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Research ArticleSPINE

Contrast between Scar and Recurrent Herniated Disk on Contrast-Enhanced MR Images

Victor Haughton, Ken Schreibman and Arthur De Smet
American Journal of Neuroradiology November 2002, 23 (10) 1652-1656;
Victor Haughton
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Ken Schreibman
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Arthur De Smet
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Article Figures & Data

Figures

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  • Fig 1.
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    Fig 1.

    Axial images of a patient with confirmed recurrent herniated disk.

    A, Axial image obtained before the administration of contrast medium.

    B, Axial image obtained 5 minutes after the administration of contrast medium.

    C, Axial image obtained 20 minutes after the administration of contrast medium shows the placement of a cursor to measure disk and scar enhancement.

  • Fig 2.
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    Fig 2.

    Sagittal unenhanced T1-weighted image (A) and axial images (B–G) obtained in one patient. B, C, and D were acquired before (B), 5 minutes (C), and 20 minutes (D) after the IV administration of nonionic contrast material. E, F, and G, were acquired before (E), 5 minutes (F), and 20 minutes (G) after the IV administration of ionic contrast material.

  • Fig 3.
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    Fig 3.

    Graph shows contrast enhancement of disk and scar from gadopentetate and gadodiamide in patient 3.

  • Fig 4.
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    Fig 4.

    Graph shows average enhancement of disk and scar with gadopentetate and gadodiamide at 5 and 20 minutes after the administration of contrast medium.

  • Fig 5.
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    Fig 5.

    Graph shows disk enhancement as a proportion of scar enhancement for gadodiamide and gadopentetate at 5 and 20 minutes after injection.

Tables

  • Figures
  • Clinical data, operative summary, and signal intensity changes with time after contrast medium injection for patients who received ionic and nonionic contrast medium

    Patient No.Age (yr)HistoryReoperation FindingsContrast MediumSignal Intensity
    Baseline5 min20 min
    ScarDiskScarDiskScarDisk
    147Two previous excisions of herniated disk at L4–L5, recurrent left leg painNot offeredGadopentetate43.148.369.940.193.448.4
    Gadodiamide33.934.687.758.089.447.1
    243L3–L4 discectomy, recurrent painAt laminectomy, large scar and fragment containing end plate and boneGadopentetate42.745.488.633.576.144.7
    Gadodiamide28.636.6103.647.786.069.0
    3375 years previously, laminectomy and discectomy at L4–L5, pain recurredAt laminectomy, large fragmentGadopentetate22.933.145.433.152.834.8
    Gadodiamide33.824.872.933.890.532.8
    447Pain in lower back, previous L4–L5 laminectomy and discectomyLost to follow-upGadopentetate68.960.099.661.8103.568.8
    Gadodiamide46.240.080.352.078.356.0
    546Previous discectomies L4–L5 and L5–S1, low back and left lower extremity painNot offeredGadopentetate25.927.147.532.242.730.5
    Gadodiamide23.522.846.025.747.039.3
    648Microdiscectomy L5–S1 1 year previously, recurrence of painNot offeredGadopentetate35.032.059.045.068.054.0
    Gadodiamide35.032.091.054.080.057.0
    739Discectomy L4–L5 in 1998, revision in 2000, gradually worsening right buttock and thigh pain for 6 monthsAnterior discectomyGadopentetate37.953.394.765.790.872.4
    Gadodiamide33.743.776.949.380.551.5
    842Microdiscectomy L4–L5, acute onset of pain radiating into left legAt laminectomy, large herniationGadopentetate24.021.067.028.0
    Gadodiamide18.022.087.040.0
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American Journal of Neuroradiology: 23 (10)
American Journal of Neuroradiology
Vol. 23, Issue 10
1 Nov 2002
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Contrast between Scar and Recurrent Herniated Disk on Contrast-Enhanced MR Images
Victor Haughton, Ken Schreibman, Arthur De Smet
American Journal of Neuroradiology Nov 2002, 23 (10) 1652-1656;

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Contrast between Scar and Recurrent Herniated Disk on Contrast-Enhanced MR Images
Victor Haughton, Ken Schreibman, Arthur De Smet
American Journal of Neuroradiology Nov 2002, 23 (10) 1652-1656;
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