Gadolinium-enhanced Magnetic resonance imaging [Neurosurgery Wiki]

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=====Gadolinium-enhanced Magnetic resonance imaging=====
Gadolinium-enhanced Magnetic resonance imaging (Gd-MRI) is often performed in the evaluation of patients with persistent [[sciatica]] after lumbar disc surgery. However, correlation between enhancement findings and clinical findings is debated and limited data is available regarding the reliability of enhancement findings.

Poor to moderate agreement was observed regarding gadolinium enhancement of the herniated disc and compressed nerve root (kappa <0.41) which was in contrast with excellent interobserver agreement about the disc level of the herniated disc and compressed nerve root (kappa >0.95). Of the 59 patients with an enhancing herniated disc at one year, 86% reported recovery compared to 100% of the 12 patients with non-enhancing herniated discs (P=0.34). Of the 12 patients with enhancement of the most affected nerve root at one year 83% reported recovery compared to 85% of the 192 patients with no enhancement (P=0.69). Patients with and without enhancing herniated discs or nerve roots at one year reported comparable outcomes on RDQ and VAS-leg pain.

Reliability of Gd-enhanced MRI findings was poor to moderate and no correlation was observed between enhancement findings and clinical findings at one year follow-up
((El Barzouhi A, Vleggeert-Lankamp CL, Lycklama À Nijeholt GJ, Van der Kallen
BF, van den Hout WB, Koes BW, Peul WC; Leiden–The Hague Spine Intervention
Prognostic Study Group. Reliability of Gadolinium-enhanced MRI findings and their
correlation with clinical outcome in patients with sciatica. Spine J. 2014 Feb
20. pii: S1529-9430(14)00225-3. doi: 10.1016/j.spinee.2014.02.028. [Epub ahead of
print] PubMed PMID: 24561397.
)).