Added value of coronal-T1W sequence to the lumbar MR imaging protocol for low back pain
Abstract
Introduction: Magnetic resonance imaging (MRI) is the most appropriate imaging method to investigate low back pain. As low back pain is very common, a large number of MRI scans are performed.
Objective: To evaluate the extraspinal findings and clinical effect of the T1-weighted spin echo (T1W SE) coronal sequence added to the lumbar MRI protocol for low back pain.
Materials and methods: In 2015, we added a T1-weighted (T1W) coronal sequence to our routine lumbar MRI protocol. We retrospectively evaluated 969 lumbar MRI images for low back pain performed with this protocol. The extraspinal MRI findings obtained from them were then grouped as associated with low back pain (Category 1) and not associated with low back pain (Category 2). We also evaluated whether the recorded incidental extraspinal findings could be detected on conventional sagittal and axial images.
Results: Ninety-six (63%) of the extraspinal findings were associated with low back pain (Category 1) and 56 (37%), Category 2. Seventy-eight percent of the extraspinal findings were detected only on coronal-T1W images and not on conventional images.
Conclusion: Adding coronal-T1W sequence to the routine protocol of lumbar MRI can help to identify extraspinal findings and guide clinical treatment.
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References
Wu A, March L, Zheng X, Huang J, Wang X, Zhao J, et al. Global low back pain prevalence and years lived with disability from 1990 to 2017: Estimates from the Global Burden of Disease Study 2017. Ann Transl Med. 2020;8:299. https://doi.org/10.21037/atm.2020.02.175
Neelapala YV, Bhagat M, Frey-Law L. Conditioned pain modulation in chronic low back pain: A systematic review of literature. Clin J Pain. 2020;36:135-41. https://doi.org/10.1097/AJP.0000000000000778
Kreiner DS, Matz P, Bono CM, Cho CH, Easa JE, Ghiselli G, et al. Guideline summary review: An evidence-based clinical guideline for the diagnosis and treatment of low back pain. Spine J. 2020;20:998-1024. https://doi.org/10.1016/j.spinee.2020.04.006
Bosmans F, van Goethem J, Vanhoenacker FM. Imaging of degeneration, inflammation, infection, ossification, and calcification of the intervertebral disk. In: Manfrè L, van Goethem J (editors). The Disc and Degenerative Disc Disease. New Procedures in Spinal Interventional Neuroradiology. Cham: Springer; 2020. p. 19-62. https://doi.org/10.1007/978-3-030-03715-4_2
Laplante BL, Ketchum JM, Saullo TR, DePalma MJ. Multivariable analysis of the relationship between pain referral patterns and the source of chronic low back pain. Pain Physician. 2012;15:171-8
Roudsari B, Jarvik JG. Lumbar spine MRI for low back pain: Indications and yield. AJR Am J Roentgenol. 2010;195:550-9. https://doi.org/10.2214/ajr.10.4367
Chou R, Qaseem A, Snow V, Casey D, Cross JT Jr, Shekelle P, et al. Diagnosis and treatment of low back pain: A joint clinical practice guideline from the American College of Physicians and the American Pain Society. Ann intern Med. 2007;147:478-91. https://doi.org/10.7326/0003-4819-147-7-200710020-00006
Douglas NM, Kristine B, Douglas PB, Kavita E, David BH, Stephen A, et al. American College of Radiology. American Society of Neuroradiology (ASNR), Society of Computed Body Tomography and Magnetic Resonance (SCBT-MR). ACR–ASNR–SCBT-MR–SSRPRACTICE Parameter for the performance of magnetic resonance imaging (MRI) of the adult spine. Resolution 18. Citation date: October 11 2020. Available from: https://www.acr.org/-/media/ACR/Files/Practice-Parameters/MR-Adult-Spine.pdf
Razek AAA, Ashmalla G. Assessment of paraspinal neurogenic tumors with diffusionweighted MR imaging. Eur Spine J. 2017;27:841-6. https://doi.org/10.1007/s00586-017-5265-6
Caranci F, Tedeschi E, Ugga L, D’Amico A, Schipani S, Bartollino S, et al. Magnetic resonance imaging correlates of benign and malignant alterations of the spinal bone marrow. Acta Biomed. 2018;89:18-33. https://doi.org/10.23750/abm.v89i1-s.7008
Israel GM, Bosniak MA. An update of the Bosniak renal cyst classification system. Urology. 2005;66:484-8. https://doi.org/10.1016/j.urology.2005.04.003
Lippman SA, Warner M, Samuels S, Olive D, Vercellini P, Eskenazi B. Uterine fibroids and gynecologic pain symptoms in a population-based study. Fertil Steril. 2003;80:1488-94. https://doi.org/10.1016/s0015-0282(03)02207-6
Sharara AI, Mansour NM, El–Hakam M, Ghaith O, El Halabi M. Duration of pain is correlated with elevation in liver function tests in patients with symptomatic choledocholithiasis. Clin Gastroenterol Hepatol. 2010;8:1077-82. https://doi.org/10.1016/j.cgh.2010.08.021
Owlia MB, Danesh-Ardakani M. Frequency of sacroiliitis among patients with low-back pain. Electron Physician. 2016;8:2094-100. https://doi.org/10.19082/2094
Simms RJ, Ong ACM. How simple are ‘simple renal cysts’? Nephrol Dial Transplant. 2014;29:106-12. https://doi.org/10.1093/ndt/gfu106
Gleeson TG, O’Connell MJ, Duke D, Ryan M, Ennis R, Eustace SJ. Coronal oblique turbo STIR imaging of the sacrum and sacroiliac joints at routine MR imaging of the lumbar spine. Emerg Radiol. 2005;12:38-43. https://doi.org/10.1007/s10140-005-0440-1
Gupta R, Mittal P, Mittal A, Mittal K, Gupta S, Kaur R. Additional merit of coronal STIR imaging for MR imaging of lumbar spine. J Craniovertebr Junction Spine. 2015;6:12-5. https://doi.org/10.4103/0974-8237.151582
Quattrocchi CC, Giona A, Di Martino AC, Errante Y, Scarciolla L, Mallio CA, et al. Extraspinal incidental findings at lumbar spine MRI in the general population: A large cohort study. Insights Imaging. 2013;4:301-8. https://doi.org/10.1007/s13244-013-0234-z
Tuncel SA, Çaglı B, Tekataş A, Kırıcı MY, Ünlü E, Gençhellaç H. Extraspinal incidental findings on routine MRI of lumbar spine: Prevalence and reporting rates in 1278 patients. Korean J Radiol. 2015;16:866-73. https://doi.org/10.3348/kjr.2015.16.4.866
Semaan HB, Bieszczad JE, Obri T, Aldinger PK, Bazerbashi MF, Al-Natour MS, et al. Incidental extraspinal findings spine magnetic resonance imaging: A retrospective study. Spine. 2015;40:1436-43. https://doi.org/10.1097/brs.0000000000001024
Park HJ, Jeon YH, Rho MH, Lee EJ, Park NH, Park SI, et al. Incidental finding of the lumbar spine at MRI during herniated intervertebral disk disease evaluation. Am J Roentgenol. 2011;196:1151-5. https://doi.org/10.2214/ajr.10.5457
Romeo V, Cavaliere C, Sorrentino C, Ponsiglione A, Ugga L, Barbuto L, et al. Clinical impact of coronal-STIR sequence in a routine lumbar spine MR imaging protocol to investigate low back pain. Medicine. 2018;97:23. https://doi.org/10.1097/md.0000000000010789
Dilli A, Cosar Ayaz FS, Karacan K, Zengin K, Ayaz UY, Karabacak OR, et al. Evaluation of renal anomalies, inferior vena cava variations, and left renal vein variations by lumbar magnetic resonance imaging in 3000 patients. Turk J Med Sci. 2017;47:1866-73. https://doi.org/10.3906/sag-1611-23
Mugera C, Suh KJ, Huisman TAGM, Weber K, Belzberg AJ, Carrino JA, et al. Sclerotic lesions of the spine: MRI assessment. J Magn Reson Imaging. 2013;38:1310-24. https://doi.org/10.1002/jmri.24247
Alexandru D, So W. Evaluation and management of vertebral compression fractures. Perm J. 2012;16:46-51. https://doi.org/10.7812/tpp/12-037
Hermann KG, Althoff CE, Schneider U, Zühlsdorf S, Lembcke A, Hamm B, et al. Spinal changes in patients with spondyloarthritis: Comparison of MR imaging and radiographic appearances. Radiographics. 2005;25:559-69. https://doi.org/10.1148/rg.253045117
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