[The diagnostic role of contrast medium-enhanced MR tomography in the diagnosis of the post-diskectomy syndrome. A prospective study of 109 patients]

Rofo. 1993 Sep;159(3):269-77. doi: 10.1055/s-2008-1032762.
[Article in German]

Abstract

In a prospective study, 132 previously operated disc levels in 109 patients with failed back surgery syndrome (FBSS) were examined by MR imaging before and after intravenous application of a contrast agent (0.1 mmol Gd-DTPA/kg). The results were compared with current CT findings in 47 cases. The images were randomized and independently assessed by two experienced radiologists. A second intervention of a total of 30 disc levels was performed in 28 patients. Contrast-enhanced-MR imaging (CE-MRI) improved the differentiation of scar from recurrent disc herniation (RDH) compared to plain MRI and CT. Agreement between the two readers was significantly higher for CE-MRI than for the other two procedures (p < or = 0.001). CE-MRI additionally had the highest diagnostic accuracy (p < or = 0.001). The preoperative diagnosis made by CE-MRI was confirmed in 27 (90%) of the reoperated disc levels. Quantitative evaluation showed that there was no contrast enhancement in RDH as opposed to pronounced enhancement of 122% in scars (p < or = 0.001). Evaluation with respect to scar age revealed a significant difference (p < or = 0.01) in contrast enhancement between scars less and more than 2.5 years old.

Publication types

  • Clinical Trial
  • Comparative Study
  • Controlled Clinical Trial
  • English Abstract

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Cicatrix / diagnosis*
  • Cicatrix / epidemiology
  • Contrast Media*
  • Female
  • Gadolinium DTPA
  • Humans
  • Intervertebral Disc / surgery*
  • Intervertebral Disc Displacement / diagnosis*
  • Intervertebral Disc Displacement / epidemiology
  • Intervertebral Disc Displacement / surgery
  • Magnetic Resonance Imaging / methods*
  • Male
  • Middle Aged
  • Organometallic Compounds*
  • Pentetic Acid / analogs & derivatives*
  • Postoperative Complications / diagnosis*
  • Postoperative Complications / epidemiology
  • Prospective Studies
  • Recurrence

Substances

  • Contrast Media
  • Organometallic Compounds
  • Pentetic Acid
  • Gadolinium DTPA