Abstract
BACKGROUND AND PURPOSE
Synthetic MR imaging is a method that can produce multiple contrasts from a single sequence, as well as quantitative maps. Our aim was to determine the feasibility of a synthetic MR image for spine imaging.
MATERIALS AND METHODS
Thirty-eight patients with clinical indications of infectious, degenerative, and neoplastic disease underwent an MR imaging of the spine (11 cervical, 8 dorsal, and 19 lumbosacral MR imaging studies). The SyntAc sequence, with an acquisition time of 5 minutes 40 seconds, was added to the usual imaging protocol consisting of conventional sagittal T1 TSE, T2 TSE, and STIR TSE.
RESULTS
Synthetic T1-weighted, T2-weighted, and STIR images were of adequate quality, and the acquisition time was 53% less than with conventional MR imaging. The image quality was rated as “good” for both synthetic and conventional images. Interreader agreement concerning lesion conspicuity was good with a Cohen κ of 0.737. Artifacts consisting of white pixels/spike noise across contrast views, as well as flow artifacts, were more common in the synthetic sequences, particularly in synthetic STIR. There were no statistically significant differences between readers concerning the scores assigned for image quality or lesion conspicuity.
CONCLUSIONS
Our study shows that synthetic MR imaging is feasible in spine imaging and produces, in general, good image quality and diagnostic confidence. Furthermore, the non-negligible time savings and the ability to obtain quantitative measurements as well as to generate several contrasts with a single acquisition should promise a bright future for synthetic MR imaging in clinical routine.
Radiologists base their diagnoses on morphologic and, increasingly more, quantitative imaging. The current trend in imaging is to reach a diagnosis based on not only morphologic and qualitative evaluation but also methods that can provide quantitative information. Quantitative imaging can be achieved by 2 different techniques: synthetic (used in clinical practice) and fingerprinting (used solely for research purposes).1,2Synthetic MR imaging is a method that can produce multiple contrasts from a single sequence, as well as quantitative T1, T2, STIR, and proton-density maps. This offers the possibility of shortening the study duration and the option of relying on more objective parameters to reach a diagnosis. Recently, this emerging technique has been applied to several brain diseases in adults3,4 and children,5⇓–7 but to our knowledge, it has never been used in spine imaging. The purpose of this work was to apply synthetic MR imaging to the spine6 and spinal cord and to compare the overall image quality, diagnostic confidence, and lesion conspicuity produced by synthetic MR imaging with conventional sequences.
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Editor’s Choice
Thirty-eight patients with clinical indications of infectious, degenerative, and neoplastic disease underwent an MR imaging of the spine. The SyntAc sequence, with an acquisition time of 5 minutes 40 seconds, was added to the usual imaging protocol consisting of conventional sagittal T1 TSE, T2 TSE, and STIR TSE. The image quality was rated as “good” for both synthetic and conventional images. Interreader agreement concerning lesion conspicuity was good with a Cohen kappa of 0.737. The authors conclude that the study shows that synthetic MR imaging is feasible in spine imaging and produces, in general, good image quality and diagnostic confidence.