Topical diagnosis of lumbar degenerative disk disease by using contrast\enhanced MRI of the spine

The diagnostic capabilities of paramagnetic contrast enhancement of the spine MRI have been studied in patients with degenerative spondylosis of the lumbar spine and radiculopathy or pain syndrome. In all cases, T1weighted spinecho MRI examinations were performed in sagittal, frontal, and axial planes with repetition times (TR) of 350 to 550 ms, echo times (TE) of 15-25 ms, and MRI slice thickness of 4 to 5 mm. Contrast enhancement was carried out with 2 ml of 0.5 M paramagnetic per 10 kg of body weight. Postcontrast studies were performed 8 to 12 min after the injection exactly the same way as the precontrast examinations. Two main syndromes were identified in contrastenhanced MRI studies of the lumbar spine, in particular: (i) isolated enhancement of the T1weighted image of the pars annularis of the intervertebral disk in the progressive protrusion (Type 1), and (ii) enhancement of images of discal hernia (extrusion), exostoses, and surrounding epidural tissue in hernia extrusions of the intervertebral discs (Type 2). Degree of enhancement did not significantly correlate with anatomic parameters of the pathologic protrusion (extrusion), but was the very factor determining the degree of pain syndrome at the respective innervation level.