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Comparison of MR and diskography in detecting radial tears of the anulus: a postmortem study
S W Yu1, V M Haughton, L A Sether
1Department of Radiology, Froedtert Memorial Lutheran Hospital, Medical College of Wisconsin, Milwaukee 53226.
Abstract:
Radial tears of the anulus fibrosus, which anatomic studies suggest are a primary event in disk degeneration, can be detected by diskography or MR imaging. We compared the sensitivity of MR and diskography in the detection of anular tears. MR, diskography, and cryomicrotomy anatomic sectioning were performed in eight cadaver lumbar spines. Diskography demonstrated 15 radial tears in 36 intervertebral disks. MR demonstrated 10 of the 15, a sensitivity of 67%. MR (T2-weighted images) in each of the diskographically normal disks showed the high signal intensity characteristic of normal disks. Thirteen of 15 disks from which contrast medium extravasated at diskography had diminished signal intensity in MR images. We conclude that although MR may demonstrate some radial tears of the anulus, and associated changes in the disk, it cannot be used as effectively as diskography to visualize a radial tear.
Insights
Diskography is more effective than Magnetic Resonance (MR) imaging for detecting radial tears in the anulus fibrosus, a key factor in disc degeneration. MR imaging identified only 67% of tears found by diskography.
Area of Science:
- Orthopedics
- Radiology
- Spine Surgery
Background:
- Radial tears of the anulus fibrosus are a primary event in disc degeneration.
- Both diskography and MR imaging can detect these anular tears.
Purpose of the Study:
- To compare the sensitivity of MR imaging and diskography in detecting radial anular tears.
Main Methods:
- Eight cadaver lumbar spines were analyzed.
- MR imaging, diskography, and cryomicrotomy were performed on intervertebral discs.
Main Results:
- Diskography identified 15 radial tears in 36 discs.
- MR imaging detected 10 of these 15 tears (67% sensitivity).
- MR imaging showed high signal intensity in normal discs and diminished signal in discs with contrast extravasation.
Conclusions:
- MR imaging can detect some radial tears and associated disc changes.
- Diskography is more effective than MR imaging for visualizing radial anular tears.