Li Hongyi, Liu Hailong, Xiao Mengqiang, Du Xiaodan, Zhang Meng, Ye Jingzhi, Lei Ming, Chen Jun, Chen Jie
Department of Radiology, Guangdong Provincial Hospital of Chinese Medicine, Zhuhai, China.
Department of Medical Imaging, Zhuhai Hospital of Integrated Traditional Chinese and Western Medicine, Guangdong, China.
Front Neurol. 2024 Dec 13;15:1490033. doi: 10.3389/fneur.2024.1490033. eCollection 2024.
CT-routine MRI fusion imaging has recently become available to evaluate spinal anatomy before surgery. Due to the 3-5 mm slice thickness and non-isotropic of routine MRI sequence, the CT-routine MRI fusion imaging is not good. The MRI multiple recalled gradient echo (MERGE) sequence is potentially useful in diagnosis of lumbar degeneration disease due to the better nerve roots visualization, 1 mm slice thickness and its isotropy.
The present study aimed to evaluate the image quality of CT-3D MERGE fusion images compared with CT and 3D MERGE images in patients with lumbar disc herniation.
Fifty-nine patients with lumbar disc herniation who underwent both lumbar CT and MRI including 3D-MERGE and routine lumbar MRI sequences were evaluated. All CT, 3D MERGE and CT-3D MERGE fusion images were separately assessed by two radiologists using five-point Likert scoring method based on five aspects: display of bony structure, intervertebral discs, nerve roots, overall anatomical details and image artifacts. Furthermore, two observers documented the sacral slope (SS), L4/5 intervertebral space heights (ISH), width and height of L4/5 intervertebral foramen (FW and FH) on CT and CT-MERGE fusion images.
There was insufficient evidence to show a difference in bony structure score between CT and CT-3D MERGE fusion images ( = 0.22), but it was significantly higher than that of MERGE ( < 0.001). The scores of intervertebral discs and nerve roots between MERGE and fusion images were not statistically different ( = 0.19 and 0.88), which were higher than CT (all < 0.001). The overall anatomical detail score of fusion imaging was higher than CT and MERGE ( < 0.001). No significant difference of image artifacts score was found among CT, MERGE and fusion images ( = 0.47). There was no significant difference in SS, ISH, FW, FH values between CT and fusion images (all > 0.05).
CT-3D MERGE fusion images exhibit superior image quality to both CT and 3D MERGE for the simultaneous observation of bony structures, intervertebral discs, and nerve roots.
CT-常规MRI融合成像最近已可用于术前评估脊柱解剖结构。由于常规MRI序列的层厚为3 - 5毫米且非各向同性，CT-常规MRI融合成像效果不佳。MRI多回波梯度回波（MERGE）序列因能更好地显示神经根、1毫米层厚及其各向同性，在腰椎退变疾病诊断中可能有用。
本研究旨在评估腰椎间盘突出症患者中CT-3D MERGE融合图像与CT及3D MERGE图像的图像质量。
对59例接受腰椎CT和MRI检查（包括3D-MERGE和常规腰椎MRI序列）的腰椎间盘突出症患者进行评估。两名放射科医生分别基于骨结构、椎间盘、神经根、整体解剖细节和图像伪影五个方面，采用五点李克特评分法对所有CT、3D MERGE和CT-3D MERGE融合图像进行评估。此外，两名观察者在CT和CT-MERGE融合图像上记录骶骨斜率（SS）、L4/5椎间隙高度（ISH）、L4/5椎间孔宽度和高度（FW和FH）。
没有足够证据表明CT与CT-3D MERGE融合图像在骨结构评分上存在差异（= 0.22），但它显著高于MERGE（< 0.001）。MERGE与融合图像在椎间盘和神经根评分上无统计学差异（= 0.19和0.88），两者均高于CT（均< 0.001）。融合成像的整体解剖细节评分高于CT和MERGE（< 0.001）。CT、MERGE和融合图像在图像伪影评分上无显著差异（= 0.47）。CT与融合图像在SS、ISH、FW、FH值上无显著差异（均> 0.05）。
对于同时观察骨结构、椎间盘和神经根，CT-3D MERGE融合图像的图像质量优于CT和3D MERGE。
