Comparison of multiple different MR-based bone imaging sequences, CT and histopathology for the assessment of degenerative changes of the spine

Zielsetzung To evaluate the performance of different MR-based bone imaging sequences for imaging of degenerative changes of the spine in comparison to CT and histopathology.

Material und Methoden The lumbar segments L2 to L4 of 20 human cadaveric spine specimens were examined using the following MR-based bone imaging sequences: 3D T1w spoiled gradient-echo sequence (T1SGRE), susceptibility-weighted imaging (SWI) and ultra-short echo time optimized for both bone (UTEb) and cartilage (UTEc) imaging. Moreover, morphological MRI sequences (T1, T2, STIR), histopathology and conventional CT were acquired as standard of reference. Semi-quantitative and quantitative morphological features of degenerative changes of the spines were evaluated by two radiologists independently on CT and MRI. Agreement between bone MR sequences and standard of reference were assessed using weighted Cohen’s κ.

Ergebnisse For the morphological assessment of degenerative changes, the overall agreement between SWI, T1SGRE images, UTE bone, and UTE cartilage images with the standard of reference was substantial to excellent (Osteophytes: SWI, κ 0.80 (95% confidence interval 0.59-1.00); T1SGRE, 0.90 (0.81-1.00); UTEb, 0.91 (0.82-1.00); Sclerosis: SWI, 0.77 (0.56-0.95); T1SGRE, 0.85 (0.76-11.00); UTEb, 0.75 (0.64-0.91)). For the visualization of the cartilaginous endplate, UTEc showed the overall best agreement ((UTEc, 0.82 (0.70-0.94), SWI, 0.51 (0.34-0.72); T1SGRE, 0.78 (0.62-0.94)). Inter-reader agreement over all parameters and MRI sequences was excellent (0.91 (0.78-1.00)).

Schlußfolgerungen Morphological assessment of degenerative changes of the spine were feasible and accurate using the MR-based bone imaging sequences compared to CT and histopathology, whereas T1SGRE showed the overall best performance for osseous changes and UTEc for the visualization of the cartilaginous endplate.

Publication History

Article published online:
29 August 2022