对比常规快速自旋回波 W MRI 和快速自旋回波 dixon 序列在腰椎退行性椎间盘疾病中的应用。
Comparison of lumbar degenerative disc disease using conventional fast spin echo W MRI and fast spin echo dixon sequences.
机构信息
Department of Radiology, Royal National Orthopaedic Hospital, Stanmore, UK.
Department of Radiology, North West Anglia Foundation Trust, Hinchingbrooke Hospital, Huntingdon, UK.
出版信息
Br J Radiol. 2021 May 1;94(1121):20201438. doi: 10.1259/bjr.20201438. Epub 2021 Mar 8.
OBJECTIVES
To compare the grading of lumbar degenerative disc disease (DDD), Modic end-plate changes (MEPC) and identification of high intensity zones (HIZ) on a combination of sagittal weighted turbo spin echo (W TSE), weighted fast spin echo (W FSE) and short tau inversion recovery (STIR) sequences (routine protocol) with a single sagittal W FSE Dixon MRI sequence which provides in-phase, opposed-phase, water only and fat only images in a single acquisition (Dixon protocol).
METHODS
50 patients underwent lumbar spine MRI using the routine protocol with the addition of a W FSE Dixon sequence. DDD grade, MEPC and HIZ for each disc level were assessed on the routine and Dixon protocols. Each protocol was reviewed independently by three readers (consultant musculoskeletal radiologists with 26-, 8- and 4 years' experience), allowing assessment of inter-reader agreement and inter protocol agreement for each assessed variable.
RESULTS
The study included 17 males and 33 females (mean age 51 years; range 8-82 years). Inter-reader agreement for DDD grade on the routine protocol was 0.57 and for the Dixon protocol was 0.63 ( = 0.08). Inter-reader agreement for MEPC on the routine protocol was 0.45 and for the Dixon protocol was 0.53 ( = 0.02), and inter-reader agreement for identification of the HIZ on the routine protocol was 0.52 and for the Dixon protocol was 0.46 ( = 0.27). Intersequence agreement for DDD grade ranged from 0.61 to 0.97, for MEPC 0.46-0.62 and for HIZ 0.39-0.5.
CONCLUSION
A single sagittal W FSE Dixon MRI sequence could potentially replace the routine three sagittal sequence protocol for assessment of lumbar DDD, MEPC and HIZ resulting in ~60% time saving.
ADVANCES IN KNOWLEDGE
Grading of lumbar DDD, presence of Modic changes and high intensity zones were compared on sagittal W TSE, W FSE and STIR sequences with a W FSE Dixon sequence, with fair-to-good correlation suggesting that three conventional sequences could be replaced by a single Dixon sequence.
目的
比较矢状位加权涡轮自旋回波（W TSE）、加权快速自旋回波（W FSE）和短回波反转恢复（STIR）序列（常规方案）与单次矢状位 W FSE Dixon MRI 序列组合（提供同相位、反相位、水相和脂相图像的单次采集）在腰椎退行性椎间盘疾病（DDD）分级、Modic 终板改变（MEPC）和高强度区（HIZ）识别方面的差异。
方法
50 例患者行腰椎 MRI 检查，常规方案加用 W FSE Dixon 序列。在常规和 Dixon 方案上评估每个椎间盘水平的 DDD 分级、MEPC 和 HIZ。每个序列由三位读者（有 26、8 和 4 年经验的骨肌放射科顾问医生）独立进行评估，以评估每个评估变量的读者间一致性和方案间一致性。
结果
研究包括 17 名男性和 33 名女性（平均年龄 51 岁；范围 8-82 岁）。常规方案上的 DDD 分级的读者间一致性为 0.57，而 Dixon 方案为 0.63（ = 0.08）。常规方案上的 MEPC 读者间一致性为 0.45，而 Dixon 方案为 0.53（ = 0.02），常规方案上的 HIZ 识别读者间一致性为 0.52，而 Dixon 方案为 0.46（ = 0.27）。DDD 分级的序列间一致性范围为 0.61-0.97，MEPC 为 0.46-0.62，HIZ 为 0.39-0.5。
结论
单次矢状位 W FSE Dixon MRI 序列有可能取代常规的三个矢状位序列方案，用于评估腰椎 DDD、MEPC 和 HIZ，从而节省约 60%的时间。
知识进展
在矢状位 W TSE、W FSE 和 STIR 序列与 W FSE Dixon 序列上比较了腰椎 DDD、Modic 改变和高强度区的分级，结果具有良好的相关性，表明三个常规序列可以被一个 Dixon 序列取代。
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