Three-dimensional turbo spin-echo sequence versus conventional two-dimensional turbo spin-echo sequences in the evaluation of lumbar intervertebral discs

Year 2018, Volume: 4 Issue: 4, 366 - 373, 04.10.2018

Volkan Kızılgöz Ali Kemal Sivrioğlu Hasan Aydın Sunay Sibel Karayol Can Hakan Yıldırım Utku Menderes

https://doi.org/10.18621/eurj.354357

Abstract

Objective: The aim of this
study was to evaluate the efficacy of a three-dimensional (3D) turbo spin-echo
(TSE) sequence for determining lumbar disc protrusions, and to compare the
findings with those of conventional two-dimensional (2D) TSE sequences and
reveal the interobserver and intermethod agreements of both sequences.

Methods:
A total of 127 discs from 84 patients were evaluated by three
radiologists. Conventional 2D TSE images and 3D TSE images were independently
interpreted with regard to disc pathology and herniation zones and were scored
for the degree of spinal stenosis and lumbar neural foraminal stenosis by the
three reviewers. To evaluate the lumbar discs, areas of protrusion or extrusion
were classified. Interobserver and intermethod reliabilities were calculated
using Krippendorff’s alpha (Kα) test.

Results: Lumbar disc pathology
identification was similar between the 2D TSE and 3D TSE sequences.
Interobserver agreements were better for 3D TSE than 2D TSE in the evaluation
of disc hernias (Kα ratio; 0.965 vs. 0.944), herniation zones (Kα ratio; 0.894
vs. 0.847), and foraminal narrowing (Kα ratio; 0.965 vs. 0.924). Both 2D and 3D
TSE had 100% sensitivity for disc pathologies and spinal stenosis, 81%
sensitivity for herniation zones, and 92.5% sensitivity for foraminal stenosis
in only operated patients.

Conclusions: The 3D TSE sequence was
comparable to conventional magnetic resonance imaging (MRI) sequences in the
evaluation of lumbar disc herniation. This approach can be used in radiology
departments either alone or combined with routine MRI for lumbar disc hernias
as a diagnostic sequence and an approach to overcome problems. 

Keywords

Magnetic resonance imaging, spin echo imaging, intervertebral disc, spine

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