The value of contrast-enhanced three-dimensional isotropic T2-weighted turbo spin-echo SPACE sequence in the diagnosis o
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ORIGINAL ARTICLE
The value of contrast‑enhanced three‑dimensional isotropic T2‑weighted turbo spin‑echo SPACE sequence in the diagnosis of patients with lumbosacral nerve root compression Chao Kong1,3 · Xiang‑Yu Li1,3 · Si‑Yuan Sun4 · Xiang‑Yao Sun1,3 · Miao Zhang2 · Zheng Sun2 · Yu Wang1,3 · Jie Lu2 · Shi‑Bao Lu1,3 Received: 17 June 2020 / Revised: 18 August 2020 / Accepted: 5 September 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose To investigate the diagnostic value of contrast-enhanced three-dimensional (3D) T2-weighted turbo spin-echo SPACE (T2-SPACE) sequence in LNRC. Methods A total of 90 surgically confirmed LNRC patients with 165 explored nerve roots were enrolled in this study. Diagnostic values were quantified using sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy. The consistency between 2D MRI and 3D T2-SPACE MRI was quantified using kappa test. The compression of specific branch in nerve root was evaluated on 2D MRI, 3D T2-SPACE MRI, and surgical findings. The pedicle height, vertebral body height (VH), proximal tilting angle of nerve root (PTA) were measured on MR images. Results The sensitivity, specificity, PPV, NPV, and accuracy by 2D MRI were 78.3%, 72.7%, 94.9%, 34.0%, and 77.6%, respectively. For 3D T2-SPACE MRI imaging, the sensitivity, specificity, PPV, NPV, and accuracy were 91.6%, 86.4%, 97.8%, 61.3%, and 90.9%, respectively. 2D MRI and 3D T2-SPACE MRI for detection of intra-foramen and extra-foramen nerve compression showed poor homogeneity (Kappa = 0.333, Kappa = 0.276, respectively). Smaller VHs and larger PTAs could be indicators for the diagnosis of foraminal nerve root compression. Conclusions 3D T2-SPACE MRI had a higher sensitivity, specificity, PPV, NPV, and accuracy than 2D MRI for detecting LNRC. The 3D T2-SPACE scan could be a good substitute to routine 2D MRI in LNRC diagnosis, especially for foraminal nerve root compression patients. Level of evidence III. Keywords Lumbosacral nerve root · Three-dimensional · Magnetic resonance imaging · Diagnosis
Chao Kong and Xiang-Yu Li contributed equally to this work. * Jie Lu [email protected] * Shi‑Bao Lu [email protected] 1
Department of Orthopedics, Xuanwu Hospital, Capital Medical University, No.45 Changchun Street, Xicheng District, Beijing 10053, China
2
Department of Radiology, Xuanwu Hospital, Capital Medical University, No.45 Changchun Street, Xicheng District, Beijing 10053, China
3
National Clinical Research Center for Geriatric Diseases, Beijing 10053, China
4
Department of Interdisciplinary Life Science, Purdue University, West Lafayette, IN 47907, USA
Introduction Lumbosacral nerve root compression (LNRC) is a common disease that leads to low back pain and radicular pain. Lumbar disc herniation and lumbar spinal stenosis are two of the most usual causes of LNRC [1–4]. Traditional twodimensional (2D) fast spin-echo (FSE) magnetic resonance imaging (MRI) is the most important tool to assess LNRC and define pa
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