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    Grade 1-2 was considered no annular fissure, grade 3-4 was considered likely or definite annular fissure. Signal abnormality of the posterior annulus was graded on the sagittal T2 weighted MR sequence utilizing a 4 point scale by consensus of three experienced neuroradiologists: grade 1: negative/barely visible; grade 2: slight posterior annular signal; grade 3: obvious bright posterior annular signal; grade 4: posterior annular signal comparable to CSF. Peripheral posterior annular fissure was identified as focal enhancement of the annulus on post-contrast imaging at 28 un-operated disk levels in 19 of these patients (10 female, 9 male; age range 19-62 years, average 41 years) and form the focus of this study. Methods & Materials Over the course of 5 years, 43 patients were identified who had combined unenhanced and enhanced lumbar MR imaging available as their pre-procedure study prior to provocation lumbar diskography. (2) The purpose of this study was to correlate the provocation diskogram response and diskogram imaging appearance of lumbar disks with peripheral annular fissures as demonstrated on pre-procedure combined unenhanced and enhanced MR imaging. (1) Studies have also demonstrated that enhancement may be common in peripheral annular fissures and T2 conspicuity may decrease with time. D., Non ASSR Member Paper/Mentor Purpose Peripheral annular fissures (annular high intensity zones [HIZ]) identified on T2 weighted MR imaging are known to correlate with diskogenic low back pain as demonstrated at provocation lumbar diskography. The contents of this website are for informational purposes only and not intended to be a substitute for professional medical advice, diagnosis, or treatment. Please seek the advice of a physician or other qualified health provider with any questions you may have regarding a medical condition. Do not disregard professional medical advice or delay in seeking it because of something you have read on this website. The contents of this website are for informational purposes only and not intended to be a substitute for professional medical advice, diagnosis, or treatment. Please seek the advice of a physician or other qualified health provider with any questions you may have regarding a medical condition. Do not disregard professional medical advice or delay in seeking it because of something you have read on this website.

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