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Diagnostic value of high-dose contrast-enhanced computed tomography of the postoperative lumbar spine

      Objective: To evaluate the accuracy of high-dose intravenous contrast-enhanced computed tomography (CT) in differentiating recurrent herniated disk from scar tissue after lumbar spine surgery. Methods: Retrospective review of postoperative contrast-enhanced lumbar CT scans obtained in 286 patients who had received 84.6 g of iodine intravenously. The correlation between CT results and surgical findings was evaluated in 37 of the patients who underwent a subsequent repeat operation within 12 weeks of the CT study. Results: In detection of recurrent herniated disk, the sensitivity of CT was 63.4%, its specificity was 75.0%, its positive predictive value was 95.5%, and its negative predictive value was 20.0%. Conclusion: This study does not support the use of high doses of contrast medium administered intravenously in CT of the postoperative lumbar spine; the results are not significantly different from those of previous reports involving lower doses of contrast medium.
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