Johnson C E, Sze G
Sloan-Kettering Cancer Center, New York, NY.
AJR Am J Roentgenol. 1990 Oct;155(4):873-80. doi: 10.2214/ajr.155.4.2119124.
MR imaging was performed in 13 patients with benign lumbar arachnoiditis both before and after IV injection of gadopentetate dimeglumine. The arachnoiditis was proved by previous myelography in 12 patients and by noncontrast MR imaging in one patient. The disease was presumably the result of previous myelography and/or surgery. It was characterized as mild in two patients, moderate in two patients, and severe in nine patients. Imaging was performed on a 1.5-T unit, and both short and long TR images were obtained before and after contrast administration. Noncontrast MR images demonstrated changes consistent with arachnoiditis in all patients. After contrast, three patients had no enhancement, three patients had minimal enhancement, three patients had mild enhancement, and four patients had moderate enhancement. In no case did contrast enhancement alter the diagnosis or reveal additional findings that could not be seen on the noncontrast images. Gadopentetate dimeglumine enhancement plays little role in the diagnosis of lumbar arachnoiditis. If used for another reason, however, short TR scans may show enhancement of adherent roots in some cases. In addition, administration of gadopentetate dimeglumine will not cause sufficient enhancement to hinder the detection of arachnoiditis on long TR images and may aid in recognition of adherent roots on short TR images.
对13例良性腰椎蛛网膜炎患者在静脉注射钆喷酸葡胺前后均进行了磁共振成像(MR成像)检查。12例患者先前通过脊髓造影证实患有蛛网膜炎,1例患者通过非增强MR成像证实。该疾病可能是先前脊髓造影和/或手术的结果。其中2例患者病情为轻度,2例为中度,9例为重度。成像在1.5-T设备上进行,在注射造影剂前后均获取了短TR和长TR图像。所有患者的非增强MR图像均显示出与蛛网膜炎一致的变化。注射造影剂后,3例患者无强化,3例患者有轻微强化,3例患者有轻度强化,4例患者有中度强化。在任何情况下,造影剂强化均未改变诊断结果,也未显示出非增强图像上看不到的额外发现。钆喷酸葡胺强化在腰椎蛛网膜炎的诊断中作用不大。然而,如果出于其他原因使用,短TR扫描在某些情况下可能会显示粘连神经根的强化。此外,注射钆喷酸葡胺不会产生足够的强化来妨碍在长TR图像上对蛛网膜炎的检测,并且可能有助于在短TR图像上识别粘连神经根。