Journal of the Korean Society of Radiology (대한영상의학회지)

The Korean Society of Radiology (대한영상의학회)
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Diffusion-Weighted MR Neurography with Unidirectional Motion-Probing Gradient to Evaluate Lumbar Nerve Roots at 1.5T MR

요추 신경근 평가를 위한 1.5T MR의 단일 방향 경사자장을 사용한 확산강조 자기공명신경조영

  • Na Yeon Yoon (Department of Radiology, CHA Bundang Medical Center, CHA University School of Medicine) ;
  • Doo Hoe Ha (Department of Radiology, CHA Bundang Medical Center, CHA University School of Medicine) ;
  • Sang Min Lee (Department of Radiology, CHA Bundang Medical Center, CHA University School of Medicine) ;
  • Hye Jung Choi (Department of Radiology, CHA Bundang Medical Center, CHA University School of Medicine)
  • 윤나연 (차의과학대학교 분당차병원 영상의학과) ;
  • 하두회 (차의과학대학교 분당차병원 영상의학과) ;
  • 이상민 (차의과학대학교 분당차병원 영상의학과) ;
  • 최혜정 (차의과학대학교 분당차병원 영상의학과)
  • Received : 2023.05.08
  • Accepted : 2023.10.25
  • Published : 2024.05.01
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Abstract

Purpose Recent studies have demonstrated the usefulness of diffusion-weighted MR neurography (DW MRN) for assessing nerve roots. This study aimed to evaluate the utility of DW MRN with a unidirectional motion-probing gradient (MPG) for the lumbar nerve roots at 1.5T MR. Materials and Methods Sixty-four lumbar spine MRI scans with DW MRN using anteroposterior unidirectional MPG were retrospectively analyzed. Any changes in the 512 lumbar spinal nerve roots from L3 to S1 were evaluated using T2-weighted imaging (T2WI), contrast-enhanced T1-weighted imaging (CE T1WI), and DW MRN, with agreement and correlation analysis. Results T2WI revealed compression of 78 nerve roots, and CE T1WI revealed 52 instances of nerve root enhancement. Sixty-seven nerve roots showed swelling and hyperintensity on DW MRN. A total of 42 nerve roots showed changes in the CE T1WI and DW MRN sequences. Moderate to substantial agreement and moderate positive correlation were observed between DW MRN and CE T1WI, as well as DW MRN and T2WI (κ = 0.59-0.65, ρ = 0.600-0.653). Conclusion DW MRN with unidirectional anteroposterior MPG can help evaluate neuritisrelated changes in spinal nerve roots and could serve as a sequence capable of complementing or substituting gadolinium CE imaging.

목적 최근 확산강조 자기공명신경조영(diffusion-weighted MR neurography; 이하 DW MRN)이 신경근 평가에 도움이 된다고 보고되었다. 본 연구는 1.5T MR에서 단일방향 경사자장을 사용한 DW MRN의 요추 신경근 평가의 유용성을 확인하고자 한다. 대상과 방법 앞뒤 방향 경사자장의 DW MRN을 포함한 64요추 MR을 후향적으로 분석했다. 제3 요추에서 제1 천추까지 총 512개 요추 신경근의 변화를 T2 강조영상, 조영증강 T1 강조영상, 그리고 DW MRN에서 평가하고 일치도와 상관관계 분석을 했다. 결과 T2 강조영상에서 78개의 신경근 압박이 있었고, 조영증강 T1 강조영상에서 52개 신경근이 조영증강되었다. DW MRN에서 67개 신경근의 부종과 고신호강도가 있었다. 조영증강 T1 강조영상과 DW MRN 모두 신경근의 변화가 나타난 경우는 42개였다. DW MRN과 조영증강 T1 강조영상, T2 강조영상 간에 중간 또는 상당한 일치도와 양의 상관관계를 보였다(κ = 0.59-0.65, ρ = 0.600-0.653). 결론 앞뒤 단일방향을 사용한 DW MRN은 척추 신경근의 변화 평가에 도움이 되며, 가돌리늄 조영증강을 대체 또는 보완하는 역할을 할 수 있을 것이다.

Keywords

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