Diagnostic values of ProSet magnetic resonance coronal source imaging for detecting symptomatic lesion in multiple lumbar foraminal stenosis.
OBJECTIVE
The aim of this study is to evaluate the values of ProSet magnetic resonance coronal source imaging (ProSet MR imaging) as a diagnostic tool for detecting symptomatic lesion in patients with multiple lumbar foraminal stenosis.


METHODS
From January 2011 to June 2015, 46 patients with unilateral and single-level radiculopathy developed from foraminal stenosis were enrolled in the study. These diagnoses were confirmed with transforaminal selective nerve root block (SNRB) and electrophysiological testing, including electromyography and nerve conduction velocity (EMG/NCV) tests. The detection of symptomatic lesion among multiple lumbar foraminal stenosis was done by identification of spinal nerve swelling (NS) and/or running course abnormalities (RCA) observed on ProSet MR imaging. These results were compared with those from transforaminal SNRB testing and conventional MR imaging. Evaluations were performed blinded by two independent examiners.


RESULTS
The diagnostic accuracy rates of the two examiners were 84.7% and 82.6% with a 0.835 kappa coefficient. NS (80.4%) showed a higher diagnostic accuracy rate compared to RCA (69.6%) for detecting symptomatic lesion. The presence or absence of both NS and RCA has a stronger relationship with symptomatic or non-symptomatic lesion compared to the relationship of either alone (p=0.00).


CONCLUSIONS
ProSet MR imaging is a simple and helpful method for providing additional diagnostic accuracy to detect symptomatic lesion in patients with multiple foraminal stenosis. NS representing chemical radiculitis was more reliable diagnostic factor of ProSet MR imaging.
Department of Neurosurgery, College of Medicine, Yeungnam University, Daegu, Republic of Korea.
So Hee
SH
Park
Department of Neurosurgery, College of Medicine, Yeungnam University, Daegu, Republic of Korea.
Ikchan
I
Jeon
Department of Neurosurgery, College of Medicine, Yeungnam University, Daegu, Republic of Korea. Electronic address: sw902@ynu.ac.kr.
Sang Woo
SW
Kim
D000368:Aged; D000369:Aged, 80 and over; D004487:Edema / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging*; D008279:Magnetic Resonance Imaging / Q000379:methods / Q000592:standards*; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D013127:Spinal Nerves / Q000000981:diagnostic imaging*; D013130:Spinal Stenosis / Q000000981:diagnostic imaging*
Foraminal stenosis; Lumbar spine; Magnetic resonance imaging; ProSet; Radiculitis; Spinal nerve root