FAT-SUPPRESSION CONTRAST-ENHANCED MRI IN THE FAILED BACK SURGERY SYNDROME - A PROSPECTIVE-STUDY

We examined 25 patients with recurrent pain after lumbar disk surgery with MRI to evaluate the usefulness of gadolinium (Gd)-enhanced fat-su ppression (FS) imaging in patients with failed back surgery. Pulse seq uences included T1-weighted (T1W) images, Gd-enhanced T1W images, and Gd-enhanced T1W images with FS. The addition of FS to Gd-enhanced T1W images improved visualization of enhancing scar in all cases, helped d istinguish scar from recurrent herniated disk, and showed more clearly the relationship of scar to the nerve roots and thecal sac. The image s also demonstrated enhancement of the facet joints and theca in 23 an d 11 cases, respectively. Intradural nerve roots were more conspicuous with FS in 21 cases. The combination of unenhanced and Gd-enhanced T1 W images with FS is recommended for routine examination of the postope rative back.