Multi-echo in steady-state acquisition improves MRI image quality and lumbosacral radiculopathy diagnosis efficacy...

Area of Science:

• Radiology
• Medical Imaging
• Neurology

Background:

• Lumbosacral plexus nerve root lesions require accurate imaging for diagnosis and treatment planning.
• Conventional MRI protocols can be time-consuming, potentially impacting patient comfort and throughput.
• Comparing novel, time-efficient techniques with established methods is crucial for advancing diagnostic capabilities.

Purpose of the Study:

• To compare the diagnostic performance of a 4-minute multi-echo in steady-state acquisition (MENSA) protocol against a 6-minute fast spin echo with variable flip angle (CUBE) protocol for lumbosacral plexus nerve root lesions.
• To evaluate image quality, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) between the two MRI sequences.
• To assess the diagnostic accuracy, sensitivity, and specificity of MENSA versus CUBE for detecting nerve root lesions.

Main Methods:

• Seventy-two subjects underwent both MENSA and CUBE MRI sequences on a 3.0-T scanner.
• Two musculoskeletal radiologists independently assessed image quality and diagnostic capability using a scoring system.
• Quantitative analysis included nerve root SNR, iliac vein CNR, and muscle CNR, with surgical reports serving as the reference standard.

Main Results:

• MENSA demonstrated significantly higher image quality ratings, nerve root SNR, iliac vein CNR, and muscle CNR compared to CUBE (P < 0.05).
• MENSA achieved higher sensitivity (96.23%), specificity (89.47%), accuracy (94.44%), and AUC (0.929) for lesion detection than CUBE.
• Both intraobserver and interobserver reliability were substantial to perfect for both sequences, with MENSA showing excellent diagnostic performance.

Conclusions:

• The 4-minute MENSA protocol provides superior image quality and high vascular contrast for lumbosacral imaging.
• MENSA offers a time-efficient alternative with high diagnostic accuracy for lumbosacral plexus nerve root lesions.
• MENSA has the potential to improve the detection and characterization of nerve root abnormalities.