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Value of a 3D T2w MR sequence for routine use in cervical and lumbar spine examinations 2011

General Spine

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

Poster

Purpose

To study the value of a 3D T2w MR sequence in comparison to 2D T2w sequence for cervical/lumbar spine MRI with special focus on detectability of pathology and scan time.

Methods & Materials

IRB approved study, written informed patient consent available. A total of 30 patients (15 c-spine, 15 l-spine) were scanned on 1.5T MR scanner (HDXT, GE Medical) with sequence protocol approved by medical authorities/insurance companies (c-spine: sag T2 FSE/T1SE, tra T2*, cor T2 STIR; l-spine: sag T2 FSE/T1SE, tra T2FSE, cor T2 STIR) and additionally a sagittal 3D Cube (slice thickness: 1 mm) for c-/l-spine) 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 2D DICOM viewer, the 3D Cube 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 l-spine exams n=6 (40%) disc protrusions, n=4 (26.7%) disc extrusions, n=1 (6,7%) stenosis of unilateral neuroforamen was found. In c-spin exams n=10 (66,7%) disc protrusions, n=1 (6,7%) disc extrusion, n=1 unilateral neuroforaminal stenosis, n=1 syrinx, n=1 dorsal displacement of anterior dura was found. Mean imaging time was 12 min 35 s for c-spine, while 3 min 37 s was necessary for 3D Cube sequence and 9 min 45 s for l-spine, while 4 min 41 s was needed for 3D Cube sequence. Regarding comparison of 3D Cube vs. T2/T1w imaging, all reported pathology was detected by readears in conventional as well as 3D sequence (n=25, 100%).

Conclusion

3D Cube sequence seems to be feasible technically for use within a routine c-/l-spine scan protocol, detection rates of pathology is equal to conventional MR sequences in our series. If medical authorities (esp. local insurance companies) accepted the use of this sequence and MPR images, e.g. T2w sag/tra sequence could be replaced by 3D 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.

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