Gadolinium-DTPA-enhanced MR imaging of the postoperative lumbar spine: time course and mechanism of enhancement

Ross, J. S.; Delamarter, Rick B.; Hueftle, MG; Masaryk, T J; Aikawa, Masamichi; Carter, J; VanDyke, Carolyn W.; Modic, M T

doi:10.2214/ajr.152.4.825

Cited by 67 publications

(42 citation statements)

References 1 publication

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“…unaware of clinical findings and treatment groups. The scar was identified by early Gd-DTPA enhancement surrounding the nerve root or thecal sac [30,40].…”

Section: Methodsmentioning

confidence: 99%

Recurrent pain after lumbar discectomy: the diagnostic value of peridural scar on MRI

Vogelsang

Finkenstaedt

Vogelsang

et al. 1999

European Spine Journal

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“…unaware of clinical findings and treatment groups. The scar was identified by early Gd-DTPA enhancement surrounding the nerve root or thecal sac [30,40].…”

Section: Methodsmentioning

confidence: 99%

Recurrent pain after lumbar discectomy: the diagnostic value of peridural scar on MRI

Vogelsang

Finkenstaedt

Vogelsang

et al. 1999

European Spine Journal

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“…In the intervertebral disc, enhancement of the uptake of Gd-DTPA has often been observed clinically in normal appearing discs (15), and there is a high prevalence of disc degeneration in asymptotic populations (16). After surgery, contrast-enhanced MR is used to distinguish scar tissue from recurrent herniation (17,18).…”

Section: Visualization Of Intervertebral Disc Degeneration In Mr Imagmentioning

confidence: 99%

Magnetic resonance imaging and spectroscopy of the intervertebral disc

Majumdar

2006

NMR in Biomedicine

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Intervertebral disc disease is an emerging health concern and has a considerable negative effect on the economy and on society. MRI has a critical role in assessing the disc, but it is still a challenge to objectively correlate disc health and pain with images. In this paper, a review of MR disc imaging techniques including grading, relaxation time measurements, diffusion, and contrast perfusion is presented. In addition, high-resolution magic-angle spinning methods to correlate in vitro disc degeneration (with pain, etc) are discussed. With the potential for gaining morphological and biochemical information, MRI shows promise for quantitative assessment of disc health.

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“…The DCE-MRI studies in the SCI literature are few and mainly qualitative, utilizing the contrast enhancement properties to either localize or estimate the size of the cord lesions in patients (7,8) and in animals (9,10). In SCI patients, Ross et al (11) studied the time course and mechanism of Gd enhancement in epidural fibrosis of postoperative lumbar spine 6 months after injury. The contrast enhancement was shown to effectively differentiate scar tissue from recurrent disk herniation in the failed-back surgery syndrome.…”

mentioning

confidence: 99%

Dynamic contrast‐enhanced MRI of experimental spinal cord injury: In vivo serial studies

Bilgen¹,

Abbe²,

Narayana³

2001

Magnetic Resonance in Med

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The progression of experimental spinal cord injury (SCI) was followed with in vivo dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and neurobehavioral studies on postinjury days 0, 2, 4, 7, 10, 14, 17, 21, 28, 35, and 42. Gadopentate dimeglumine (Gd) was administered IV and postcontrast, T 1 -weighted, axial images were acquired repetitively for up to 60 min. Images were analyzed to determine the spatial and temporal evolution of the intensity enhancement. A statistical decision mechanism was developed to objectively detect the enhancement. Strong and rapid enhancement was observed at the epicenter of injury, indicating a significant compromise in blood spinal cord barrier. The enhanced regions in each slice were combined to estimate the area and volume of the lesion. On the day of injury, around 85% of the total cord area at the epicenter showed enhancement within the first 15 min of Gd administration. At the same time, the enhanced volumes attained nearly 40% of the total cord volume and extended axially over 8 mm along the cord. The blood-spinal cord barrier (BSCB) maintains a highly regulated homeostatic environment in the spinal cord (SC) tissue. This regulatory function is sustained by various structures, including the capillary endothelial tight junctions. Under normal physiological conditions, BSCB protects the cord tissue by exhibiting selective permeability to the constituents of intravascular fluid (1,2). A traumatic insult to SC disrupts the structural and biochemical integrity of BSCB. The altered tight junctional patency allows vesicular transport of toxic substances from blood plasma to interstitial spaces. This makes the SC tissue environment unfavorable for neuronal survival, and inhibits tissue repair processes and neurologic recovery. By following the changes in BSCB after injury, important information may be gained about the regions of initial SC tissue damage and a time window for effective drug delivery across the barrier. Assessing BSCB in the late phases of the injury may help evaluate the progression of spinal cord injury (SCI) as well as the efficacy of potential therapeutic interventions.Changes in BSCB permeability can be followed experimentally using intravascularly administered tracers (such as plasma proteins, radiolabeled proteins, and small-molecular-weight molecules) that can cross the compromised barrier (3,4). Although these tracer-based techniques provide valuable information about the status of BSCB, they are either fully invasive, necessitating histological analysis of tissue, or less invasive but still requiring intravenous injection of radio-tracers with subsequent blood sampling along with imaging, as in the case of autoradiography. Moreover, active transport mechanisms involved in some of these tracers may introduce a bias in quantifying the BSCB permeability (4).As an alternative to the above techniques, dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI), with the exogenous paramagnetic contrast agent gadopentetate-dimeglumine (Gd, for short)...

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Gadolinium-DTPA-enhanced MR imaging of the postoperative lumbar spine: time course and mechanism of enhancement

Cited by 67 publications

References 1 publication

Recurrent pain after lumbar discectomy: the diagnostic value of peridural scar on MRI

Recurrent pain after lumbar discectomy: the diagnostic value of peridural scar on MRI

Magnetic resonance imaging and spectroscopy of the intervertebral disc

Dynamic contrast‐enhanced MRI of experimental spinal cord injury: In vivo serial studies

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