A 75-year-old man with a posterior epidural disk migration

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Presentation transcript:

A 75-year-old man with a posterior epidural disk migration A 75-year-old man with a posterior epidural disk migration.A, Sagittal T2-weighted (TR/TE, 4000/119.8) fast spin-echo MR image of the lumbar spine at the midline plane reveals a mass lesion (arrow) with isointensity relative to the intervertebral disk at th... A 75-year-old man with a posterior epidural disk migration.A, Sagittal T2-weighted (TR/TE, 4000/119.8) fast spin-echo MR image of the lumbar spine at the midline plane reveals a mass lesion (arrow) with isointensity relative to the intervertebral disk at the posterior epidural space at the L2–3 level, compressing the dura (arrowheads).B, Right parasagittal T2-weighted image shows a disrupted outermost annulus fibrosus (white arrow) of the intervertebral disk at L2–3. By comparison, the intact outermost annulus fibrosus (black arrows) is shown as a delicate dark line along the margin of the disk at adjacent L1–2 and L3–4 levels.C, Axial T1-weighted (TR/TE, 600/10.42) fast spin-echo MR image obtained at the level of the migrating disk fragment shows an irregularly shaped mass lesion (arrows), with an isointense signal intensity relative to the intervertebral disk at the right posterior epidural space, which is contrasted by high-signal-intensity epidural fat.D, Axial gadolinium-enhanced T1-weighted (TR/TE, 466.7/10.22) MR image with fat saturation at the disk fragment level shows a rim enhancement of the epidural disk material (arrows).E, The same pulse sequence MR image obtained at a higher level than that in D at the intervertebral disk shows a tractlike enhancement (arrows) from the site behind the ruptured annulus fibrosus to the right posterior epidural space, indicating the route of disk migration.F, Photomicrograph of the surgical specimen shows increased vasculature (arrows) and focal mild lymphocytic infiltration at the edge of the degenerated fibrocartilage (asterisk) (H&E, original magnification ×100). C.Y. Chen et al. AJNR Am J Neuroradiol 2006;27:1592-1594 ©2006 by American Society of Neuroradiology