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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 2011

General Spine

Sedat, Alibek, MD
Hubertus, Gloger, MD, Non ASSR Member

Poster

Purpose

To 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 GRE (MEDIC, 3 mm slice thickness) and additionally 3D GRE (COSMIC, 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 complete exam. A total of 14 (77.8%) disc protrusions, 6 (33.3%) dorsal displacement of anterior dura, 3 (16.7%) disc extrusions, 3 (16.7%) unilateral neuroforaminal stenosis, 2 (11.1%) syrinx was found. Mean imaging time was 12 min 15 s for c-spine, while 2 min 25 s was necessary for 3D COSMIC sequence. Regarding comparison of 3D COSMIC vs. conventional 2D MR sequences, all reported pathology was detected by readers in both sequences (n=28, 100%).

Conclusion

3D GRE sequence (i.e. COSMIC) seems to be technically feasible for use within a routine c-spine scan protocol, detection rates of pathology is equal to conventional 2D sequences in our series. If medical authorities (esp. local insurance companies) accepted the use of this sequence and MPR images, conventinal 2D sequences could be replaced by 3D COSMIC sequence and exam time could be saved without penalty in detection rates of pathology. 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.