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AJNR Awards, New Junior Editors, and more. Read the latest AJNR updates

Research ArticleSpine Imaging and Spine Image-Guided Interventions

Postoperative MRI Evaluation of a Radiofrequency Cordotomy Lesion for Intractable Cancer Pain

A. Vedantam, P. Hou, T.L. Chi, K.R Hess, P.M. Dougherty, E. Bruera and A. Viswanathan
American Journal of Neuroradiology April 2017, 38 (4) 835-839; DOI: https://doi.org/10.3174/ajnr.A5100
A. Vedantam
aFrom the Department of Neurosurgery (A. Vedantam, A. Viswanathan), Baylor College of Medicine, Houston, Texas
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P. Hou
bDepartments of Imaging Physics (P.H.)
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T.L. Chi
cDiagnostic Radiology (T.L.C)
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K.R Hess
dBiostatistics (K.R.H.)
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P.M. Dougherty
ePain Medicine (P.M.D.)
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E. Bruera
fPalliative Care and Rehabilitation Medicine (E.B.), University of Texas MD Anderson Cancer Center, Houston, Texas.
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A. Viswanathan
aFrom the Department of Neurosurgery (A. Vedantam, A. Viswanathan), Baylor College of Medicine, Houston, Texas
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    Fig 1.

    A, Intraprocedural CT myelogram showing the electrode entering the spinal cord parenchyma in the right anterolateral quadrant. B, Postoperative axial T2-weighted MR image of the cordotomy lesion with overlay of the cord anatomy and anatomic location of the anterolateral spinothalamic tracts marked (black pattern).

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    Fig 2.

    A, Axial T2-weighted image at the level of the cordotomy lesion for patient 1 shows the demarcated hyperintense lesion in the right anterolateral quadrant. B, Midline reference lines and the line bisecting the anterolateral quadrant show the portion of lesion in the dorsolateral (x) and ventromedial (y) regions of the anterolateral quadrant.

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    Fig 3.

    A, Sagittal T2-weighted image of the cervical spine for patient 6 shows hyperintensity in the anterior half of the cord at C1–C2. Axial T2-weighted image (B) shows hyperintensity in the right anterolateral quadrant. Axial T1-weighted (C) image with isointense signal in the lesion and a contrast-enhanced T1-weighted (D) image with no enhancement of the lesion.

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    Fig 4.

    Sagittal T2-weighted image (A) and axial T2-weighted image (B) of the cervical spine of patient 4 show hyperintensity with central hypointensity at C1–C2. Axial T1-weighted (C) and contrast-enhanced T1-weighted (D) images show an isointense lesion with peripheral enhancement.

Tables

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  • Demographic and imaging data on 10 patients who underwent percutaneous cordotomy for intractable cancer pain

    No.Age (yr)SexNo. of Pial PenetrationsNo. of RF AblationsArea of T2W Lesion (cm2)Area of T2W Lesion in ALQ (cm2)Length of T2W Lesion (cm)
    143M32.1460.08001.9850
    266F33.1880.11501.7800
    354F22.1360.08701.1950
    453F23.1170.0850.5480
    576M33.2980.16702.3600
    668M23.2350.14101.7450
    761M32.2460.07101.8200
    855F33.2380.14701.9000
    959F24.1330.1060.8200
    1050M32.3050.16502.1600
    • Note:—RF indicates radiofrequency; T2W, T2-weighted.

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American Journal of Neuroradiology: 38 (4)
American Journal of Neuroradiology
Vol. 38, Issue 4
1 Apr 2017
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A. Vedantam, P. Hou, T.L. Chi, K.R Hess, P.M. Dougherty, E. Bruera, A. Viswanathan
Postoperative MRI Evaluation of a Radiofrequency Cordotomy Lesion for Intractable Cancer Pain
American Journal of Neuroradiology Apr 2017, 38 (4) 835-839; DOI: 10.3174/ajnr.A5100

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Postoperative MRI Evaluation of a Radiofrequency Cordotomy Lesion for Intractable Cancer Pain
A. Vedantam, P. Hou, T.L. Chi, K.R Hess, P.M. Dougherty, E. Bruera, A. Viswanathan
American Journal of Neuroradiology Apr 2017, 38 (4) 835-839; DOI: 10.3174/ajnr.A5100
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