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Multi-echo in steady-state acquisition improves MRI image quality and lumbosacral radiculopathy diagnosis efficacy compared with T2 fast spin-echo sequence

  • Spinal Neuroradiology
  • Published:
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Abstract

Purpose

This study compares the performance of a 4-min multi-echo in steady-state acquisition (MENSA) with a 6-min fast spin echo with variable flip angle (CUBE) protocol for the assessment of lumbosacral plexus nerve root lesions.

Methods

Seventy-two subjects underwent MENSA and CUBE sequences on a 3.0-T MRI scanner. Two musculoskeletal radiologists independently assessed the images for quality and diagnostic capability. A qualitative assessment scoring system for image quality and quantitative nerve signal-to-noise ratio (SNR) and iliac vein and muscle contrast-to-noise ratios (CNR) was applied. Using surgical reports as the reference, sensitivity, specificity, accuracy, and area under the receiver operating characteristic curves (AUC) were evaluated. Intraclass correlation coefficients (ICC) and weighted kappa were used to calculate reliability.

Results

MENSA image quality rating (3.679 ± 0.47) was higher than for CUBE images (3.038 ± 0.68), and MENSA showed higher mean nerve root SNR (36.935 ± 8.33 vs. 27.777 ± 7.41), iliac vein CNR (24.678 ± 6.63 vs. 5.210 ± 3.93), and muscle CNR (19.414 ± 6.07 vs. 13.531 ± 0.65) than CUBE (P < 0.05). Weighted kappa and ICC values indicated good reliability. Sensitivity, specificity, and accuracy of diagnosis based on MENSA images were 96.23%, 89.47%, and 94.44%, respectively, and AUC was 0.929, compared with 92.45%, 84.21%, 90.28%, and 0.883 for CUBE images. The two correlated ROC curves were not significantly different. Weighted kappa values for intraobserver (0.758) and interobserver (0.768–0.818) reliability were substantial to perfect.

Conclusion

A time-efficient 4-min MENSA protocol exhibits superior image quality and high vascular contrast with the potential to produce high-resolution lumbosacral nerve root images.

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Data Availability

The data that support the findings of this study are available from the corresponding author, Xiaoming Li, upon reasonable request.

Abbreviations

3D:

Three-dimensional

TSE:

Turbo spin echo

FSE:

Fast spin echo

TR:

Repetition time

SSFP-FID:

Steady-state free precession-free induction decay

SNR:

Signal-to-noise ratio

CNR:

Contrast-to-noise ratio

CR:

Contrast ratio

MENSA:

Multi-echo in steady-state acquisition

CUBE:

3D fast spin echo with variable flip angle

ROC:

Receiver operating characteristics

AUC:

Areas under receiver operating characteristics curves

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Funding

This study was supported by the National Natural Science Foundation of China (NSFC) (No. 81930045).

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Authors and Affiliations

  1. Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095, Jiefang Road, Wuhan City, 430030, Hubei Province, China

    Shuang Hu, Yitong Li, Bowen Hou, Yao Zhang, Gang Wu & Xiaoming Li

  2. MR Research, GE Healthcare, Beijing, China

    Weiyin Vivian Liu

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  1. Shuang Hu
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  2. Yitong Li
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  4. Yao Zhang
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  6. Gang Wu
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  7. Xiaoming Li
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Correspondence to Gang Wu or Xiaoming Li.

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Ethical approval was waived by the Institutional Review Board of Tongji hospital.

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Informed consent was obtained from all individual participants included in the study.

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Hu, S., Li, Y., Hou, B. et al. Multi-echo in steady-state acquisition improves MRI image quality and lumbosacral radiculopathy diagnosis efficacy compared with T2 fast spin-echo sequence. Neuroradiology 65, 969–977 (2023). https://doi.org/10.1007/s00234-023-03130-z

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