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Lumbar disc high-intensity zone.
Correlation of magnetic resonance imaging and discography. |
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AUTHORS: |
Schellhas KP; Pollei SR; Gundry CR; Heithoff KB |
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AUTHOR AFFILIATION: |
Center for Diagnostic Imaging, St. Louis Park,
Minnesota, USA. |
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SOURCE: |
Spine 1996 Jan 1;21(1):79-86 |
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CITATION IDS: |
PMID: 9122767 UI: 97063166 |
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ABSTRACT: |
STUDY DESIGN: This study correlated a specific lumbar disc
abnormality described as the high-intensity zone observed on
high-field magnetic resonance imaging with discography. OBJECTIVES:
To analyze the significance of high-intensity zones in lumbar discs
of symptomatic patients with low back/radicular pain. SUMMARY OF
BACKGROUND DATA: Aprill and Bogduk described an 86% incidence of
concordantly painful discography in lumbar discs exhibiting a
posterior high-intensity zone on T2-weighted magnetic resonance
imaging studies performed on back pain sufferers. They assert that
the high-intensity zone is a reliable marker of discogenic pain in
symptomatic subjects. METHODS: Consecutive cases of lumbar spine
high-field magnetic resonance imaging using T2- weighted images on
symptomatic patients followed by discography at all high-intensity
zone levels and at non-high-intensity zone control levels were
reviewed until 100 high-intensity zone discs in 63 patients were
found. Seventeen lifelong asymptomatic (for low back/radicular pain)
adults were also scanned as magnetic resonance imaging controls. All
magnetic resonance scans and discograms were agreed on by at least
two of the radiologist authors. RESULTS: Eighty-seven of 100 of the
high-intensity zone discs proved concordantly painful at
discography. All 87 painful and concordant discs exhibited abnormal
morphology with anular tears extending either well into or through
the outer third of the anulus fibrosus. Sixty-five of 67
non-high-intensity zone control discs were nonconcordant and of
lower sensation intensity than the high- intensity zone discs. Only
one high-intensity zone was found in the control subjects. CONCLUSIONS:
In patients with symptomatic low back pain, the high-intensity zone
is a reliable marker of painful outer anular disruption. |
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MAIN MESH HEADINGS: |
Intervertebral Disk/*pathology
Intervertebral Disk/*radiography
Lumbar Vertebrae/*pathology
Lumbar Vertebrae/*radiography
*Magnetic Resonance Imaging |
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ADDITIONAL MESH HEADINGS: |
Adult
Back Pain/diagnosis
Back Pain/radiography
Comparative Study
Human
Laminectomy
Medical Records
Middle Age
Pain/diagnosis
Peripheral Nervous System Diseases/diagnosis
Peripheral Nervous System Diseases/physiopathology
Peripheral Nervous System Diseases/radiography
Reference Values
Retrospective Studies
Spinal Fusion
Spinal Nerve Roots |
