Although magnetic resonance (MR) with
contrast-enhancement has been used as standard imaging tool for distinguishing
recurrent disc herniation from postoperative epidural fibrosis, it is
relatively invasive and vulnerable to contrast material-related complication. Also,
the differentiation between recurrent disc herniation and postoperative
epidural fibrosis on non-enhanced MR is not always clear. Until now, no study
has evaluated the diagnostic usefulness of MR texture analysis (MRTA) for
differentiation between recurrent disc herniation from postoperative epidural
fibrosis. Therefore, the purpose of this study is to evaluate the usefulness of
MRTA for differentiation between recurrent disc herniation from postoperative
epidural fibrosis. Regarding mean, skewness, MPP, and entropy, values on all
sequences were significantly lower in recurrent disc herniation than those in
postoperative epidural fibrosis (p<0.001).
The best performing MRTA parameters were MPP on T2WI (AUC, 0.81; 95 % CI, 0.72-0.90)
and on T1WI (AUC, 0.80; 95 % CI, 0.70- 0.88). There were excellent
interobserver agreements for all measurements (ICC, 0.838–0.905).