title: MR assessment of lumbar disk herniation treated with oxygen-ozone diskolysis: the role of DWI and related ADC versus intervertebral disk volumetric analysis for detecting treatment response.
abstract: We prospectively assessed the diagnostic criteria of morphologic MRI study (MMS) and the accuracy of DWI and related ADC values (DWI-ADC) versus intervertebral disk volumetric analysis (IDVA) for predicting shrinkage of lumbar disk herniation treated with oxygen-ozone (O2-O3) diskolysis. Sixty-eight patients (36 men and 32 women; mean age 39) with lumbosciatica underwent O2-O3 diskolysis. The six-month MRI follow-up was performed with FSE-T2 and T2-fat, SE-T1 and DWI-weighted images. IDVA was determined using OsiriX(®). Diagnostic criteria and accuracy were evaluated with regards to DWI and related ADC in detecting response to ozone therapy. Fifty-eight of 68 patients had successful outcomes (responders), whereas ten patients showed unsatisfactory outcomes (non-responders). MMS showed that a centrally located herniated disk and grade 1 nerve root compression were more common in the responder group (p < 0.05). DWI-ADC and IDVA showed statistically significant shrinkage in the sixth month of follow-up (p < 0.05) with a mean ADC value reduction of 2.10 × 10(-3) mm(2)/s +/- 0.19 SD in the second month of follow-up (p < 0.05). DWI-ADC had an accuracy of 0.81 in detecting response to therapy around the second month of follow-up. DWI-ADC appear to be useful adjuncts to MMS in the follow-up of patients undergoing O2-O3 diskolysis.
authors.affiliation: University of L'Aquila, L'Aquila, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Splendiani
authors.forename: M
authors.initials: M
authors.lastname: Perri
authors.forename: A
authors.initials: A
authors.lastname: Conchiglia
authors.forename: F
authors.initials: F
authors.lastname: Fasano
authors.forename: G
authors.initials: G
authors.lastname: Di Egidio
authors.forename: C
authors.initials: C
authors.lastname: Masciocchi
authors.forename: M
authors.initials: M
authors.lastname: Gallucci
mesh_terms: D000328:Adult; D038524:Diffusion Magnetic Resonance Imaging; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000628:therapy*; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging* / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D010100:Oxygen / Q000008:administration & dosage*; D010126:Ozone / Q000008:administration & dosage*; D010147:Pain Measurement; D012372:ROC Curve; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D010126:Ozone; D010100:Oxygen