Magnetic resonance imaging of the cervical spine: comparison of 2D T2-weighted turbo spin echo, 2D T2*weighted gradient-recalled echo and 3D T2-weighted variable flip-angle turbo spin echo sequences

Abstract

To compare an isotropic three-dimensional (3D) high-resolution T2-weighted (w) MR sequence and its reformations with conventional sequences for imaging of the cervical spine. Fifteen volunteers were examined at 1.5 T using sagittal and axial 3D T2-w, sagittal and axial 2D T2w, and axial 2D T2*w MR sequences. Axial reformations of the sagittal 3D dataset were generated (3D MPR T2w). Signal-to-noise and image homogeneity were evaluated in a phantom and in vivo. Visibility of ten anatomical structures of the cervical spine was evaluated. Artifacts were assessed. For statistical analysis, Cohen's kappa, Wilcoxon matched pairs, and t-testing were utilized. There were no significant differences in homogeneity between the sequences. Sagittal 3D T2w enabled better delineation of nerve roots, neural foramina, and intraforaminal structures compared to sagittal 2D T2w. Axial 3D T2w and axial 3D MPR T2w resulted in superior visibility of most anatomical structures compared to axial 2D T2w and comparable results to 2D T2*w concerning the spinal cord, nerve roots, intraforaminal structures, and fat. Artifacts were most pronounced in axial 2D T2w and axial 3D T2w. Acquisition of a 3D T2w data set is feasible in the cervical spine with superior delineation of anatomical structures compared to 2D sequences.