T2 shine-through phenomena in diffusion-weighted MR imaging of lumbar discs after oxygen-ozone discolysis: a randomized, double-blind trial with steroid and O2-O 3 discolysis versus steroid only

Perri M, Grattacaso G, di Tunno V, Marsecano C, Gennarelli A, Michelini G, Splendiani A, Di Cesare E, Masciocchi C, Gallucci M.

Abstract
PURPOSE:
To evaluate the discal morpho-structural changes as predictive sign in the clinical outcome after Ozone Therapy in lumbar disc herniation using the T2 shine-through effect in DWI.

METHODS:
One hundred and fifty-four patients suffering from lumbosciatica (89 men and 65 women; range 23-62 years) were included in previous MR study performed with FSE-T2 and T2-fat, SE-T1 and DWI sequences and were randomly assigned to two groups. Seventy-seven patients (Control Group) underwent conservative treatment with intraforaminal injection of steroid and anesthetic. The remaining 77 patients (Study Group) underwent the same treatment with the addiction of oxygen-ozone (O2-O3). During the coming 6 months, an MRI follow-up with the same sequences was performed. An intervertebral disc volumetric analysis (IDVA), DWI signal score and post treatment clinical outcome evaluation were performed for an assessment of hernia reduction. χ 2 test, Student’s t test and analysis of covariance were used for comparison of variables.

RESULTS:
In the Study Group, 58 over 77 patients had a successful outcome (Responders). In the Responders group, DWI T2 shine-through effect was present during MRI follow-up and in particular in 53 of 77 patients in the 6 months of follow-up (P < 0.05). Moreover, in the same group was present a statistically significant discs’ shrinkage in the sixth month of follow-up (P < 0.05) as showed by IDVA.

CONCLUSIONS:
T2 shine-through effect in DWI is present before morphological disc reduction and moreover could be considered as a predictive sign of response to oxygen-ozone treatment.

Fonte: http://www.ncbi.nlm.nih.gov/pubmed

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