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Thoracic disk herniation: MR imaging
J S Ross1, N Perez-Reyes, T J Masaryk
1Department of Radiology, University Hospitals, Case Western Reserve University, Cleveland, Ohio 44106.
Abstract:
The authors undertook a retrospective study to assess the role of magnetic resonance (MR) imaging in thoracic disk herniation. The initial MR images were interpreted independently of other findings. These interpretations were compared with the findings of plain and computed tomography (CT) myelography and surgery, when available. Sixteen thoracic disk herniations were confirmed with plain and CT myelography and/or surgery. Plain myelography was performed on 14 patients and showed focal ventral filling defects in nine. Results of CT myelography were equivalent to those of MR imaging with three pulse sequences (sagittal T1 and T2 weighted, axial T1 weighted) in the identification of all the abnormal levels. In two patients, the signal from the herniated disk was so low on all sequences that thoracic disk herniation had to be inferred from the mass effect on the spinal cord. Precise location of the abnormal level with body coil MR images was achieved in six of 13 patients.
Insights
Magnetic resonance (MR) imaging effectively identifies thoracic disk herniation, comparable to CT myelography. However, precise localization can be challenging due to low signal intensity in some cases.
Area of Science:
- Radiology
- Neurosurgery
- Spinal Imaging
Background:
- Thoracic disk herniation is a rare condition.
- Accurate diagnosis is crucial for effective treatment.
Purpose of the Study:
- To evaluate the diagnostic accuracy of magnetic resonance (MR) imaging for thoracic disk herniation.
- To compare MR imaging findings with conventional methods like plain and computed tomography (CT) myelography and surgical confirmation.
Main Methods:
- Retrospective analysis of MR images from patients with suspected thoracic disk herniation.
- Independent interpretation of MR images.
- Comparison with plain myelography, CT myelography, and surgical findings.
Main Results:
- Sixteen cases of thoracic disk herniation were confirmed.
- MR imaging, using sagittal T1 and T2 weighted, and axial T1 weighted sequences, demonstrated diagnostic equivalence to CT myelography.
- In two cases, herniation was inferred from spinal cord mass effect due to low disk signal intensity.
- Accurate level localization using body coil MR images was achieved in 6 of 13 patients.
Conclusions:
- MR imaging is a valuable tool for diagnosing thoracic disk herniation.
- CT myelography and MR imaging show comparable diagnostic performance.
- Challenges in precise level localization may arise from low signal intensity of the herniated disk.