regarding post operative spine how dd between disc reminants and scar:
a- posteriolateral indentation through thecah sac.
b- retraction of thecal sac
c- ill defined round border mass
d- mass effect
scar mostly involves larger area, show homogenous enhancement...while scar may take ring ,or non homogenous or no enhanncement... the retraction of the thecal sac favous epidural scar, although ehancement is the most reliable criteria. Other features that can help are signal intensity i.e disc follows the signal of parent disc and is usually located ventrally.
→ Postoperative disk herniation and epidural scar: on MRI unenhanced images epidural scar is isointense relative to the disk on T1- weighted images and hypointense on T2- weighted images. Epidural scar unlike disk herniation does not displace but attracts the epidural fat, nerve root, epidural veins, and thecal sac. MRI contrast-enhancement is very effective for differentiating scar and disk. Postoperative disk herniations may enhance at the periphery of the fragment whereas scar tissue in the epidural space enhances homogenously. Rarely the entire disk fragment can enhance.
a- posteriolateral indentation through thecah sac.
b- retraction of thecal sac
c- ill defined round border mass
d- mass effect
scar mostly involves larger area, show homogenous enhancement...while scar may take ring ,or non homogenous or no enhanncement... the retraction of the thecal sac favous epidural scar, although ehancement is the most reliable criteria. Other features that can help are signal intensity i.e disc follows the signal of parent disc and is usually located ventrally.
→ Postoperative disk herniation and epidural scar: on MRI unenhanced images epidural scar is isointense relative to the disk on T1- weighted images and hypointense on T2- weighted images. Epidural scar unlike disk herniation does not displace but attracts the epidural fat, nerve root, epidural veins, and thecal sac. MRI contrast-enhancement is very effective for differentiating scar and disk. Postoperative disk herniations may enhance at the periphery of the fragment whereas scar tissue in the epidural space enhances homogenously. Rarely the entire disk fragment can enhance.