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CC BY-NC-ND 4.0 · Indian J Radiol Imaging 2023; 33(03): 327-331
DOI: 10.1055/s-0043-1764490
Original Article

Does Chemical Shift Magnetic Resonance Imaging Improve Visualization of Pars Interarticularis Defect?

Emily Smith
1   Department of Radiology, Russells Hall Hospital, Dudley, United Kingdom
,
Neha Nischal 
2   Department of Musculoskeletal Radiology, Royal Orthopaedic Hospital, Birmingham, United Kingdom
,
Jennifer Murphy
2   Department of Musculoskeletal Radiology, Royal Orthopaedic Hospital, Birmingham, United Kingdom
,
Christine Azzopardi
2   Department of Musculoskeletal Radiology, Royal Orthopaedic Hospital, Birmingham, United Kingdom
,
Karthikeyan P. Iyengar 
3   Department of Orthopedics, Southport and Ormskirk Hospital, Southport, United Kingdom
,
Shahnawaz Haleem 
4   Department of Spine Surgery, Royal Orthopaedic Hospital, Birmingham, United Kingdom
,
Rajesh Botchu
2   Department of Musculoskeletal Radiology, Royal Orthopaedic Hospital, Birmingham, United Kingdom
› Author Affiliations Funding None.
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Abstract

Introduction A unilateral or bilateral pars interarticularis defect (spondylolysis) is a leading cause of axial back pain in adolescent athletes. Currently, a spectrum of imaging modalities is used for assessment of pars interarticularis defects.

Objectives The aim of this study is to compare the accuracy of chemical shift sequence (magnetic resonance imaging [MRI]) technique to conventional MRI sequences in the detection of pars defects.

Patients and Methods Conventional T1, T2, and short tau inversion recovery sagittal and axial, as well as “in-” and “out-” phase chemical shift sagittal MRI sequences of 70 consecutive patients referred for low back pain were reviewed. Demographic details, clinical indication, and presence/diagnosis of pars defects using a 5-point Likert scale on both conventional and chemical shift MRI sequences. Spearman's correlation was used for statistical analysis. Intraclass correlation coefficient analysis was evaluated to assess the intraclass reliability between observers. Data were analyzed using DATAtab web-based statistics software (2022).

Results A total of 70 patients with an average age of 54.34 years with a female predominance were included. There were 11 pars defects in the cohort. Both in and out phases of chemical shift imaging were able to identify pars defect and intact pars. However, out phase was relatively better in delineating pars defects, while the in phase was superior in identifying an intact pars, though this was not statistically significant. There was good intra- and interobserver reliabilities.

Conclusion Chemical shift MRI sequence is a quicker, complementary technique to assess and analyze pars interarticularis confidently than conventionally utilized MRI sequences in patients being evaluated for axial back pain.

Keywords

spondylolysis - magnetic resonance imaging - chemical shift - back pain - athletes


Publication History

Article published online:
20 March 2023

© 2023. Indian Radiological Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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