An Optimized CT Protocol for Detecting Suspected Cauda Equina Syndrome: A Comparative Analysis with MRI.

Area of Science:

• Radiology
• Diagnostic Imaging
• Neurosurgery

Background:

• Lumbar disc herniation can cause nerve compression and cauda equina syndrome.
• MR imaging is standard but often unavailable in emergencies.
• Limited MR imaging access presents challenges for timely diagnosis.

Purpose of the Study:

• To evaluate an optimized CT lumbar spine protocol.
• To assess CT's diagnostic accuracy as an alternative to MR imaging.
• To determine CT's utility in suspected neural compression cases.

Main Methods:

• Prospective enrollment of patients with suspected lumbar disc herniation or cauda equina syndrome.
• An optimized CT protocol was used to assess spinal stenosis.
• An expert radiologist, blinded to clinical data, graded CT and MR imaging findings.

Main Results:

• CT demonstrated high diagnostic accuracy compared to MR imaging (sensitivity/specificity 97%).
• CT correctly identified all cases requiring urgent surgical decompression.
• CT accurately predicted MR imaging findings in 97% of cases.

Conclusions:

• Optimized CT is a valuable tool for diagnosing lumbar disc herniation and neural compression.
• CT can serve as an adjunct to MR imaging in emergency settings with limited access.
• This CT protocol can improve emergency resource allocation and patient triage.