mFFE CT-like MRI Sequences for the Assessment of Vertebral Fractures
Objectives: The aim of this study was to evaluate the diagnostic performance, image quality, and inter- and intra-observer agreement of the 3D T1 multi-echo fast field echo (mFFE) sequence in cervico-thoraco-lumbar vertebral fractures compared with conventional computed tomography (CT) as the gold s...
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MDPI AG
2024-10-01
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| author | David Ferreira Branco Hicham Bouredoucen Marion Hamard Karel Gorican Pierre-Alexandre Poletti Bénédicte Marie Anne Delattre Sana Boudabbous |
| author_facet | David Ferreira Branco Hicham Bouredoucen Marion Hamard Karel Gorican Pierre-Alexandre Poletti Bénédicte Marie Anne Delattre Sana Boudabbous |
| author_sort | David Ferreira Branco |
| collection | DOAJ |
| description | Objectives: The aim of this study was to evaluate the diagnostic performance, image quality, and inter- and intra-observer agreement of the 3D T1 multi-echo fast field echo (mFFE) sequence in cervico-thoraco-lumbar vertebral fractures compared with conventional computed tomography (CT) as the gold standard. Methods: We conducted a prospective single-centre study including 29 patients who underwent spinal magnetic resonance imaging (MRI) at the surgeon’s request, in addition to CT for vertebral fracture assessment and classification. A 3D T1 mFFE sequence was added to the standard MRI protocol. Consecutively, two readers analyzed the 3D mFFE sequence alone, the 3D mFFE sequence with the entire MRI protocol, including the STIR and T1 sequences, and, finally, the CT images in random order and 1 month apart. A standardized assessment was performed to determine the presence or absence of a fracture, its location, its classification according to the Genant and AO classifications for traumatic and osteoporotic fractures, respectively, the loss of height of the anterior and posterior walls of the vertebral body, and the presence of concomitant disco-ligamentous lesions. Contingency tables, intraclass correlation coefficients, and Cohen’s kappa tests were used for statistical analysis. Results: A total of 25 fractures were recorded (48% cervical, 20% thoracic, and 32% lumbar), of which 52% were classified A, according to the AO classification system. The quality of the 3D mFFE image was good or excellent in 72% of cases. Inter-observer agreement was near perfect (0.81–1) for vertebral body height and for AO and Genant classifications for all modalities. Intra-observer agreement was strong-to-near perfect between CT and the 3D mFFE sequence. Regarding the diagnostic performance of the 3D mFFE sequence, the sensitivity was 0.9200 and 0.9600, the specificity was 0.9843 and 0.9895, and the accuracy was 0.9861 and 0.9769 for Readers 1 and 2, respectively. In addition, up to 40% of intervertebral disc lesions and 33% of ligamentous lesions were detected by the 3D mFFE sequence compared to CT, allowing four AO type A fractures to be reclassified as type B. Conclusions: The 3D mFFE sequence allows accurate diagnosis of vertebral fractures, with superiority over CT in detecting disco-ligamentous lesions and a more precise classification of fractures, which can prompt clinicians to adapt their management despite an image quality that still requires improvement in some cases. Key points: Vertebral fractures and disco-ligamentous lesions can be assessed using CT-like MRI sequences, with 3D T1 mFFE being superior to CT for the detection of disco-ligamentous lesions. CT-like images using the 3D T1 mFFE sequence improve the diagnostic accuracy of bone structures in MRI. |
| format | Article |
| id | doaj-art-bc733320d07742b2ae7496b504040b8d |
| institution | Kabale University |
| issn | 2075-4418 |
| language | English |
| publishDate | 2024-10-01 |
| publisher | MDPI AG |
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| series | Diagnostics |
| spelling | doaj-art-bc733320d07742b2ae7496b504040b8d2024-11-08T14:34:55ZengMDPI AGDiagnostics2075-44182024-10-011421243410.3390/diagnostics14212434mFFE CT-like MRI Sequences for the Assessment of Vertebral FracturesDavid Ferreira Branco0Hicham Bouredoucen1Marion Hamard2Karel Gorican3Pierre-Alexandre Poletti4Bénédicte Marie Anne Delattre5Sana Boudabbous6Geneva University Hospitals, Rue Gabrielle-Perret-Gentil 4, 1205 Geneva, SwitzerlandGeneva University Hospitals, Rue Gabrielle-Perret-Gentil 4, 1205 Geneva, SwitzerlandGeneva University Hospitals, Rue Gabrielle-Perret-Gentil 4, 1205 Geneva, SwitzerlandGeneva University Hospitals, Rue Gabrielle-Perret-Gentil 4, 1205 Geneva, SwitzerlandGeneva University Hospitals, Rue Gabrielle-Perret-Gentil 4, 1205 Geneva, SwitzerlandGeneva University Hospitals, Rue Gabrielle-Perret-Gentil 4, 1205 Geneva, SwitzerlandGeneva University Hospitals, Rue Gabrielle-Perret-Gentil 4, 1205 Geneva, SwitzerlandObjectives: The aim of this study was to evaluate the diagnostic performance, image quality, and inter- and intra-observer agreement of the 3D T1 multi-echo fast field echo (mFFE) sequence in cervico-thoraco-lumbar vertebral fractures compared with conventional computed tomography (CT) as the gold standard. Methods: We conducted a prospective single-centre study including 29 patients who underwent spinal magnetic resonance imaging (MRI) at the surgeon’s request, in addition to CT for vertebral fracture assessment and classification. A 3D T1 mFFE sequence was added to the standard MRI protocol. Consecutively, two readers analyzed the 3D mFFE sequence alone, the 3D mFFE sequence with the entire MRI protocol, including the STIR and T1 sequences, and, finally, the CT images in random order and 1 month apart. A standardized assessment was performed to determine the presence or absence of a fracture, its location, its classification according to the Genant and AO classifications for traumatic and osteoporotic fractures, respectively, the loss of height of the anterior and posterior walls of the vertebral body, and the presence of concomitant disco-ligamentous lesions. Contingency tables, intraclass correlation coefficients, and Cohen’s kappa tests were used for statistical analysis. Results: A total of 25 fractures were recorded (48% cervical, 20% thoracic, and 32% lumbar), of which 52% were classified A, according to the AO classification system. The quality of the 3D mFFE image was good or excellent in 72% of cases. Inter-observer agreement was near perfect (0.81–1) for vertebral body height and for AO and Genant classifications for all modalities. Intra-observer agreement was strong-to-near perfect between CT and the 3D mFFE sequence. Regarding the diagnostic performance of the 3D mFFE sequence, the sensitivity was 0.9200 and 0.9600, the specificity was 0.9843 and 0.9895, and the accuracy was 0.9861 and 0.9769 for Readers 1 and 2, respectively. In addition, up to 40% of intervertebral disc lesions and 33% of ligamentous lesions were detected by the 3D mFFE sequence compared to CT, allowing four AO type A fractures to be reclassified as type B. Conclusions: The 3D mFFE sequence allows accurate diagnosis of vertebral fractures, with superiority over CT in detecting disco-ligamentous lesions and a more precise classification of fractures, which can prompt clinicians to adapt their management despite an image quality that still requires improvement in some cases. Key points: Vertebral fractures and disco-ligamentous lesions can be assessed using CT-like MRI sequences, with 3D T1 mFFE being superior to CT for the detection of disco-ligamentous lesions. CT-like images using the 3D T1 mFFE sequence improve the diagnostic accuracy of bone structures in MRI.https://www.mdpi.com/2075-4418/14/21/2434magnetic resonance imagingCT-likebonedisc and ligamentous lesionsspinespinal fracture |
| spellingShingle | David Ferreira Branco Hicham Bouredoucen Marion Hamard Karel Gorican Pierre-Alexandre Poletti Bénédicte Marie Anne Delattre Sana Boudabbous mFFE CT-like MRI Sequences for the Assessment of Vertebral Fractures Diagnostics magnetic resonance imaging CT-like bone disc and ligamentous lesions spine spinal fracture |
| title | mFFE CT-like MRI Sequences for the Assessment of Vertebral Fractures |
| title_full | mFFE CT-like MRI Sequences for the Assessment of Vertebral Fractures |
| title_fullStr | mFFE CT-like MRI Sequences for the Assessment of Vertebral Fractures |
| title_full_unstemmed | mFFE CT-like MRI Sequences for the Assessment of Vertebral Fractures |
| title_short | mFFE CT-like MRI Sequences for the Assessment of Vertebral Fractures |
| title_sort | mffe ct like mri sequences for the assessment of vertebral fractures |
| topic | magnetic resonance imaging CT-like bone disc and ligamentous lesions spine spinal fracture |
| url | https://www.mdpi.com/2075-4418/14/21/2434 |
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