Department of Radiology, Klinikum Rechts der Isar, School of Medicine, Technical University of Munich, Ismaninger Strasse 22, 81675, Munich, Germany.
Department of Neuroradiology, Klinikum Rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany.
Eur Radiol. 2023 Feb;33(2):1445-1455. doi: 10.1007/s00330-022-09061-2. Epub 2022 Aug 18.
To evaluate the performance of single-echo Dixon water-fat imaging and computed tomography (CT)-like imaging based on a single ultrashort echo time (sUTE) MR sequence for imaging of vertebral fractures as well as degenerative bone changes of the spine in comparison to conventional CT and MR sequences.
Thirty patients with suspected acute vertebral fractures were examined using a 3-T MRI, including an sUTE sequence as well as short-tau inversion recovery (STIR) and T1-weighted sequences. During postprocessing, water-fat separation was performed by solving the smoothness-constrained inverse water-fat problem based on a single-complex UTE image. By removing the unwanted low-frequency phase terms, additional MR-based susceptibility-weighted-like (SW-like) images with CT-like contrast were created. Two radiologists evaluated semi-quantitative and quantitative features of fractures and degenerative changes independently and separately on CT and MR images.
In total, all 58 fractures were accurately detected of whom 24 were correctly classified as acute fractures with an edema detected on the water-fat-separated UTE images, using STIR and T1w sequences as standard of reference. For the morphological assessment of fractures and degenerative changes, the overall agreement between SW-like images and CT was substantial to excellent (e.g., Genant: κ 0.90 (95% confidence interval 0.54-1.00); AO/Magerl: κ 0.75 (95% confidence interval 0.43-1.00)). Overall inter-reader agreement for water-fat-separated UTE images and SW-like images was substantial to almost perfect.
Detection and assessment of vertebral fractures and degenerative bone changes of the spine were feasible and accurate using water-fat-separated images as well as SW-like images, both derived from the same sUTE-Dixon sequence.
• The detection of acute vertebral fractures was feasible using water-fat-separated images and CT-like images reconstructed from one sUTE sequence. • Assessment of the vertebral fractures using SW-like images with CT-like contrast was found to be comparable to conventional CT. • sUTE imaging of the spine can help reduce examination times and radiation exposure.
评估单回波 Dixon 水脂成像和基于单超短回波时间 (sUTE) MR 序列的 CT 样成像在成像椎体骨折以及脊柱退行性骨改变方面的性能，与常规 CT 和 MR 序列进行比较。
30 例疑似急性椎体骨折患者接受 3T MRI 检查，包括 sUTE 序列以及短 tau 反转恢复 (STIR) 和 T1 加权序列。在图像处理过程中，通过基于单复数 UTE 图像的平滑约束反水脂问题求解来进行水脂分离。通过去除不需要的低频相位项，创建具有 CT 样对比的附加 MR 敏感加权样 (SW 样) 图像。两位放射科医生独立且分别在 CT 和 MR 图像上评估骨折和退行性改变的半定量和定量特征。
总共准确检测到所有 58 处骨折，其中 24 处骨折被正确分类为急性骨折，在水脂分离 UTE 图像上检测到水肿，以 STIR 和 T1w 序列为参考标准。对于骨折和退行性改变的形态学评估，SW 样图像与 CT 的总体一致性为中等至高（例如，Genant：κ 0.90（95%置信区间 0.54-1.00）；AO/Magerl：κ 0.75（95%置信区间 0.43-1.00））。水脂分离 UTE 图像和 SW 样图像之间的总体读者间一致性为中等至高。
使用水脂分离图像和源自同一 sUTE-Dixon 序列的 SW 样图像，对椎体骨折和脊柱退行性骨改变的检测和评估是可行和准确的。
• 使用水脂分离图像和基于单 sUTE 序列重建的 CT 样图像，实现了急性椎体骨折的检测。
• 使用具有 CT 样对比的 SW 样图像评估椎体骨折的结果与常规 CT 相当。
• 脊柱 sUTE 成像有助于减少检查时间和辐射暴露。
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