RESUMO
To evaluate the ability of double-echo steady-state (DESS) MRI to detect pars interarticularis fracture and bone marrow edema (BME) in spondylolysis, 500 lumber pars interarticularis from 50 consecutive patients (38 males and 12 females, mean age 14.2 ± 3.28 years) with spondylolysis who underwent both MRI and CT within 1 week were evaluated. All participants were young athletes who complained of lower back pain. Fractures were classified into four grades and CT was used as a reference; BME was evaluated in a binary manner and STIR was used as a reference. The diagnostic performance of fractures on DESS and T1WI, and BME on DESS was assessed by two radiologists independently. For fracture detection, DESS showed high diagnostic performance at a sensitivity of 94%, specificity of 99.5%, and accuracy of 98.8%, whereas T1WI showed lower sensitivity (70.1%). Fracture grading performed by DESS showed excellent agreement with CT grading (Kappa = 0.9). For BME, the sensitivity, specificity, and accuracy of DESS were 96.5%, 100%, and 99.6%, respectively. The inter-rater agreement of DESS for fracture and BME was 0.8 and 0.85, respectively. However, the inter-rater agreement for fracture on T1WI was 0.52. DESS had high diagnostic performance for fracture and BME in pars interarticularis. In conclusion, DESS had potential to detect all critical imaging findings in spondylolysis and may replace the role of CT.
RESUMO
PURPOSE: T1WI (T1 weighted image) was acquired in order to grade bone fusion following the studies by FIFA (Federation Internationale de Football Associations). Research using images other than T1WI has not been reported. The aim of this study is to evaluate the grade of epiphyseal fusion by T2* weighted images (T2*WI) and to investigate new findings on T2*WI as compared with T1WI. METHODS: A total of 87 subjects, all junior football players between the ages of 12 and 17 years old, were examined. T1 and T2* WI were obtained using a 1.2T Open type MR system. The T1WI and T2*WI were rated twice randomly by four radiologists using the FIFA grading system. RESULTS: The intra-rater reliability for grading was higher in T1WI (The Intraclass Correlation Coefficient (ICC)=0.949-0.985) than in T2*WI (ICC=0.917-0.943). The inter-rater reliability for grading was also higher in T1WI (ICC=0.923) than in T2*WI (ICC=0.867). CONCLUSIONS: This research showed that T1WI is a better sequence than T2*WI to evaluate bone fusion following FIFA protocol. It was speculated that the reason for this is that T1WI has higher tissue contrast resolution and enables clearer images of the epiphyseal fusion than T2*WI and the grading system by T1WI was not suitable for T2*WI.
RESUMO
PURPOSE: This study was performed to introduce and evaluate the potential of kinematic magnetic resonance imaging (KMRI) using a high-field open-magnet magnetic resonance (MR) system. METHODS: We attempted to perform KMRI of healthy volunteers' lumbar spine and knee in the lateral position and ankle in the supine position utilizing the superconducting, horizontally opened, 1.2 T MR system (OASIS, HITACHI, Tokyo, Japan). For the KMRI of the lumbar spine, the volunteer had to lie on one side while maintaining maximally anteflexed, neutral, and maximally retroflexed positions and remain still for the duration of the acquisition time for each posture. In the same way, KMRI of the knee was performed with the volunteer's knee flexed at 0°, 30°, 60°, 90°, and 120° in the lateral position, and KMRI of the ankle was performed with the volunteer's ankle in maximally dorsiflexed, neutral, and maximally plantarflexed positions while lying in the supine position. RESULTS: We could acquire higher quality kinematic MR images than those acquired using low-field MR systems. The spinal canal, intervertebral discs and foramina, and facet joints in lumbar spine KMRI; the ligaments, menisci and patellofemoral joint in knee KMRI; and the tibiotalar articulation and peroneal tendon in ankle KMRI were clearly depicted. CONCLUSION: The results of our pilot trial indicated that a superconducting horizontally opened, 1.2 T MR system offers high-quality KMRI images and can be utilized for the kinematic diagnosis and evaluation of sports injuries.
