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Post Lumbar Discography CT: Angiography CT (ACT) vs Conventional CT 2005

Interventional Spine

Carlos L Perez, MD
Lisa L Yang , MD, Non ASSR Member
Jon Anderson , PhD, Non ASSR Member
Tom Lane , PhD, Non ASSR Member
Amy McAnulty , RN, Non ASSR Member
David P Chason , MD, ASSR Member

Purpose

To evaluate the utility of ACT vs. CT for the evaluation of the disc space following lumbar discography.

Methods & Materials

10 patients underwent provocative lumbar discography for the evaluation of discogenic low back pain on a standard angiography table equippped with rotational 3D imaging. ACT (rotational sequence) was performed immediately following completion of the study. Routine conventional post-discography CT was obtained within 1.5 hours following the procedure. ACT images of the injected disc spaces were reviewed in standard orthogonal planes (MPR) on a 3D workstation in a bone window and compared to routine helical CT for the distribution and extent of annular fissuring.

Results

ACT provided nearly equivalent diagnostic quality images of the disc space/nuclear morphology following lumbar discography when compared to conventional CT. The restricted axial FOV required additional acquisitions in some cases. ACT had the advantage of being able to be performed immediately following discography thereby limiting the dissipation of the injected contrast.

Conclusion

ACT is a promising new technique that has the potential to obviate the need for conventional post-discography CT in the evaluation of the lumbar disc, as well as saving time, cost and radiation exposure to the patient.

Images

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