Hossein Jomleh, Fariborz Faeghi, Mehrnaz Rasteh, Babak Rafiei
School of Allied Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Islamic Republic of Iran.
Radiology Department, Shahid Madani Hospital, Karaj, Alborz, Islamic Republic of Iran.
Eur J Radiol Open. 2018 Dec 28;6:36-41. doi: 10.1016/j.ejro.2018.12.003. eCollection 2019.
to evaluate diagnostic value and image quality of T2-weighted Three-dimensional isotropic turbo spin-echo (SPACE) in comparison with T2-weighted two-dimensional turbo spin-echo (TSE) sequences for comprehensive evaluation of lumbar spine pathologies.
Thirty-five participants with lumbar discopathy were examined on a 1.5-T MRI system with both 2D TSE and 3D SPACE sequences. Obtained images were analyzed with synedra view personal (V 17.0.0.2) software in terms of calculating image quality factors such as signal to noise ratio (SNR) and contrast to noise ratio (CNR) for selected regions of interest. In addition, images were referred to radiologists to report their pathologic indexes. The visibility of anatomical structures in the 3D and 2D sequences was qualitatively assessed by two radiologists independently. Cohen's kappa (k) and Wilcoxon signed rank test was used for the statistical analysis.
In this study, the 3D SPACE T2-weighted sequence showed significant higher SNR and CNR as well as visibility in all of the regions of interest except vertebrae and intervertebral discs (p-value < 0.05). Inter-observer agreement for visibility of regions of interest was substantial and perfect (k > 0.6). Also, inter-observer and inter-method agreements for pathologic indexes were substantial and perfect for all of the pathologic indexes (k > 0.6). Inter-observer agreement for 3D SPACE sequence was higher (k = 0.793) in comparison with 2D-TSE sequence (k = 0.603). 3D SPACE sequence and its multi-planar reconstructions (MPR) scan time were less (192 s) than 2D TSE in the sagittal, axial and coronal planes (209 s).
3D SPACE sequence for lumbar spine MRI proved to have higher SNR, CNR, and visibility for all regions of lumbar spine except vertebrae and disc. Inter-observer and inter-method agreements for pathologic indexes between 3D SPACE and 2D TSE sequences were substantial and 3D SPACE had a higher inter-observer agreement and less scan time. Therefore, T2 weighted 3D SPACE sequence, and its MPR might be an excellent alternative for 2D TSE in sagittal, axial, and coronal planes, especially for patients with abnormal curvature of the lumbar spine.
比较T2加权三维各向同性涡轮自旋回波（SPACE）序列与T2加权二维涡轮自旋回波（TSE）序列在腰椎病变综合评估中的诊断价值和图像质量。
35例腰椎间盘病变患者在1.5-T MRI系统上采用二维TSE序列和三维SPACE序列进行检查。使用synedra view personal（V 17.0.0.2）软件对获取的图像进行分析，计算选定感兴趣区域的图像质量因子，如信噪比（SNR）和对比噪声比（CNR）。此外，将图像提交给放射科医生报告其病理指标。由两名放射科医生独立对三维和二维序列中解剖结构的可视性进行定性评估。采用Cohen's kappa（k）检验和Wilcoxon符号秩检验进行统计分析。
在本研究中，三维SPACE T2加权序列在除椎体和椎间盘外的所有感兴趣区域均显示出显著更高的SNR、CNR以及可视性（p值<0.05）。观察者间对感兴趣区域可视性的一致性较高且完美（k>0.6）。此外，观察者间和方法间对病理指标的一致性在所有病理指标中均较高且完美（k>0.6）。与二维TSE序列（k = 0.603）相比，三维SPACE序列的观察者间一致性更高（k = 0.793）。三维SPACE序列及其多平面重建（MPR）扫描时间（192秒）在矢状面、轴位和冠状面均少于二维TSE序列（209秒）。
腰椎MRI的三维SPACE序列在除椎体和椎间盘外的所有腰椎区域均具有更高的SNR、CNR和可视性。三维SPACE序列和二维TSE序列在病理指标上的观察者间和方法间一致性较高，且三维SPACE序列的观察者间一致性更高，扫描时间更短。因此，T2加权三维SPACE序列及其MPR在矢状面、轴位和冠状面可能是二维TSE的极佳替代方案，尤其适用于腰椎曲度异常的患者。
