柔性线圈联合PROPELLER序列在侧卧位腰椎MRI中的图像质量评估：与常规仰卧位MRI比较

OBJECTIVE: To evaluate image quality of decubitus lumbar spine MRI using a flexible coil with or without Periodically Rotated Overlapping Parallel Lines with Enhanced Reconstruction (PROPELLER) sequence compared to that of the conventional supine lumbar spine MRI.

MATERIALS AND METHODS: This study was conducted on patients who underwent decubitus lumbar spine MRI applying a flexible coil at a single center between February 1 and March 11, 2025, and had a Numeric Rating Scale (NRS) pain score ≥ 5, while examining supine MRI. Signal-to-noise ratio (SNR) in T2-weighted fast-spin-echo (FSE) sequence for supine, decubitus, and PROPELLER sequence at decubitus position were measured and compared using the Wilcoxon signed-rank test. Two radiologists independently evaluated the subjective image quality of each spine MRI.

RESULTS: A total of 35 patients (mean age, 66 ± 13 years) were included in our study. On T2-weighted sagittal images, cerebrospinal fluid (CSF) SNR was highest in the supineFSE (589.3, 95% CI: 482.1-695.1) and significantly lower in both decubitusFSE (431.2, 95% CI: 365.9-479.9) and decubitusPROPELLER (417.8, 95% CI: 389.2-439.1) (p < 0.001). On T2-weighted axial images, SNRCSF values of supineFSE (284.6, 95% CI: 256.4-331.0) and decubitusPROPELLER (245.0, 95% CI: 215.7-336.1) were both statistically higher than that of decubitusFSE (176.1, 95% CI: 135.9-209.2) (p < 0.001). In qualitative analysis, there was no statistical difference across supineFSE, decubitusFSE, and decubitusPROPELLER.

CONCLUSION: Image quality of decubitus lumbar spine MRI using a flexible coil was clinically feasible with acceptable image quality. PROPELLER sequence improved SNRCSF on axial images in decubitus position.