Ces radiol. 2011, 65(1):70-73

Can contrast-enhanced MRI bring new information in diagnosis of disc herniation?Case report

Andrea Burgetová¹, Petr Dušek², Martin Mašek¹, Manuela Vaněčková¹, Zdeněk Seidl^1,3

¹ Radiodiagnostická klinika 1. LF UK a VFN, Praha

² Neurologická klinika 1. LF UK a VFN, Praha

³ Vyšší zdravotnická škola, Praha

Intervertebral disc hernia is a common cause of back pain and radicular symptoms. Although some patients can not avoid surgery, many patients achieve clinical improvement and often complete resolution of symptoms by conservative therapy. The MRI has documented a number of cases in where the conservatively treated patients showed a regression of disc herniation, which was associated with clinical improvement. In addition to high sensitivity and specificity in the diagnosis of herniation MRI has the potential to predict spontaneous resorption of the herniation and the clinical course of disease. If symptoms persist MRI may help in deciding between surgical and conservative therapy. The most important positive prognostic factor for the resorption of disc herniation appears to be peripheral enhancing rim on contrast-enhanced MRI. Other factors are higher water content in herniated disc (increased signal intensity on T2WI) and type of herniation, the greatest chance for resorption has a free fragment. The aim of our case report is to show that MRI and especially postcontrast MRI has some potential in predicting the clinical course of the disease, which is not yet sufficiently exploited.

Keywords: conservative treatment, lumbar disc herniation, magnetic resonance imaging, rim enhancement, spontaneous regression

Grants and funding:

Studie byla podpořena granty Ministerstva zdravotnictví ČR MZOVFN2005 a MSMT021620849.

Accepted: February 10, 2011; Published: March 1, 2011  Show citation