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Diagnostic value of a new axial loading MRI device in patients with suspected lumbar spinal stenosis

  • Musculoskeletal
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A Commentary to this article was published on 22 May 2023

Abstract

Objectives

This study was carried out to investigate a new device for axial loading MRI (alMRI) in the diagnosis of lumbar spinal stenosis (LSS).

Methods

A total of 87 patients with suspected LSS sequentially underwent conventional MRI and alMRI using a new device with pneumatic shoulder-hip compression mode. Four quantitative parameters of dural sac cross-sectional area (DSCA), sagittal vertebral canal diameter (SVCD), disc height (DH), and ligamentum flavum thickness (LFT) at L3-4, L4-5, and L5-S1 in both examinations were measured and compared. Eight qualitative indicators were compared as valuable diagnostic information. Image quality, examinee comfort, test–retest repeatability, and observer reliability were also assessed.

Results

Using the new device, all 87 patients successfully completed alMRI with no statistically significant differences in image quality and examinee comfort from conventional MRI. Statistically significant changes were observed in DSCA, SVCD, DH, and LFT after loading (p < 0.01). SVCD, DH, LFT, and DSCA changes were all positively correlated (r = 0.80, 0.72, 0.37, p < 0.01). Eight qualitative indicators increased from 501 to 669 after axial loading, for a total increase of 168 (33.5%). Nineteen patients (21.8%, 19/87) developed absolute stenosis after axial loading and 10 of them (11.5%, 10/87) also had a significant reduction in DSCA (> 15 mm2). The test–retest repeatability and observer reliability were good to excellent.

Conclusion

The new device is stable for performing alMRI and can exacerbate the severity of spinal stenosis, providing more valuable information for diagnosing LSS and reducing missed diagnoses.

Key Points

• The new axial loading MRI (alMRI) device could detect a higher frequency of patients with lumbar spinal stenosis (LSS).

• The new device with pneumatic shoulder-hip compression mode was used to investigate its applicability in alMRI and diagnostic value for LSS.

• The new device is stable for performing alMRI and can provide more valuable information for diagnosing LSS.

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Abbreviations

AlMRI:

Axial loading magnetic resonance imaging

DH:

Disc height

DSCA:

Dural sac cross-sectional area

FOV:

Field of view

FRFSE:

Fast recovery fast spin-echo

FSE:

Fast spin-echo

ICC:

Intraclass correlation coefficient

LFT:

Ligamentum flavum thickness

LSS:

Lumbar spinal stenosis

SVCD:

Sagittal vertebral canal diameter

TE:

Echo time

TR:

Repetition time

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Funding

This study has received funding from the General Program of the Special Project of Military Health Care.

Author information

Authors and Affiliations

  1. Department of Radiology, the 305 Hospital of PLA, Beijing, 100017, China

    Xingyu Fang, Lin Liu, Wei Lv & Zhiquan Tang

  2. Department of Laboratory, the 305 Hospital of PLA, Beijing, 100017, China

    Jialin Li

  3. Department of the Health Service, Guard Bureau of the Joint Staff, 2 Fuyou Street, Beijing, 100017, China

    Liwei Wang & Daifeng Gao

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  1. Xingyu Fang
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  2. Jialin Li
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  7. Daifeng Gao
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Correspondence to Daifeng Gao.

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The scientific guarantor of this publication is Gao Daifeng.

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The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.

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No complex statistical methods were necessary for this paper.

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• retrospective

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Fang, X., Li, J., Wang, L. et al. Diagnostic value of a new axial loading MRI device in patients with suspected lumbar spinal stenosis. Eur Radiol 33, 3200–3210 (2023). https://doi.org/10.1007/s00330-023-09447-w

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