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[Disk highlighting after injection in MRI. Macroscopy and histology of 25 postoperative recurrences]
G Cosnard1, Y S Cordoliani, C Pharaboz
1Service de radiologie, HIA Val-de-Grâce, Paris.
Abstract:
400 cases of failed back syndrome were examined with MRI in a prospective study (SE w Rho and T2, SE wT1 before and after injection of paramagnetic contrast agent in axial and sagittal planes). After second time surgery, 70 cases of herniated disks were found. 25 herniated disks were studied in microscopy and results correlated with enhanced herniated disks. Authors describe 4 types of enhancement: veinous plexus (5/24), inflammatory or granulomatous tissue (12/24), degenerative disc with fibrosis (5/24) and osteophytosis (2/24). The criterions of each pattern are described.
Insights
Magnetic Resonance Imaging (MRI) identified four enhancement patterns in herniated discs after contrast administration in failed back syndrome patients. These patterns correlate with specific pathological findings, aiding diagnosis.
Area of Science:
- Radiology
- Neurosurgery
- Pathology
Context:
- Failed back syndrome (FBS) presents diagnostic challenges.
- MRI is a key imaging modality for spinal pathologies.
- Understanding disc enhancement is crucial for FBS management.
Purpose:
- To prospectively evaluate MRI enhancement patterns in herniated discs in FBS patients.
- To correlate MRI findings with microscopic pathology.
- To classify enhancement patterns for improved diagnostic accuracy.
Summary:
- 400 FBS cases underwent MRI with contrast.
- 70 herniated discs were identified post-surgery.
- Microscopic analysis of 25 herniated discs revealed four enhancement patterns: venous plexus, inflammatory/granulomatous tissue, degenerative disc with fibrosis, and osteophytosis.
- Specific criteria for each pattern were established.
Impact:
- Provides a classification system for disc enhancement in FBS.
- Enhances the diagnostic utility of contrast-enhanced MRI in spinal surgery.
- Aids in differentiating causes of recurrent disc herniation and surgical failure.