Diagnostic Utility of Double-Echo Steady-State (DESS) MRI for Fracture and Bone Marrow Edema Detection in Adolescent Lumbar Spondylolysis

To evaluate the ability of double-echo steady-state (DESS) MRI to detect pars interarticularis fracture and bone marrow edema (BME) in spondylolysis, 500 lumber pars interarticularis from 50 consecutive patients (38 males and 12 females, mean age 14.2 ± 3.28 years) with spondylolysis who underwent b...

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Main Authors: Atsushi Kitakado, Takeshi Fukuda, Jiro Kobayashi, Hiroya Ojiri
Format: Article
Language:English
Published: MDPI AG 2023-01-01
Series:Diagnostics
Subjects:
Online Access:https://www.mdpi.com/2075-4418/13/3/461
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author Atsushi Kitakado
Takeshi Fukuda
Jiro Kobayashi
Hiroya Ojiri
author_facet Atsushi Kitakado
Takeshi Fukuda
Jiro Kobayashi
Hiroya Ojiri
author_sort Atsushi Kitakado
collection DOAJ
description To evaluate the ability of double-echo steady-state (DESS) MRI to detect pars interarticularis fracture and bone marrow edema (BME) in spondylolysis, 500 lumber pars interarticularis from 50 consecutive patients (38 males and 12 females, mean age 14.2 ± 3.28 years) with spondylolysis who underwent both MRI and CT within 1 week were evaluated. All participants were young athletes who complained of lower back pain. Fractures were classified into four grades and CT was used as a reference; BME was evaluated in a binary manner and STIR was used as a reference. The diagnostic performance of fractures on DESS and T1WI, and BME on DESS was assessed by two radiologists independently. For fracture detection, DESS showed high diagnostic performance at a sensitivity of 94%, specificity of 99.5%, and accuracy of 98.8%, whereas T1WI showed lower sensitivity (70.1%). Fracture grading performed by DESS showed excellent agreement with CT grading (Kappa = 0.9). For BME, the sensitivity, specificity, and accuracy of DESS were 96.5%, 100%, and 99.6%, respectively. The inter-rater agreement of DESS for fracture and BME was 0.8 and 0.85, respectively. However, the inter-rater agreement for fracture on T1WI was 0.52. DESS had high diagnostic performance for fracture and BME in pars interarticularis. In conclusion, DESS had potential to detect all critical imaging findings in spondylolysis and may replace the role of CT.
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spelling doaj.art-c0432df5f2e842bdbeaa41d091813b882023-11-16T16:25:02ZengMDPI AGDiagnostics2075-44182023-01-0113346110.3390/diagnostics13030461Diagnostic Utility of Double-Echo Steady-State (DESS) MRI for Fracture and Bone Marrow Edema Detection in Adolescent Lumbar SpondylolysisAtsushi Kitakado0Takeshi Fukuda1Jiro Kobayashi2Hiroya Ojiri3Department of Radiology, Medical Scanning, 6-10-1 Nishi-Shinjuku-ku, Tokyo 160-0023, JapanDepartment of Radiology, The Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-ku, Tokyo 105-8461, JapanDepartment of Radiology, Medical Scanning, 6-10-1 Nishi-Shinjuku-ku, Tokyo 160-0023, JapanDepartment of Radiology, The Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-ku, Tokyo 105-8461, JapanTo evaluate the ability of double-echo steady-state (DESS) MRI to detect pars interarticularis fracture and bone marrow edema (BME) in spondylolysis, 500 lumber pars interarticularis from 50 consecutive patients (38 males and 12 females, mean age 14.2 ± 3.28 years) with spondylolysis who underwent both MRI and CT within 1 week were evaluated. All participants were young athletes who complained of lower back pain. Fractures were classified into four grades and CT was used as a reference; BME was evaluated in a binary manner and STIR was used as a reference. The diagnostic performance of fractures on DESS and T1WI, and BME on DESS was assessed by two radiologists independently. For fracture detection, DESS showed high diagnostic performance at a sensitivity of 94%, specificity of 99.5%, and accuracy of 98.8%, whereas T1WI showed lower sensitivity (70.1%). Fracture grading performed by DESS showed excellent agreement with CT grading (Kappa = 0.9). For BME, the sensitivity, specificity, and accuracy of DESS were 96.5%, 100%, and 99.6%, respectively. The inter-rater agreement of DESS for fracture and BME was 0.8 and 0.85, respectively. However, the inter-rater agreement for fracture on T1WI was 0.52. DESS had high diagnostic performance for fracture and BME in pars interarticularis. In conclusion, DESS had potential to detect all critical imaging findings in spondylolysis and may replace the role of CT.https://www.mdpi.com/2075-4418/13/3/461spondylolysispars interarticularisfracturebone marrow edemamagnetic resonance imagingcomputed tomography
spellingShingle Atsushi Kitakado
Takeshi Fukuda
Jiro Kobayashi
Hiroya Ojiri
Diagnostic Utility of Double-Echo Steady-State (DESS) MRI for Fracture and Bone Marrow Edema Detection in Adolescent Lumbar Spondylolysis
Diagnostics
spondylolysis
pars interarticularis
fracture
bone marrow edema
magnetic resonance imaging
computed tomography
title Diagnostic Utility of Double-Echo Steady-State (DESS) MRI for Fracture and Bone Marrow Edema Detection in Adolescent Lumbar Spondylolysis
title_full Diagnostic Utility of Double-Echo Steady-State (DESS) MRI for Fracture and Bone Marrow Edema Detection in Adolescent Lumbar Spondylolysis
title_fullStr Diagnostic Utility of Double-Echo Steady-State (DESS) MRI for Fracture and Bone Marrow Edema Detection in Adolescent Lumbar Spondylolysis
title_full_unstemmed Diagnostic Utility of Double-Echo Steady-State (DESS) MRI for Fracture and Bone Marrow Edema Detection in Adolescent Lumbar Spondylolysis
title_short Diagnostic Utility of Double-Echo Steady-State (DESS) MRI for Fracture and Bone Marrow Edema Detection in Adolescent Lumbar Spondylolysis
title_sort diagnostic utility of double echo steady state dess mri for fracture and bone marrow edema detection in adolescent lumbar spondylolysis
topic spondylolysis
pars interarticularis
fracture
bone marrow edema
magnetic resonance imaging
computed tomography
url https://www.mdpi.com/2075-4418/13/3/461
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