Fast-field-echo resembling a CT using restricted echo-spacing (FRACTURE) can differentiate osteophytes from disc...

To evaluate the diagnostic performance of fast-field-echo resembling a CT using restricted echo-spacing (FRACTURE) for differentiating cervical osteophytes and disc herniations.

Patients suspected of cervical radiculopathy (CR) with FRACTURE, conventional MRI, and CT scans were retrospectively included between October 17, 2023 and July 24, 2024. A total of 43 patients (20 women, 23 men; mean age, 57.3 ± 1.8 years) were enrolled and 516 intervertebral foramina were analyzed from bilateral C2/3 to C7/T1 on sagittal images. CT combined with MRI was the reference standard to identify osteophytes and disc herniations. The diagnostic performance of different images for identifying osteophytes and disc herniations was evaluated. The inter-modality differences, correlations, and agreements were assessed by measuring the sizes of osteophytes and disc herniations.

For osteophytes, the sensitivity and specificity of FRACTURE were 94.7 % and 98.9 %, respectively; the area under the curve (AUC) of FRACTURE (AUC = 0.968) was significantly higher than that of T1WI (AUC = 0.688) and T2WI (AUC = 0.738). For disc herniations, the sensitivity and specificity of FRACTURE were 95.6 % and 99.2 %, respectively; the AUC of FRACTURE (AUC = 0.974) was also significantly higher than that of T1WI (AUC = 0.855) and T2WI (AUC = 0.864). A strong correlation (R² = 0.84) and an excellent agreement (ICC = 0.917) were achieved between FRACTURE and CT for osteophytes measurements. Strong correlations and excellent agreements were also obtained for disc herniations measurements between FRACTURE and T1WI (R² = 0.82, ICC = 0.990)/T2WI (R² = 0.92, ICC = 0.951).

FRACTURE enables the reliable differentiation of osteophytes and disc herniations in patients with CR.