Wang Qizheng, Xing Xiaoying, Zhang Zixian, Ji Xiaoxi, He Shipei, Yang Yuxin, Xu Jiajia, Zhao Qiang, Lang Ning
Department of Radiology, Peking University Third Hospital, Beijing, PR China.
United Imaging Research Institute of Intelligent Imaging, Beijing, PR China.
Insights Imaging. 2025 Jun 3;16(1):114. doi: 10.1186/s13244-025-01997-5.
To assess the potential of fast field echo resembling a CT using restricted echo-spacing (FRACTURE) sequence to enhance conventional MRI in detecting bone abnormalities of cervical spondylosis.
137 consecutive patients with cervical spondylosis who underwent clinically indicated paired CT and MRI within 2 weeks between January and June 2024. After routine MRI, the 3D-FRACTURE sequences were performed. Three radiologists independently evaluated the data during three sessions: (1) CT with consensus, (2) routine MRI, and (3) FRACTURE, with a 4-week interval between sessions. Assessments included osteophytes, bony foraminal stenosis, posterior longitudinal ligament ossification (OPLL), their anatomical location, and diagnostic confidence, using CT as the reference standard. Inter- and intra-reader reproducibility was assessed using multi-rater Fleiss κ and the intraclass correlation coefficient (ICC), respectively. The non-inferiority assessment compared routine MRI/FRACTURE and CT diagnoses using a relative reduction margin of 0.5.
The study sample comprised 82 males and 55 females (age 56.9 ± 9.8 years). ICC indicated good to excellent inter-rater reliability for FRACTURE (osteophytes: ICC, 0.83-1.00; OPLL: ICC, 0.73-0.92; bony foraminal stenosis: ICC, 0.76-0.98), which was superior to conventional MRI (most ICC values < 0.7). The diagnostic confidence by FRACTURE sequences was significantly higher than by routine MRI (p < 0.001). Non-inferiority analysis demonstrated that FRACTURE and CT detection were similar for osteophyte, bony foraminal stenosis, and OPLL within a margin of 0.5.
The FRACTURE sequence demonstrated comparable performance to CT in bone abnormalities detection in cervical spondylosis, superior to the routine MRI protocol.
The FRACTURE sequence addresses the limitations of conventional MRI in evaluating bone abnormalities, potentially minimizing radiation exposure and streamlining the diagnostic process for patients.
MRI has advantages in the evaluation of cervical spondylosis, but is still insufficient in bone abnormalities evaluation. The FRACTURE sequence performed comparably to CT in bone abnormalities detection in cervical spondylosis. MRI with FRACTURE sequences may provide a non-ionizing method for assessing cervical spondylosis in some clinical settings.
评估使用受限回波间距（FRACTURE）序列的快速场回波类似CT技术增强传统MRI检测颈椎病骨异常的潜力。
2024年1月至6月期间，137例连续的颈椎病患者在2周内接受了临床指示的配对CT和MRI检查。在常规MRI检查后，进行3D-FRACTURE序列检查。三位放射科医生在三个阶段独立评估数据：（1）达成共识的CT，（2）常规MRI，（3）FRACTURE，阶段之间间隔4周。评估包括骨赘、椎间孔狭窄、后纵韧带骨化（OPLL）、它们的解剖位置以及诊断置信度，以CT作为参考标准。分别使用多评分者Fleiss κ和组内相关系数（ICC）评估阅片者间和阅片者内的可重复性。非劣效性评估使用0.5的相对降低幅度比较常规MRI/FRACTURE和CT诊断。
研究样本包括82名男性和55名女性（年龄56.9±9.8岁）。ICC表明FRACTURE的阅片者间可靠性良好至优秀（骨赘：ICC，0.83 - 1.00；OPLL：ICC，0.73 - 0.92；椎间孔狭窄：ICC，0.76 - 0.98），优于传统MRI（大多数ICC值<0.7）。FRACTURE序列的诊断置信度显著高于常规MRI（p<0.001）。非劣效性分析表明，在0.5的幅度内，FRACTURE和CT对骨赘、椎间孔狭窄和OPLL的检测相似。
在颈椎病骨异常检测中，FRACTURE序列表现出与CT相当的性能，优于常规MRI方案。
FRACTURE序列解决了传统MRI在评估骨异常方面的局限性，有可能减少辐射暴露并简化患者的诊断过程。
MRI在颈椎病评估中具有优势，但在骨异常评估方面仍不足。在颈椎病骨异常检测中，FRACTURE序列表现与CT相当。在某些临床环境中，具有FRACTURE序列的MRI可能提供一种非电离方法来评估颈椎病。
