Barrera M C, Alústiza J M, Gervás C, Recondo J A, Villanúa J A, Salvador E
OSATEK-San Sebastián, Paseo Doctor Beguiristain 109, 20014 San Sebastián, Spain.
Clin Radiol. 2001 Feb;56(2):133-7. doi: 10.1053/crad.2000.0587.
To compare turbo T2 weighted spin echo (TSE T2) and turbo-FLAIR (fluid attenuated inversion recovery) vs gadolinium enhanced T1 weighted spin echo (SE T1) sequence in the differential diagnosis between disc herniation and post-surgical fibrosis.
Sixty-four patients who underwent surgical treatment for lumbar disc herniation with persistent or recurrent post-surgical symptoms were studied with a 0.5 Tesla MR system. The sequences used were TSE T2, turbo-FLAIR and T1 SE with and without intravenous gadolinium DTPA. The enhanced T1 SE sequence was considered the gold standard. Sensitivity and specificity were calculated.
The sensitivity was 100% for both TSE T2 and turbo-FLAIR sequences. The specificity was 94% for TSE T2 and 92% for turbo-FLAIR. Negative predictive value was 100% for both sequences and positive predictive value 84% and 80% for TSE T2 and turbo-FLAIR, respectively.
Although both sequences show high sensitivity, TSE-T2 presents greater specificity than turbo-FLAIR as compared to enhanced T1 SE. TSE T2 also offers the advantage of myelographic effect. We consider that the use of rapid sequences may avoid the need for intravenous contrast medium in most cases, reserving gadolinium DTPA only to those where all the criteria for hernia or fibrosis are not fulfilled.
比较涡轮T2加权自旋回波（TSE T2）和涡轮液体衰减反转恢复序列（turbo-FLAIR）与钆增强T1加权自旋回波（SE T1）序列在椎间盘突出症与术后纤维化鉴别诊断中的应用。
对64例接受过腰椎间盘突出症手术治疗且术后症状持续或复发的患者，采用0.5特斯拉磁共振成像系统进行研究。使用的序列包括TSE T2、turbo-FLAIR以及静脉注射钆喷酸葡胺前后的T1 SE序列。增强T1 SE序列被视为金标准。计算敏感度和特异度。
TSE T2和turbo-FLAIR序列的敏感度均为100%。TSE T2序列的特异度为94%，turbo-FLAIR序列的特异度为92%。两种序列的阴性预测值均为100%，TSE T2序列和turbo-FLAIR序列的阳性预测值分别为84%和80%。
尽管两种序列均显示出高敏感度，但与增强T1 SE序列相比，TSE-T2序列的特异度高于turbo-FLAIR序列。TSE T2序列还具有脊髓造影效果的优势。我们认为，在大多数情况下，使用快速序列可能无需静脉注射造影剂，仅对那些不符合疝或纤维化所有标准的患者使用钆喷酸葡胺。
