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C-1238 - Lumbosacral Transitional Vertebrae: A diagnostic challenge by MRI. The value of MDCT and conventional radiograph in the definitive diagnosis.

M. Rodríguez Eiriz, Á. Calleja Bonilla, A. Mas Bonet, M. Picado, A. Moll Servera, M. Gassent Balaguer, S. L. Barrero Varon; Palma. Mallorca. Illes Balears/ES Type: Educational Exhibit
Area of Interests: Neuroradiology spine, Bones, Anatomy
Imaging Techniques: Conventional radiography, CT, MR
Procedures: Normal variants, Education, Computer Applications-3D
Special Focus: Education and training
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Learning objectives: To highlight the importance of identifying lumbosacral transitional vertebrae (LSTV) by MRI. To demonstrate the usefulness of multidetector computer tomography (MDCT) in the definitive diagnosis of LSTV.   To explain Castellvi´s method as the standard classification system.

Background: Introduction: Lumbosacral transitional vertebra (LSTV) is a common variant of the lumbosacral spine in general population with a reported prevalence of 4-30%.   It is defined either as a sacralization of the lowest lumbar segment (L5) or lumbarization of the most superior sacral segment (S1).[...]

Findings and procedure details: We made a retrospective review of 31 patients with a suspicion of LSTV by MRI.   One of the variants we found was the presence of hypoplastic ribs, difficult to differentiate from hypertrophic transverse process, so in these cases it was necessary to count since C2.   In most cases the pa[...]

Conclusion: LSTV can be difficult to diagnose by MRI, so it is important to bear this anatomical variant in mind to avoid misdiagnosis and the possible resulting consequences.   Nevertheless, MDCT and conventional radiograph are helpful tools when there is any diagnostic doubt.

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References: 1. G.P. Konin, D.M. Walz. Lumbosacral Transitional Vertebrae: Classification, Imaging Findings, and Clinical Relevance. AJNR Am J Neuroradiol 31:1778 – 86, 2010.   2. Delport, E. G.; Cucuzzella, T. R.; Kim, N.; Marley, J.; Pruitt, C. & Delport, A. G. Lumbosacral transitional vertebrae: inci[...]

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