title: Usefulness of three-dimensional T1-weighted spoiled gradient-recalled echo and three-dimensional heavily T2-weighted images in preoperative evaluation of spinal dysraphism.
abstract: OBJECTIVE
  The aim of this study was to evaluate the usefulness of three-dimensional T1-weighted spoiled gradient-recalled echo (3D T1-GRE) images for the preoperative anatomical evaluation of lumbosacral lipoma, thick filum terminale, and myelomeningocele as a means of compensating for the drawbacks of 3D heavily T2-weighted (3D hT2-W) images.
  
  
  METHODS
  Nine patients with lumbosacral lipomas, one patient with tight filum terminale, and five patients with myelomeningoceles were included in this study. 3D T1-GRE images were compared with 3D hT2-W images or conventional magnetic resonance images in terms of delineation of lipomas and other structures in the patients with lipomas and tight filum terminale. For patients with myelomeningoceles, 3D T1-GRE images were compared with 3D hT2-W images in terms of artifacts in the cerebrospinal fluid (CSF) space.
  
  
  RESULTS
  The 3D T1-GRE images demonstrated lipomas with good contrast to the spinal cord and CSF space and more clearly delineated the anatomical relationship between lipomas and these structures than did the 3D hT2-W images. The 3D T1-GRE images delineated dural defects through which extradural lipomas penetrated into the intradural space. The 3D T1-GRE images also demonstrated the presence or absence of lipomas in the filum terminale and the absence of artifact in the myelomeningoceles. Furthermore, they were useful for differentiating artifacts observed on the 3D hT2-W images from nerve elements.
  
  
  CONCLUSIONS
  The complementary use of 3D T1-GRE and 3D hT2-W images may compensate for the drawbacks of 3D hT2-W images and may eventually improve lesion visualization and surgical decision making.
authors.affiliation: Department of Neurosurgery, Kyushu University, Fukuoka, Japan, nobuya@ns.med.kyushu-u.ac.jp.
authors.forename: Nobuya
authors.initials: N
authors.lastname: Murakami
authors.forename: Takato
authors.initials: T
authors.lastname: Morioka
authors.forename: Kimiaki
authors.initials: K
authors.lastname: Hashiguchi
authors.forename: Takashi
authors.initials: T
authors.lastname: Yoshiura
authors.forename: Akio
authors.initials: A
authors.lastname: Hiwatashi
authors.forename: Satoshi O
authors.initials: SO
authors.lastname: Suzuki
authors.forename: Akira
authors.initials: A
authors.lastname: Nakamizo
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Amano
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Hata
authors.forename: Tomio
authors.initials: T
authors.lastname: Sasaki
mesh_terms: D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods*; D007223:Infant; D007231:Infant, Newborn; D008067:Lipoma / Q000175:diagnosis*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D013120:Spinal Cord Neoplasms / Q000175:diagnosis*; D016135:Spinal Dysraphism / Q000175:diagnosis*