1 Department of Radiology, College of Medicine, Inha University, Incheon, South Korea.
2 Department of Radiology, Stanford University, Stanford, CA.
AJR Am J Roentgenol. 2018 May;210(5):1131-1140. doi: 10.2214/AJR.17.17855. Epub 2018 Apr 9.
The purpose of this study was to evaluate the feasibility of 3D ultrashort TE (UTE) MRI in depicting the cartilaginous endplate (CEP) and its abnormalities and to investigate the association between CEP abnormalities and disk degeneration on T2-weighted spin-echo (SE) MR images in cervical disks in vivo.
Eight healthy volunteers and 70 patients were examined using 3-T MRI with the 3D UTE cones trajectory technique (TR/TE, 16.1/0.032, 6.6). In the volunteer study, quantitative and qualitative assessments of CEP depiction were conducted for the 3D UTE and T2-weighted SE imaging. In the patient study, CEP abnormalities were analyzed. Intersequence agreement between the images obtained with the first-echo 3D UTE sequence and the images created by subtracting the second-echo from the first-echo 3D UTE sequence (subtracted 3D UTE) and the intraobserver and interobserver agreements for 3D UTE overall were also tested. The CEP abnormalities on the 3D UTE images correlated with the Miyazaki grading of the T2-weighted SE images.
In the volunteer study, the CEP was well visualized on 3D UTE images but not on T2-weighted SE images (p < 0.001). In the patient study, for evaluation of CEP abnormalities, intersequence agreements were substantial to almost perfect, intraobserver agreements were substantial to almost perfect, and interobserver agreements were moderate to substantial (p < 0.001). All of the CEP abnormalities correlated with the Miyazaki grade with statistical significance (p < 0.001).
Three-dimensional UTE MRI feasibly depicts the CEP and CEP abnormalities, which may be associated with the severity of disk degeneration on T2-weighted SE MRI.
本研究旨在评估 3D 超短回波时间(UTE)MRI 描绘软骨终板(CEP)及其异常的可行性,并探讨颈椎间盘 T2 加权自旋回波(SE)MR 图像上 CEP 异常与椎间盘退变之间的关系。
8 名健康志愿者和 70 名患者使用 3T MRI 进行检查,采用 3D UTE 圆锥轨迹技术(TR/TE,16.1/0.032,6.6)。在志愿者研究中,对 3D UTE 和 T2 加权 SE 成像进行了 CEP 描绘的定量和定性评估。在患者研究中,分析了 CEP 异常。首先,对 3D UTE 序列的第一回波图像与从第一回波 3D UTE 序列减去第二回波得到的图像(减去的 3D UTE)之间的图像序列之间的一致性进行了测试。还测试了 3D UTE 整体的观察者内和观察者间一致性。3D UTE 图像上的 CEP 异常与 T2 加权 SE 图像的 Miyazaki 分级相关。
在志愿者研究中,CEP 在 3D UTE 图像上得到很好的显示,但在 T2 加权 SE 图像上则无法显示(p < 0.001)。在患者研究中,对于 CEP 异常的评估,序列间的一致性为高度一致到几乎完美,观察者内的一致性为高度一致到几乎完美,观察者间的一致性为中度到高度一致(p < 0.001)。所有的 CEP 异常均与 Miyazaki 分级具有统计学意义上的相关性(p < 0.001)。
3D UTE MRI 可以很好地描绘 CEP 和 CEP 异常,这可能与 T2 加权 SE MRI 上椎间盘退变的严重程度有关。