1
|
Sam A, S J, Pandian V, Ramakrishnan KK, Natarajan P, Muralidharan Y. Evaluating the Efficacy of Volume Isotropic Turbo Spin Echo Acquisition Versus T2-Weighted Turbo Spin Echo Imaging in the Diagnosis of Nerve Root and Perineuronal Pathologies in Spinal Disorders. Cureus 2024; 16:e60988. [PMID: 38915957 PMCID: PMC11195522 DOI: 10.7759/cureus.60988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2024] [Accepted: 05/24/2024] [Indexed: 06/26/2024] Open
Abstract
Background While two-dimensional (2D) turbo spin echo (TSE) sequences offer better through-plane resolution than three-dimensional (3D) isotropic TSE sequences images, with a narrower thickness of the slice, 3D isotropic TSE sequences are known to have a weaker in-plane resolution as well as blurring of the image. These elements may make it more difficult to distinguish between nearby structures that may affect nerve roots and small nerve roots during spinal imaging. This study aimed to analyze the accuracy of T2 TSE sequence and volumetric isotropic TSE acquisition in determining the indentation of nerve roots and perineural diseases such as nerve sheath tumors and Tarlov cysts. Methods Fifty patients who attended the Department of Radiodiagnosis for magnetic resonance (MR) spine participated in this prospective study. Routine MR lumbosacral (LS) spine sequences, such as survey, coronal T2 short-tau inversion recovery (STIR), sagittal T2 TSE, sagittal T1 TSE, and axial T2 TSE, were carried out after a localizer was acquired. More sequences from volume isotropic turbo spin echo acquisition (VISTA) were acquired. For both 2D and 3D sequences, the visibility ratings for perineural cysts, spinal canal stenosis, and nerve root indentation were evaluated. Visibility ratings ranged from zero to four. Results In the cases of perineural cyst, spinal canal stenosis, and nerve root impingement, the mean difference between the VISTA and T2 TSE visibility scores was 0.04, 0.54, and 0.56, respectively. The VISTA and T2 TS had standard deviation differences of 0.006, 0.026, and 0.06, respectively. The "t" values for nerve root impingement, spinal canal stenosis, and perineural cysts were, in order, 50, 180, and 70. Because the p-value was <0.01, a statistically significant variation has been observed. Conclusion In the diagnosis of neural and perineuronal disorders, the visibility scores for 3D T2 TSE (VISTA) were considerably better than those for 2D T2 TSE in identifying perineural cysts, spinal canal stenosis, and nerve root indentation.
Collapse
Affiliation(s)
- Ajina Sam
- Department of Radiology, Saveetha Medical College and Hospital, Saveetha Institute of Medical and Technical Sciences (SIMATS), Saveetha University, Chennai, IND
| | - Jaypradha S
- Department of Radiology, Saveetha Medical College and Hospital, Saveetha Institute of Medical and Technical Sciences (SIMATS), Saveetha University, Chennai, IND
| | - Vinoth Pandian
- Department of Radiology, Saveetha Medical College and Hospital, Saveetha Institute of Medical and Technical Sciences (SIMATS), Saveetha University, Chennai, IND
| | - Karthik Krishna Ramakrishnan
- Department of Radiology, Saveetha Medical College and Hospital, Saveetha Institute of Medical and Technical Sciences (SIMATS), Saveetha University, Chennai, IND
| | - Paarthipan Natarajan
- Department of Radiology, Saveetha Medical College and Hospital, Saveetha Institute of Medical and Technical Sciences (SIMATS), Saveetha University, Chennai, IND
| | - Yuvaraj Muralidharan
- Department of Radiodiagnosis, Saveetha Medical College and Hospital, Chennai, IND
| |
Collapse
|
2
|
Jain A, Aniq H, Mistry A. SLAP Injury and the Superior Labrum. Semin Musculoskelet Radiol 2022; 26:577-584. [DOI: 10.1055/s-0042-1758840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
AbstractInjuries around the superior labrum are a common cause of shoulder dysfunction and pain. The injuries sustained result mainly from repetitive microtrauma but can also occur following a fall on outstretched hand. Both athletic and general populations can be affected. Injuries to the superior labrum are called superior labrum anterior and posterior (SLAP) tears. Based on cross-sectional imaging findings, the literature defines four main SLAP tears (I–IV) and six extended types (V–X). An accurate description of imaging findings of the SLAP tear type, along with concomitant findings, aids clinicians in treatment planning. We also briefly discuss management options, postoperative appearance of superior labral repair, and the diagnosis of a retear.
Collapse
Affiliation(s)
- Abhishek Jain
- Liverpool University Hospitals, Royal Liverpool University Hospital, Liverpool, United Kingdom
| | - Hifz Aniq
- Liverpool University Hospitals, Royal Liverpool University Hospital, Liverpool, United Kingdom
| | - Alpesh Mistry
- Liverpool University Hospitals, Royal Liverpool University Hospital, Liverpool, United Kingdom
| |
Collapse
|
3
|
Mardani-Kivi M, Alizadeh A, Asadi K, Izadi A, Leili EK, arzpeyma SF. Can indirect magnetic resonance arthrography be a good alternative to magnetic resonance imaging in diagnosing glenoid labrum lesions?: a prospective study. Clin Shoulder Elb 2022; 25:182-187. [PMID: 35791684 PMCID: PMC9471823 DOI: 10.5397/cise.2021.00598] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 12/07/2021] [Indexed: 12/02/2022] Open
Abstract
Background This study was designed to evaluate and compare the diagnostic value of magnetic resonance imaging (MRI) and indirect magnetic resonance arthrography (I-MRA) imaging with those of arthroscopy and each other. Methods This descriptive-analytical study was conducted in 2020. All patients who tested positive for labrum lesions during that year were included in the study. The patients underwent conservative treatment for 6 weeks. In the event of no response to conservative treatment, MRI and I-MRA imaging were conducted, and the patients underwent arthroscopy to determine their ultimate diagnosis and treatment plan. Imaging results were assessed at a 1-week interval by an experienced musculoskeletal radiologist. Image interpretation results and arthroscopy were recorded in the data collection form. Results Overall, 35 patients comprised the study. Based on the kappa coefficient, the results indicate that the results of both imaging methods are in agreement with the arthroscopic findings, but the I-MRA consensus rate is higher than that of MRI (0.612±0.157 and 0.749±0.101 vs. 0.449±0.160 and 0.603±0.113). The sensitivity, specificity, negative predictive value, positive predictive value, and accuracy of MRI in detecting labrum tears were77.77%, 75.00%, 91.30%, 50.00%, and 77.14%, respectively, and those of I-MRA were 88.88%, 75.00%, 92.30%, 66.66%, and 85.71%. Conclusions Here, I-MRA showed higher diagnostic value than MRI for labral tears. Therefore, it is recommended that I-MRA be used instead of MRI if there is an indication for potential labrum lesions.
Collapse
|
4
|
Truong NM, Cevallos N, Lansdown DA, Ma CB, Feeley BT, Zhang AL. Biceps Tenodesis Demonstrates Lower Reoperation Rates Compared to SLAP Repair for Treatment of SLAP Tears in a Large Cross-Sectional Population. Arthroscopy 2022; 38:1802-1809.e2. [PMID: 34920004 DOI: 10.1016/j.arthro.2021.11.049] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 11/17/2021] [Accepted: 11/30/2021] [Indexed: 02/02/2023]
Abstract
PURPOSE To use a contemporary cross-sectional data set to evaluate trends in surgical treatment for superior labrum anterior and posterior (SLAP) tears and compare surgical outcomes with respect to 2-year revision surgery rates following index SLAP repair versus biceps tenodesis (BT). METHODS Patients diagnosed with a SLAP tear between 2010 and 2017 were queried using the Mariner PearlDiver database and stratified by demographic variables and surgical treatment with arthroscopic SLAP repair or arthroscopic/open BT. From 2015 to 2017, Current Procedural Terminology (CPT) and International Classification of Diseases 10th revision (ICD-10) codes were used to track ipsilateral subsequent reoperation within 2-years of index surgery. RESULTS Between 2010 to 2017, 16.6% of 377,463 patients diagnosed with a SLAP tear underwent surgery (62.3% SLAP repair vs 37.7% BT). 52.4% of BT procedures were arthroscopic (47.6% open). The frequency of SLAP repairs decreased from 74.0% to 46.2% (61%), while the frequency of BTs increased from 26.0% to 53.8% (202%) during the study period. Patients under age 50 were more likely to undergo SLAP repair, and those undergoing BT were more likely to be over 50 with higher CCI and comorbidity risk. 6.3% of 16,186 patients identified with ICD-10 coding required reoperation within 2-years postoperatively. SLAP repair demonstrated a higher revision rate (6.8%; 95% CI, 6.3-7.4%) than BT (5.7%; 95% CI, 5.2-6.2%; P =.0002), (open 5.8% vs arthroscopic BT 5.5%). Arthroscopic debridement, including biceps tenotomy, revision SLAP repair, and revision BT were the most common subsequent procedures. Patients aged 40 to 49 had the highest rate of revision surgery (7.8%). CONCLUSIONS The treatment trend for SLAP tears is changing, with SLAP repair becoming significantly less utilized and BT now becoming the preferred option, especially in patients over 50. Arthroscopic and open BT demonstrated slightly lower risk for reoperation than SLAP repair. LEVEL OF EVIDENCE IV, cross-sectional study.
Collapse
Affiliation(s)
- Nicole M Truong
- Department of Orthopaedic Surgery, University of California-San Francisco, San Francisco, California, U.S.A
| | - Nicolas Cevallos
- Department of Orthopaedic Surgery, University of California-San Francisco, San Francisco, California, U.S.A
| | - Drew A Lansdown
- Department of Orthopaedic Surgery, University of California-San Francisco, San Francisco, California, U.S.A
| | - C Benjamin Ma
- Department of Orthopaedic Surgery, University of California-San Francisco, San Francisco, California, U.S.A
| | - Brian T Feeley
- Department of Orthopaedic Surgery, University of California-San Francisco, San Francisco, California, U.S.A
| | - Alan L Zhang
- Department of Orthopaedic Surgery, University of California-San Francisco, San Francisco, California, U.S.A..
| |
Collapse
|
5
|
Lee SE, Jung JY, Lee SY, Park H. Progression of long head of the biceps brachii tendon abnormality on magnetic resonance imaging after rotator cuff repair. Br J Radiol 2021; 94:20210366. [PMID: 34233512 DOI: 10.1259/bjr.20210366] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVES To correlate the deterioration of preserved long head of biceps tendon (LHB) after rotator cuff repair with preoperative and postoperative MRI factors. METHODS Total of 209 shoulder joints (F:M = 145:64; mean age 57.4 years) which underwent rotator cuff repair and at least two postoperative MRI scans over 10 months after surgery were included. LHB integrity was graded with a five point severity scale. LHB deterioration was defined by increased composite score of integrity and extent score between the preoperative and second postoperative MRI. For preoperative and postoperative MRI factors, size and location of superior cuff -supraspinatus and infraspinatus- and subscapularis tears, fatty degeneration of rotator cuff, preoperative LHB status, subluxation of LHB, superior labral tear, acromion type, repaired rotator cuff status, postoperative capsulitis and acromioplasty state were assessed. Logistic regression was used to evaluate the association between LHB deterioration and aforementioned factors. Same analysis was conducted for 62 shoulder joints with a long-term follow-up MRI. RESULTS Of the 209 shoulders, 49.3% (n = 103) showed LHB deterioration on short-term follow-up MRI. In long-term follow-up subgroup, 32 LHBs were further deteriorated. In multivariate analysis, fatty degeneration of superior cuff showed significant association with LHB deterioration in both short-term (p = .04, p = .007) and long-term subgroups (p = .004, p = .005) among preoperative and postoperative factors, respectively. CONCLUSIONS Degree of fatty degeneration in superior cuff is associated with LHB deterioration on postoperative MRI. ADVANCES IN KNOWLEDGE Our results support that tenotomy or tenodesis of LHB should be considered during rotator cuff repair, especially in patients with advanced fatty degeneration of rotator cuff.
Collapse
Affiliation(s)
- Seung Eun Lee
- Department of Radiology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Joon-Yong Jung
- Department of Radiology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - So-Yeon Lee
- Department of Radiology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Hyerim Park
- Department of Radiology, Soonchunhyang University Cheonan Hospital, Cheonan-si, Republic of Korea
| |
Collapse
|
6
|
Bunnell KM, Hemke R, Husseini JS, Torriani M, Huang SY, Bredella MA. Does MR arthrography cause intracranial gadolinium deposition? Skeletal Radiol 2020; 49:1051-1056. [PMID: 31982970 DOI: 10.1007/s00256-020-03380-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Revised: 01/14/2020] [Accepted: 01/20/2020] [Indexed: 02/02/2023]
Abstract
PURPOSE To determine (i) whether intra-articular gadolinium from MR arthrography (MRA) results in gadolinium deposition in the brain and (ii) whether there is a correlation between intra-articular gadolinium dose and intracranial gadolinium deposition. MATERIALS AND METHODS This retrospective study was institutional review board (IRB) approved and HIPAA compliant. The study group included consecutive adult patients who had undergone MRA of the hip or shoulder and subsequent MRI of the brain. None of the patients had a history of intravenous gadolinium exposure. A control group of patients of similar age and sex who were never exposed to gadolinium and had brain MRIs available was included. Signal intensities (SI) of four brain regions: pons, dentate nuclei (DN), globus pallidi (GP), and thalamus (Thal) normalized to cerebrospinal fluid (CSF) and expressed in SI ratios were measured on T1-weighted non-contrast MR images. Groups were compared using the student's t test. Linear correlation analysis of gadolinium dose and brain SI ratios was performed, and Pearson correlation coefficients (r) are reported. RESULTS We identified 109 patients (mean age 44 ± 14 years, 54% men) who had undergone MRA and 149 controls of similar age and sex distribution. There was no significant difference in mean SI ratios of the brain regions between patients and controls: pons/CSF (p = 0.7), DN/CSF (p = 0.4), GP/CSF (p > 0.99), Thal/CSF (p = 0.3). Within the MRA group, gadolinium dose was not associated with SI ratios (p > 0.2). CONCLUSION Our study found no MR evidence of intracranial gadolinium deposition following MRA. In addition, there was no association between intra-articular gadolinium dose and SI ratios in commonly affected regions of the brain.
Collapse
Affiliation(s)
- Katherine M Bunnell
- Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Yawkey 6E, 55 Fruit Street, Boston, MA, 02114, USA
| | - Robert Hemke
- Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Yawkey 6E, 55 Fruit Street, Boston, MA, 02114, USA
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centers, Academic Medical Center, Amsterdam Movement Sciences, Amsterdam, the Netherlands
| | - Jad S Husseini
- Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Yawkey 6E, 55 Fruit Street, Boston, MA, 02114, USA
| | - Martin Torriani
- Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Yawkey 6E, 55 Fruit Street, Boston, MA, 02114, USA
| | - Susie Y Huang
- Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Yawkey 6E, 55 Fruit Street, Boston, MA, 02114, USA
| | - Miriam A Bredella
- Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Yawkey 6E, 55 Fruit Street, Boston, MA, 02114, USA.
| |
Collapse
|
7
|
Abstract
Background: SLAP lesions of the shoulder are challenging to diagnose by clinical means alone. Interpretation of MR images requires knowledge of the normal appearance of the labrum, its anatomical variants, and the characteristic patterns of SLAP lesions. In general, high signal extending anterior and posterior to the biceps anchor is the hallmark of SLAP lesions. Common diagnostic criteria for a SLAP lesion by MR or MR arthrography include the following: presence of a laterally curved, high signal intensity in the labrum on a coronal image, multiple or branching lines of high signal intensity in the superior labrum on a coronal image, full-thickness detachment with irregularly marginated high signal intensity and/or separation >2 mm on conventional MRI or 3 mm on MR arthrography between the labrum and glenoid on a coronal image, and a paralabral cyst extending from the superior labrum. Methods: MR diagnosis of SLAP tears may be improved with provocative maneuvers, such as longitudinal traction of the arm or positioning of the shoulder in abduction and external rotation during imaging. The use of intra-articular contrast distends the joint similar to what occurs during arthroscopy and forced diffusion under the labrum may improve the ability to detect SLAP lesions that might not be seen with standard MR. Improved diagnostic accuracy for SLAP tears is seen with 3-T compared with 1.5-T MR imaging, with or without intra-articular contrast material. Conclusion: Regardless of MR findings, however, physicians should be cautious when recommending surgery in the patient with a vague clinical picture. The patient’s history, physical exam, and imaging evaluation all should be considered together in making the decision to proceed with surgery.
Collapse
Affiliation(s)
- Robert D Boutin
- Department of Radiology, UC Davis School of Medicine, 4860 Y St., Suite 3100, Sacramento, CA 95817, USA
| | - Richard A Marder
- Department of Orthopaedic Surgery, UC Davis School of Medicine, 4860 Y St., Suite 3800, Sacramento, CA 95817, USA
| |
Collapse
|
8
|
Ajuied A, McGarvey CP, Harb Z, Smith CC, Houghton RP, Corbett SA. Diagnosis of glenoid labral tears using 3-tesla MRI vs. 3-tesla MRA: a systematic review and meta-analysis. Arch Orthop Trauma Surg 2018; 138:699-709. [PMID: 29582141 DOI: 10.1007/s00402-018-2894-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Indexed: 11/24/2022]
Abstract
BACKGROUND Various protocols exist for magnetic resonance arthrogram (MRA) of the shoulder, including 3D isotropic scanning and positioning in neutral (2D neutral MRA), or abduction-external-rotation (ABER). HYPOTHESIS MRA does not improve diagnostic accuracy for labral tears when compared to magnetic resonance imaging (MRI) performed using 3-Tesla (3T) magnets. METHOD Systematic review of the Cochrane, MEDLINE, and PubMed databases according to PRISMA guidelines. Included studies compared 3T MRI or 3T MRA (index tests) to arthroscopic findings (reference test). Methodological appraisal performed using QUADAS-2. Pooled sensitivity and specificity were calculated. RESULTS Ten studies including 929 patients were included. Index test bias and applicability were a concern in the majority of studies. The use of arthroscopy as the reference test raised concern of verification bias in all studies. For anterior labral lesions, 3T MRI was less sensitive (0.83 vs. 0.87 p = 0.083) than 3T 2D neutral MRA. Compared to 3T 2D neutral MRA, both 3T 3D Isotropic MRA and 3T ABER MRA significantly improved sensitivity (0.87 vs. 0.95 vs. 0.94). For SLAP lesions, 3T 2D neutral MRA was of similar sensitivity to 3T MRI (0.84 vs. 0.83, p = 0.575), but less specific (0.99 vs. 0.92 p < 0.0001). For posterior labral lesions, 3T 2D neutral MRA had greater sensitivity than 3T 3D Isotropic MRA and 3T MRI (0.90 vs. 0.83 vs. 0.83). CONCLUSIONS At 3-T, MRA improved sensitivity for diagnosis of anterior and posterior labral lesions, but reduced specificity in diagnosis of SLAP tears. 3T MRA with ABER positioning further improved sensitivity in diagnosis of anterior labral tears. LEVEL OF EVIDENCE IV.
Collapse
Affiliation(s)
- Adil Ajuied
- Department of Trauma and Orthopaedics, Guy's and St Thomas' Hospital NHS Foundation Trust, London, SE1 9RT, UK.,Fortius Clinic, 17 Fitzhardinge St, London, W1H 6EQ, UK
| | - Ciaran P McGarvey
- Department of Trauma and Orthopaedics, Guy's and St Thomas' Hospital NHS Foundation Trust, London, SE1 9RT, UK.
| | - Ziad Harb
- Department of Trauma and Orthopaedics, Guy's and St Thomas' Hospital NHS Foundation Trust, London, SE1 9RT, UK
| | - Christian C Smith
- Department of Trauma and Orthopaedics, Guy's and St Thomas' Hospital NHS Foundation Trust, London, SE1 9RT, UK
| | - Russell P Houghton
- Department of Radiology, Guy's and St Thomas' Hospital NHS Foundation Trust, London, SE1 9RT, UK
| | - Steven A Corbett
- Department of Trauma and Orthopaedics, Guy's and St Thomas' Hospital NHS Foundation Trust, London, SE1 9RT, UK.,Fortius Clinic, 17 Fitzhardinge St, London, W1H 6EQ, UK
| |
Collapse
|
9
|
Lin DJ, Wong TT, Kazam JK. Shoulder Injuries in the Overhead-Throwing Athlete: Epidemiology, Mechanisms of Injury, and Imaging Findings. Radiology 2018; 286:370-387. [PMID: 29356641 DOI: 10.1148/radiol.2017170481] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
The unparalleled velocity achieved by overhead throwers subjects the shoulder to extreme forces, resulting in both adaptive changes and pathologic findings that can be detected at imaging. A key biomechanical principle of throwing is achieving maximum external rotation, which initially leads to adaptive changes that may result in a pathologic cascade of injuries. In addition to the well-established concepts of glenohumeral internal rotation deficit and internal impingement, osseous and soft-tissue injuries of the shoulder unique to overhead athletes are illustrated. The epidemiology and biomechanics of throwing injuries are reviewed, and examples from the authors' institutional experience with competitive, collegiate, and professional baseball players are provided to demonstrate the constellation of unique imaging findings seen in overhead throwing athletes. Given the widespread popularity of baseball, and other sports relying on overhead throwing motions at all playing levels from recreational to professional, it is important for radiologists in various practice settings to be familiar with the special mechanisms, locations, and types of shoulder injuries seen in the overhead throwing population. © RSNA, 2018.
Collapse
Affiliation(s)
- Dana J Lin
- From the Department of Radiology, New York-Presbyterian Hospital, Columbia University Medical Center, 622 W 168th St, MC-28, New York, NY 10032
| | - Tony T Wong
- From the Department of Radiology, New York-Presbyterian Hospital, Columbia University Medical Center, 622 W 168th St, MC-28, New York, NY 10032
| | - Jonathan K Kazam
- From the Department of Radiology, New York-Presbyterian Hospital, Columbia University Medical Center, 622 W 168th St, MC-28, New York, NY 10032
| |
Collapse
|
10
|
Lee SH, Yun SJ, Jin W, Park SY, Park JS, Ryu KN. Comparison between 3D isotropic and 2D conventional MR arthrography for diagnosing rotator cuff tear and labral lesions: A meta-analysis. J Magn Reson Imaging 2018; 48:1034-1045. [DOI: 10.1002/jmri.26024] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Accepted: 02/20/2018] [Indexed: 02/01/2023] Open
Affiliation(s)
- Sun Hwa Lee
- Department of Emergency Medicine; Sanggye Paik Hospital, Inje University College of Medicine; Seoul Republic of Korea
| | - Seong Jong Yun
- Department of Radiology; Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine; Seoul Republic of Korea
| | - Wook Jin
- Department of Radiology; Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine; Seoul Republic of Korea
| | - So Young Park
- Department of Radiology; Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine; Seoul Republic of Korea
| | - Ji Seon Park
- Department of Radiology; Kyung Hee University Hospital; Seoul Republic of Korea
| | - Kyung Nam Ryu
- Department of Radiology; Kyung Hee University Hospital; Seoul Republic of Korea
| |
Collapse
|
11
|
Lee SH, Yun SJ, Yoon Y. Diagnostic performance of shoulder magnetic resonance arthrography for labral tears having surgery as reference: comparison of high-resolution isotropic 3D sequence (THRIVE) with standard protocol. Radiol Med 2018; 123:620-630. [PMID: 29582321 DOI: 10.1007/s11547-018-0879-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Accepted: 03/20/2018] [Indexed: 01/02/2023]
Abstract
PURPOSE To compare the diagnostic performance of T1 high-resolution isotropic volume excitation (THRIVE) sequence with that of a standard protocol for direct shoulder magnetic resonance arthrography (MRA) for the diagnosis of superior labral anterior-to-posterior (SLAP) and Bankart lesions, using arthroscopy findings as a reference standard. MATERIALS AND METHODS We retrospectively studied 84 patients who underwent direct shoulder 3T MRA using THRIVE and two-dimensional three-plane proton-density fat-suppressed (2D-PD-FS) sequences. One reviewer evaluated the contrast-to-noise ratio (CNR) as a quantitative image quality. Other two reviewers independently evaluated the subjective image noise, image sharpness, and radiologic diagnosis as qualitative image quality. Arthroscopic surgical findings were considered the reference standard. Wilcoxon rank sum, Chi-square/Fisher's exact, and DeLong's tests, as well as intraclass correlation coefficients (ICCs) were used to evaluate differences between THRIVE and 2D-PD-FS images. RESULTS THRIVE images had significantly higher CNR (p < 0.001), and subjective ratings of image noise (p = 0.009) and sharpness (p = 0.039) than 2D-PD-FS images (p < 0.001). THRIVE images had similar (p ≥ 0.18) diagnostic performance (sensitivity, 93.0-97.2%; specificity, 95.8-100%; accuracy, 95.2-97.6%) for the diagnosis of SLAP and Bankart lesions with excellent agreement (ICC = 0.898-0.942) when compared to 2D-PD-FS images (sensitivity, 86.1-91.7%; specificity, 93.8-95.8%; accuracy, 90.5-92.9%; agreement, ICC = 0.782-0.858). The scan time was reduced by 69% for THRIVE sequence compared to 2D-PD-FS sequence (2 min 40 s vs. 8 min 40 s). CONCLUSION The THRIVE sequence may be helpful in the diagnosis of SLAP and Bankart lesions, and may be routinely used during direct shoulder 3T MRA.
Collapse
Affiliation(s)
- Sun Hwa Lee
- Department of Emergency Medicine, Sanggye Paik Hospital, Inje University College of Medicine, 1342 Dongil-ro, Nowon-gu, Seoul, 01757, Republic of Korea
| | - Seong Jong Yun
- Department of Radiology, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, 892 Dongnam-ro, Gangdong-gu, Seoul, 05278, Republic of Korea.
| | - Youngno Yoon
- Department of Radiology, Gangnam Severance Hospital, College of Medicine, Yonsei University, 211 Eonju-ro, Gangnam-gu, Seoul, 06273, Republic of Korea
| |
Collapse
|
12
|
Comparison Between Isotropic 3-Dimensional Fat-Suppressed T2-Weighted Fast Spin Echo (FSE) and Conventional 2-Dimensional Fat-Suppressed Proton-Weighted FSE Shoulder Magnetic Resonance Imaging at 3-T in Patients With Shoulder Pain. J Comput Assist Tomogr 2018; 42:559-565. [DOI: 10.1097/rct.0000000000000721] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
13
|
Symanski JS, Subhas N, Babb J, Nicholson J, Gyftopoulos S. Diagnosis of Superior Labrum Anterior-to-Posterior Tears by Using MR Imaging and MR Arthrography: A Systematic Review and Meta-Analysis. Radiology 2017; 285:101-113. [PMID: 28604236 DOI: 10.1148/radiol.2017162681] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Purpose To evaluate the diagnostic accuracies of nonenhanced magnetic resonance (MR) imaging and MR arthrography for diagnosis of superior labrum anterior-to-posterior (SLAP) tears by using a systematic review and meta-analysis. Materials and Methods A comprehensive literature search was performed on the two main concepts of MR imaging (MR imaging, and direct and indirect MR arthrography) and SLAP tears. Inclusion criteria consisted of original studies that assessed the diagnostic accuracy of MR imaging, direct MR arthrography, and/or indirect MR arthrography for the detection of SLAP tears, by using surgical findings as the reference standard. The Quality Assessment of Diagnostic Accuracy Studies 2, or QUADAS-2 Quality Assessment of Diagnostic Accuracy Studies 2 Quality Assessment of Diagnostic Accuracy Studies 2 , tool was used to assess methodologic quality. Meta-analyses were performed that compared MR imaging studies to direct MR arthrography studies and indirect MR arthrography studies, 3-T studies to 1.5-T studies, and low-bias MR imaging studies to low-bias direct MR arthrography studies. Study variation was analyzed by using the Cochran Q test of heterogeneity and the I2 statistic. Results Thirty-two studies met inclusion and exclusion criteria, including 3524 imaging examinations: 1963 direct MR arthrography examinations (23 studies), 1402 MR examinations (14 studies), and 159 indirect MR arthrography examinations (three studies). Twelve studies had low risk for bias, two had questionable risk, and 18 had high risk. Mean sensitivities of direct MR arthrography, MR imaging, and indirect MR arthrography for SLAP tear diagnosis were 80.4%, 63.0%, and 74.2%, respectively. Mean specificities of direct MR arthrography, MR imaging, and indirect MR arthrography were 90.7%, 87.2%, and 66.5%, respectively. Summary receiver operator characteristic (ROC) curve demonstrated superior accuracy of direct MR arthrography compared with those of MR imaging and indirect MR arthrography. Similar findings were observed in the low-bias subanalysis. Summary ROC curve demonstrated overall superiority of 3-T imaging, with or without intra-articular contrast material compared with 1.5-T imaging, with or without intra-articular contrast material. Significant variance was observed for MR imaging and direct MR arthrography (P < .001) studies for both mean sensitivity and specificity. Conclusion Direct MR arthrography appears to be more accurate than nonenhanced MR imaging for diagnosis of SLAP tears, whereas 3-T MR imaging with or without intra-articular contrast material appears to improve diagnostic accuracy compared with 1.5-T MR imaging with or without intra-articular contrast material. © RSNA, 2017 Online supplemental material is available for this article.
Collapse
Affiliation(s)
- John S Symanski
- From the Department of Radiology, NYU Langone Medical Center/Hospital for Joint Diseases, 660 First Ave, New York, NY 10016 (J.S.S., J.B., S.G.); Department of Radiology, Cleveland Clinic, Cleveland, Ohio (N.S.); and NYU Health Sciences Library, NYU School of Medicine, New York, NY (J.N.)
| | - Naveen Subhas
- From the Department of Radiology, NYU Langone Medical Center/Hospital for Joint Diseases, 660 First Ave, New York, NY 10016 (J.S.S., J.B., S.G.); Department of Radiology, Cleveland Clinic, Cleveland, Ohio (N.S.); and NYU Health Sciences Library, NYU School of Medicine, New York, NY (J.N.)
| | - James Babb
- From the Department of Radiology, NYU Langone Medical Center/Hospital for Joint Diseases, 660 First Ave, New York, NY 10016 (J.S.S., J.B., S.G.); Department of Radiology, Cleveland Clinic, Cleveland, Ohio (N.S.); and NYU Health Sciences Library, NYU School of Medicine, New York, NY (J.N.)
| | - Joseph Nicholson
- From the Department of Radiology, NYU Langone Medical Center/Hospital for Joint Diseases, 660 First Ave, New York, NY 10016 (J.S.S., J.B., S.G.); Department of Radiology, Cleveland Clinic, Cleveland, Ohio (N.S.); and NYU Health Sciences Library, NYU School of Medicine, New York, NY (J.N.)
| | - Soterios Gyftopoulos
- From the Department of Radiology, NYU Langone Medical Center/Hospital for Joint Diseases, 660 First Ave, New York, NY 10016 (J.S.S., J.B., S.G.); Department of Radiology, Cleveland Clinic, Cleveland, Ohio (N.S.); and NYU Health Sciences Library, NYU School of Medicine, New York, NY (J.N.)
| |
Collapse
|
14
|
Sung J, Jee WH, Jung JY, Jang J, Kim JS, Kim YH, Ha KY. Diagnosis of Nerve Root Compromise of the Lumbar Spine: Evaluation of the Performance of Three-dimensional Isotropic T2-weighted Turbo Spin-Echo SPACE Sequence at 3T. Korean J Radiol 2017; 18:249-259. [PMID: 28096733 PMCID: PMC5240479 DOI: 10.3348/kjr.2017.18.1.249] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2015] [Accepted: 08/12/2016] [Indexed: 11/29/2022] Open
Abstract
Objective To explore the performance of three-dimensional (3D) isotropic T2-weighted turbo spin-echo (TSE) sampling perfection with application optimized contrasts using different flip angle evolution (SPACE) sequence on a 3T system, for the evaluation of nerve root compromise by disc herniation or stenosis from central to extraforaminal location of the lumbar spine, when used alone or in combination with conventional two-dimensional (2D) TSE sequence. Materials and Methods Thirty-seven patients who had undergone 3T spine MRI including 2D and 3D sequences, and had subsequent spine surgery for nerve root compromise at a total of 39 nerve levels, were analyzed. A total of 78 nerve roots (48 symptomatic and 30 asymptomatic sites) were graded (0 to 3) using different MRI sets of 2D, 3D (axial plus sagittal), 3D (all planes), and combination of 2D and 3D sequences, with respect to the nerve root compromise caused by posterior disc herniations, lateral recess stenoses, neural foraminal stenoses, or extraforaminal disc herniations; grading was done independently by two readers. Diagnostic performance was compared between different imaging sets using the receiver operating characteristics (ROC) curve analysis. Results There were no statistically significant differences (p = 0.203 to > 0.999) in the ROC curve area between the imaging sets for both readers 1 and 2, except for combined 2D and 3D (0.843) vs. 2D (0.802) for reader 1 (p = 0.035), and combined 2D and 3D (0.820) vs. 3D including all planes (0.765) for reader 2 (p = 0.049). Conclusion The performance of 3D isotropic T2-weighted TSE sequence of the lumbar spine, whether axial plus sagittal images, or all planes of images, was not significantly different from that of 2D TSE sequences, for the evaluation of nerve root compromise of the lumbar spine. Combining 2D and 3D might possibly improve the diagnostic accuracy compared with either one.
Collapse
Affiliation(s)
- Jinkyeong Sung
- Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea
| | - Won-Hee Jee
- Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea
| | - Joon-Yong Jung
- Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea
| | - Jinhee Jang
- Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea
| | - Jin-Sung Kim
- Department of Neurosurgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea
| | - Young-Hoon Kim
- Department of Orthopedic Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea
| | - Kee-Yong Ha
- Department of Orthopedic Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea
| |
Collapse
|
15
|
Abstract
Imaging of the shoulder forms an important adjunct in clinical decision making in patients with shoulder instability. The typical lesions related with classic anterior and anteroinferior shoulder dislocation are an anteroinferior labral avulsion with or without bony fragment of bone loss – a (bony) Bankart lesion – and a posterolateral humeral head impaction fracture – the Hill-Sachs lesions. These are relatively straightforward to identify on imaging, although normal variants of the inferior labrum and variants of labral damage may cause confusion. Other capsuloligamentous lesions, often associated with less typical types of instability, are much more difficult to identify correctly on imaging, as they occur in the anterosuperior part of the glenohumeral joint with its many normal variants or because they result in more subtle, and therefore easily overlooked, changes in morphology or signal intensity. This paper aims at describing the appearance of the normal and pathologic glenohumeral joint related to shoulder instability. Ample reference will be given as to why identification of abnormalities, whether normal or pathologic, is important to the surgeon facing a treatment decision.
Collapse
|
16
|
Abstract
Repetitive, high-velocity overhead throwing can lead to several adaptive changes in the throwing shoulder, which over time lead to structural microtrauma and eventually overt injury. MR imaging is a useful imaging modality to evaluate these changes and to characterize their acuity and severity. Understanding the throwing motion and the effects of this motion on the structures of the shoulder can help radiologists to recognize these findings and provide useful information to referring physicians, which may affect the treatment of these athletes. This article reviews shoulder pathomechanics and MR imaging findings in overhead throwing athletes.
Collapse
|
17
|
Yi J, Cha JG, Lee YK, Lee BR, Jeon CH. MRI of the anterior talofibular ligament, talar cartilage and os subfibulare: Comparison of isotropic resolution 3D and conventional 2D T2-weighted fast spin-echo sequences at 3.0 T. Skeletal Radiol 2016; 45:899-908. [PMID: 26992909 DOI: 10.1007/s00256-016-2367-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2015] [Revised: 03/03/2016] [Accepted: 03/07/2016] [Indexed: 02/02/2023]
Abstract
PURPOSE To determine the accuracy of a three-dimensional (3D) T2-weighted fast spin-echo (FSE) magnetic resonance (MR) sequence compared with two-dimensional (2D) sequence for diagnosing anterior talofibular ligament (ATFL) tears, chondral lesion of the talus (CLT) and os subfibulare/avulsion fracture of the distal fibula (OSF). MATERIALS AND METHODS Thirty-five patients were included, who had undergone ankle MRI with 3D T2-weighted FSE and 2D T2-weighted FSE sequences, as well as subsequent ankle arthroscopy, between November 2013 and July 2014. Each MR imaging sequence was independently scored by two readers retrospectively for the presence of ATFL tears, CLT and OSF. The area under the receiver operating curve (AUC) was compared to determine the discriminatory power of the two image sequences. Interobserver agreement was expressed as unweighted kappa value. RESULTS Arthroscopic findings confirmed 21 complete tears of the ATFL, 14 partial tears of the ATFL, 17 CLTs and 7 OSFs. There were no significant differences in the diagnoses of ATFL tears (p = 0.074-0.501), CLT (p = 0.090-0.450) and OSF (p = 0.317) obtained from the 2D and 3D sequences by either reader. The interobserver agreement rates between two readers using the 3D T2-weighted FSE sequence versus those obtained with the 2D sequence were substantial (κ = 0.659) versus moderate (κ = 0.553) for ATFL tears, moderate (κ = 0.499) versus substantial (κ = 0.676) for CLT and substantial (κ = 0.621) versus substantial (κ = 0.689) for OSF. CONCLUSION Three-dimensional isotropic T2-weighted FSE MRI of the ankle resulted in no statistically significant difference in diagnostic performance compared to two-dimensional T2-weighted FSE MRI in the evaluation of ATFL tears, CLTs and OSFs.
Collapse
Affiliation(s)
- Jisook Yi
- Department of Radiology, Soonchunhyang University Bucheon Hospital, 170 Jomaru-ro, Wonmi-gu, Bucheon-si, 14584, Korea
| | - Jang Gyu Cha
- Department of Radiology, Soonchunhyang University Bucheon Hospital, 170 Jomaru-ro, Wonmi-gu, Bucheon-si, 14584, Korea.
| | - Young Koo Lee
- Department of Orthopedics, Soonchunhyang University Bucheon Hospital, 170 Jomaru-ro, Wonmi-gu, Bucheon-si, 14584, Korea
| | - Bo Ra Lee
- Department of Biomedical Statistics, Soonchunhyang University Bucheon Hospital, 170 Jomaru-ro, Wonmi-gu, Bucheon-si, 14584, Korea
| | - Chan Hong Jeon
- Division of Rheumatology, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, 170 Jomaru-ro, Wonmi-gu, Bucheon-si, 14584, Korea
| |
Collapse
|
18
|
Magnetic Resonance Imaging in Patients With Mechanical Low Back Pain Using a Novel Rapid-Acquisition Three-Dimensional SPACE Sequence at 1.5-T: A Pilot Study Comparing Lumbar Stenosis Assessment With Routine Two-Dimensional Magnetic Resonance Sequences. Can Assoc Radiol J 2016; 67:368-378. [PMID: 27245289 DOI: 10.1016/j.carj.2015.11.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2015] [Revised: 11/09/2015] [Accepted: 11/10/2015] [Indexed: 12/20/2022] Open
Abstract
PURPOSE To minimize the burden of overutilisation of lumbar spine magnetic resonance imaging (MRI) on a resource-constrained public healthcare system, it may be helpful to image some patients with mechanical low-back pain (LBP) using a simplified rapid MRI screening protocol at 1.5-T. A rapid-acquisition 3-dimensional (3D) SPACE (Sampling Perfection with Application-optimized Contrasts using different flip angle Evolution) sequence can demonstrate common etiologies of LBP. We compared lumbar spinal canal stenosis (LSCS) and neural foraminal stenosis (LNFS) assessment on 3D SPACE against conventional 2-dimensional (2D) MRI. METHODS We prospectively performed 3D SPACE and 2D spin-echo MRI sequences (axial or sagittal T1-weighted or T2-weighted) at 1.5-T in 20 patients. Two blinded readers assessed levels L3-4, L4-5 and L5-S1 using: 1) morphologic grading systems, 2) global impression on the presence or absence of clinically significant stenosis (n = 60 disc levels for LSCS, n = 120 foramina for LNFS). Reliability statistics were calculated. RESULTS Acquisition time was ∼5 minutes for SPACE and ∼20 minutes for 2D MRI sequences. Interobserver agreement of LSCS was substantial to near perfect on both sequences (morphologic grading: kappa [k] = 0.71 SPACE, k = 0.69 T2-weighted; global impression: k = 0.85 SPACE, k = 0.78 T2-weighted). LNFS assessment had superior interobserver reliability using SPACE than T1-weighted (k = 0.54 vs 0.37). Intersequence agreement of findings between SPACE and 2D MRI was substantial to near perfect by global impression (LSCS: k = 0.78 Reader 1, k = 0.85 Reader 2; LNFS: k = 0.63 Reader 1, k = 0.66 Reader 2). CONCLUSIONS 3D SPACE was acquired in one-quarter the time as the conventional 2D MRI protocol, had excellent agreement with 2D MRI for stenosis assessment, and had interobserver reliability superior to 2D MRI. These results justify future work to explore the role of 3D SPACE in a rapid MRI screening protocol at 1.5-T for mechanical LBP.
Collapse
|
19
|
Sheridan K, Kreulen C, Kim S, Mak W, Lewis K, Marder R. Accuracy of magnetic resonance imaging to diagnose superior labrum anterior-posterior tears. Knee Surg Sports Traumatol Arthrosc 2015; 23:2645-50. [PMID: 24985524 DOI: 10.1007/s00167-014-3109-z] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2013] [Accepted: 05/29/2014] [Indexed: 01/02/2023]
Abstract
PURPOSE The purpose of this study was to evaluate the accuracy of magnetic resonance imaging (MRI) and magnetic resonance arthrography (MRA) in diagnosing superior labral anterior-posterior (SLAP) lesions. We hypothesized that the accuracy of MRI and MRA was lower than previously reported. METHODS Between 2006 and 2008, 444 patients who had both shoulder arthroscopy and an MRI (non-contrast or MR arthrography) for shoulder pain at our institution prior to surgery were identified and included in the study. The radiologic diagnosis and surgical evaluation were compared to determine the accuracy of diagnosing a SLAP lesion by MRI. Using arthroscopy as the standard, sensitivity, specificity, accuracy, positive predictive value (PPV), and negative predictive value (NPV) were calculated for all MRIs, as well as separately for the non-intra-articular contrast MRI group and the MR arthrography group. RESULTS Of the 444 patients having an MRI and arthroscopy for shoulder pain, 121 had a SLAP diagnosis by MRI and 44 had a SLAP diagnosis by arthroscopy. Overall, MRI had an accuracy of 76 %, a PPV of 24 %, and a NPV of 95 %. Sensitivity was 66 %, and specificity was 77 %. MR arthrography had an accuracy of 69 %, sensitivity of 80 %, and a PPV of 29 %. Non-contrast MRI had an accuracy of 85 %, sensitivity of 36 %, and a PPV of 13 %. CONCLUSIONS In our retrospective study of 444 patients, sensitivity, specificity, and accuracy were all lower than previously reported in the literature for diagnosing SLAP lesions. Our data indicated that while MRI could exclude a SLAP lesion (NPV = 95 %), MRI alone was not an accurate clinical tool. MR arthrography had a large number of false-positive readings in this study. We concluded that even with intra-articular contrast, MRI had limitations in the ability to diagnose surgically proven SLAP lesions.
Collapse
Affiliation(s)
- Kent Sheridan
- Department of Orthopaedic Surgery, Davis Medical Center, University of California, 4860 Y Street, Suite 3800, Sacramento, CA, 95817, USA,
| | | | | | | | | | | |
Collapse
|
20
|
Lee S, Jee WH, Jung JY, Lee SY, Ryu KS, Ha KY. MRI of the lumbar spine: comparison of 3D isotropic turbo spin-echo SPACE sequence versus conventional 2D sequences at 3.0 T. Acta Radiol 2015; 56:174-81. [PMID: 24553584 DOI: 10.1177/0284185114524196] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
BACKGROUND Three-dimensional (3D) fast spin-echo sequence with variable flip-angle refocusing pulse allows retrospective alignments of magnetic resonance imaging (MRI) in any desired plane. PURPOSE To compare isotropic 3D T2-weighted (T2W) turbo spin-echo sequence (TSE-SPACE) with standard two-dimensional (2D) T2W TSE imaging for evaluating lumbar spine pathology at 3.0 T MRI. MATERIAL AND METHODS Forty-two patients who had spine surgery for disk herniation and had 3.0 T spine MRI were included in this study. In addition to standard 2D T2W TSE imaging, sagittal 3D T2W TSE-SPACE was obtained to produce multiplanar (MPR) images. Each set of MR images from 3D T2W TSE and 2D TSE-SPACE were independently scored for the degree of lumbar neural foraminal stenosis, central spinal stenosis, and nerve compression by two reviewers. These scores were compared with operative findings and the sensitivities were evaluated by McNemar test. Inter-observer agreements and the correlation with symptoms laterality were assessed with kappa statistics. RESULTS The 3D T2W TSE and 2D TSE-SPACE had similar sensitivity in detecting foraminal stenosis (78.9% versus 78.9% in 32 foramen levels), spinal stenosis (100% versus 100% in 42 spinal levels), and nerve compression (92.9% versus 81.8% in 59 spinal nerves). The inter-observer agreements (κ = 0.849 vs. 0.451 for foraminal stenosis, κ = 0.809 vs. 0.503 for spinal stenosis, and κ = 0.681 vs. 0.429 for nerve compression) and symptoms correlation (κ = 0.449 vs. κ = 0.242) were better in 3D TSE-SPACE compared to 2D TSE. 3D TSE-SPACE with oblique coronal MPR images demonstrated better inter-observer agreements compared to 3D TSE-SPACE without oblique coronal MPR images (κ = 0.930 vs. κ = 0.681). CONCLUSION Isotropic 3D T2W TSE-SPACE at 3.0 T was comparable to 2D T2W TSE for detecting foraminal stenosis, central spinal stenosis, and nerve compression with better inter-observer agreements and symptom correlation.
Collapse
Affiliation(s)
- Sungwon Lee
- Department of Radiology, Seoul St Mary’s Hospital, School of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Won-Hee Jee
- Department of Radiology, Seoul St Mary’s Hospital, School of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Joon-Yong Jung
- Department of Radiology, Seoul St Mary’s Hospital, School of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - So-Yeon Lee
- Department of Radiology, Seoul St Mary’s Hospital, School of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
- Present: Department of Radiology, KangbukSamsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Kyeung-Sik Ryu
- Department of Neurosurgery, Seoul St Mary’s Hospital, School of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Kee-Yong Ha
- Department of Orthopedic Surgery, Seoul St Mary’s Hospital, School of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| |
Collapse
|
21
|
Lee JH, Yoon YC, Jee S, Kwon JW, Cha JG, Yoo JC. Comparison of three-dimensional isotropic and two-dimensional conventional indirect MR arthrography for the diagnosis of rotator cuff tears. Korean J Radiol 2014; 15:771-80. [PMID: 25469089 PMCID: PMC4248633 DOI: 10.3348/kjr.2014.15.6.771] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2014] [Accepted: 08/24/2014] [Indexed: 01/20/2023] Open
Abstract
OBJECTIVE To compare the accuracy between a three-dimensional (3D) indirect isotropic T1-weighted fast spin-echo (FSE) magnetic resonance (MR) arthrography and a conventional two-dimensional (2D) T1-weighted sequences of indirect MR arthrography for diagnosing rotator cuff tears. MATERIALS AND METHODS The study was approved by our Institutional Review Board. In total, 205 patients who had undergone indirect shoulder MR arthrography followed by arthroscopic surgery for 206 shoulders were included in this study. Both conventional 2D T1-weighted FSE sequences and 3D isotropic T1-weighted FSE sequence were performed in all patients. Two radiologists evaluated the images for the presence of full- or partial-thickness tears in the supraspinatus-infraspinatus (SSP-ISP) tendons and tears in the subscapularis (SSC) tendons. Using the arthroscopic findings as the reference standard, the diagnostic performances of both methods were analyzed by the area under the receiver operating characteristic curve (AUC). RESULTS Arthroscopy confirmed 165 SSP-ISP tendon tears and 103 SSC tendon tears. For diagnosing SSP-ISP tendon tears, the AUC values were 0.964 and 0.989 for the 2D sequences and 3D T1-weighted FSE sequence, respectively, in reader I and 0.947 and 0.963, respectively, in reader II. The AUC values for diagnosing SSC tendon tears were 0.921 and 0.925, respectively, for reader I and 0.856 and 0.860, respectively, for reader II. There was no significant difference between the AUC values of the 2D and 3D sequences in either reader for either type of tear. CONCLUSION 3D indirect isotropic MR arthrography with FSE sequence and the conventional 2D arthrography are not significantly different in terms of accuracy for diagnosing rotator cuff tears.
Collapse
Affiliation(s)
- Ji Hyun Lee
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 135-710, Korea
| | - Young Cheol Yoon
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 135-710, Korea
| | | | - Jong Won Kwon
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 135-710, Korea
| | - Jang Gyu Cha
- Department of Radiology, Soonchunhyang University Bucheon Hospital, Bucheon 420-767, Korea
| | - Jae Chul Yoo
- Department of Orthopedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 135-710, Korea
| |
Collapse
|
22
|
Kloth JK, Winterstein M, Akbar M, Meyer E, Paul D, Kauczor HU, Weber MA. Comparison of 3D turbo spin-echo SPACE sequences with conventional 2D MRI sequences to assess the shoulder joint. Eur J Radiol 2014; 83:1843-9. [PMID: 25082477 DOI: 10.1016/j.ejrad.2014.06.011] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2013] [Revised: 05/20/2014] [Accepted: 06/16/2014] [Indexed: 11/29/2022]
Abstract
PURPOSE To determine the accuracy and reliability of three-dimensional (3D) T1- and proton density (PD)-weighted turbo spin-echo (TSE) sampling perfection with application-optimized contrasts using different flip-angle evolution (SPACE) compared with conventional 2D sequences in assessment of the shoulder-joint. MATERIALS AND METHODS Ninety-three subjects were examined on a 3-T MRI system with both conventional 2D-TSE sequences in T1-, T2- and PD-weighting and 3D SPACE sequences in T1- and PD-weighting. All examinations were assessed independently by two reviewers for common pathologies of the shoulder-joint. Agreement between 2D- and 3D-sequences and inter-observer-agreement was evaluated using kappa-statistics. RESULTS Using conventional 2D TSE sequences as standard of reference, sensitivity, specificity, and accuracy values of 3D SPACE were 81.8%, 95.1%, and 93.5% for injuries of the supraspinatus-tendon (SSP), 81.3%, 93.5%, and 91.4% for the cartilage layer and 82.4%, 98.5%, and 97.5% for the long biceps tendon. Concordance between 2D and 3D was almost perfect for tendinopathies of the SSP (κ=0.85), osteoarthritis (κ=1), luxation of the biceps tendon (κ=1) and adjacent bone marrow (κ=0.92). Inter-observer-agreement was generally higher for conventional 2D TSE sequences (κ, 0.23-1.0), when compared to 3D SPACE sequences (κ, -0.33 to 1.0) except for disorders of the long biceps tendon and supraspinatus tendon rupture. CONCLUSION Because of substantial and almost perfect concordance with conventional 2D TSE sequences for common shoulder pathologies, MRI examination-time can be reduced by nearly 40% (up to 11 min) using 3D-SPACE without loss of information.
Collapse
Affiliation(s)
- Jost Karsten Kloth
- Diagnostic and Interventional Radiology, University Hospital Heidelberg, Im Neuenheimer Feld 110, D-69120 Heidelberg, Germany.
| | - Marianne Winterstein
- Diagnostic and Interventional Radiology, University Hospital Heidelberg, Im Neuenheimer Feld 110, D-69120 Heidelberg, Germany.
| | - Michael Akbar
- Orthopedic and Trauma Surgery, University Hospital Heidelberg, Schlierbacher Landstraße 200a, D-69118 Heidelberg, Germany.
| | | | | | - Haus-Ulrich Kauczor
- Diagnostic and Interventional Radiology, University Hospital Heidelberg, Im Neuenheimer Feld 110, D-69120 Heidelberg, Germany.
| | - Marc-André Weber
- Diagnostic and Interventional Radiology, University Hospital Heidelberg, Im Neuenheimer Feld 110, D-69120 Heidelberg, Germany.
| |
Collapse
|
23
|
Park SY, Lee IS, Park SK, Cheon SJ, Ahn JM, Song JW. Comparison of three-dimensional isotropic and conventional MR arthrography with respect to the diagnosis of rotator cuff and labral lesions: focus on isotropic fat-suppressed proton density and VIBE sequences. Clin Radiol 2014; 69:e173-82. [PMID: 24457018 DOI: 10.1016/j.crad.2013.11.019] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2013] [Revised: 10/23/2013] [Accepted: 11/26/2013] [Indexed: 11/15/2022]
Abstract
AIM To compare the diagnostic accuracies of three-dimensional (3D) isotropic magnetic resonance arthrography (MRA) using fat-suppressed proton density (PD) or volume interpolated breath-hold examination (VIBE) sequences with that of conventional MRA for the diagnosis of rotator cuff and labral lesions. MATERIALS AND METHODS Eighty-six patients who underwent arthroscopic surgery were included. 3D isotropic sequences were performed in the axial plane using fat-suppressed PD (group A) in 53 patients and using VIBE (group B) in 33 patients. Reformatted images were obtained corresponding to conventional images, and evaluated for the presence of labral and rotator cuff lesions using conventional and 3D isotropic sequences. The diagnostic performances of each sequence were determined using arthroscopic findings as the standard. RESULTS Good to excellent interobserver agreements were obtained for both 3D isotropic sequences for the evaluation of rotator cuff and labral lesions. Excellent agreement was found between two-dimensional (2D) and 3D isotropic MRA, except for supraspinatus tendon (SST) tears by both readers and for subscapularis tendon (SCT) tears by reader 2 in group B. 2D MRA and 3D isotropic sequences had high diagnostic performances for rotator and labral tears, and the difference between the two imaging methods was insignificant. CONCLUSIONS The diagnostic performances of 3D isotropic VIBE and PD sequences were similar to those of 2D MRA.
Collapse
Affiliation(s)
- S Y Park
- Department of Radiology, Pusan National University Hospital, Biomedical Research Institute, Republic of Korea; Pusan National University School of Medicine, Busan, Republic of Korea
| | - I S Lee
- Department of Radiology, Pusan National University Hospital, Biomedical Research Institute, Republic of Korea; Pusan National University School of Medicine, Busan, Republic of Korea.
| | - S K Park
- Department of Radiology, Pusan National University Hospital, Biomedical Research Institute, Republic of Korea; Pusan National University School of Medicine, Busan, Republic of Korea
| | - S J Cheon
- Pusan National University School of Medicine, Busan, Republic of Korea; Department of Orthopaedic Surgery, Pusan National University Hospital, Biomedical Research Institute, Republic of Korea
| | - J M Ahn
- Pusan National University School of Medicine, Busan, Republic of Korea; Department of Orthopaedic Surgery, Pusan National University Hospital, Biomedical Research Institute, Republic of Korea
| | - J W Song
- Department of Radiology, Inje University Haeundae Paik Hospital, Busan, Republic of Korea
| |
Collapse
|
24
|
Mugler JP. Optimized three‐dimensional fast‐spin‐echo MRI. J Magn Reson Imaging 2014; 39:745-67. [PMID: 24399498 DOI: 10.1002/jmri.24542] [Citation(s) in RCA: 248] [Impact Index Per Article: 24.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2013] [Accepted: 10/31/2013] [Indexed: 11/10/2022] Open
Affiliation(s)
- John P. Mugler
- Department of Radiology and Medical ImagingUniversity of Virginia School of MedicineCharlottesville Virginia USA
| |
Collapse
|