Abstract
Our aim was to evaluate the efficacy of Diffusion Weighted Imaging (DWI) and Constructive Interference Steady State (CISS) sequences in the depiction of lumbar disc hernias, including sequestrated and extruded discs. 100 patients; 35 males and 65 females, with 3 sequestration-16 extruded and 81 protruded all together 100 herniated discs were involved in this study. If a patient had more than one herniated disc, then the more precise herniation was included. All the MRI procedures were handled in Siemens Symphony Power 1.5 T. magnet. DWI- Apparent diffusion coefficient (ADC mapping) and CISS sequences were obtained in axial planes. Statistical analysis of CISS and DWI results were analysed by fischer's test, chi square statistics. CISS sequence had a 89% sensitivity, 100% specificity for all lumbar disc hernias, had 100% sensitivity and specificity in the evaluation of sequestrated and extruded discs. DWI had a 77% sensitivity and %100 specificity, had 100% sensitivity and 50% specificity in the evaluation of extrusion, 100% sensitivity and specificity in the evaluation of sequestration. CISS sequence and quantitative DWI may be alternative imaging modalities to the routine MR imaging sequences in the depiction of lumbar disc hernias, including sequestration and extruded discs.
Highlights
The most common cause of back pain is the herniation of an intervertebral disc, which may cause nerve impingement and radicular symptoms or a neurological deficit [1, 2]
Constructive Interference Steady State (CISS), a gradient-echo technique with steady-state free precession, and Diffusion Weighted Imaging (DWI)-Apparent Diffusion Coefficient (ADC) mapping are newer pulse sequences that have been proposed to improve the quality of routine Magnetic Resonance (MR) imaging modalities [1, 4, 5]
Surgical and histopathological findings were considered the gold standard for diagnosis of the disc herniations that were treated through surgery, and routine lumbar MR imaging was performed for the nonoperated herniations
Summary
The most common cause of back pain is the herniation of an intervertebral disc, which may cause nerve impingement and radicular symptoms or a neurological deficit [1, 2]. For the analysis of lumbar disc hernias, conventional lumbosacral MR imaging and MR myelography can provide adequate information, but recent developments in MR hardware technology and pulse sequences have further refined the technique [1, 4]. Constructive Interference Steady State (CISS), a gradient-echo technique with steady-state free precession, and Diffusion Weighted Imaging (DWI)-Apparent Diffusion Coefficient (ADC) mapping are newer pulse sequences that have been proposed to improve the quality of routine MR imaging modalities [1, 4, 5]. We illustrate and discuss the utility of 3-Dimensional (3D)-CISS and DWI-ADC mapping in the diagnosis of lumbar intervertebral herniations, including extruded and sequestrated discs, as compared with the MR imaging modality
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