Objective : The three-dimensional magnetic resonance imaging (3D MRI) has facilitated image acquisition without slice gaps, with studies reporting its effectiveness in visualizing the lower cranial nerves. The 3D T2 sampling perfection with application-optimized contrast using different flip angle evolution (3D T2-SPACE) sequence is a 3D turbo spin-echo sequence that produces images with fewer cerebrospinal fluid flow artifacts and higher resolutions. In this study, we evaluated the visualization ability of the 3D T2-SPACE sequence in the cervical spine.
Materials : We included 62 patients (39 men and 23 women ; mean age, 58 [14-85] years) who were admitted to our hospital with cervical spine lesions and were imaged with 2D T2-weighted image (T2WI) and 3D T2-SPACE sequences between April 2017 and March 2019. Data from 39 patients (23 men and 16 women ; mean age, 60 [17-80] years) were measured under identical conditions and with the same equipment to subsequently evaluate the contrast-to-noise ratio (CNR).
Methods : We used the CNR in sagittal 2D T2WI and 3D T2-SPACE images to assess the visibility of anatomical structures by comparing the spinal cord, vertebral body, intervertebral disc, posterior longitudinal ligament, subcutaneous fat, and semispinalis cervicis muscle with the cerebrospinal fluid. We used the EU-proposed method for calculating CNR and paired t-tests for statistical analysis.
Results : The 3D T2-SPACE sequence produced high-resolution multiplanar reconstruction images in considerably thin slices within 5-6 minutes. This sequence was particularly effective in examining cases of scoliosis and paraforaminal lesions, which is particularly challenging when using slice gaps in the 2D T2WI. Furthermore, the 3D T2-SPACE sequence showed fewer cerebrospinal fluid flow and magnetic susceptibility artifacts and a higher CNR than the 2D T2WI sequence (p<0.01). The tissue contrast was significantly better in 3D T2-SPACE than in 2D T2WI images, which ensured excellent visibility.
Conclusions : The 3D T2-SPACE sequence compensated for the disadvantages of the 3D gradient echo sequence. It generated a higher CNR than the 2D T2WI sequence. The 3D T2-SPACE sequence may have superior visibility over conventional methods and could be used as an alternative imaging method.
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