PMID- 27057844
OWN - NLM
STAT- MEDLINE
DCOM- 20160825
LR  - 20210109
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Print)
IS  - 0025-7974 (Linking)
VI  - 95
IP  - 14
DP  - 2016 Apr
TI  - SEMAC-VAT MR Imaging Unravels Peri-instrumentation Lesions in Patients With 
      Attendant Symptoms After Spinal Surgery.
PG  - e3184
LID - 10.1097/MD.0000000000003184 [doi]
LID - e3184
AB  - The study aimed for evaluating the diagnostic value of a 2D Turbo Spin Echo (TSE) 
      magnetic resonance (MR) imaging sequence implanted slice-encoding metal artifact 
      correction (SEMAC) and view-angle tilting (VAT) in patients with spinal 
      instrumentation.Sixty-seven consecutive patients with an average age of 
      59.7 +/- 17.8 years old (range: 32-75 years) were enrolled in this study. Both 
      sagittal, axial T1-weighted and T2-weighted MRI images were acquired with a 
      standard TSE sequence and a high-bandwidth TSE sequence implemented the SEMAC and 
      VAT techniques. Three continuous sections around the instrumentation in axial and 
      sagittal images were selected for quantitative evaluation. The measurement 
      included cumulative areas of signal void on axial images and the length of spinal 
      canal obscuration on sagittal images. Three radiologists independently evaluated 
      all images blindly. The inter-observer reliability was evaluated with inter-class 
      coefficient. We defined patients with discomfortable symptoms caused by spinal 
      instrumentation as spinal instrumentation adverse reaction.Visualizations of all 
      periprosthetic anatomic structures were significantly better for SEMAC-VAT 
      compared with standard imaging. For axial images, the area of signal void at the 
      level of the instrumentation were statistically reduced with SEMAC-VAT TSE 
      sequences than with standard TSE sequences for T2-weighted images (9.9 +/- 2.6 cm 
      vs 29.8 +/- 14.7 cm, P < 0.001). For sagittal imaging, the length of spinal canal 
      obscuration at the level of the instrumentation was reduced from 5.2 +/- 2.0 cm to 
      1.2 +/- 0.6 cm on T2-weighted images (P < 0.001), and from 4.8 +/- 2.1 cm to 
      1.1 +/- 0.5 cm on T1-weighted images with SEMAC-VAT sequences (P < 0.001). 
      Interobserver agreement for visualization of anatomic structures and image 
      quality was good for both SEMAC-VAT (k = 0.77 and 0.68, respectively) and 
      standard (k = 0.74 and 0.80, respectively) imaging. The number of abnormal 
      findings noted on SEMAC images (59 findings) was significantly higher than 
      detected on standard images (40 findings). The incidence rate of spinal 
      instrumentation adverse reaction was 38.81%.MR images with SEMAC-VAT can 
      significantly reduce metal artifacts for spinal instrumentation and improve 
      delineation of the instrumentation and periprosthetic region. Furthermore, 
      SEMAC-VAT technique can improve diagnostic accuracy in patients with 
      post-instrumentation spinal diseases.
FAU - Qi, Shun
AU  - Qi S
AD  - From the Department of Radiology (SQ, LLG, YL, HY), Xijing Hospital, the Fourth 
      Military Medical University, Xi'an, PR China; Department of Orthopaedics (ZGW), 
      No. 518 Hospital of Chinese People's Liberation Army, Xi'an, PR China; Department 
      of Orthopedics (ZGW), Lanzhou General Hospital of Lanzhou Military Region, 
      People's Liberation Army, Lanzhou, PR China; Department of Radiotherapy (YFM), 
      Xijing Hospital, the Fourth Military Medical University, Xi'an, PR China; 
      Department of Radiology (SQ, JY), The First Affiliated Hospital of Medical 
      College of Xi'an Jiaotong University, Xi'an, PR China; Siemens Healthcare (PLZ), 
      MR Collaborations NE Asia, Beijing, PR China; Siemens Healthcare (MN), Erlangen, 
      Germany; and Department of Orthopaedics (HQW), Xijing Hospital, The Fourth 
      Military Medical University, Xi'an, PR China.
FAU - Wu, Zhi-Gang
AU  - Wu ZG
FAU - Mu, Yun-Feng
AU  - Mu YF
FAU - Gao, Lang-Lang
AU  - Gao LL
FAU - Yang, Jian
AU  - Yang J
FAU - Zuo, Pan-Li
AU  - Zuo PL
FAU - Nittka, Mathias
AU  - Nittka M
FAU - Liu, Ying
AU  - Liu Y
FAU - Wang, Hai-Qiang
AU  - Wang HQ
FAU - Yin, Hong
AU  - Yin H
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
RN  - D1JT611TNE (Titanium)
SB  - IM
MH  - Adult
MH  - Aged
MH  - *Artifacts
MH  - *Bone Screws
MH  - Female
MH  - Humans
MH  - *Image Enhancement
MH  - Magnetic Resonance Imaging/*methods
MH  - Male
MH  - Middle Aged
MH  - Neurosurgical Procedures
MH  - Postoperative Complications/*diagnosis
MH  - Prospective Studies
MH  - Spinal Cord/*surgery
MH  - *Titanium
PMC - PMC4998760
COIS- The authors have no conflicts of interest to disclose.
EDAT- 2016/04/09 06:00
MHDA- 2016/08/26 06:00
PMCR- 2016/04/08
CRDT- 2016/04/09 06:00
PHST- 2016/04/09 06:00 [entrez]
PHST- 2016/04/09 06:00 [pubmed]
PHST- 2016/08/26 06:00 [medline]
PHST- 2016/04/08 00:00 [pmc-release]
AID - 00005792-201604050-00020 [pii]
AID - 10.1097/MD.0000000000003184 [doi]
PST - ppublish
SO  - Medicine (Baltimore). 2016 Apr;95(14):e3184. doi: 10.1097/MD.0000000000003184.