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Axial T1-weighted imaging of the lumbar spine: a redundancy or an asset?

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Abstract

Objective

To determine the diagnostic value of axial T1-weighted imaging for patients suffering from lower back pain.

Materials and methods

In this retrospective study, 100 consecutive lumbar spine MRIs obtained in patients with chronic low back pain were reviewed in two sessions: First, readers viewed core sequences (sagittal T1-weighted, STIR and T2-weighted, and axial T2-weighted) with axial T1-weighted sequences, and second, readers viewed cores sequences alone. Readers recorded the presence of disc degeneration, nerve root compromise, facet joint arthritis, and stenosis at each lumbar spine level as well as the presence of lipoma of filum terminale (LFT), spondylolisthesis, transitional vertebrae, and fractures. The McNemar, Wilcoxon signed-rank, and student T tests were utilized.

Results

For 100 studies, 5 spine levels were evaluated (L1–L2 through L5–S1). There were cases of disc disease (444/500 bulges, 56/500 herniations), nerve root compromise (1/500 nerve enlargement, 36/500 contact only, 20/500 displacement or compression), facet arthritis (438/500), stenosis (58/500 central canal, 64/500 lateral recess, 137/500 neuroforaminal), 6/100 LFTs, and other abnormalities (58/500 spondylolisthesis, 10/100 transitional vertebrae, 10/500 fracture/spondylolysis). There was no difference in diagnostic performance between the interpretation sessions (with and without axial T1-weighted imaging) at any level (p > 0.05), although four small additional LFTs were identified with axial T1-weighted imaging availability.

Conclusion

There was no clinically significant difference in the interpretation of lumbar spine MRI viewed with and without axial T1-weighted imaging, suggesting that the axial T1-weighted sequence does not add diagnostic value to routine lumbar spine MRI.

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Authors and Affiliations

  1. The Russell H. Morgan Department of Radiology & Radiological Science, Johns Hopkins Medical Institutions, Baltimore, MD, USA

    Ali Ghasemi, Rodrigo Luna, Patrick Debs & Laura Fayad

  2. Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA

    Arvin Kheterpal

  3. Department of Orthopaedic Surgery, Johns Hopkins Medical Institutions, Baltimore, MD, USA

    Laura Fayad

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  1. Ali Ghasemi
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Correspondence to Laura Fayad.

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Conflict of interest

Laura M. Fayad has received funding as follows: NIH R61 R61AT012279, National Therapeutic Acceleration Program, and NIH U01AR080993-01A, John Staurulakis Endowed Scholar Award.

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Ghasemi, A., Luna, R., Kheterpal, A. et al. Axial T1-weighted imaging of the lumbar spine: a redundancy or an asset?. Skeletal Radiol 53, 1061–1070 (2024). https://doi.org/10.1007/s00256-023-04522-1

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  • DOI: https://doi.org/10.1007/s00256-023-04522-1

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