The Value of the T2-Weighted Multipoint Dixon Sequence in MRI of Sacroiliac Joints for the Diagnosis of Active and Chronic Sacroiliitis

Özgen, Ali

doi:10.2214/ajr.16.16774

Cited by 55 publications

(58 citation statements)

References 21 publications

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“…Most of our spine MR imaging examinations are performed with 3-T (12). In musculoskeletal applications, Dixon SE imaging has been mostly used to provide more homogeneous fat suppression than is achieved with CHESS, notably with large fields of view, such as in spine imaging, and higher signalto-noise ratio than with STIR imaging (11,(15)(16)(17)(18)(19)(20)(21). In addition, Dixon SE T2weighted water-only images have shown low sensitivity to susceptibility artifacts and performance similar to that of T2weighted CHESS and STIR techniques in detecting pathologic spinal abnormalities (16,19,22).…”

Section: Patient Populationmentioning

confidence: 99%

“…An additional advantage of Dixon techniques is the ability to provide, in one acquisition, several series of images with different contrasts (ie, both nonfat-suppressed and fat-suppressed images). This approach has been used in various musculoskeletal applications to decrease imaging times (15,16,19,23). On the basis of the rationale that fatonly images generated with the Dixon technique could provide the same information on bone marrow replacement lesions as can T1-weighted sequences, we hypothesized that the standard protocol for the detection of bone marrow metastases could be reduced to a single Dixon T2-weighted sequence, thereby providing an opportunity to reduce acquisition time.…”

Section: Patient Populationmentioning

confidence: 99%

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Bone Marrow Metastases: T2-weighted Dixon Spin-Echo Fat Images Can Replace T1-weighted Spin-Echo Images

et al. 2018

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Purpose To test the potential of Dixon T2-weighted fat-only sequences to replace T1-weighted sequences for the detection of bone metastases, with the hypothesis that diagnostic performance with an alternative magnetic resonance (MR) imaging protocol (sagittal spin-echo Dixon T2-weighted fat-only and water-only imaging) would not be inferior to that with the standard protocol (sagittal spin-echo T1-weighted and spin-echo Dixon T2-weighted water-only imaging). Materials and Methods A total of 121 consecutive whole-spine MR imaging examinations (63 men; mean age ± standard deviation, 61.4 years ± 11.8) performed for suspected vertebral bone metastases were included in this retrospective, institutional review board-approved study. Quantitative image analysis was performed for 30 randomly selected spine levels. Qualitative analysis was performed separately by two musculoskeletal radiologists, who registered the number of metastases for each spine level. Areas under the curve with the protocols were compared on the basis of nonparametric receiver operating characteristic curve estimations by using a noninferiority test on paired data, with a best valuable comparator as a reference. Interobserver and interprotocol agreement was assessed by using κ statistics. Results Contrast-to-noise ratio was significantly higher on the alternative protocol images than on the standard protocol images (181.1 [95% confidence interval: 140.4, 221.7] vs 84.7 [95% confidence interval: 66.3, 103.1] respectively; P < .001). Diagnostic performance was not significantly inferior with the alternative protocol than with the standard protocol for both readers in a per-patient analysis (sensitivity, 97.9%-98.9% vs 93.6%-97.9%; specificity, 85.2%-92.6% vs 92.6%-96.3%; area under the curve, 0.92-0.96 vs 0.95, respectively; all P ≤ .02) and a per-spine level analysis (all P < .01). Interobserver and interprotocol agreement was good to very good (κ = 0.70-0.81). Conclusion Dixon T2-weighted fat-only and water-only imaging provide, in one sequence, diagnostic performance similar to that of the standard combination of morphologic sequences for the detection of probable spinal bone metastases, thereby providing an opportunity to reduce imaging time by eliminating the need to perform T1 sequences. RSNA, 2017 An earlier incorrect version of this article appeared online. This article was corrected on November 6, 2017.

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Section: Patient Populationmentioning

confidence: 99%

Section: Patient Populationmentioning

confidence: 99%

Bone Marrow Metastases: T2-weighted Dixon Spin-Echo Fat Images Can Replace T1-weighted Spin-Echo Images

et al. 2018

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“…11 Acquiring a T2-weighted Dixon sequence can provide combined information about water and fat content that might eliminate the need for T1weighted and STIR or fat-saturated T2-weighted sequences. 12 Interpreting WB-MRI is challenging. All the different sequences should be viewed simultaneously, using the maximal intensity projection for DWI and correlating ADC maps with the T1-weighted and STIR anatomical images.…”

Section: Wb-mri Techniquementioning

confidence: 99%

Update on Whole-body MRI in Musculoskeletal Applications

Vilanova

García‐Figueiras

Luna

et al. 2019

Semin Musculoskelet Radiol

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Whole-body magnetic resonance imaging (WB-MRI) is a powerful tool increasingly used to assess oncologic and nononcologic diseases. WB-MRI provides information about diffuse multifocal pathologies with excellent anatomical definition through high soft tissue contrast and spatial resolution as well as valuable functional information from diffusion-weighted images. In addition to its roles in establishing the diagnosis and assessing the extent and severity of disease, WB-MRI is also useful for monitoring the response to treatment for malignant and benign systemic diseases affecting the musculoskeletal system. This article reviews and updates the applications of WB-MRI in current practice, discussing the role of this helpful tool in various conditions involving the musculoskeletal system including bone metastases, hematologic cancers, inflammatory processes, infections, and multisystemic-multifocal bone, nerve, vascular, and muscle/soft tissue disorders, as well as other idiopathic conditions.

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“…Recently, there has been a growing interest in the use of the Dixon fat suppression technique combined with fast spin-echo (FSE) acquisitions for various musculoskeletal applications, including spine MRI [8][9][10][11][12][13][14][15]. The Dixon technique presents some advantages compared with other fat suppression methods.…”

Section: Introductionmentioning

confidence: 99%

“…Secondly, it provides higher signal-to-noise ratio than short-tau inversion recovery (STIR) techniques [8,9,[16][17][18]. Finally, the Dixon technique has the advantage of producing, in a single acquisition, four sets of images with different contrasts, which has been advantageously used to reduce examination time by waiving the need to acquire some standard sequences, such as for the imaging of sacroiliitis, spinal metastases, or the knee [10][11][12][13]. Specifically, a Dixon T2-weighted sequence generates in-phase (similar to standard T2-weighted images), out-of-phase, fat-only, and water-only images (corresponding to fat-suppressed T2-weighted images) [19][20][21].…”

Section: Introductionmentioning

confidence: 99%

MRI of non-specific low back pain and/or lumbar radiculopathy: do we need T1 when using a sagittal T2-weighted Dixon sequence?

et al. 2020

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Objective To show that for the MRI workup of non-specific low back pain and/or lumbar radiculopathy, the acquisition of T1weighted sequences in the sagittal plane could be waived when using an FSE T2-weighted Dixon sequence. Materials and methods Three musculoskeletal radiologists retrospectively reviewed fifty lumbar spine MRI examinations performed for non-specific low back pain and/or lumbar radiculopathy. Two protocols were separately analyzed in the sagittal plane: a standard protocol (T1-weighted, in-phase, and water-only images of an FSE T2-weighted Dixon sequence) and a simplified protocol (fat-only, in-phase, and water-only images of an FSE T2-weighted Dixon sequence). Eight items usually assessed on T1-weighted sequences were analyzed for each of the vertebrae (n = 250), vertebral endplates (n = 500), vertebral corners (n = 1000), foramina (n = 500), lamina (n = 500), and facet joints (n = 500). Interchangeability of these protocols was tested using the individual equivalence index. A decrease in interobserver agreement of ≥ 5% when one reader used the simplified protocol compared with when both readers used the standard protocol was considered clinically significant. Interreader and intrareader agreement were assessed using kappa statistics. Rates of findings with each protocol were compared using odd ratios. Results The standard and simplified protocols were interchangeable (range of upper bound of the 95%CI of individual equivalence index = 0.25 to 1.38%). Intraprotocol and interprotocol interreader kappa values were similar (0.253-0.671 vs. 0.236-0.723, respectively). Rates of findings were not statistically significantly different (p ≥ 0.074), or were higher with the simplified protocol (p ≤ 0.036). Conclusion In our target population, a single sagittal T2-weighted Dixon sequence may replace the recommended combination of T1-, T2-, and fat-suppressed T2-weighted sequences. Key Points • In patients with non-specific low back pain or lumbar radiculopathy, spine MRI in the sagittal plane could be limited to a single FSE T2-weighted Dixon sequence, hereby reducing the acquisition time. • A simplified protocol of spine MRI in the sagittal plane combining FSE T2-weighted Dixon sequence provides the same information as a standard protocol including T1-, T2-, and fat-suppressed T2-weighted sequences for the workup of degenerative lumbar spine lesions. • For some findings shown on the simplified protocol, such as focal bone marrow replacement lesions or signs of infection, additional sequences including pre-and post-contrast T1-weighted sequences may be required, as is currently the case when using the standard protocol.

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The Value of the T2-Weighted Multipoint Dixon Sequence in MRI of Sacroiliac Joints for the Diagnosis of Active and Chronic Sacroiliitis

Abstract: The T2-weighted multipoint Dixon sequence is superior to conventional MRI sequences in depicting diagnostic signs of active and chronic sacroiliitis and therefore may be used as a single sequence.

Cited by 55 publications

References 21 publications

Bone Marrow Metastases: T2-weighted Dixon Spin-Echo Fat Images Can Replace T1-weighted Spin-Echo Images

Bone Marrow Metastases: T2-weighted Dixon Spin-Echo Fat Images Can Replace T1-weighted Spin-Echo Images

Update on Whole-body MRI in Musculoskeletal Applications

MRI of non-specific low back pain and/or lumbar radiculopathy: do we need T1 when using a sagittal T2-weighted Dixon sequence?

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