Coronal magnetic resonance imaging of three-dimensional fast-field echo with water-selective excitation improves the sensitivity and reliability of identification of extraforaminal lumbar disc herniation

Jia, Jingyu; Liu, Xijuan; Li, Wugen; Xiong, Xi; Wu, Tianlong; He, Dingwen

doi:10.1177/0300060519882546

Cited by 6 publications

(8 citation statements)

References 10 publications

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“…Byun et al ( 9 ) observed that the technology could additionally demonstrate the 3D relationship between the nerve root and the intervertebral disc, which is conducive to the discovery of extreme lateral disc herniation. Our previous study confirmed that the sensitivity and specificity of the technique in identifying extreme lateral disc herniation are better than those of conventional MRI ( 10 ). Subsequently, it has also been verified by our other study that the CMRI is beneficial in the differential diagnosis of tumor-like disc herniation ( 5 ).…”

Section: Discussionsupporting

confidence: 77%

Case Report: The Coronal Magnetic Resonance Imaging of Three-Dimensional Fast-Field Echo With Water-Selective Excitation Can Identify the Wrapping of Spinal Nerve Fibers Into Subdural Tumors Prior to Operation

et al. 2022

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PurposeIn the present study, the authors intend to identify the spatial relationship between subdural tumors and spinal nerve fibers of cauda equina prior to operation using the coronal MRI of three-dimensional fast-field echo with water-selective excitation (CMRI).MethodsIn total, 30 case series with surgically and pathologically verified subdural tumors were enrolled in the present study. The spatial relationship between subdural tumors and spinal nerve fibers of the cauda equina was assessed via conventional MRI and CMRI by three experts prior to operation. The spatial relationship between subdural tumors and spinal nerve fibers of the cauda equina was classified using CMRI. The accuracy of imaging observation was determined via intraoperative observation.ResultsThough conventional MRI and gadolinium (Gd)-enhanced MRI (Gd MRI) cannot identify the spatial relationship between subdural tumors and spinal nerve fibers of cauda equina in all cases, CMRI can identify it prior to operation and divide the spatial relationship of spinal nerve fibers of cauda equina with subdural tumors into three types. CMRI shows higher sensitivity (97.44%) and specificity (90.47%) in identifying the spatial relationship of spinal nerve fibers of cauda equina with subdural tumors. Additionally, CMRI also showed a substantial agreement with a kappa value of 0.78.ConclusionHerein, the authors first describe a potential novel application that CMRI can successfully identify the spatial relationship between subdural tumors and spinal nerve fibers of cauda equina prior to operation, which play an essential role in making a prudent surgical plan and preventing postoperative nerve damage.SummaryIntraoperative observation confirms spinal nerve fibers of cauda equina are often wrapped into subdural tumors of the thoracolumbar and lumbar region, which can result in a high rate of sensory and motor dysfunction after the operation due to the unconscious about the wrapping of nerves into subdural tumors prior to operation. To date, there is not an effective strategy to identify the wrapping before operation.

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Section: Discussionsupporting

confidence: 77%

Case Report: The Coronal Magnetic Resonance Imaging of Three-Dimensional Fast-Field Echo With Water-Selective Excitation Can Identify the Wrapping of Spinal Nerve Fibers Into Subdural Tumors Prior to Operation

et al. 2022

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“…The CMRI scanning parameters were consistent with those used in previous studies 28,29 . Sequence development was performed using a 3.0‐T whole‐body scanner (GE Medical Systems, Chicago, IL) with a spine coil.…”

Section: Methodsmentioning

confidence: 99%

“…To avoid these disadvantages, coronal MRI of threedimensional (3D) fast-field echo with water-selective excitation (CMRI) is considered a non-invasive and reliable novel technology [26][27][28][29] . Byun et al and Shen et al confirmed that CMRI can show the whole length of the nerve root from the origin of the nerve root to the extraforaminal region; the 3D space between the herniated disc and nerve root can also be shown after CMR images are reconstructed without invasive examination 26,27 .…”

Section: Introductionmentioning

confidence: 99%

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Differential Diagnosis of Mimicking Tumor Discs Using Coronal Magnetic Resonance Imaging of Three‐Dimensional Fast‐Field Echo with Water‐Selective Excitation: A Single Center Retrospective Study

Yuan

Zhi

et al. 2022

Orthopaedic Surgery

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Objective: As disc fragment completely loses contact with the parent disc and can migrate in all directions of the epidural space, making it appear similar to schwannoma, it is fairly difficult to make a definitive diagnosis for mimicking tumor discs. The aim of this research is to differentially diagnose mimicking tumor discs and schwannomas using coronal magnetic resonance imaging (MRI) of three-dimensional fast-field echo with water-selective excitation (CMRI).Methods: Among 76 patients (38 men and 38 women; mean age, 52.88 AE 15.80 [range,) who were retrospectively examined in this study, 38 were primarily diagnosed with schwannomas and pathologically diagnosed with mimicking tumor discs after surgery, and 38 were primarily diagnosed with neurogenic tumors and pathologically diagnosed with schwannomas after surgery. Open surgery was performed in all the patients between March 2016 and April 2020. The preliminary diagnosis of all patients was considered an intraspinal tumor based on conventional twodimensional MRI sequences. After open surgery, the final diagnosis was confirmed to mimic a tumor disc or schwannoma based on postoperative pathology reports. The sensitivity, specificity, and reliability of CMRI and conventional MRI for identifying mimicking tumor discs and schwannomas were compared. Chi-square and McNemar tests were used for statistical analyses.Results: Symptoms were considerably relieved in all the patients after surgery. Seven patients had grade 1 extensor digitorum longus, triceps surae, or quadriceps femoris muscle strength prior to surgery. No nerve root injury was observed in any of the patients. CMRI showed significantly higher sensitivity (94.74%) and specificity (94.74%) than conventional MRI (71.05% and 92.11%, respectively; p = 0.012 < 0.05, and p = 1 > 0.05, respectively) for differential identification between mimicking tumor discs and schwannomas. Moreover, CMRI showed a higher reliability (kappa value = 0.787) than conventional MRI (kappa value = 0.374).Conclusions: CMRI is a better non-invasive technology for the identification of intraspinal lesions, especially for differentiating between mimicking tumor discs and schwannomas.

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“…As early as 2012, Woo Mok Byun discussed the role of 3D MR lumbosacral radiculography in the diagnosis of symptomatic extraforaminal disc herniation [ 9 ]. In our previous studies, CMRI was used to improve the diagnosis of extremely lateral lumbar intervertebral disc herniation and distinguish between lumbar discs mimicking tumor and schwannomas [ 10 , 11 ]. So Hee Park, Sang Woo Kim, and Sartoretti E studied the value of ProSet MR Or CMRI in multiple lumbar foraminal stenosis and foraminal or extraforaminal lesions at L5-S1 [ 19 – 22 ].…”

Section: Introductionmentioning

confidence: 99%

Accuracy of Coronal Magnetic Resonance Imaging Diagnosis of Multi-Segmental Lumbar Disc Herniation: A Single-Center Retrospective Analysis

Jia

et al. 2023

Med Sci Monit

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Background Multi-segment herniation of lumbar intervertebral discs is a complex lumbar spine disease, and it is difficult to identify the responsible segment using only magnetic resonance imaging (MRI). The present study screened 47 patients with multi-segment lumbar disc herniation (MSLDH) to evaluate coronal magnetic resonance imaging (CMRI) of three-dimensional fast-field echo with water-selective excitation to identify the responsible segment of multi-segment lumbar disc herniation (MSLDH) and to assess the accuracy and utility of CMRI. Material/Methods This retrospective study included 44 patients with low back pain or lower-extremity symptoms from January 2019 to December 2021. The imaging (including CMRI) and clinical data of the patients were analyzed by 3 independent, blinded experts. The Kappa statistical method was used to characterize the reader-to-reader reliability to qualitatively evaluate the data. Results CMRI showed high diagnostic performance, with 90.2% sensitivity, 94.9% positive predictive value (PPV), 80% negative predictive value (NPV), and 83.4% accuracy, and there were significant differences in hospital length of stay ( P =0.013) and surgical bleeding ( P =0.006) ( P <0.01) between single-segment and multi-segment patients. Conclusions CMRI is highly accurate in revealing the shape, signal, and position of the intraspinal and extraspinal lumbosacral plexus, and reducing surgical segments can help improve postoperative outcomes for patients.

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Coronal magnetic resonance imaging of three-dimensional fast-field echo with water-selective excitation improves the sensitivity and reliability of identification of extraforaminal lumbar disc herniation

Cited by 6 publications

References 10 publications

Case Report: The Coronal Magnetic Resonance Imaging of Three-Dimensional Fast-Field Echo With Water-Selective Excitation Can Identify the Wrapping of Spinal Nerve Fibers Into Subdural Tumors Prior to Operation

Case Report: The Coronal Magnetic Resonance Imaging of Three-Dimensional Fast-Field Echo With Water-Selective Excitation Can Identify the Wrapping of Spinal Nerve Fibers Into Subdural Tumors Prior to Operation

Differential Diagnosis of Mimicking Tumor Discs Using Coronal Magnetic Resonance Imaging of Three‐Dimensional Fast‐Field Echo with Water‐Selective Excitation: A Single Center Retrospective Study

Accuracy of Coronal Magnetic Resonance Imaging Diagnosis of Multi-Segmental Lumbar Disc Herniation: A Single-Center Retrospective Analysis

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