TY - JOUR
T1 - Degenerative narrowing of the cervical spine neural foramina
T2 - Evaluation with high-resolution 3DFT gradient-echo MR imaging
AU - Yousem, D. M.
AU - Atlas, S. W.
AU - Goldberg, H. I.
AU - Grossman, R. I.
PY - 1991/1/1
Y1 - 1991/1/1
N2 - Conventional two-dimensional Fourier transform (2DFT) MR evaluation of osteophytic disease of the cervical neural foramina is limited by section thickness, signal-to-noise problems, and CSF flow artifacts. We evaluated the role of thin-section, high-resolution, gradient-refocused three-dimensional Fourier transform (3DFT) MR imaging in assessing degenerative foraminal narrowing in the cervical spine. Contiguous 1.5-mm axial 3DFT gradient-recalled acquisition in the steady state MR images of 120 neural foramina at 60 disk levels were evaluated blindly and independently by three neuroradiologists. High-resolution axial CT was used as the gold standard in all patients. 3DFT MR was found to agree with CT in the detection of neural foraminal narrowing and in the determination of the cause of the narrowing in approximately 76% of neural foramina. The accuracy for the assessment of neural foraminal narrowing on 3DFT MR ranged from 73% to 82% when a 5°-flip-angle, high-intensity CSF technique was used. When using the 30°-flip-angle, low-intensity CSF technique, the accuracy ranged from 66% to 86%. When the cause of narrowing was evaluated, the 5° and 30° studies agreed with CT in 70-92% and 48-88% of the levels, respectively. When lesions were missed on MR, it was usually because of osteophytic disease. The interobserver concordance of MR and CT interpretations was higher for detecting the presence of narrowing than its cause. This MR technique is a useful method in the evaluation of foraminal stenosis since contrast between disk, cord, osteophyte, and CSF is high without the need for intrathecal injections. The wide range of interpreter accuracy and interobserver correlation is attributed to a steep learning curve for evaluating the MR images.
AB - Conventional two-dimensional Fourier transform (2DFT) MR evaluation of osteophytic disease of the cervical neural foramina is limited by section thickness, signal-to-noise problems, and CSF flow artifacts. We evaluated the role of thin-section, high-resolution, gradient-refocused three-dimensional Fourier transform (3DFT) MR imaging in assessing degenerative foraminal narrowing in the cervical spine. Contiguous 1.5-mm axial 3DFT gradient-recalled acquisition in the steady state MR images of 120 neural foramina at 60 disk levels were evaluated blindly and independently by three neuroradiologists. High-resolution axial CT was used as the gold standard in all patients. 3DFT MR was found to agree with CT in the detection of neural foraminal narrowing and in the determination of the cause of the narrowing in approximately 76% of neural foramina. The accuracy for the assessment of neural foraminal narrowing on 3DFT MR ranged from 73% to 82% when a 5°-flip-angle, high-intensity CSF technique was used. When using the 30°-flip-angle, low-intensity CSF technique, the accuracy ranged from 66% to 86%. When the cause of narrowing was evaluated, the 5° and 30° studies agreed with CT in 70-92% and 48-88% of the levels, respectively. When lesions were missed on MR, it was usually because of osteophytic disease. The interobserver concordance of MR and CT interpretations was higher for detecting the presence of narrowing than its cause. This MR technique is a useful method in the evaluation of foraminal stenosis since contrast between disk, cord, osteophyte, and CSF is high without the need for intrathecal injections. The wide range of interpreter accuracy and interobserver correlation is attributed to a steep learning curve for evaluating the MR images.
UR - http://www.scopus.com/inward/record.url?scp=0025861836&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0025861836&partnerID=8YFLogxK
M3 - Article
AN - SCOPUS:0025861836
SN - 0361-803X
VL - 156
SP - 1229
EP - 1236
JO - The American journal of roentgenology and radium therapy
JF - The American journal of roentgenology and radium therapy
IS - 6
ER -