AJDRAJNR - American Journal of Neuroradiology

Published ahead of print on February 12, 2009
doi: 10.3174/ajnr.A1497
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Symptomatic Nerve Root Changes on Contrast-Enhanced MR Imaging after Surgery for Lumbar Disk Herniation

Y.S. Leea, E.S. Choib and C.J. Songc

a Department of Radiology, Daejeon St. Mary's Hospital, The Catholic University of Korea, Daejeon, Korea
b Department of Rehabilitation Medicine, Daejeon St. Mary's Hospital, The Catholic University of Korea, Daejeon, Korea
c Department of Radiology, Chungnam National University School of Medicine, Daejeon, Korea


Figure 1
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  		Fig 1. A 53-year-old man who underwent an operation 15 years ago. A, Precontrast axial T1-weighted MR image shows left subarticular recurrent disk herniation at L4-L5 level (arrow). B, Postcontrast axial T1-weighted MR image shows contrast enhancement in the left intradural nerve root (arrow).


Figure 2
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  		Fig 2. A 63-year-old man with left L5 radiculopathy on the electromyographic study, who underwent an operation 12 months ago. A, Axial T1-weighted MR image before contrast injection shows left central intermediate signal intensity epidural lesion (arrow). B, Axial T1-weighted MR image after contrast injection. Enhancement is noted in the left epidural and intradural L5 nerve root (arrows). Nonenhanced disk protrusion is seen (arrowhead). Nonenhanced sagittal T1-weighted (C) and enhanced sagittal T1-fat suppressed (D) MR images show mildly enhanced intradural nerve root and bright enhancement of epidural nerve root (arrows).


Figure 3
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  		Fig 3. A 27-year-old man with recurrent disk herniation confirmed by reoperation. A, Precontrast axial T1- weighted MR image at L5-S1 level shows left subarticular recurrent disk extrusion with intermediate signal intensity (arrowhead). Thickened and posteriorly displaced left intradural nerve root (arrow) is noted. B, Postcontrast axial T1-weighted MR image reveals nonenhanced recurrent disk herniation. A combination of nerve root enhancement, thickening, and displacement (arrow) is also seen.


Figure 4
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  		Fig 4. A 21-year-old man with recurrent left S1 sciatica and radiculopathy by electromyography. A, Precontrast axial T1-weighted MR image reveals an intermediate signal intensity lesion in the left epidural space including an ill-defined margin of the left S1 nerve root (arrows). B, Postcontrast axial T1-weighted image shows enhancement of left epidural mass, suggesting postoperative fibrosis (arrows) and focal enhancement of the thickened left epidural S1 nerve root (arrowhead).





Copyright © 2009 by the American Society of Neuroradiology. Print ISSN: 0195-6108 Online ISSN: 1936-959X