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

AJR. American Journal of Roentgenology
Jae Sung MyungHeung Sik Kang

Abstract

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. 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. 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 diskog...Continue Reading

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