Gd-DTPA in the postoperative spine

This paper reports how initial experience with Gd-DTPA in 17 patients after reoperation indicated that epidural scar enhanced while herniated disk did not on early postinjection images. Over a 1-year period, 234 new patients with FBSS underwent MR imaging, and 16 went on to reoperation, for a total of 33 patients with surgical correlation. The time for surgery ranged form 6 weeks to 32 years. Enhanced MR imaging predicted the surgical findings in 31, of 33 patients (35 of 37 levels). Eight patients has scar only , 12 disk only, 14 disk and scars, and three no aberrant tissue. Incorrect MR findings include one case with epidural enhancement that was disk at surgery. Causes of failure include partial volume averaging and incorporation of disk fragments in scar with early enhancement. Gd-DTPA MR imaging continuers to be the single best method for evaluating the postoperative patient