CONTRAST-ENHANCED COMPUTED-TOMOGRAPHY AND MAGNETIC-RESONANCE-IMAGING IN THE DIAGNOSIS OF RECURRENT DISC HERNIATION

A positive result of re-operation in patients with recurrent symptoms after lumbar disc surgery is likely only if a new disc herniation is p resent. An improved ability to differentiate between recurrent disc he rniation and scar tissue by contrast enhanced CT and MRI is suggested in earlier studies. In a prospective study 29 patients were selected f or operation for suspected recurrent disc herniation. The inclusion of the patients was based on clinical symptoms and signs and myelography or non-enhanced CT. All patients were examined by CT and MRI both wit h and without intravenous contrast pre-operatively. The examinations w ere evaluated blind on a five point scale and statistical analysed by a regret function. Intravenous contrast improved the diagnostic power of both CT and MRI. MRI was superior to CT in both non-enhanced and en hanced examinations. MRI with intravenous contrast enhancement is prop osed as the primary examination in patients with suspected recurrent d isc herniation.