Department of Radiology, NYU Langone Health, New York, NY, USA.
Texas Scottish Rite Hospital for Children, Dallas, TX, USA.
Acta Radiol. 2021 Jan;62(1):58-66. doi: 10.1177/0284185120913000. Epub 2020 Mar 31.
Half-Fourier acquisition single-shot turbo spin-echo (HASTE), continuous radial gradient-echo (GRE), and True FISP allow real-time dynamic assessment of the spine.
To evaluate the feasibility of adding dynamic sequences to routine spine magnetic resonance imaging (MRI) for assessment of spondylolisthesis.
Retrospective review was performed of patients referred for dynamic MRI of the cervical or lumbar spine between January 2017 and 2018 who had flexion-extension radiographs within two months of MRI. Exclusion criteria were: incomplete imaging; spinal hardware; and inability to tolerate dynamic examination. Blinded, independent review by two board-certified musculoskeletal radiologists was performed to assess for spondylolisthesis (>3 mm translation); consensus review of dynamic radiographs served as the gold standard. Cervical spinal cord effacement was assessed. Inter-reader agreement and radiographic concordance was calculated for each sequence.
Twenty-one patients were included (8 men, 13 women; mean age 47.9 ± 16.5 years). Five had MRI of the cervical spine and 16 had MRI of the lumbar spine. Mean acquisition time was 18.4 ± 1.7 min with dynamic sequences in the range of 58-77 s. HASTE and True FISP had the highest inter-reader reproducibility (κ = 0.88). Reproducibility was better for the lumbar spine (κ = 0.94) than the cervical spine (κ = 0.28). Sensitivity of sequences for spondylolisthesis was in the range of 68.8%-78.6%. All three sequences had high accuracy levels: ≥90.5% averaged across the cervical and lumbar spine. Cervical cord effacement was observed during dynamic MRI in two cases (100% agreement).
Real-time dynamic MRI sequences added to spine MRI protocols provide reliable and accurate assessment of cervical and lumbar spine spondylolisthesis during flexion and extension.
半傅里叶采集单次激发快速自旋回波（HASTE）、连续放射状梯度回波（GRE）和真实稳态进动快速成像（True FISP）允许对脊柱进行实时动态评估。
评估在常规脊柱磁共振成像（MRI）中添加动态序列以评估脊柱滑脱的可行性。
对 2017 年 1 月至 2018 年期间因颈椎或腰椎动态 MRI 而转诊的患者进行回顾性研究，这些患者在 MRI 检查前两个月内有屈伸位 X 线片。排除标准为：成像不完整；脊柱内固定；以及不能耐受动态检查。由两名经过董事会认证的肌肉骨骼放射科医生进行盲法、独立的回顾性评估，以评估是否存在脊柱滑脱（>3mm 平移）；动态 X 线片的共识评估作为金标准。评估颈椎脊髓压迫。计算每个序列的读者间一致性和放射学一致性。
共纳入 21 例患者（8 名男性，13 名女性；平均年龄 47.9±16.5 岁）。5 例患者行颈椎 MRI，16 例患者行腰椎 MRI。动态序列的采集时间平均为 18.4±1.7 分钟，范围为 58-77 秒。HASTE 和 True FISP 的读者间重复性最高（κ=0.88）。腰椎的重复性（κ=0.94）优于颈椎（κ=0.28）。脊柱滑脱的序列敏感性在 68.8%-78.6%之间。三种序列的准确性均较高：颈椎和腰椎的平均准确率≥90.5%。在 2 例（100%）中观察到动态 MRI 期间的颈椎脊髓压迫。
实时动态 MRI 序列添加到脊柱 MRI 方案中，可在屈伸运动期间可靠、准确地评估颈椎和腰椎的脊柱滑脱。
