Bobman S A, Atlas S W, Listerud J, Grossman R I
Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia 19104.
Radiology. 1991 May;179(2):557-62. doi: 10.1148/radiology.179.2.2014311.
A modified fat-suppression pulse sequence (consisting of combined frequency-selective fat presaturation followed by a spin-echo acquisition when fat and water magnetization vectors have opposite phase) was used to optimize the conspicuity of intravenous enhancement by gadopentetate dimeglumine on magnetic resonance images in 10 patients previously operated on for lumbar discogenic disease as well as in two patients with herniated disks who had not previously undergone surgery. This technique produced the greatest degree of fat suppression in the phantom study. In six of the patients who had previously undergone surgery, epidural enhancement was more obvious on the fat-suppressed images than on conventional spin-echo images, while in four patients, enhancement was equivalent. The herniated disks in two patients not previously operated on were not enhanced with either technique. Contrast enhancement was universally distinguishable from fat signal and from nonenhancing water-containing tissue on the fat-suppressed images obtained after contrast material administration. This technique may reduce the need for precontrast imaging. Furthermore, postoperative enhancement of nerve roots was more obvious on fat-suppressed images in seven of eight patients. This finding might represent previously undiagnosed degrees of arachnoidal inflammation, which may be a factor in the failed back syndrome.
采用一种改良的脂肪抑制脉冲序列（由频率选择性脂肪预饱和与脂肪和水磁化矢量处于反相位时的自旋回波采集相结合组成），以优化钆喷酸葡胺静脉增强在磁共振图像上的显影效果，对10例既往接受过腰椎间盘源性疾病手术的患者以及2例既往未接受过手术的椎间盘突出患者进行了研究。在体模研究中，该技术产生了最大程度的脂肪抑制。在6例既往接受过手术的患者中，脂肪抑制图像上的硬膜外增强比传统自旋回波图像上更明显，而在4例患者中，增强效果相当。2例既往未接受过手术的患者的椎间盘突出在两种技术下均未增强。在注射对比剂后获得的脂肪抑制图像上，对比增强与脂肪信号和未增强的含水组织普遍可区分。该技术可能减少对比前成像的需求。此外，8例患者中有7例在脂肪抑制图像上神经根的术后增强更明显。这一发现可能代表了先前未被诊断出的蛛网膜炎症程度，这可能是腰椎术后失败综合征的一个因素。
