Spiral gradient echo versus cartesian turbo spin echo imaging for sagittal contrast-enhanced fat-suppressed T1 weighted spine MRI: an inter-individual comparison study

Objectives: To compare a novel 3D spiral gradient echo (GRE) sequence with a conventional 2D cartesian turbo spin echo (TSE) sequence for sagittal contrast-enhanced (CE) fat-suppressed (FS) T1 weighted (T1W) spine MRI. Methods: In this inter-individual comparison study, 128 patients prospectively underwent sagittal CE FS T1W spine MRI with either a 2D cartesian TSE (“TSE”, 285 s, 64 patients) or a 3D spiral GRE sequence (“Spiral”, 93 s, 64 patients). Between both groups, patients were matched in terms of anatomical region (cervical/thoracic/lumbar spine and sacrum). Three readers used 4-point Likert scales to assess images qualitatively in terms of overall image quality, presence of artifacts, spinal cord visualization, lesion conspicuity and quality of fat suppression. Results: Spiral achieved a 67.4% scan time reduction compared to TSE. Interreader agreement was high (alpha=0.868-1). Overall image quality (4;[3,4] vs 3;[3,4], p<0.001 – p=0.002 for all readers), presence of artifacts (4;[3,4] vs 3;[3,4] p=0.027 – p=0.046 for all readers), spinal cord visualization (4;[4,4] vs 4;[3,4], p<0.001 for all readers), lesion conspicuity (4;[4,4] vs 4;[4,4], p=0.016 for all readers) and quality of fat suppression (4;[4,4] vs 4;[4,4], p=0.027 – p=0.033 for all readers), were all deemed significantly improved by all three readers on Spiral images as compared to TSE images Conclusion: We demonstrate the feasibility of a novel 3D spiral GRE sequence for improved and rapid sagittal CE FS T1W spine MRI. Advances in knowledge: A 3D spiral GRE sequence allows for improved sagittal CE FS T1W spine MRI at very short scan times.