Diagnosis of lumbar disc herniation by three-dimensional MRI

Taira, Gaku; Endo, Kenji; Ito, Koichi; Ichimaru, Katsuji; Imakiire, Atsuhiro; Miura, Yukio

doi:10.1007/s007760050017

Cited by 10 publications

(5 citation statements)

References 9 publications

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“…Meanwhile, the 3D space location between the herniated disc and nerve root can also be clearly visualized. Although 3D MRI [ 24 , 25 ] has been used to diagnose symptomatic extraforaminal disc herniation, spinal cord and nerve root compression in recent years, this is the first investigation to indicate that 3D MRI is a helpful imaging tool for differentiating between diagnosis of disc sequestration that mimics a tumor and neurinoma prior to operation.…”

Section: Discussionmentioning

confidence: 99%

Two cases in which 3D MRI was used to differentiate between a disc mass that mimics a tumor and neurinoma

Jia

Wei

et al. 2018

BMC Musculoskelet Disord

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BackgroundSince disc sequestration that mimics a tumor is rare and sometimes presents with an atypical appearance upon magnetic resonance imaging (MRI), it is often confused with other more common epidural and intradural neoplasms, particularly neurinoma. Open surgery is necessary due to the difficult of achieving a definitive diagnosis using computed tomography, MRI, and gadolinium- enhanced MRI prior to operation. Herein, we describe the use of coronal MR images of 3D fast-field echo with water selective excitation in the diagnosis of disc sequestration mimicking a tumor.Case presentationTwo patients were admitted to our hospital with back pain, radiating pain, and hypoesthesia in the right lower limb. MRI revealed tumor-like masses in the lateral recess of L3 and posterior to the body of L4. The initial diagnosis indicated disc sequestration mimicking a tumor and neurinoma. The coronal MR images of 3D fast-field echo with water selective excitation showed a clear boundary between the tumor-like mass and the nerve root. Moreover, the mass was also completely separated from the dura. Therefore, neurinoma was excluded as a possible diagnosis prior to operation. Surgical excision to perform removal of the gross mass was performed in one patient. The histopathological diagnosis was consistent with the 3D fast-field echo with water-selective excitation MRI. Another patient was successfully treated by minimally invasive endoscopic surgery.ConclusionsDisc sequestration that mimics a tumor is difficult to diagnose preoperatively. As a non–invasive strategy, coronal MR images of 3D fast-field echo with water selective excitation is a helpful imaging tool for differentiating between diagnosis of disc sequestration that mimics a tumor and neurinoma prior to operation. If the disc fragment of mimicking tumor can be identified prior to operation, open surgery may not be necessary for all patients. Minimally invasive endoscopic surgery also is an alternative strategy.

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Section: Discussionmentioning

confidence: 99%

Two cases in which 3D MRI was used to differentiate between a disc mass that mimics a tumor and neurinoma

Jia

Wei

et al. 2018

BMC Musculoskelet Disord

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“…1,[8][9][10] The surgical treatment of these herniations requires the use of the far lateral paravertebral approaches. Such approaches dictate accurate knowledge of the anatomy of the lumbar nerve roots and their relation with the bony landmarks in the extraforaminal area.…”

Section: Discussionmentioning

confidence: 99%

“…Each new technological development led to the description of new approaches and techniques in lumbar disc surgery. [2][3][4][5][6][7] The use of axial CT scans and MRI facilitate the diagnosis of far lateral disc herniations, [8][9][10] which comprise 2.6-11.7% of all lumbosacral disc herniations. [11][12][13][14] The relatively high rate of far lateral disc herniations, and reports of unsuccessful results with classical surgical approaches to them have led to the use of extraforaminal approaches since the 1980 s. 15 A variety of far lateral approaches have been described for far lateral disc herniations below the L2-L3 intervertebral disc space.…”

Section: Introductionmentioning

confidence: 99%

The relation between the lumbar vertebrae and the spinal nerves for far lateral lumbar spinal approaches

Güvençer

Naderi

Kiray

et al. 2008

Journal of Clinical Neuroscience

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“…6,9,10 The coronal image is reconstructed using software and can clearly show the 3D space location between the herniated disc and nerve root. 10,11 Symptomatic disc herniation and spinal cord and nerve root compression have recently been diagnosed by CMRI and 3D MRI. [9][10][11][12] However, the sensitivity, specificity, and reliability of CMRI and 3D MRI for the diagnosis of extraforaminal lumbar disc herniation have not been adequately addressed.…”

Section: Introductionmentioning

confidence: 99%

Coronal magnetic resonance imaging of three-dimensional fast-field echo with water-selective excitation improves the sensitivity and reliability of identification of extraforaminal lumbar disc herniation

Jia

Liu

et al. 2019

J Int Med Res

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Objective The complete view of the nerve root, including the extraforaminal zone, can be displayed by coronal magnetic resonance imaging (MRI) of three-dimensional (3D) fast-field echo with water-selective excitation (CMRI). However, its sensitivity, specificity, and reliability for the diagnosis of extraforaminal lumbar disc herniation are unclear. We compared the sensitivity, specificity, and reliability of conventional MRI, CMRI, and 3D MRI for the identification of extraforaminal lumbar disc herniation. Methods This study involved 140 patients (68 with extraforaminal lumbar disc herniation and 72 with paramedian disc herniation). Their mean age was 44.57 ± 14.59 years. Conventional MRI, CMRI, and 3D MRI of all patients were evaluated by five experts. The reliability, sensitivity, and specificity of the three imaging techniques for identification of extraforaminal lumbar disc herniation were compared using kappa statistics and the chi-squared test. Results CMRI showed higher agreement (0.843) than conventional MRI (0.671) and 3D MRI (0.771) for the identification of extraforaminal lumbar disc herniation. CMRI demonstrated higher sensitivity (95.6% vs. 91.2%) than conventional MRI (85.3% vs. 70.6%) and 3D MRI (92.6% vs. 86.7%) regardless of whether performed by junior or senior surgeons. Conclusions CMRI is helpful for identification of extraforaminal disc herniation by junior and senior orthopedic surgeons.

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Diagnosis of lumbar disc herniation by three-dimensional MRI

Cited by 10 publications

References 9 publications

Two cases in which 3D MRI was used to differentiate between a disc mass that mimics a tumor and neurinoma

Two cases in which 3D MRI was used to differentiate between a disc mass that mimics a tumor and neurinoma

The relation between the lumbar vertebrae and the spinal nerves for far lateral lumbar spinal approaches

Coronal magnetic resonance imaging of three-dimensional fast-field echo with water-selective excitation improves the sensitivity and reliability of identification of extraforaminal lumbar disc herniation

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