Department of Spine Surgery, Ganga Medical Centre and Hospitals Pvt. Ltd., Coimbatore, India.
Department of Spine Surgery, Ganga Medical Centre and Hospitals Pvt. Ltd., Coimbatore, India.
World Neurosurg. 2023 Dec;180:e599-e606. doi: 10.1016/j.wneu.2023.09.116. Epub 2023 Oct 2.
This study aimed to determine the accuracy and reliability of using magnetic resonance imaging (MRI) to characterize thoracic pedicle morphology in the normal population.
Computed tomography (CT) and MRI datasets of 63 surgically treated patients were included in the study. Bilateral T3, T6, T9, and T12 vertebral levels were evaluated for the type of pedicle, pedicle chord length, and pedicle isthmic diameter on both MRI and CT scans. Pedicles were classified according to Sarwahi et al. into type A (normal pedicle), >4 mm cancellous channel; type B, 2-4 mm channel; type C, completely cortical channels >2 mm; and type D, <2 mm cortical bone channel.
Of 504 pedicles, 294 were classified as type A, 173 as type B, 24 as type C, and 13 as type D based on a CT scan. MRI had an overall accuracy rate of 92.86% for detecting type A, 96.53% for type B, and 100% for type C and type D compared with CT scans. Regarding the thoracic levels, MRI had an overall concordance of 97.98% at T3 level, 94.43% at T6 level, 98.11% at T9 level, and 99.3% at T12 level with CT readings. Comparing measurements between MRI and CT studies for pedicle isthmic diameter and pedicle chord length showed moderate to good reliability at all measured levels.
Pedicle measurements obtained by MRI may be used to estimate pedicle dimensions, allowing surgeons to preoperatively determine pedicle screw sizes based on MRI scans alone.
本研究旨在确定磁共振成像（MRI）在正常人群中对胸椎椎弓根形态进行特征描述的准确性和可靠性。
研究纳入了 63 例接受手术治疗的患者的 CT 和 MRI 数据集。在 MRI 和 CT 扫描中，评估双侧 T3、T6、T9 和 T12 椎体水平的椎弓根类型、椎弓根弦长和椎弓根峡部直径。根据 Sarwahi 等人的分类，椎弓根分为 A 型（正常椎弓根），即有>4mm 的松质骨通道；B 型，即 2-4mm 的通道；C 型，即>2mm 的完全皮质骨通道；D 型，即<2mm 的皮质骨通道。
根据 CT 扫描，504 个椎弓根中，294 个为 A 型，173 个为 B 型，24 个为 C 型，13 个为 D 型。与 CT 扫描相比，MRI 检测 A 型的总体准确率为 92.86%，B 型为 96.53%，C 型和 D 型为 100%。在胸椎水平，MRI 与 CT 读数的总体一致性为 T3 水平 97.98%，T6 水平 94.43%，T9 水平 98.11%，T12 水平 99.3%。比较 MRI 和 CT 研究中椎弓根峡部直径和椎弓根弦长的测量值，在所有测量水平均显示出中度至高度可靠性。
MRI 获得的椎弓根测量值可用于估计椎弓根尺寸，使外科医生能够仅根据 MRI 扫描术前确定椎弓根螺钉的尺寸。
