PURPOSE: To assess the degree of agreement between a rapid T2-weighted fast spin-echo protocol and a detailed protocol for the detection of lumbar spondylosis and to determine the sensitivity and specificity of the rapid protocol with respect to the detailed protocol. MATERIALS AND METHODS: Forty-eight patients with low back pain were studied with both a detailed four-sequence protocol and a two-sequence rapid screening protocol (acquisition time of 28 and 2.5 min for the detailed and screening protocols, respectively). The two protocol groups were numerically graded for the findings of lumbar spondylosis. RESULTS: Agreement for presence or absence of disc abnormality was 87% for the two techniques. The screening protocol showed a disc abnormality in 91% of all disc herniations and 84% of all disc bulges seen on the detailed study. All moderate and severe (grades two and three in this protocol) bulges and herniations were detected by the screening protocol. Foraminal narrowing, annular tear of the disc, degenerative changes of the facet joints, and nerve root swelling were all better shown on the detailed protocol. CONCLUSION: A rapid, two-plane, single-echo fast spin-echo sequence protocol is adequate to detect potentially significant degenerative disease of the lumbar spine. Its 2.5-min acquisition time allows a complete patient study (including patient preparation) to be performed in less than 10-15 min.
PURPOSE: To assess the degree of agreement between a rapid T2-weighted fast spin-echo protocol and a detailed protocol for the detection of lumbar spondylosis and to determine the sensitivity and specificity of the rapid protocol with respect to the detailed protocol. MATERIALS AND METHODS: Forty-eight patients with low back pain were studied with both a detailed four-sequence protocol and a two-sequence rapid screening protocol (acquisition time of 28 and 2.5 min for the detailed and screening protocols, respectively). The two protocol groups were numerically graded for the findings of lumbar spondylosis. RESULTS: Agreement for presence or absence of disc abnormality was 87% for the two techniques. The screening protocol showed a disc abnormality in 91% of all disc herniations and 84% of all disc bulges seen on the detailed study. All moderate and severe (grades two and three in this protocol) bulges and herniations were detected by the screening protocol. Foraminal narrowing, annular tear of the disc, degenerative changes of the facet joints, and nerve root swelling were all better shown on the detailed protocol. CONCLUSION: A rapid, two-plane, single-echo fast spin-echo sequence protocol is adequate to detect potentially significant degenerative disease of the lumbar spine. Its 2.5-min acquisition time allows a complete patient study (including patient preparation) to be performed in less than 10-15 min.
Authors: William Hollingworth; Darryl T Gray; Brook I Martin; Sean D Sullivan; Richard A Deyo; Jeffrey G Jarvik Journal: J Gen Intern Med Date: 2003-04 Impact factor: 5.128