Added value of 3D fast-field-echo (FRACTURE) sequences for cervical spondylosis diagnosis: a prospective multi-reader non-inferiority study.

IF 4.1 2区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Insights into Imaging Pub Date : 2025-06-03 DOI:10.1186/s13244-025-01997-5

Qizheng Wang, Xiaoying Xing, Zixian Zhang, Xiaoxi Ji, Shipei He, Yuxin Yang, Jiajia Xu, Qiang Zhao, Ning Lang

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引用次数: 0

Abstract

Objectives: 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.

Materials and methods: 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.

Results: 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.

Conclusion: The FRACTURE sequence demonstrated comparable performance to CT in bone abnormalities detection in cervical spondylosis, superior to the routine MRI protocol.

Critical relevance statement: The FRACTURE sequence addresses the limitations of conventional MRI in evaluating bone abnormalities, potentially minimizing radiation exposure and streamlining the diagnostic process for patients.

Key points: 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.

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三维快速场回波（骨折）序列对颈椎病诊断的附加价值：一项前瞻性多阅读器非效性研究。

目的：利用有限回波间隔（骨折）序列评估类似CT的快速场回波增强常规MRI检测颈椎病骨异常的潜力。材料与方法：2024年1月至6月，连续137例颈椎病患者在2周内行临床指示的配对CT和MRI检查。常规MRI后，进行3d -骨折序列检查。三位放射科医生在三个疗程中独立评估数据：(1)一致的CT，(2)常规MRI，(3)骨折，疗程之间间隔4周。评估包括骨赘、椎间孔狭窄、后纵韧带骨化（OPLL）及其解剖位置和诊断可信度，以CT作为参考标准。分别使用多倍率的Fleiss κ和类内相关系数（ICC）评估阅读器间和阅读器内的可重复性。非劣效性评价比较常规MRI/骨折和CT诊断的相对降低幅度为0.5。结果：男性82例，女性55例，年龄56.9±9.8岁。ICC显示骨折(骨癣：ICC， 0.83-1.00；Opll: icc, 0.73-0.92；结论：骨折序列在颈椎病的骨异常检测中表现出与CT相当的性能，优于常规MRI方案。关键相关性声明：骨折序列解决了传统MRI在评估骨异常方面的局限性，潜在地减少了辐射暴露并简化了患者的诊断过程。重点：MRI对颈椎病的评价有优势，但对骨骼异常的评价仍有不足。骨折序列在颈椎病骨异常检测中的表现与CT相当。MRI与骨折序列可能提供一种非电离方法评估颈椎病在一些临床设置。

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

Insights into Imaging Medicine-Radiology, Nuclear Medicine and Imaging

CiteScore

7.30

自引率

4.30%

发文量

182

审稿时长

13 weeks

期刊介绍： Insights into Imaging (I³) is a peer-reviewed open access journal published under the brand SpringerOpen. All content published in the journal is freely available online to anyone, anywhere! I³ continuously updates scientific knowledge and progress in best-practice standards in radiology through the publication of original articles and state-of-the-art reviews and opinions, along with recommendations and statements from the leading radiological societies in Europe. Founded by the European Society of Radiology (ESR), I³ creates a platform for educational material, guidelines and recommendations, and a forum for topics of controversy. A balanced combination of review articles, original papers, short communications from European radiological congresses and information on society matters makes I³ an indispensable source for current information in this field. I³ is owned by the ESR, however authors retain copyright to their article according to the Creative Commons Attribution License (see Copyright and License Agreement). All articles can be read, redistributed and reused for free, as long as the author of the original work is cited properly. The open access fees (article-processing charges) for this journal are kindly sponsored by ESR for all Members. The journal went open access in 2012, which means that all articles published since then are freely available online.