Comparison of T2 Dixon and Standard Sagittal MRI Sequences for Evaluating Lumbar Spine Degeneration

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 magnetic resonance imaging of 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 of 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 interreader agreement was compared between standard protocol and Dixon protocol. Secondly the K values and their standard errors were used to perform a Z-test to examine if there are significant statistical differences
between the two sequences.
Results: 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.

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): 511-520. doi: http://doi.org/10.37185/LnS.1.1.759