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Value of a 3D GRE sequence in comparison to conventional cervical spine MR with special focus on detectability of pathology and scan time 2012

General Spine

Sedat, Alibek, MD, Assoc. Professor

Poster

Purpose

Tu study the value of a 3D GRE sequence in comparison to conventional cervical spine MR with special focus on detectability of pathology and scan time

Methods & Materials

IRB approved study, written informed patient consent available. A total of 18 patients were scanned on 1.5T MR scanner (HDXT, GE Medical) with sequence protocol approved by medical authorities/insurance companies including sag T2 FSE/T1SE, cor T2 STIR, ax 2D MEDIC (GRE, 3 mm slice thickness) and additionally an ax 3D COSMIC (GRE, slice thickness: 1 mm) was performed. Images were reviewed retrospectively by two radiologists in consensus, both blinded for patient history with the question of detectability of pathology. 2D sequences were reviewed with a standard DICOM viewer, 3D COSMIC was reviewed on a 3D DICOM viewer in MPR-mode, interactively.

Results

All MR sequences were performed successfully without artefacts which lead to repetition of sequences or the complete exam. In c-spine exams n=14 (77.8%) disc protrusions, n=3 (16.7%) disc extrusion, n=3 (16.7%) unilateral neuroforaminal stenosis, n=2 (11.1%), syrinx, n=6 (33.3%) dorsal displacement of anterior dura was found. Mean imaging time was 13 min 15 s for c-spine, while 2 min 25 s was necessary for 3D COSMIC sequence. Regarding comparison of 3D COSMIC vs. 2D MEDIC sequence, all reported pathology was detected by readers in both sequences (n=28, 100%).

Conclusion

3D COSMIC sequence seems to be feasible technically for use within a routine c-spine scan protocol, detection rates of pathology is equal to conventional 2D MEDIC sequences in our series. If medical authorities (esp. local insurance companies) accepted the use of this sequence and MPR images, 2D MEDIC sequence could be replaced by 3D COSMIC sequence, exam time could be saved without penalty in image quality. Further studies with special focus on quantitative assessment (e.g. SNR/CNR) with greater number of patients should be performed to confirm clinical value of initial results.