Abstract:
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Purpose: The aims of this study were 3 fold: 1. to assess and compare the detectability of the structures that are affected by cervical spondylosis with 4 MRI sequences; 2. to compare the accuracy of MRI sequences in the measurement of neural foraminal size; 3. to compare the performance of MRI sequences in the evaluation of neural foraminal stenosis.
Methods and Materials: 20 healthy subjects were examined. T2* weighted (w) 3D-gradient echo sequence with magnetization transfer saturation pulse (3D-FFE-MTC), T2 w. 3D turbo spin echo sequence (T2-3D-TSE) with and without fat supression (FS), and balanced-FFE (b-FFE) sequence was compared. Spinal cord SNR, cerebrospinal fluid (CSF) SNR, and CSF-spinal cord CNR was calculated quantitatively. The detectability of neural foramina, spinal roots, uncinate process and ligamentum flava was graded on a 5-points scale (0:minimum, 4:maximum) qualitatively. The presence of the artifacts and overall image quality was graded on a 4-points scale (0:minimum, 3:maximum). 10 out of 20 healthy subjects were examined by CT to measure the size of neural foramina. 20 patients with known cervical spondylosis were evaluated with regard to the degree of foraminal stenosis.
Results: b-FFE sequence yielded the best results for each of 3 quantitative evaluation. In terms of qualitative evaluation, T2-3D-TSE/FS(-)and b-FFE sequences were superior to the other 2 (p< 0.01). For the neural foramina b-FFE yielded the least score, however the other 3 sequences were not significantly different. Artifacts were most commonly seen using 3D-FFE-MTC. In terms of overall image quality T2-3D-TSE/FS(-) yielded the highest score, followed by b-FFE. T2-3D-TSE/FS(-) sequence correlated best to CT concerning the neural foraminal size (r:0.885). Except 3D-FFE-MTC, there was no statistically significant difference between the other 3 sequences with regard to neural foraminal stenosis. However,the degree of neural foraminal stenosis was least on the T2-3D-TSE/FS(-)sequence, implying higher rates of false positive scores to the degree of stenosis with other 3 sequences.
Conclusion: 3D-FFE-MTC sequence is frequently preferred for cervical spinal MRI studies. However, our study yielded the best scores for T2-3D-TSE/FS(-) sequence, followed by b-FFE in the quantitative and qualitative evaluation of the structures affected by cervical spondylosis. T2-3D-TSE/FS(-) sequence produces less exaggeration of neural foraminal stenosis. With these advantages, T2-3D-TSE/FS(-) can be preferred in patients with cervical spondylosis.
Questions about this event email: kmyazicioglu@yahoo.com
Mahmutyazicioglu MD, K,
MR Imaging in Cervical Spondylosis: Comparison of Three-dimensional Gradient Echo, Turbo Spin Echo and Steady-State Gradient Echo Sequences. Radiological Society of North America 2003 Scientific Assembly and Annual Meeting, November 30 - December 5, 2003 ,Chicago IL.
http://archive.rsna.org/2003/3103767.html
