Gadolinium Enhancement Is Not Associated With Disc Inflammation in Patients With Sciatica

Niek Djuric, Xiaoyu Yang, Abdelilah El Barzouhi, Raymond W.J.G. Ostelo, Sjoerd G.van Duinen, Geert J.Lycklama À. Nijeholt, Bas F.W. van der Kallen, Wilco C. Peul, Carmen L.A. Vleggeert-Lankamp

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Abstract

STUDY DESIGN: Retrospective observational histological study. OBJECTIVE: To evaluate the reliability of gadolinium enhancement as a marker for inflammation by associating gadolinium enhancement findings with the degree of inflammation as measured by macrophage infiltration in disc material retrieved during disc surgery in patients with sciatica. SUMMARY OF BACKGROUND DATA: Disc inflammation often occurs in sciatica patients, a noninvasive tool that is used to assess disc inflammation is Gadolinium enhanced MR imaging. METHODS: Disc tissue was retrieved from patients in the Sciatica trial (N = 119), a multicenter randomized controlled trial in patients with sciatica. Disc tissue was embedded in paraffin and stained with hematoxylin and CD68. Tissue samples were categorized as mild (0-10 macrophages/cm), moderate (10-100 macrophages/cm), and considerable (>100 macrophages/cm) inflammation. Of the 119 MRIs, 96 were additionally performed with contrast-enhanced gadolinium. RESULTS: Seventy-four patients showed gadolinium enhancement of the disc herniation and 26 of the nerve root. Degree of inflammation by macrophages was not associated with gadolinium enhancement of nerve roots or herniated discs. These results did not change if the patient groups with and without Modic type 2 changes were evaluated separately. Furthermore, no associations were observed between gadolinium enhancement and presence of Modic type 2 changes. CONCLUSION: This study found gadolinium enhanced MRI findings to be unreliable as an indicator for inflammation of disc herniation or nerve root in patients with sciatica.2.

Original languageEnglish
Pages (from-to)E742-E748
JournalSpine
Volume44
Issue number12
DOIs
Publication statusPublished - 15 Jun 2019

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Sciatica
Gadolinium
Inflammation
Macrophages
Intervertebral Disc Displacement
Hematoxylin
Paraffin
Observational Studies
Randomized Controlled Trials

Cite this

Djuric, N., Yang, X., Barzouhi, A. E., Ostelo, R. W. J. G., Duinen, S. G. V., Nijeholt, G. J. L. À., ... Vleggeert-Lankamp, C. L. A. (2019). Gadolinium Enhancement Is Not Associated With Disc Inflammation in Patients With Sciatica. Spine, 44(12), E742-E748. https://doi.org/10.1097/BRS.0000000000003004
Djuric, Niek ; Yang, Xiaoyu ; Barzouhi, Abdelilah El ; Ostelo, Raymond W.J.G. ; Duinen, Sjoerd G.van ; Nijeholt, Geert J.Lycklama À. ; van der Kallen, Bas F.W. ; Peul, Wilco C. ; Vleggeert-Lankamp, Carmen L.A. / Gadolinium Enhancement Is Not Associated With Disc Inflammation in Patients With Sciatica. In: Spine. 2019 ; Vol. 44, No. 12. pp. E742-E748.
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title = "Gadolinium Enhancement Is Not Associated With Disc Inflammation in Patients With Sciatica",
abstract = "STUDY DESIGN: Retrospective observational histological study. OBJECTIVE: To evaluate the reliability of gadolinium enhancement as a marker for inflammation by associating gadolinium enhancement findings with the degree of inflammation as measured by macrophage infiltration in disc material retrieved during disc surgery in patients with sciatica. SUMMARY OF BACKGROUND DATA: Disc inflammation often occurs in sciatica patients, a noninvasive tool that is used to assess disc inflammation is Gadolinium enhanced MR imaging. METHODS: Disc tissue was retrieved from patients in the Sciatica trial (N = 119), a multicenter randomized controlled trial in patients with sciatica. Disc tissue was embedded in paraffin and stained with hematoxylin and CD68. Tissue samples were categorized as mild (0-10 macrophages/cm), moderate (10-100 macrophages/cm), and considerable (>100 macrophages/cm) inflammation. Of the 119 MRIs, 96 were additionally performed with contrast-enhanced gadolinium. RESULTS: Seventy-four patients showed gadolinium enhancement of the disc herniation and 26 of the nerve root. Degree of inflammation by macrophages was not associated with gadolinium enhancement of nerve roots or herniated discs. These results did not change if the patient groups with and without Modic type 2 changes were evaluated separately. Furthermore, no associations were observed between gadolinium enhancement and presence of Modic type 2 changes. CONCLUSION: This study found gadolinium enhanced MRI findings to be unreliable as an indicator for inflammation of disc herniation or nerve root in patients with sciatica.2.",
author = "Niek Djuric and Xiaoyu Yang and Barzouhi, {Abdelilah El} and Ostelo, {Raymond W.J.G.} and Duinen, {Sjoerd G.van} and Nijeholt, {Geert J.Lycklama {\`A}.} and {van der Kallen}, {Bas F.W.} and Peul, {Wilco C.} and Vleggeert-Lankamp, {Carmen L.A.}",
year = "2019",
month = "6",
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doi = "10.1097/BRS.0000000000003004",
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Djuric, N, Yang, X, Barzouhi, AE, Ostelo, RWJG, Duinen, SGV, Nijeholt, GJLÀ, van der Kallen, BFW, Peul, WC & Vleggeert-Lankamp, CLA 2019, 'Gadolinium Enhancement Is Not Associated With Disc Inflammation in Patients With Sciatica' Spine, vol. 44, no. 12, pp. E742-E748. https://doi.org/10.1097/BRS.0000000000003004

Gadolinium Enhancement Is Not Associated With Disc Inflammation in Patients With Sciatica. / Djuric, Niek; Yang, Xiaoyu; Barzouhi, Abdelilah El; Ostelo, Raymond W.J.G.; Duinen, Sjoerd G.van; Nijeholt, Geert J.Lycklama À.; van der Kallen, Bas F.W.; Peul, Wilco C.; Vleggeert-Lankamp, Carmen L.A.

In: Spine, Vol. 44, No. 12, 15.06.2019, p. E742-E748.

Research output: Contribution to JournalArticleAcademicpeer-review

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T1 - Gadolinium Enhancement Is Not Associated With Disc Inflammation in Patients With Sciatica

AU - Djuric, Niek

AU - Yang, Xiaoyu

AU - Barzouhi, Abdelilah El

AU - Ostelo, Raymond W.J.G.

AU - Duinen, Sjoerd G.van

AU - Nijeholt, Geert J.Lycklama À.

AU - van der Kallen, Bas F.W.

AU - Peul, Wilco C.

AU - Vleggeert-Lankamp, Carmen L.A.

PY - 2019/6/15

Y1 - 2019/6/15

N2 - STUDY DESIGN: Retrospective observational histological study. OBJECTIVE: To evaluate the reliability of gadolinium enhancement as a marker for inflammation by associating gadolinium enhancement findings with the degree of inflammation as measured by macrophage infiltration in disc material retrieved during disc surgery in patients with sciatica. SUMMARY OF BACKGROUND DATA: Disc inflammation often occurs in sciatica patients, a noninvasive tool that is used to assess disc inflammation is Gadolinium enhanced MR imaging. METHODS: Disc tissue was retrieved from patients in the Sciatica trial (N = 119), a multicenter randomized controlled trial in patients with sciatica. Disc tissue was embedded in paraffin and stained with hematoxylin and CD68. Tissue samples were categorized as mild (0-10 macrophages/cm), moderate (10-100 macrophages/cm), and considerable (>100 macrophages/cm) inflammation. Of the 119 MRIs, 96 were additionally performed with contrast-enhanced gadolinium. RESULTS: Seventy-four patients showed gadolinium enhancement of the disc herniation and 26 of the nerve root. Degree of inflammation by macrophages was not associated with gadolinium enhancement of nerve roots or herniated discs. These results did not change if the patient groups with and without Modic type 2 changes were evaluated separately. Furthermore, no associations were observed between gadolinium enhancement and presence of Modic type 2 changes. CONCLUSION: This study found gadolinium enhanced MRI findings to be unreliable as an indicator for inflammation of disc herniation or nerve root in patients with sciatica.2.

AB - STUDY DESIGN: Retrospective observational histological study. OBJECTIVE: To evaluate the reliability of gadolinium enhancement as a marker for inflammation by associating gadolinium enhancement findings with the degree of inflammation as measured by macrophage infiltration in disc material retrieved during disc surgery in patients with sciatica. SUMMARY OF BACKGROUND DATA: Disc inflammation often occurs in sciatica patients, a noninvasive tool that is used to assess disc inflammation is Gadolinium enhanced MR imaging. METHODS: Disc tissue was retrieved from patients in the Sciatica trial (N = 119), a multicenter randomized controlled trial in patients with sciatica. Disc tissue was embedded in paraffin and stained with hematoxylin and CD68. Tissue samples were categorized as mild (0-10 macrophages/cm), moderate (10-100 macrophages/cm), and considerable (>100 macrophages/cm) inflammation. Of the 119 MRIs, 96 were additionally performed with contrast-enhanced gadolinium. RESULTS: Seventy-four patients showed gadolinium enhancement of the disc herniation and 26 of the nerve root. Degree of inflammation by macrophages was not associated with gadolinium enhancement of nerve roots or herniated discs. These results did not change if the patient groups with and without Modic type 2 changes were evaluated separately. Furthermore, no associations were observed between gadolinium enhancement and presence of Modic type 2 changes. CONCLUSION: This study found gadolinium enhanced MRI findings to be unreliable as an indicator for inflammation of disc herniation or nerve root in patients with sciatica.2.

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