Housley Daniel, Caine Abby, Cherubini Giunio, Taeymans Olivier
Dick White Referrals, Diagnostic Imaging, Newmarket, Cambridgeshire, United Kingdom of Great Britain and Northern Ireland.
Vet Radiol Ultrasound. 2017 Jul;58(4):433-443. doi: 10.1111/vru.12500. Epub 2017 Apr 20.
Sagittal T2-weighted sequences (T2-SAG) are the foundation of spinal protocols when screening for the presence of intervertebral disc extrusion. We often utilize sagittal short-tau inversion recovery sequences (STIR-SAG) as an adjunctive screening series, and experience suggests that this combined approach provides superior detection rates. We hypothesized that STIR-SAG would provide higher sensitivity than T2-SAG in the identification and localization of intervertebral disc extrusion. We further hypothesized that the parallel evaluation of paired T2-SAG and STIR-SAG series would provide a higher sensitivity than could be achieved with either independent sagittal series when viewed in isolation. This retrospective diagnostic accuracy study blindly reviewed T2-SAG and STIR-SAG sequences from dogs (n = 110) with surgically confirmed intervertebral disc extrusion. A consensus between two radiologists found no significant difference in sensitivity between T2-SAG and STIR-SAG during the identification of intervertebral disc extrusion (T2-SAG: 92.7%, STIR-SAG: 94.5%, P = 0.752). Nevertheless, STIR-SAG accurately identified intervertebral disc extrusion in 66.7% of cases where the evaluation of T2-SAG in isolation had provided a false negative diagnosis. Additionally, one radiologist found that the parallel evaluation of paired T2-SAG and STIR-SAG series provided a significantly higher sensitivity than T2-SAG in isolation, during the identification of intervertebral disc extrusion (T2-SAG: 78.2%, paired T2-SAG, and STIR-SAG: 90.9%, P = 0.017). A similar nonsignificant trend was observed when the consensus of both radiologists was taken into consideration (T2-SAG: 92.7%, paired T2-SAG, and STIR-SAG = 97.3%, P = 0.392). We therefore conclude that STIR-SAG is capable of identifying intervertebral disc extrusion that is inconspicuous in T2-SAG, and that STIR-SAG should be considered a useful adjunctive sequence during preliminary sagittal screening for intervertebral disc extrusion in low-field magnetic resonance.
矢状面T2加权序列（T2-SAG）是筛查椎间盘突出症时脊柱检查方案的基础。我们经常使用矢状面短tau反转恢复序列（STIR-SAG）作为辅助筛查序列，经验表明这种联合方法能提供更高的检出率。我们假设STIR-SAG在椎间盘突出症的识别和定位方面比T2-SAG具有更高的敏感性。我们进一步假设，与单独观察任一矢状面序列相比，配对的T2-SAG和STIR-SAG序列的平行评估能提供更高的敏感性。这项回顾性诊断准确性研究对110只经手术证实患有椎间盘突出症的犬的T2-SAG和STIR-SAG序列进行了盲法评估。两位放射科医生达成的共识是，在识别椎间盘突出症时，T2-SAG和STIR-SAG之间的敏感性无显著差异（T2-SAG：92.7%，STIR-SAG：94.5%，P = 0.752）。然而，在单独评估T2-SAG得出假阴性诊断的病例中，STIR-SAG能准确识别出66.7%的椎间盘突出症。此外，一位放射科医生发现，在识别椎间盘突出症时，配对的T2-SAG和STIR-SAG序列的平行评估比单独的T2-SAG具有显著更高的敏感性（T2-SAG：78.2%，配对的T2-SAG和STIR-SAG：90.9%，P = 0.017）。考虑两位放射科医生的共识时，观察到类似的无显著差异趋势（T2-SAG：92.7%，配对的T2-SAG和STIR-SAG = 97.3%，P = 0.392）。因此，我们得出结论，STIR-SAG能够识别在T2-SAG中不明显的椎间盘突出症，并且在低场磁共振初步矢状面筛查椎间盘突出症时，STIR-SAG应被视为一种有用的辅助序列。
