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MR diskography and CT diskography with gadodiamide-iodinated contrast mixture for the diagnosis of foraminal impingement

Cited 2 time in Web of Science Cited 4 time in Scopus
Authors
Myung, Jae Sung; Lee, Joon Woo; Park, Geon Woo; Yeom, Jin Sup; Choi, Ja-Young; Hong, Sung Hwan; Kang, Heung Sik
Issue Date
2008-08-22
Publisher
American Roentgen Ray Society
Citation
AJR Am J Roentgenol 2008; 191(3):710-715
Keywords
Cefazolin/administration & dosage/diagnostic useContrast MediaDrug CombinationsFemaleGadolinium DTPA/administration & dosage/*diagnostic useHumansImage Enhancement/methodsIntervertebral Disk/*pathology/*radiographyIntervertebral Disk Displacement/*diagnosisIohexol/administration & dosage/*diagnostic useLumbar Vertebrae/pathology/radiographyMagnetic Resonance Imaging/*methodsMaleMiddle AgedNerve Compression Syndromes/*diagnosisSensitivity and SpecificitySpinal Nerve Roots/pathology/radiographyTomography, X-Ray Computed/*methods
Abstract
OBJECTIVE: This study was designed to investigate whether the use of MR diskography would result in improved reader confidence over the use of CT diskography alone for evaluating foraminal impingement causing lumbar radiculopathy. SUBJECTS AND METHODS: Sixteen disk levels in 14 consecutive patients with suspected foraminal impingement causing lumbar radiculopathy were prospectively included in the study. A mixture of diluted gadodiamide and iodinated contrast material was injected at each disk level. After diskography, a CT scan (CT diskography) and T1-weighted fat-suppressed MR image (MR diskography) were obtained. Two spine radiologists and an orthopedic spine surgeon independently scored CT diskography and MR diskography for foraminal evaluation on a 3-point scale: 1, low confidence; 2, moderate confidence; and 3, high confidence. Each reader also assessed whether MR diskography showed an additional benefit over CT diskography with regard to the depiction of foraminal abnormalities only. Another radiologist reviewed conventional MR images focused on disk height and morphology. RESULTS: The reviewers' confidence scores for MR diskography were superior to those for CT diskography (reader 1, p = 0.00008; reader 2, p = 0.0008; reader 3, p = 0.0015) (p < 0.05). MR diskography was considered beneficial in 13 of 16 disk levels (reader 1), 14 of 16 (reader 2), and 14 of 16 (reader 3). MR diskography increased the confidence scores for the detection of foraminal impingement, especially in cases of severe disk degeneration, but did not show additional benefits in cases of an extensive vacuum in the disk or large disk extrusion. CONCLUSION: Simultaneous MR diskography and CT diskography with a mixture of gadodiamide and iodinated contrast material may be beneficial for evaluating foraminal impingement causing lumbar radiculopathy.
ISSN
1546-3141 (Electronic)
Language
English
URI
http://www.ajronline.org/cgi/reprint/191/3/710.pdf

http://hdl.handle.net/10371/67502
DOI
https://doi.org/10.2214/AJR.07.3148
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College of Medicine/School of Medicine (의과대학/대학원)Orthopedic Surgery (정형외과학전공)Journal Papers (저널논문_정형외과학전공)
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