High-Resolution 3D versus Standard-Resolution 2D T2-Weighted Turbo Spin Echo MRI for the Assessment of Lumbar Nerve Root Compromise

Tomography

David Czell¹  Alex Alfieri²  Elisabeth Sartoretti³  Árpád Schwenk³  Thomas Sartoretti³  Christoph A. Binkert³  Sabine Sartoretti-Schefer³  Lukas Wildi⁴  Michael Wyss⁵ 

[1] Faculty of Medicine, University of Zürich, 8006 Zürich, Switzerland;Institute of Neurosurgery, Kantonsspital Winterthur, 8401 Winterthur, Switzerland;Institute of Radiology, Kantonsspital Winterthur, Brauerstrasse 15, 8401 Winterthur, Switzerland;Institute of Rheumatology, Kantonsspital Winterthur, 8401 Winterthur, Switzerland;Philips Health Systems, 8810 Zürich, Switzerland;

关键词: spine;    radiculopathy;    magnetic resonance imaging;    spinal nerve roots;    acceleration;   

DOI  :  10.3390/tomography8010020

来源: DOAJ

【 摘 要 】

Radiculopathy can be caused by nerve root irritation and nerve root compression at the level of the lateral recess or at the level of the intervertebral foramen. T2-weighted (T2w) MRI is considered essential to evaluate the nerve root and its course, starting at the lateral recess through the intervertebral foramen to the extraforaminal space. With the introduction of novel MRI acceleration techniques such as compressed SENSE, standard-resolution 2D T2w turbo spin echo (TSE) sequences with a slice-thickness of 3–4 mm can be replaced with high-resolution isotropic 3D T2w TSE sequences with sub-millimeter resolution without prolonging scan time. With high-resolution 3D MRI, the course of the nerve root can be visualized more precisely due to a detailed depiction of the anatomical situation and less partial volume effects, potentially allowing for a better detection of nerve root compromise. In this intra-individual comparison study, 55 patients with symptomatic unilateral singular nerve root radiculopathy underwent MRI with both 2D standard- and 3D high-resolution T2w TSE MRI sequences. Two readers graded the degree of lumbar lateral recess stenosis and lumbar foraminal stenosis twice on both image sets using previously validated grading systems in an effort to quantify the inter-readout and inter-sequence agreement of scores. Inter-readout agreement was high for both grading systems and for 2D and 3D imaging (Kappa = 0.823–0.945). Inter-sequence agreement was moderate for both lumbar lateral recess stenosis (Kappa = 0.55–0.577) and lumbar foraminal stenosis (Kappa = 0.543–0.572). The percentage of high degree stenosis with nerve root deformity increased from 16.4%/9.8% to 41.8–43.6%/34.1% from 2D to 3D images for lateral recess stenosis/foraminal stenosis, respectively. Therefore, we show that while inter-readout agreement of grading systems is high for both standard- and high-resolution imaging, the latter outperforms standard-resolution imaging for the visualization of lumbar nerve root compromise.

【 授权许可】

Unknown