Objective

To compare the utility of constructive interference in steady-state (CISS) sequence over T2-weighted (T2W) sequence in the accurate delineation of the tethering element on magnetic resonance (MR) imaging in patients of tethered cord syndrome (TCS) and correlation with intraoperative findings.

Methods

MR findings of fifty-six consecutive patients with operative findings of TCS were studied. The intraoperative findings of all patients were studied and compared with the preoperative imaging findings on T2W imaging and CISS images.

Results

CISS images provided more information than T2W imaging. The overall sensitivity of CISS in MR evaluation of patients with TCS was higher (99.17%) as compared with the T2W sequence (71.48%) especially in the detection of precise position/extent of tethered cord, assessment of filum terminale thickening, detection of a fibrous spur in cases of split cord malformation, detection of dorsal dermal sinus, and evaluation of its precise extent and ramifications. The area under the ROC curve was higher with CISS (0.99) than with T2W sequence (0.85) which reflects its good predictive value as a screening test. This information was useful to the operating surgeon.

Conclusion

CISS sequence for imaging TCS can help enhance the overall surgical outcome of the patients ensuring completeness of the surgery. CISS should be routinely performed in the work-up of patients with tethered cord syndrome.

中文翻译：

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CISS 成像在治疗脊髓栓系综合征中的实用性。

客观的

比较稳态 (CISS) 序列相对于 T2 加权 (T2W) 序列的建设性干扰在脊髓栓系综合征 (TCS) 患者磁共振 (MR) 成像中精确描绘束缚元素的效用以及与术中发现。

方法

研究了 56 名具有 TCS 手术结果的连续患者的 MR 结果。研究了所有患者的术中发现，并与术前 T2W 成像和 CISS 图像的成像结果进行了比较。

结果

CISS 图像比 T2W 成像提供了更多信息。与 T2W 序列（71.48%）相比，CISS 在 TCS 患者 MR 评估中的总体敏感性更高（99.17%），特别是在检测栓系绳的精确位置/范围、评估终丝增厚、检测裂索畸形病例中的纤维刺，检测背侧真皮窦，并评估其精确范围和分支。CISS（0.99）的ROC曲线下面积高于T2W序列（0.85），这反映了其作为筛选试验的良好预测价值。这些信息对手术外科医生很有用。

结论

用于 TCS 成像的 CISS 序列可以帮助提高患者的整体手术结果，确保手术的完整性。CISS 应在脊髓栓系综合征患者的检查中常规进行。