Cervical disk herniation: CT demonstration after contrast enhancement

Two-millimeter-thick transverse axial CT scans were obtained at the 2, 3, or 4 cervical disk level in 25 patients with cervical radiculopathy. Scans were obtained before and after high dose (bolus/drip) intravenous administration of contrast medium. Clinical signs and symptoms were correlated with radiographic and surgical findings. Ventral epidural and intervertebral foraminal veins were consistently well visualized with this technique. Venous and dural enhancement provided better anatomic definition than did non-contrast CT. Visualization of posterior displacement of the enhanced epidural veins and epidural enhancement surrounding extruded disk fragments on postinfusion studies provided excellent delineation of disk extrusion and in some cases allowed demarcation of multiple discrete free disk fragments. Although noninfusion scans are usually diagnostic and sufficient, the improved anatomic information available from infusion CT may increase diagnostic certainty and in selected cases obviates the need for myelography for accurate daignosis of patients with focal cervical radiculopathy.