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Gadolinium-enhanced nerve roots in lumbar disk herniation
G Crisi1, P Carpeggiani, C Trevisan
1Department of Neuroradiology, Policlinico, Modena, Italia.
AJNR. American Journal of Neuroradiology
|November 1, 1993
Summary
Selective intrathecal nerve root enhancement on MRI may visualize radiculopathy from lumbar disk herniation. This finding, potentially transient in the acute phase, offers insights into degenerative disk disease pathophysiology.
Area of Science:
- Radiology
- Neurology
- Orthopedics
Background:
- Lumbar disk herniation is a common cause of low back pain and radiculopathy.
- Magnetic Resonance Imaging (MRI) is crucial for diagnosing lumbar disk herniation.
- Contrast-enhanced MRI can provide additional information about nerve root involvement.
Purpose of the Study:
- To analyze contrast-enhanced features of intrathecal nerve roots in non-surgically treated lumbar disk herniation.
- To evaluate the correlation between nerve root enhancement and herniated disk characteristics, peridiscal enhancement, and patient symptoms.
Main Methods:
- Pre- and postcontrast MRI scans were performed on twenty non-surgically treated patients with lumbar disk herniation.
- Intrathecal nerve roots and surrounding tissues were assessed for enhancement patterns.
Main Results:
- Selective enhancement of ipsilateral intradural roots was observed in 30% of patients, persisting on delayed scans.
- Minimal or "selective" enhancement, distinct from normal root enhancement, was seen in 55% of patients.
- Peridiscal enhancement around herniated disks was common (92%) but did not correlate with root enhancement or symptoms.
Conclusions:
- Selective intrathecal nerve root enhancement may represent direct visualization of radiculopathy due to disk herniation.
- This enhancement is likely a transient phenomenon, more prominent in the acute phase.
- While not immediately clinically useful, it provides insights into the pathophysiology of degenerative disk disease.