The clinical significance of gadolinium enhancement of lumbar disc herniations and nerve roots on preoperative MRI

The clinical significance of preoperative gadolinium DPTA enhancement aroun d disc herniations and in the epidural space on MRI is not clear. The relat ion of nerve root enhancement to dysfunction also remains controversial. To investigate the clinical significance of contrast enhancement we looked at the symptoms and signs and gadolinium DPTA-enhanced images of 71 consecuti ve surgical candidates in a standardised fashion. Annular rupture and disc enhancement were found to be closely related, and correlated with sensory l oss and paresis, respectively. Nerve root enhancement was found to be relat ed to neurological deficits in general and sensory impairment in particular .