Magnetic resonance imaging in the evaluation of cervical foraminal stenosis: comparison of 3D T2 SPACE with sagittal oblique 2D T2 TSE

Abstract

Objective The oblique orientation of the cervical neural foramina challenges the implementation of a short MRI protocol with concurrent excellent visualization of the spine. While sagittal oblique T2-weighted sequences permit good evaluation of the cervical neuroforamina, all segments may not be equally well depicted on a single sequence and conspicuity of foraminal stenosis may be limited. 3D T2-weighted sequences can be reformatted in arbitrary planes, including the sagittal oblique. We set out to compare 3D T2w SPACE sequences with sagittal oblique reformations and sagittal oblique 2D T2w TSE sequences for the evaluation of cervical foraminal visibility and stenosis. Materials and methods Sixty consecutive patients who underwent MRI of the cervical spine with sagittal oblique 2D T2w TSE and 3D T2w SPACE sequences were included. Image homogeneity of the sequences was evaluated. Imaging sets were assessed for structure visibility and foraminal stenosis by two independent readers. Results of the sequences were compared by Wilcoxon matched-pairs tests. Interreader agreement was evaluated by weighted κ. Results Visibility of most structures was rated good to excellent on both sequences (mean visibility scores ≥ 4.5 of 5), though neuroforaminal contents were better seen on sagittal oblique T2w TSE (mean scores 4.1–4.6 vs. 3.1–4.1 on 3D T2w SPACE, p < 0.01). Stenosis grades were comparable between sequences (mean 1.1–2.6 of 4), with slightly higher values for 3D T2w SPACE at some levels (difference ≤ 0.3 points). Conclusion 3D T2w SPACE is comparable with sagittal oblique 2D T2w TSE in the evaluation of cervical neural foramina.

An optimized 1.5 Tesla MRI protocol of the brachial plexus

“…Signal ROIs were drawn as circles with 8-15 mm 2 areas, positioned on the radicular post-ganglionic tracts of the C6 and C7 nerves bilaterally, totaling four ROIs, and reporting their average. 16 For muscles, one ROI was placed on the left supraspinatus. CNR and SNR were calculated using the following formulas: SNR = (Signal ROI/SD of the noise); CNR = (SNR(muscle)ÀSNR(nerves))/SD noise.…”

“…Drawing on methods from previous studies, 15,16 the delineation of relevant anatomical structures, such as spinal cord, nerve roots, trunks, chords, and main branches, was scored using a five-point grading system: 1, non-existent; 2, poor; 3, acceptable; 4, good; 5, excellent. The impact of artifacts on image quality and interpretation was assessed using a five-point grading system: 5, absent; 4, minimal; 3, mild; 2, moderate; 1, severe/limiting diagnostic value.…”

Flexible array coil for cervical and extraspinal (FACE) MRI at 3.0 Tesla

“…Clinical c-spine/neck protocols typically employ multiple two-dimensional (2D) acquisitions, which have inherent limitations, including partial volume averaging, the inability to generate multiplanar reformations (MPR), and long acquisition times (Sahr et al 2021). To address such limitations, there has been growing interest in highresolution three-dimensional (3D) imaging (Barnaure et al 2022), which can overcome partial volume effects by MPR capabilities. To reduce scan times and improve image quality, parallel imaging (PI) and deep-learning (DL) reconstruction, respectively (Jardon et al 2022, Sun et al 2022, may be applied.…”