• Marco Perri, Giuseppe Grattacaso, Valeria Di Tunno, Claudia Marsecano, Ernesto Di Cesare, Alessandra Splendiani, and Massimo Gallucci.
• Biotechnological and Applied Clinical Sciences Department, University of L'Aquila, Italy.
• Neuroradiol J. 2015 Apr 1;28(2):198-204.

PurposeEvaluate the discal morpho-structural changes as a predictive sign in the clinical outcome after ozone therapy in lumbar disc herniation using the T2-shine through effect in diffusion-weighted imaging (DWI).MethodOne hundred and fifty-four patients suffering from lumbosciatica (89 men and 65 women; age range, 23-62 years) were included, previous MR study performed with FSE-T2 and T2-fat, SE-T1 and DWI sequences, and were randomly assigned to two groups. Seventy-seven patients (control group) underwent conservative treatment with intraforaminal injection of steroid and anaesthetic. The remaining 77 patients (study group) underwent the same treatment with the addition of oxygen-ozone (O2-O3). During the following six months, a MRI follow-up with the same sequences was performed. An intervertebral disc volumetric analysis (IDVA), DWI signal score and post treatment clinical outcome evaluation were performed for an assessment of hernia reduction. χ² test, Student's t test and analysis of covariance were used for comparison of variables.ResultsIn the study group, 58 of 77 patients had a successful outcome (responders). In the responders group, DWI T2-shine through effect was present during MRI follow-up and in particular in 53 of 77 patients in six months of follow-up (p < 0.05). Moreover, in the same group a statistically significant disc shrinkage was shown by IDVA in sixth months of follow-up (p < 0.05).ConclusionsT2-shine through effect in DWI is present before morphological disc reduction and moreover could be considered as a predictive sign of response to oxygen-ozone treatment.© The Author(s) 2015 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

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