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Diagnostic Value of an Additional Sequence (Large-Field Coronal Stir) in a Routine Lumbar Spine MR Imaging Protocol to Investigate Lumbar Radiculopathy

Objective. Lumbar radiculopathy mainly originates in the spine (lumbar disc herniation or spine osteoarthritis) but can sometimes be explained by extra-spinal nerve compression or confused with referred pain mimicking radiculopathy. Our main objective was to demonstrate the clinical benefit of the l...

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Autores principales: Patriat, Quentin, Prigent, François-Victor, Aho, Serge, Lenfant, Marc, Ramon, André, Loffroy, Romaric, Lambert, Aurelien, Ornetti, Paul
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10573339/
https://www.ncbi.nlm.nih.gov/pubmed/37834894
http://dx.doi.org/10.3390/jcm12196250
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author Patriat, Quentin
Prigent, François-Victor
Aho, Serge
Lenfant, Marc
Ramon, André
Loffroy, Romaric
Lambert, Aurelien
Ornetti, Paul
author_facet Patriat, Quentin
Prigent, François-Victor
Aho, Serge
Lenfant, Marc
Ramon, André
Loffroy, Romaric
Lambert, Aurelien
Ornetti, Paul
author_sort Patriat, Quentin
collection PubMed
description Objective. Lumbar radiculopathy mainly originates in the spine (lumbar disc herniation or spine osteoarthritis) but can sometimes be explained by extra-spinal nerve compression or confused with referred pain mimicking radiculopathy. Our main objective was to demonstrate the clinical benefit of the large-field coronal STIR (coroSTIR) sequence in the etiological assessment of lumbar radiculopathy with a duration of more than six weeks. Materials and methods. Six hundred consecutive lumbar MRI scans performed using the same protocol were retrospectively reviewed. Two musculoskeletal radiologists independently assessed the coroSTIR sequence for the presence of extra-spinal anomalies (ESA) that could explain or contribute to the lumbar radiculopathy. The presence of an ESA was then correlated with sex, age, topography and lateralization of radiculopathy, history of vertebral surgery, as well as the presence of a spinal cause explaining the symptoms. Extra-spinal incidentalomas (ESI) with potential clinical impact visible only on the coroSTIR sequence were also systematically reported. Results. An extra-spinal cause was detected on the coroSTIR sequence in 68 cases (11.3%), mainly gluteal tendinobursitis (30.9%), congestive hip osteoarthritis (25%), degenerative sacroiliac arthropathy (14.7%), or inflammatory sacroilitis (7.3%). Their prevalence was significantly correlated in multivariate regression with age (58 years vs. 53 years, p = 0.01), but not with the type of radiating pain (sciatica or cruralgia). The presence of ESI was also frequent (70 cases, 11.7%), including some potentially severe diagnoses (38% of tumor or pseudo-tumor mass requiring further assessment or monitoring). Conclusions. Considering its acceptable acquisition time, the detection of a significant number of potentially symptom-related extra-spinal anomalies, and the discovery of a non-negligible number of extra-spinal incidentalomas with potential clinical impact, the coronal STIR should be performed systematically in routine MRI for lumbar radiculopathy.
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spelling pubmed-105733392023-10-14 Diagnostic Value of an Additional Sequence (Large-Field Coronal Stir) in a Routine Lumbar Spine MR Imaging Protocol to Investigate Lumbar Radiculopathy Patriat, Quentin Prigent, François-Victor Aho, Serge Lenfant, Marc Ramon, André Loffroy, Romaric Lambert, Aurelien Ornetti, Paul J Clin Med Article Objective. Lumbar radiculopathy mainly originates in the spine (lumbar disc herniation or spine osteoarthritis) but can sometimes be explained by extra-spinal nerve compression or confused with referred pain mimicking radiculopathy. Our main objective was to demonstrate the clinical benefit of the large-field coronal STIR (coroSTIR) sequence in the etiological assessment of lumbar radiculopathy with a duration of more than six weeks. Materials and methods. Six hundred consecutive lumbar MRI scans performed using the same protocol were retrospectively reviewed. Two musculoskeletal radiologists independently assessed the coroSTIR sequence for the presence of extra-spinal anomalies (ESA) that could explain or contribute to the lumbar radiculopathy. The presence of an ESA was then correlated with sex, age, topography and lateralization of radiculopathy, history of vertebral surgery, as well as the presence of a spinal cause explaining the symptoms. Extra-spinal incidentalomas (ESI) with potential clinical impact visible only on the coroSTIR sequence were also systematically reported. Results. An extra-spinal cause was detected on the coroSTIR sequence in 68 cases (11.3%), mainly gluteal tendinobursitis (30.9%), congestive hip osteoarthritis (25%), degenerative sacroiliac arthropathy (14.7%), or inflammatory sacroilitis (7.3%). Their prevalence was significantly correlated in multivariate regression with age (58 years vs. 53 years, p = 0.01), but not with the type of radiating pain (sciatica or cruralgia). The presence of ESI was also frequent (70 cases, 11.7%), including some potentially severe diagnoses (38% of tumor or pseudo-tumor mass requiring further assessment or monitoring). Conclusions. Considering its acceptable acquisition time, the detection of a significant number of potentially symptom-related extra-spinal anomalies, and the discovery of a non-negligible number of extra-spinal incidentalomas with potential clinical impact, the coronal STIR should be performed systematically in routine MRI for lumbar radiculopathy. MDPI 2023-09-28 /pmc/articles/PMC10573339/ /pubmed/37834894 http://dx.doi.org/10.3390/jcm12196250 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Patriat, Quentin
Prigent, François-Victor
Aho, Serge
Lenfant, Marc
Ramon, André
Loffroy, Romaric
Lambert, Aurelien
Ornetti, Paul
Diagnostic Value of an Additional Sequence (Large-Field Coronal Stir) in a Routine Lumbar Spine MR Imaging Protocol to Investigate Lumbar Radiculopathy
title Diagnostic Value of an Additional Sequence (Large-Field Coronal Stir) in a Routine Lumbar Spine MR Imaging Protocol to Investigate Lumbar Radiculopathy
title_full Diagnostic Value of an Additional Sequence (Large-Field Coronal Stir) in a Routine Lumbar Spine MR Imaging Protocol to Investigate Lumbar Radiculopathy
title_fullStr Diagnostic Value of an Additional Sequence (Large-Field Coronal Stir) in a Routine Lumbar Spine MR Imaging Protocol to Investigate Lumbar Radiculopathy
title_full_unstemmed Diagnostic Value of an Additional Sequence (Large-Field Coronal Stir) in a Routine Lumbar Spine MR Imaging Protocol to Investigate Lumbar Radiculopathy
title_short Diagnostic Value of an Additional Sequence (Large-Field Coronal Stir) in a Routine Lumbar Spine MR Imaging Protocol to Investigate Lumbar Radiculopathy
title_sort diagnostic value of an additional sequence (large-field coronal stir) in a routine lumbar spine mr imaging protocol to investigate lumbar radiculopathy
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10573339/
https://www.ncbi.nlm.nih.gov/pubmed/37834894
http://dx.doi.org/10.3390/jcm12196250
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