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Thoracic disc herniation and spinal cord compression. MRI and gadolinium-enhancement
M Boukobza1, A Tebeka, J P Sichez
1Service de Neuroradiologie, Hôpital de la Pitié, Paris.
Abstract:
The authors present a study of 6 patients aimed at assessing the role of Magnetic Resonance Imaging with gadolinium-enhancement in the diagnosis of thoracic disc herniation. The results of MRI were compared with the findings of computed tomography, myelography and surgery. In two patients, the signal from the herniated disc was so low on all sequences that thoracic disc herniation was diagnosed only on the mass effect on the cord. The anterior longitudinal epidural venous plexus (AEVP) is displaced posteriorly and thickened in case of thoracic disc herniation. Gadolinium-enhancement of AEVP was marked in these conditions, giving a "tent-like" round configuration, or "lifted band" appearance. The exact volume and mass effect of the thoracic disc herniation were assessed by T1-enhanced images on the sagittal and axial planes.
Insights
Gadolinium-enhanced MRI aids in diagnosing thoracic disc herniation by visualizing the anterior longitudinal epidural venous plexus (AEVP). This technique reveals characteristic "tent-like" or "lifted band" appearances, improving diagnostic accuracy.
Area of Science:
- Radiology
- Neurosurgery
- Spinal Imaging
Background:
- Thoracic disc herniation is challenging to diagnose.
- Conventional imaging may not always provide definitive results.
Purpose of the Study:
- To evaluate the diagnostic utility of gadolinium-enhanced Magnetic Resonance Imaging (MRI) for thoracic disc herniation.
- To assess the role of AEVP changes in diagnosis.
Main Methods:
- A study of 6 patients with suspected thoracic disc herniation.
- Comparison of MRI findings with computed tomography, myelography, and surgical outcomes.
- Analysis of T1-enhanced MRI sequences, including sagittal and axial planes.
Main Results:
- Gadolinium enhancement of the anterior longitudinal epidural venous plexus (AEVP) was observed in thoracic disc herniation.
- Characteristic "tent-like" or "lifted band" appearances of AEVP were noted.
- MRI effectively assessed disc herniation volume and spinal cord mass effect, even when disc signal was low.
Conclusions:
- Gadolinium-enhanced MRI is valuable for diagnosing thoracic disc herniation.
- AEVP enhancement patterns provide key diagnostic indicators.
- T1-enhanced MRI accurately quantifies herniation size and cord compression.