Application of three-dimensional (3D) magnetic resonance (MR) Multi-Echo iN Steady-state Acquisition sequences in preoperative evaluation of lumbar disc herniation: a prospective study.

IF 2.9 2区 医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
Quantitative Imaging in Medicine and Surgery Pub Date : 2024-10-01 Epub Date: 2024-09-13 DOI:10.21037/qims-23-1834
Xuelin Pan, Yuting Wen, Kangkang Huang, Jing Li, Wanjiang Li, Weijie Yan, Deying Wen, Miaoqi Zhang, Shangxian Wang, Xinyi Zhang, Zhenlin Li, Xin Rong
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引用次数: 0

Abstract

Background: Conventional spinal magnetic resonance imaging (MRI) cannot provide accurate diagnosis and surgical planning; thin-layer scanning can enhance the diagnostic efficacy. This study aimed to investigate the value of 3-dimensional (3D) magnetic resonance (MR) in preoperative evaluation of lumbar disc herniation, with a focus on the application of Multi-Echo iN Steady-state Acquisition (MENSA) sequence.

Methods: A total of 51 patients who underwent lumbar disc herniation surgery in West China Hospital of Sichuan University from June 2021 to December 2021 were prospectively enrolled. A cross-sectional study was conducted on those patients. The Cube group was scanned using 3D-FSE-Cube sequence, the Cube stir group was scanned using 3D-FSE-Cube Short Tau Inversion Recovery (STIR) sequence, and the MENSA group was scanned using MENSA sequence. Signal and noise values of nerve, herniated disc, ligamentum flavum (LF), and soft tissue were measured on the 3 groups. Signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were calculated. Objective scores were calculated by analysis of variance (ANOVA). Image quality was scored by a 5-point method. Friedman test was used to compare subjective scores, and Kappa test was used to evaluate the consistency of 2 readers' scores.

Results: The nerve root SNRs in the MENSA and Cube stir groups were higher than that in the Cube group (P<0.01), but there was no substantial statistical difference between the 2 groups. The herniated disc and LF SNRs of the MENSA group were greater than those of the Cube stir and Cube groups (P<0.01). Soft tissue SNR was greater in the MENSA group compared with the Cube stir group (P<0.01), which was greater than the SNR in the Cube group (P<0.01). The nerve root CNR of the Cube group (102.88±73.19) was greater than that of the MENSA group (55.98±25.26, P<0.01), which was higher than the CNR in the Cube Stir group (29.42±16.22, P<0.01). The herniated disc CNR was higher in the MENSA and Cube groups than that in the Cube Stir group. The CNR of LF was greater in the MENSA group (37.71±16.87) compared to the Cube group (29.76±25.73, P=0.03), which was greater than that in the Cube stir group (10.50±7.75, P<0.01). Among the subjective ratings of 2 reviewers, MENSA sequence scored highest in the qualitative measures of image quality. In the consistency test, the Kappa values of 2 readers for 3 groups of images were all greater than 0.73, indicating good consistency. The differences of subjective scores among all groups were statistically significant (P<0.05). Overall, it was indicated that the consistency test results of the 2 readers were statistically significant and consistent. The MENSA group had the highest accuracy in diagnosing nerve compression. In addition, MENSA sequence ranked highest among the 3 sequences with 94.1% diagnostic accuracy.

Conclusions: The preoperative 3D MRI MENSA sequence can clearly depict the nerve roots and offer desirable contrast between the nerve roots, LF, bone, and intervertebral discs (IVDs). Patients with lumbar degeneration can effectively benefit from MENSA sequence since it provides useful imaging information to help understand disc herniation and compression of adjacent tissues when developing preoperative surgical strategies.

三维(3D)磁共振(MR)多回波 iN 稳态采集序列在腰椎间盘突出症术前评估中的应用:一项前瞻性研究。
背景:传统的脊柱磁共振成像(MRI)无法提供准确的诊断和手术规划;薄层扫描可提高诊断效果。本研究旨在探讨三维磁共振成像(MR)在腰椎间盘突出症术前评估中的价值,重点关注多回波稳态采集(MENSA)序列的应用:方法:前瞻性纳入 2021 年 6 月至 2021 年 12 月在四川大学华西医院接受腰椎间盘突出症手术的 51 例患者。对这些患者进行了横断面研究。立方体组采用三维-FSE-立方体序列扫描,立方体搅拌组采用三维-FSE-立方体短头反转恢复(STIR)序列扫描,MENSA组采用MENSA序列扫描。测量了三组神经、椎间盘突出、黄韧带(LF)和软组织的信号和噪声值。计算信噪比(SNR)和对比噪比(CNR)。通过方差分析(ANOVA)计算客观评分。图像质量采用 5 级评分法。Friedman检验用于比较主观评分,Kappa检验用于评估两名读者评分的一致性:结果:MENSA组和Cube搅拌组的神经根信噪比高于Cube组(PC结论:术前三维 MRI MENSA 序列可清晰显示神经根,并在神经根、LF、骨和椎间盘(IVDs)之间提供理想的对比度。腰椎退行性变患者可从 MENSA 序列中有效获益,因为它提供了有用的成像信息,有助于在制定术前手术策略时了解椎间盘突出和邻近组织的压迫情况。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Quantitative Imaging in Medicine and Surgery
Quantitative Imaging in Medicine and Surgery Medicine-Radiology, Nuclear Medicine and Imaging
CiteScore
4.20
自引率
17.90%
发文量
252
期刊介绍: Information not localized
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