Comparison of T1 and T2 weighted images of the lumbar spine.

ABSTRACT

In order to develop an optimal routine magnetic resonance (MR) spine scanning protocol, we have compared the relative efficacy of performing T1- and T2-weighted images in patients with various disorders of the lumbar region. Forty cases were randomly selected from studies performed from 1984 to 1987 and the T1- and T2-weighted images of each case were separated and interpreted blindly and independently by two neuroradiologists. Our results indicate no significant difference between T1- and T2-weighted images in the depiction of disc protrusion. The T2-weighted images were superior in depicting disc dessication, but the clinical significance of identifying a dessication disc remains uncertain. No significant difference in the depiction of osteophytes was seen between T1- and T2-weighted images. Cases of tethered cord, metastatic disease, and arachnoiditis were better delineated with T1-weighted images. The increase in signal of cerebrospinal fluid (CSF) with T2-weighting often obscured lesions within the spinal canal. In a signal case of postoperative discitis, the T2-weighted images disclosed disc space abnormalities and epidural fluid collections not appreciated on T1-weighted images. The T1-weighted images, however, did show thecal sac and adjacent epidural extension more clearly. In cases of metastatic disease, increase in the signal of metastases with T2 weighting often rendered them isointense to surrounding medullary bone. Given the lack of superiority of T2-weighted images over T1-weighted images in evaluating intervertebral disc protrusions and the superiority of T1-weighted images in depicting nearly all other abnormalities observed in this series, we no longer acquire T2-weighted images of the lumbar spine on a routine basis.(ABSTRACT TRUNCATED AT 250 WORDS)