Glickstein M F, Sussman S K
Department of Radiology, Hartford Hospital, CT 06106.
Skeletal Radiol. 1991;20(5):333-7. doi: 10.1007/BF01267658.
Magnetic resonance imaging (MRI) has become a principal modality in the evaluation of the post-operative lumbar spine. Gadolinium-diethylenetriamine-pentaacetic acid (Gd-DTPA) can often facilitate differentiation of scar from recurrent disc herniation according to established criteria. Scar has been believed to enhance predictably. We reviewed the contrast-enhanced MR scans of 44 patients who were examined for recurrent back pain following disc surgery and attempted to assess the enhancement characteristics of scar as a function of the time interval between initial surgery and the imaging study. In 44 patients, scar was believed to be present at 32 of 49 disc levels. The degree of enhancement was related to the postoperative interval; those studies performed no later than 9 months after surgery tended to exhibit the greatest degree of enhancement. Surgical confirmation of these MRI findings was available in 12 patients. In patients examined long after surgery, scar enhancement may be less intense than in those examined shortly after surgery, or even nonexistent. This temporal factor should be considered when using contrast material to differentiate scar from recurrent disc herniation in post-operative examinations of the lumbar spine.
磁共振成像（MRI）已成为评估腰椎术后情况的主要手段。钆喷酸葡胺（Gd-DTPA）通常可根据既定标准，有助于区分瘢痕与复发性椎间盘突出。一直以来人们认为瘢痕会呈现可预测的强化表现。我们回顾了44例因椎间盘手术后复发性背痛而接受检查的患者的增强磁共振扫描图像，并试图评估瘢痕的强化特征与初次手术和成像检查之间时间间隔的关系。在44例患者中，49个椎间盘节段中有32个节段被认为存在瘢痕。强化程度与术后间隔时间有关；那些在手术后不超过9个月进行的检查往往显示出最大程度的强化。12例患者的MRI结果得到了手术证实。在术后很长时间才接受检查的患者中，瘢痕强化可能不如术后不久接受检查的患者明显，甚至可能不存在。在腰椎术后检查中使用对比剂区分瘢痕与复发性椎间盘突出时，应考虑这一时间因素。
