Improved visualization of the lumbar spine nerve roots in dogs using water excitation (ProSet) as opposed to short tau inversion recovery: A retrospective study of two fat suppression MRI sequences.

Abstract

Magnetic resonance imaging fat suppression techniques are commonly used for diagnosis of canine spinal disease, however, studies comparing different techniques are currently lacking. This retrospective, methods comparison study aimed to evaluate water excitation and STIR MRI pulse sequences for visualization of canine lumbar spinal nerve roots. For inclusion, all dogs had to have dorsal planar MRI studies of the lumbar spine using both sequences. Visual grading analysis was used for scoring the following five criteria: degree of fat suppression; nerve root visualization; subjective tissue contrast; presence of noise; and overall better image quality. Scores were independently recorded by three board-certified veterinary radiologists on two separate occasions, 3-6weeks apart. A total of 90 dogs were sampled. A two-tailed t-test showed that there were significant differences in all scored parameters (P<0.00001), with the exception of noise (P=0.47343), and that the water excitation sequence scored higher in all cases excluding noise. A Gwets AC kappa for intraobserver and interobserver reliability showed "almost perfect" agreement for the nerve roots in both tests (intra: k=0.88; inter: k=0.90). Intraobserver agreement was "substantial" for the degree of fat suppression (k=0.68), subjective tissue contrast (k=0.75), and overall better image quality (k=0.76) and it was "fair" for the noise (k=0.46). Interobserver agreement was "moderate" for the degree of fat suppression (k=0.53), subjective tissue contrast (k=0.63), and overall better image quality (k=0.66) and "slight" for noise (k=0.25). These findings supported using the water excitation pulse sequence for fat-suppressed MRI of canine lumbar spinal nerve roots.