus and surrounding the pelvicaliceal system with or without dilated renal veins. The exact size of the RAVM and the relation to the pelvicaliceal system were well demonstrated by delayed images or drip infusion technique, whereas the bolus injection technique was essential to document the vascular nature. The potential pitfalls in diagnosis that can occur if only an infusion study is performed are discussed.

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