Contrast enhanced computed tomography and magnetic resonance imaging in the diagnosis of recurrent disc herniation.
A positive result of re-operation in patients with recurrent symptoms after lumbar disc surgery is likely only if a new disc herniation is present. An improved ability to differentiate between recurrent disc herniation and scar tissue by contrast enhanced CT and MRI is suggested in earlier studies. In a prospective study 29 patients were selected for operation for suspected recurrent disc herniation. The inclusion of the patients was based on clinical symptoms and signs and myelography or non-enhanced CT. All patients were examined by CT and MRI both with and without intravenous contrast pre-operatively. The examinations were evaluated blind on a five point scale and statistical analysed by a regret function. Intravenous contrast improved the diagnostic power of both CT and MRI. MRI was superior to CT in both non-enhanced and enhanced examinations. MRI with intravenous contrast enhancement is proposed as the primary examination in patients with suspected recurrent disc herniation.
Albeck
M J
MJ
Department of Neurosurgery, University Clinic, Rigshospitalet, Copenhagen, Denmark.
Wagner
A
A
Knudsen
L L
LL
D000328:Adult; D003287:Contrast Media; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D007405:Intervertebral Disc Displacement / Q000175:diagnosis* / Q000601:surgery; D007432:Intraoperative Period; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D015588:Observer Variation; D012008:Recurrence; D014057:Tomography, X-Ray Computed
D003287:Contrast Media