Ionic versus Nonionic Paramagnetic Contrast Media in Differentiating between Postoperative Scar and Recurrent Disk
Jui-Sheng Hsua,
Gin-Chung Liua,
Shih-Hsien Chena,
Twei-Shiun Jawa,
Wun-Jer Shenb and
Chiao-Yun Chena
a Department of Radiology, Kaohsiung Medical University, Kaohsiung, Taiwan, R.O.C
b the Po-Cheng Orthopedic Institute, Kaohsiung, Taiwan, R.O.C
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FIG 1. Axial view images of a patient with surgically confirmed recurrent herniated disk.
A, Obtained before the administration of gadopentetate dimeglumine (0.1 mmol/kg).
B, Obtained 5 min after the administration of gadopentetate dimeglumine (0.1 mmol/kg).
C, Obtained 50 min after the administration of gadopentetate dimeglumine (0.1 mmol/kg).
D, Obtained 5 min after the administration of contrast medium. Placement of cursor to measure recurrent disk (1) and scar (2) enhancement. Contrast ratio between scar and recurrent disk fragment is greater at 5 min than at 50 min.
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FIG 2. Graph of the average enhancement in scar and in recurrent disk fragment as a function of time after the injection of 0.1 mmol/kg gadopentetate dimeglumine (M) or gadodiamide (O). The scar tended to decrease in enhancement and the recurrent disk fragment tended to increase in enhancement with time.
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FIG 3. MR images of a patient with recurrent herniated disk
A, Sagittal view unenhanced T2-weighted MR image.
B, Axial view image obtained before the IV administration of ionic contrast medium.
C, Axial view image obtained 5 min after the IV administration of ionic contrast medium.
D, Axial view image obtained 50 min after the IV administration of ionic contrast medium. Contrast ratio is greater after administration of ionic rather than nonionic contrast media at 50 min (see panel G).
E, Axial view image obtained before the IV administration of nonionic contrast medium.
F, Axial view image obtained 5 min after the IV administration of nonionic contrast medium.
G, Axial view image obtained 50 min after the IV administration of nonionic contrast medium. Contrast ratio is greater after administration of ionic rather than nonionic contrast media at 50 min.
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FIG 4. Graph of the contrast ratio between scar and recurrent disk fragment as a function of time after injection of 0.1 mmol/kg ionic (M) and nonionic (O) contrast medium. The contrast radio tended to decrease with time (arithmetic mean ± SD, n = 20).
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