![]() The exclusion criteria were as follows: 1) scoliosis involving a vertebral column curvature greater than 15°, 2) extensive vertebral fractures resulting in difficulty in assessing axial images, 3) severe postoperative infection that could disrupt the border of the dural sac and paraspinal muscle, 4) previous cervical spinal surgery with metallic hardware, 5) ossification of the posterior longitudinal ligament, and 6) metastasis involving the cervical spine. From February 2009 to November 2011, 102 patients who underwent 64-slice non-enhanced MDCT and 1.5-T MRI of the cervical spine with a maximum time interval of 5 days between imaging were evaluated. The Institutional Review Board approved the research protocol and waived the requirement for patient informed consent because the study was retrospective in nature. The aim of the present study was to investigate the assessment of cervical intervertebral disc herniation using 64-slice MDCT and MRI. However, to our knowledge, no comparison of inter-modality agreement in the assessment of cervical herniated disc herniation between non-contrast MDCT and MRI has been reported. ![]() When CT is performed on postoperative patients who have undergone preoperative MRI to evaluate disc herniation, radiologists may find it difficult to compare the views of the herniated disc afforded by MRI and CT. MDCT is frequently used as a practical and cost-effective approach to investigating correlative compressive lesions, such as disc herniation or spondylosis, in cervical spine patients who have failed a course of conservative therapy, may be candidates for interventional or surgical treatment, and have a contraindication to MRI ( 13). The recent development of multidetector-row computed tomography (MDCT) allows a scan acquisition time of a few seconds and improvement in spatial resolution using thinner collimation, enhancing improved multi-planar reconstructions and diminishing motion artifacts. However, the use of non-contrast CT in the evaluation of disc herniation has been limited due to several disadvantages, including the lack of soft-tissue contrast, radiation exposure, the effects of partial volume averaging, the time required for reformatting multiple thin (1.5-3-mm) sections over multiple vertebral bodies and intervening discs, beam-hardening artifacts in the lower cervical spines caused by the bony structures of the shoulder girdle, and image degradation related to motion artifacts ( 12). Non-contrast CT also plays an important role in the preoperational assessment of lumbar disc herniated diseases ( 9, 10, 11), with a diagnostic performance similar to that of lumbar spine MRI ( 10). Additionally, contrast-enhanced CT ( 7) and CT myelography ( 8) remain useful imaging tools in the evaluation of cervical radiculopathy, but they carry the risk of anaphylactic reactions and nephrotoxicity with the use of iodinated contrast material. Magnetic resonance imaging (MRI) is currently considered the imaging modality of choice in patients with cervical radiculopathy, because it does not expose patients to a radiation hazard, has excellent soft-tissue resolution, and can create multi-planar images ( 3, 4, 5, 6). Herniation of the nucleus pulposus is a relatively rare cause of cervical radiculopathy, which usually occurs in younger age groups than cervical spondylosis ( 1, 2). These can be caused by decreased disc height and degenerative changes in the uncovertebral and facet joints (i.e., cervical spondylosis). ![]() Cervical radiculopathy is caused by a combination of compression and inflammation of a spinal nerve.
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