Contrast media of high and low molecular weights in the detection of recurrent herniated disks

Our goal was to compare contrast enhancement of recurrent herniated disk fragments and scar after intravenous injection of a new high-molecular-weight contrast medium, Gadomer 17 (gadomer), with that after injection of a low-molecular-weight contrast medium, (gadopentetate dimeglumine).

Recurrent herniated disks were modeled in dogs by placing a fragment of intervertebral disk cartilage in the epidural space at laminectomy. MR imaging was performed with one of the contrast media at 20 and 50 days and with the other medium at 22 and 52 days. The changes in signal intensity from baseline in the disk fragment and in the adjacent scar tissue was measured at 2, 22, and 45 minutes. Differences were tested for significance with a student t-test.

At 50 days after surgery, signal intensity in the intervertebral disk fragment increased by an average of 0.52 at 2 minutes after injection of gadomer and by an average of 0.90 after injection of gadopentetate. For scar, the increases in signal intensity were 1.41 (gadomer) and 1.62 (gadopentetate). At 22 and 45 minutes after injection, the signal intensity change in the disk fragment continued to be significantly greater after gadopentetate than after gadomer injection. In comparison with the changes at 50 days, both scar and disk fragment tended to show greater signal intensity changes at 20 days. Signal intensity changes in the disk fragments were significantly less after gadomer than after gadopentetate. Signal intensity changes in scar were slightly less with gadomer than with gadopentetate.

Greater contrast is achieved between scar and recurrent herniated disk with a higher-molecular-weight contrast medium than with one of lower molecular weight. The difference between the high- and low-molecular-weight contrast media increases with maturation of the scar tissue.