ABSTRACT

Objective: To evaluate the diagnostic performance and inter observer agreement between standard sagittal protocol and Dixon protocol in assessment of high intensity zones and Modic end plate changes in patients who undergo MRI lumbar spine for lumbar radiculopathy.
Study Design: Cross-sectional study.
Place and Duration of Study: The study was conducted at the Department of Diagnostic Radiology, Wah Medical College Wah Cantt, Pakistan in period of three months from March 2024 to May 2024.
Methods: Total 163 patients of either gender above age of 30 years were included in the study presented with complaint of lumbar radiculopathy. All patients underwent magnetic resonance imaging lumbar spine. Two experienced radiologists first assessed the high intensity zones and Modic end plate changes for each level of lumbar spine on the sagittal T2 Dixon sequences and then on standard sagittal sequences independently from one another.  Findings were recorded on performa. Data was analyzed using SPSS version 23. First the agreement between readers 1 and 2 was examined for the Dixon protocol and then on standard protocol in assessment of high intensity zone and Modic end plate changes using kappa statistics and the size of the inter-reader agreement was compared between standard protocol and Dixon protocol. Secondly the κ values and their standard errors were used to perform a Z-test to examine if there are significant statistical differences between the two sequences.
Result: Both the Dixon and standard protocols demonstrate high inter observer agreement with Cohen’s Kappa values indicating almost perfect concordance. The Z-test comparisons between the protocols show no statistically significant differences in agreement for either high intensity zones or Modic end plate changes assessments at any spinal level, as all P-values were above the 0.05 threshold. Both protocols exhibit comparable reliability in evaluating lumbar spine conditions.
Conclusion: Single sagittal T2 Dixon sequence could replace the standard sagittal sequences for the assessment of high intensity zones and Modic end plate changes with a 30% acquisition time reduction at 1.5T.

Keywords: Lumbar Radiculopathy, Lumbar Spine, Magnetic Resonance Imaging

How to cite this: Raza SJ, Madiha, Ikram M, Gul N, Jabeen F, Ajmal A. Comparison of T2 Dixon and Standard Sagittal MRI Sequences for Evaluating Lumbar Spine Degeneration. Life and Science. 2024; 5(4): 511-519. doi: http://doi.org/10.37185/LnS.1.1.759