Restricted magnetic resonance imaging of the lumbar backbone has excessive sensitivity for detection of acute fractures, an infection, and malignancy.
Skeletal Radiol. 2016 Dec;45(12):1687-1693
Authors: Wang B, Fintelmann FJ, Kamath RS, Kattapuram SV, Rosenthal DI
OBJECTIVE: The target of this research is to find out how a restricted protocol MR examination compares to a full standard MR examination for the detection of non-degenerative pathology reminiscent of acute fracture, an infection, and malignancy.
MATERIALS AND METHODS: A pattern of 349 non-contrast MR exams was chosen retrospectively containing a three:1:1:1 distribution of adverse/degenerative change solely, acute fracture, an infection, and malignancy. This resulted in a good distribution of pathology and non-pathology. A restricted protocol MR examination was simulated by extracting T1-weighted sagittal and T2-weighted fat-saturated (or STIR) sagittal sequences from every examination and submitting them for blinded assessment by two skilled musculoskeletal radiologists. The exams have been evaluated for the presence or absence of non-degenerative pathology. Interpretation of the restricted examination was in comparison with the unique report of the total examination. If both reader disagreed with the unique report, the case was submitted for an unblinded adjudication course of with the participation of a 3rd musculoskeletal radiologist to determine a consensus prognosis.
RESULTS: There have been 5 false negatives for a sensitivity of 96.9 % for the restricted protocol MR examination. An infection within the psoas, paraspinal muscle tissues, and sacroiliac joint, in addition to acute fractures in transverse processes and sacrum have been missed by a number of readers. No circumstances of malignancy have been missed. General diagnostic accuracy was 96.zero % (335/349).
CONCLUSIONS: MR imaging of the lumbar backbone restricted to sagittal T1-weighted and sagittal T2 fat-saturated (or STIR) sequences has excessive sensitivity for the detection of acute fracture, an infection, or malignancy in comparison with a standard MR examination.
PMID: 27726015 [PubMed – indexed for MEDLINE]