Does postcontrast MR enhancement in lumbar disk herniation have prognostic value?
OBJECTIVE
The aim of our study was to evaluate the prognostic value, if any, of Gd-enhanced MR in patients with lumbar disk herniation.


METHODS
Fifteen patients undergoing conservative treatment for acute lumbar disk herniation were included in a prospective Gd-DTPA follow-up MR study. In each patient, the size of the herniation was measured, and, according to the changes in pathology that occurred, patients were divided into four categories. In addition, on the basis of the clinical outcome patients were divided into three classes.


RESULTS
In 11 of 15 patients, MR performed in the acute phase of the disease showed Gd-DTPA enhancement around the herniated disk; in all cases, disk herniation was markedly reduced at follow-up MRIs. The clinical outcome was good. In the remaining four cases, no enhancement was evident in the acute phase or at follow-up MRIs; no modification in the size of disk herniation was demonstrated at follow-up in two. Symptoms were unchanged in two patients and mildly improved in one.


CONCLUSIONS
Epidural enhancement, which is likely related to an inflammatory process, seems to play a role in the modification of the size of disk herniation.
Gallucci
M
M
Department of Radiology, University of L'Aquila, Italy.
Bozzao
A
A
Orlandi
B
B
Manetta
R
R
Brughitta
G
G
Lupattelli
L
L
D000208:Acute Disease; D000328:Adult; D003287:Contrast Media; D005260:Female; D005500:Follow-Up Studies; D019786:Gadolinium DTPA; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy; D008159:Lumbar Vertebrae / Q000473:pathology*; D008297:Male; D009942:Organometallic Compounds; D004369:Pentetic Acid / Q000031:analogs & derivatives*; D011379:Prognosis; D011446:Prospective Studies; D016896:Treatment Outcome
D003287:Contrast Media; D009942:Organometallic Compounds; D004369:Pentetic Acid; D019786:Gadolinium DTPA