Hungarian Radiology

[Multisegmental tuberculous spondylodiscitis in a patient with Helicobacter pylori infection]

SZÁNTÓ Dezső, SZŰCS Gabriella, DITRÓI Edit

JUNE 20, 2007

Hungarian Radiology - 2007;81(03-04)

[INTRODUCTION - Prospective randomized examination has been verified association between asymptomatic chronic Helicobacter pylori infection and systemic vascular inflammation and endothelial dysfunction in certain cases. CASE REPORT - A case of a 71 year-old female patient is described with proven coexisting primary tuberculous bronchoadenitis, secondary tuberculous spondylodiscitis and Helicobacter pylori infection as a cause of uncertain abdominal disorder. The patient's height decreased by 9 cm during 6 months, since the onset of the symptoms. The diagnosis was based on respiratory function test, positive rapid ureal test, bronchoscopy, cytologic and microbiological examinations. On dorsolumbal spinal plain films showed wedge, biconcave crus and mass deformities of nine vertebras. High serum level of CRP and C3 complement was suggestive of acute reactive inflammation. Before the introduction of drug therapy an MR examination was planned, however the patient died of an acute myocardial infarct on the 8th day after admission The postmortem findings proved the presence of pulmonary and vertebral tuberculosis, there was no evindence of aortocoronal and spinal vasculitis. The epispinal tissues were not involved. CONCLUSION - The patient’s case history, autopsy findings and the literature data are suggestive of the role chronic Helicobacter pylori infection in the development of spondylodiscitis and the deterioration of the disease.]

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[Correlation of clinical parameters with myocardial perfusion grades in acute myocardial infarct patients]

UNGI Tamás, JÓNÁS Zsuzsanna, UNGI Imre, SASI Viktor, ZIMMERMAN Zsolt, PALKÓ András

[INTRODUCTION - The prognosis after opening the obstructed infarct-related coronary artery is influenced by several factors. In routine clinical practice revascularization is considered to be successful when the restoration of epicardial blood flow is complete. However, functional impairment in the myocardium can occur even with open epicardial arteries. There are two angiographic parameters closely related to myocardial viability: myocardial blush grade (MBG) that describes the quantity of contrast material in the myocardium, and TIMI myocardial perfusion grade (TMP) that describes its outflow dynamics. Our goal was to assess the prognostic value of these two parameters in the framework of a prospective clinical study. PATIENTS AND METHODS - We compared the two parameters based on visual estimation (MBG and TMP) with those characterizing myocardial impairment, such as ejection fraction (EF), wall motion score index (WMSI), creatine-kinase release and chest pain score in 22 patients with acute myocardial infarction and successful revascularization. Our results were obtained by Spearman's rank correlation and χ2-tests at a confidence interval of 95%. RESULTS - Close correlation with TMP was found in case of both parameters measured by echocardiography (EF: r=0.59, p=0.02; WMSI: r=-0.51, p=0.046). These results were supported by the correlation with creatinekinase release (r=-0.54, P=0.01). By the present number of patients, MBG does not show significant correlation with the measured clinical parameters. Presence of chest pain is associated neither with TMP nor with MBG. CONCLUSIONS - Assessing myocardial perfusion by visual evaluation provides useful prognostic information. The extent of chest pain does not indicate myocardial dysfunction. The clearence of the dye (used in TMP definition) is more characteristic to myocardial viability than maximal contrast density (used in MBG definition).]

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