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Abstract

High-Resolution MR Imaging of Sequestered Lumbar Intervertebral Disks

Thomas J. Masaryk, Jeffrey S. Ross, Michael T. Modic, Francis Boumphrey, Henry Bohlman and Geoffrey Wilber
American Journal of Neuroradiology March 1988, 9 (2) 351-358;
Thomas J. Masaryk
1Department of Radiology, University Hospitals of Cleveland, Case Western Reserve University, 2074 Abington Rd., Cleveland. OH 44106. Address reprint requests to T. J. Masaryk
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Jeffrey S. Ross
1Department of Radiology, University Hospitals of Cleveland, Case Western Reserve University, 2074 Abington Rd., Cleveland. OH 44106. Address reprint requests to T. J. Masaryk
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Michael T. Modic
1Department of Radiology, University Hospitals of Cleveland, Case Western Reserve University, 2074 Abington Rd., Cleveland. OH 44106. Address reprint requests to T. J. Masaryk
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Francis Boumphrey
2Department of Orthopaedic Surgery, Cleveland Clinic Foundation, Cleveland, OH 44106
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Henry Bohlman
3Department of Orthopaedic Surgery, University Hospitals of Cleveland, Case Western Reserve University, Cleveland, OH 44106
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Geoffrey Wilber
3Department of Orthopaedic Surgery, University Hospitals of Cleveland, Case Western Reserve University, Cleveland, OH 44106
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Abstract

We retrospectively reviewed the MR examinations of 20 patients with surgically documented sequestered lumbar disks (free fragments). Sixteen of 20 cases demonstrated extradural masses that were distinct from the interspace of origin and had intermediate signal on T1-weighted images but increased signal on T2-weighted images. In 12 cases there was migration of the sequestered fragment. Sequestered disks that migrated away from the interspace had an irregular, oblong appearance, while those near the interspace were round in configuration. Additionally, the interspace of origin consistently demonstrated loss of signal on T2-weighted images when compared with intact lumbar disks. Sagittal 12-weighted images best depicted the absence of a high-signal pedicle contiguous with the interspace of origin in sequestered disks. These findings were applied to a prospective group of 20 patients undergoing lumbar diskectomy. There was an 89% sensitivity, 82% specificity, and 85% accuracy for MR in distinguishing sequestered disks from other forms of lumbar disk herniation.

We conclude that high-resolution MR imaging is sensitive in detecting disk disease and specific in characterizing various subtypes of extradural defects. MR uses morphology as well as changes in signal intensity to make these distinctions.

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American Journal of Neuroradiology
Vol. 9, Issue 2
1 Mar 1988
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High-Resolution MR Imaging of Sequestered Lumbar Intervertebral Disks
Thomas J. Masaryk, Jeffrey S. Ross, Michael T. Modic, Francis Boumphrey, Henry Bohlman, Geoffrey Wilber
American Journal of Neuroradiology Mar 1988, 9 (2) 351-358;

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High-Resolution MR Imaging of Sequestered Lumbar Intervertebral Disks
Thomas J. Masaryk, Jeffrey S. Ross, Michael T. Modic, Francis Boumphrey, Henry Bohlman, Geoffrey Wilber
American Journal of Neuroradiology Mar 1988, 9 (2) 351-358;
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