Lumbar hernia is a rare condition whose diagnosis is hardly achieved. The prevalence is higher in elderly men. The present case report describes the case of a male, 78-year-old patient who underwent pleural effusion drainage 17 years before presenting with clinical manifestations and tomographic findings compatible with acquired secondary Grynfeltt's hernia.

Keywords: Lumbar hernia, Grynfeltt's hernia, Superior lumbar hernia

OBJECTIVE: To select the best mathematical algorithms for lumbar spine imaging studies to assess arthrodesis with metal implant. MATERIALS E METHODS: The images acquisition was performed with a multidetector (16 rows) CT scanner, and 2 mm and 4 mm slice thickness. Images of ten patients were reconstructed with filters 20, 40, 60 and 80, employing multiplanar three-dimensional volume-rendering techniques. A total of 320 images were evaluated by three experienced radiologists who rated the images from 1 to 5 (1 = unacceptable; 2 = substandard; 3 = acceptable; 4 = above the average; 5 = excellent). Additionally, noise measurements were performed for correlation with the type of filter utilized. RESULTS: For 2 mm thickness and filters 20, 40, 60 e 80, mean noise measurements for images reconstruction were, respectively, 24.7 ± 4.3, 35.5 ± 4.2, 106.0 ± 18.5 and 145.9 ± 26.9, and for 4 mm and filters 20, 40, 60 and 80 were, respectively, 18.1 ± 2.4, 25.1 ± 4.6, 76.7 ± 17.2 and 106.6 ± 23.4. CONCLUSION: Three-dimensional color images could be better visualized with filter 20; however, in the case of gray-scale, filters 40 or 60 could be useful to demonstrate the arthrodesis pedicle screws in higher detail. For multiplanar reconstructions with 2 mm slice thickness, the filter 40 was the most appropriate, and for 4 mm, a filter 60 presented a better image quality.

Keywords: Computed tomography, Arthrodesis, Lumbar spine, Image quality

Thoracic asymmetries characterized by increased radiolucency of the lungs are important causes of morbidity in infants and children. Evaluation of affected patients frequently requires multiple imaging methods to diagnose the abnormality and to plan the surgical correction. The authors review and illustrate the characteristics of both common and rare thoracic asymmetries with emphasis on the radiological findings. The usefulness of different imaging methods in the diagnosis and treatment of these conditions is evaluated. The differential diagnosis as well the pitfalls and diagnostic difficulties are also discussed.

Keywords: Thoracic diseases, Congenital cystic adenomatoid malformation, Congenital lobar emphysema, Congenital diaphragmatic hernia

Disc herniation with posterior epidural migration is a rare and often symptomatic entity. Multiple are the natural barriers that prevent this pattern of migration. Enhanced magnetic resonance imaging is the diagnostic modality of choice in these cases. The diagnostic dilemma in this case was the contraindication to the use of contrast since the patient was known to have chronic renal failure.

Keywords: Lumbar hernia; Complication; Epidural space; Posterior; Magnetic resonance imaging; Contrast.

OBJECTIVE: To demonstrate five discal cysts with detailed magnetic resonance imaging findings in nonsurgical and following postoperative microdiscectomy. MATERIALS AND METHODS: Five discal cysts in four patients who underwent magnetic resonance imaging were found through a search in our database and referral from a single orthopedic spine surgeon. Computed tomography in two cases and computed tomography discography in one case were also performed. RESULTS: Five discal cysts were present in four patients. Three patients had no history of previous lumbar surgery and the other patient presented with two discal cysts and recurrent symptoms after partial laminectomy and microdiscectomy. All were oval shaped and seated in the anterior epidural space. Four were ventrolateral, and the other one was centrally positioned in the anterior spinal canal. One showed continuity with the central disc following discography. Three were surgically removed. CONCLUSION: Magnetic resonance imaging can easily depict an epidural cyst and the diagnosis of a discal cyst should be raised when an homogeneous ventrolateral epidural cyst contiguous to a mild degenerated disc is identified.

Keywords: Magnetic resonance imaging; Lumbar spine; Discal cyst; Extradural cyst.

Os nervos cranianos representam extensões das estruturas funcionais do cérebro que cruzam a cabeça e o pescoço. Eles estão ligados a diferentes estruturas cranianas e se relacionam com diversas doenças. Uma compreensão profunda de sua complexa anatomia e aparência normal de imagem permite ao examinador identificar e caracterizar com mais precisão as anormalidades. A ressonância magnética com contraste é uma importante ferramenta para avaliar essas estruturas, especialmente as sequências tridimensionais de precessão livre de estado estacionário, que proporcionam alta resolução espacial e de partes moles, apesar da fina espessura dos nervos cranianos. Na maioria dos casos, os achados de imagem são inespecíficos, e uma anamnese completa, exame físico dirigido e testes laboratoriais são necessários para estreitar o diagnóstico diferencial. Este ensaio iconográfico ilustra e discute doenças congênitas, traumáticas e vasculares dos nervos cranianos, mostrando imagens em uma abordagem fisiopatológica.

Keywords: Neuroimagem/métodos; Radiologia/métodos; Ressonância magnética/métodos; Nervos cranianos/diagnóstico por imagem.