title: Comparison Study between Conventional Sequence and Slice-Encoding Metal Artifact Correction (SEMAC) in the Diagnosis of Postoperative Complications in Patients Receiving Lumbar Inter-Body Fusion and Pedicle Screw Fixation Surgery.
abstract: OBJECTIVE
  Slice-Encoding Metal Artifact Correction (SEMAC) sequence is one of the metal artifact reduction techniques of anatomical structure, but there has been no report about evaluation of post-operative complications. The purpose of this article is to compare the anatomical visibility between fast spin echo (FSE) and FSE-SEMAC and to evaluate the additional value of FSE-SEMAC in diagnostic confidence of the complications.
  
  
  METHODS
  We conducted a retrospective study with 54 patients who received lumbar spinal surgery and MR images including FSE-SEMAC. For the semi-quantitative evaluation, the visibility of anatomical structures (neural foramen, bone-inter-body cage interface, central canal, nerve root in epidural space, back muscle, and bone-pedicle screw interface) was evaluated. For qualitative evaluation, we evaluated FSE and FSE with FSE-SEMAC independently, and recorded the diagnostic confidence level of post-operative complications. Generalized estimating equation regression analysis was used for statistical analysis, and a weighted kappa was used for inter-observer agreement.
  
  
  RESULTS
  Scores of 6 imaging findings with FSE-SEMAC were significantly higher than that of FSE (P-value < .0001). Inter-observer agreements show good reliability (weighted kappa = 0.45-0.75). Both reviewers deemed 37 (reviewer 1) or 19 more (reviewer 2) post-operative complications with FSE plus FSE-SEMAC, compared to FSE only. Except for central canal stenosis (P-value = .2408), diagnostic confidence level for other post-operative complications were significantly higher with FSE plus FSE-SEMAC (P-value = .0000) than FSE.
  
  
  CONCLUSIONS
  FSE-SEMAC significantly reduces image distortion, compared to FSE sequence in 3.0-T MR. Also, diagnostic confidence for post-operative complications was higher when FSE with additional FSE-SEMAC compared to FSE only.
authors.affiliation: Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Sol Bee
authors.initials: SB
authors.lastname: Han
authors.affiliation: Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Young Cheol
authors.identifier: http://orcid.org/0000-0002-7822-5344
authors.initials: YC
authors.lastname: Yoon
authors.affiliation: Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Jong Won
authors.initials: JW
authors.lastname: Kwon
mesh_terms: D000368:Aged; D016477:Artifacts; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D008670:Metals; D065289:Pedicle Screws; D011183:Postoperative Complications / Q000000981:diagnostic imaging* / Q000209:etiology*; D015203:Reproducibility of Results; D012189:Retrospective Studies; D013123:Spinal Fusion / Q000009:adverse effects*
chemical_list: D008670:Metals