E1635. Assessment of Degenerative Disease in the Cervical Spine Using Zero Echo Time (ZTE) MR Imaging
  1. Clement Tran; Columbia University Medical Center
  2. Zohaib Ahmad; Columbia University Medical Center
  3. Pallavi Utukuri; Columbia University Medical Center
  4. Patrick Quarterman; Columbia University Medical Center
  5. Maggie Fung; Columbia University Medical Center
  6. Angela Lignelli; Columbia University Medical Center
  7. Tony Wong; Columbia University Medical Center
To determine utility of zero echo time (ZTE) MR for assessing degenerative disease in the cervical spine.

Materials and Methods:
This was a retrospective review of 42 patients (mean age: 53 ± 18 years, 15 men, 27 women who that had cervical spine MRIs with routine sequences and ZTE (TE = , TR = , slice, FOV, matrix). Two radiologists divided the studies and performed an initial review using only routine sequences. Every cervical disc level for each patient was graded for degree of neural foraminal (NF) narrowing, canal stenosis, and facet OA using previously established scales (0: normal, 1: mild, 2: moderate, 3: severe), as well as the presence of OPLL. NF narrowing and canal stenosis were determined to be caused by all disc, all osteophyte, or a combination of both. This determination was given a confidence level on a Likert scale (1-5). The same evaluations were made in a separate second review using ZTE with recons in addition to routine sequences. Statistics performed with chi-squared, Fisher’s exact, and kappa.

With moderate to severe NF narrowing (grade 2 - 3) (n = 142 foramina), ZTE changed assessment of the cause of narrowing (all disc, all osteophyte, or combination) in 56% (80/142) of the foramina and increased confidence in 60% (85/142). The cause of narrowing changed more frequently when initial confidence level was low (1 - 3) versus high (4 - 5) on routine sequences: 88% (14/16) versus 52% (66/126) (p = 0.007). With moderate to severe canal stenosis (grade 2-3) (n = 36 disc levels), ZTE changed assessment of the cause of stenosis at 42% (15/36) of the levels and increased confidence at 31% (11/36). The cause of stenosis changed more frequently when initial confidence level was low (1 - 4) versus high (5) on routine sequences: 64% (9/14) versus 27% (6/22) (p = 0.041). The degree of facet OA changed in 13% (65/504) and the presence of OPLL changed in 4% (11/294) of the assessed disc levels. ZTE kappa: NF (0.57), canal (0.61), facet OA (0.16), OPLL (0.18).

ZTE changes assessment of foraminal narrowing, canal stenosis, facet OA, and OPLL in the cervical spine. CT can assess soft versus hard discs, facet OA, and OPLL to determine operative treatment plans. ZTE provides CT-like quality that has potential to replace their function.