Eric Andre Davalos BS, Presenter: Nothing to Disclose

Bao H. Do MD, Abstract Co-Author: Nothing to Disclose

Deepak Behera MD, Abstract Co-Author: Nothing to Disclose

Brian Hargreaves, Abstract Co-Author: Nothing to Disclose

Garry Evan Gold MD, MSEE, Abstract Co-Author: Consultant, Zimmer Holdings, Inc Consultant, ICON plc Consultant, ArthroCare Corporation Research support, General Electric Company

Sandip Biswal MD, Abstract Co-Author: Co-founder, SiteOne Therapeutics Inc Consultant, General Electric Company Stockholder, Atreus Pharmaceuticals, Inc

A novel isotropic MRI sequence, 3D Fast Spin-Echo (FSE) Cube, has the potential to complement or perhaps even replace current conventional imaging sequences. We compared 3D-FSE-Cube to conventional 2D sequences for the investigation of the lumbar spine.  

IRB approval was attained. Twenty-two patients (13 men, 9 women; ages 27-81 yrs) were referred for low back or lower extremity pain. All patients were imaged on a 3.0-T MR unit). 3D FSE Cube protocol consists of coronal FSE T2-weighted pulse sequence with fat-saturation ( TE/TR (3,000/35); 26-cm FOV; 288 x 256; bandwidth, 195; 90° flip angle. Post-processing techniques, including MIP and multiplanar reformation, were used to generate images of the lumbar spine with Osirix software. The images from both conventional and 3D FSE Cube scans were reviewed side by side for each case by two radiologists with experience in musculoskeletal MRI. Radiologists were blinded to each other. Each reviewer classified the relative degree of diagnostic confidence for the 3D FSE Cube images compared to the conventional images using a 3-point scale (were more confident, less confident, or equally confident) in their ability to assess for several spinal pathologies.

Images were reviewed for spinal canal stenosis, neural foraminal narrowing, pars defect, bone marrow edema, facet fluid, focal bone lesions, cord signal abnormality and annular fissure. The diagnostic confidence was higher or equal for the 3D FSE Cube images in the evaluation of spinal canal stenosis, lateral recess stenosis, pars defect, and facet fluid (22/22, 100% of patients). The diagnostic confidence was lower for the 3D FSE Cube images in the evaluation of neural foraminal narrowing, bone marrow edema, focal bone lesions, cord signal abnormality and annular fissure (22/22, 100% of patients).

3D FSE Cube sequence improves the detection of pars defect, lateral recess stenosis and central canal stenosis. With further optimization of this sequence, it could potentially eliminate the need for 2D acquisitions in multiple planes, thus decreasing image time.

Our preliminary experience has shown that the 3D FSE Cube sequence could improve diagnosis of certain spinal pathologies.

Davalos, E, Do, B, Behera, D, Hargreaves, B, Gold, G, Biswal, S, MR Imaging of Lumbar Spine Using 3D FSE Cube and OsiriX: Initial Experience.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11034189.html