Moffit B, Reicher M, Lufkin R, Bentson J
Department of Radiological Sciences, UCLA School of Medicine 90024.
Comput Med Imaging Graph. 1988 Sep-Oct;12(5):271-6. doi: 10.1016/0895-6111(88)90037-7.
In order to develop an optimal routine magnetic resonance (MR) spine scanning protocol, we have compared the relative efficacy of performing T1- and T2-weighted images in patients with various disorders of the lumbar region. Forty cases were randomly selected from studies performed from 1984 to 1987 and the T1- and T2-weighted images of each case were separated and interpreted blindly and independently by two neuroradiologists. Our results indicate no significant difference between T1- and T2-weighted images in the depiction of disc protrusion. The T2-weighted images were superior in depicting disc dessication, but the clinical significance of identifying a dessication disc remains uncertain. No significant difference in the depiction of osteophytes was seen between T1- and T2-weighted images. Cases of tethered cord, metastatic disease, and arachnoiditis were better delineated with T1-weighted images. The increase in signal of cerebrospinal fluid (CSF) with T2-weighting often obscured lesions within the spinal canal. In a signal case of postoperative discitis, the T2-weighted images disclosed disc space abnormalities and epidural fluid collections not appreciated on T1-weighted images. The T1-weighted images, however, did show thecal sac and adjacent epidural extension more clearly. In cases of metastatic disease, increase in the signal of metastases with T2 weighting often rendered them isointense to surrounding medullary bone. Given the lack of superiority of T2-weighted images over T1-weighted images in evaluating intervertebral disc protrusions and the superiority of T1-weighted images in depicting nearly all other abnormalities observed in this series, we no longer acquire T2-weighted images of the lumbar spine on a routine basis.(ABSTRACT TRUNCATED AT 250 WORDS)
为制定最佳的常规磁共振（MR）脊柱扫描方案，我们比较了对患有各种腰椎疾病的患者进行T1加权和T2加权成像的相对效果。从1984年至1987年进行的研究中随机选取40例病例，由两位神经放射科医生对每个病例的T1加权和T2加权图像进行分离，并进行盲法独立解读。我们的结果表明，在椎间盘突出的显示方面，T1加权和T2加权图像之间无显著差异。T2加权图像在显示椎间盘退变方面更具优势，但识别退变椎间盘的临床意义仍不明确。在骨赘的显示上，T1加权和T2加权图像之间未见显著差异。脊髓栓系、转移性疾病和蛛网膜炎病例用T1加权图像能更好地显示。T2加权时脑脊液（CSF）信号增强常掩盖椎管内病变。在一例术后椎间盘炎病例中，T2加权图像显示了T1加权图像未发现的椎间盘间隙异常和硬膜外积液。然而，T1加权图像更清晰地显示了硬脊膜囊和相邻的硬膜外扩展。在转移性疾病病例中，T2加权时转移灶信号增强常使其与周围髓质骨呈等信号。鉴于在评估椎间盘突出方面T2加权图像并不优于T1加权图像，且T1加权图像在显示本系列中观察到的几乎所有其他异常方面具有优势，我们不再常规获取腰椎的T2加权图像。（摘要截短至250字）
