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

The clinical significance of preoperative gadolinium DPTA enhancement around disc herniations and in the epidural space on MRI is not clear. The relation 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 consecutive surgical candidates in a standardised fashion. Annular rupture and disc enhancement were found to be closely related, and correlated with sensory loss and paresis, respectively. Nerve root enhancement was found to be related to neurological deficits in general and sensory impairment in particular.