Evaluation of syringomyelia with three-dimensional constructive interference in a steady state (CISS) sequence

Area of Science:

• Radiology
• Medical Imaging
• Neurology

Background:

• Syringomyelia is a condition characterized by the formation of fluid-filled cavities within the spinal cord.
• Accurate assessment of syringomyelia's extent and internal structure is crucial for diagnosis and treatment planning.
• Conventional magnetic resonance imaging (MRI) sequences, such as spin-echo (SE), have limitations in visualizing these details.

Purpose of the Study:

• To evaluate the efficacy of the three-dimensional constructive interference in steady state (3D-CISS) sequence for assessing syringomyelia.
• To compare the diagnostic performance of 3D-CISS with conventional T1- and T2-weighted SE sequences.
• To determine the optimal MRI technique for visualizing syringomyelia's characteristics.

Main Methods:

• Prospective study of eleven patients diagnosed with syringomyelia.
• Acquisition of sagittal MRI images using T1-weighted SE, T2-weighted SE, and 3D-CISS sequences.
• Comparative analysis of image quality, artifacts, visualization of syrinx extent and internal structure, and contrast-to-noise ratio (CNR).

Main Results:

• 3D-CISS demonstrated significantly better contrast between the spinal cord and cerebrospinal fluid (CSF) compared to T1-weighted SE (P < 0.01).
• CSF flow artifacts were significantly reduced with 3D-CISS compared to T2-weighted SE (P < 0.01).
• 3D-CISS, particularly with multiplanar reconstruction (MPR), excelled in visualizing syrinx extent, internal structures, septations, and cavity communications.

Conclusions:

• The 3D-CISS sequence provides superior visualization of syringomyelia compared to conventional SE sequences.
• 3D-CISS should be incorporated into MRI protocols for evaluating syringomyelia.
• This advanced sequence enhances the detailed assessment of syrinx morphology, improving diagnostic accuracy.