Evaluation of lumbar pain with weight-bearing MRI: Preliminary experience.

Abstract

PURPOSE/INTRODUCTION: To assess the usefulness of weight-bearing examination of the lumbar spine performed with a dedicated MRI scanner in the evaluation of patients with clinical evidence of lumbar pain. MATERIALS AND METHODS: Between August 2008 and July 2009, 40 patients with clinical evidence of lumbar pain (group A) and a similar number of healthy volunteers (group B) were submitted to MRI examination of lumbar spine. Spin echo T1w and fast spin echo T2w images were acquired with a 0.25 Tesla scanner (G-Scan, Esaote Spa, Genoa, Italy) in both weight-bearing position and conventional supine position. A dedicated receiving coil for the lumbar spine was used. Three radiologists, blinded on history and clinical examination of subjects, assessed, in consensus, variations of lumbar lordosis angle and presence of pathology on images acquired in both positions, in different sequences and in different planes. RESULTS: In group A, conventional supine MRI was positive for pathology in 30/40 cases while weight-bearing MRI was positive in 39/40 cases. In all cases of group B, no signs of pathology was found in both positions. Weight-bearing MRI showed modifications of lumbar lordosis angle in all cases of both groups in respect to conventional supine MRI. DISCUSSION/CONCLUSION: Imaging the lumbar spine in weight-bearing position with a dedicated MRI scanner and a dedicated coil could allow identification of pathology which could be overlooked if imaging patients only in the supine position.