Comparison of wideband steady‐state free precession and T2‐weighted fast spin echo in spine disorder assessment at 1.5 and 3 T

Wideband steady‐state free precession (WB‐SSFP) is a modification of balanced steady‐state free precession utilizing alternating repetition times to reduce susceptibility‐induced balanced steady‐state free precession limitations, allowing its use for high‐resolution myelographic‐contrast spinal imaging. Intertissue contrast and spatial resolution of complete‐spine‐coverage 3D WB‐SSFP were compared with those of 2D T₂‐weighted fast spin echo, currently the standard for spine T₂‐imaging. Six normal subjects were imaged at 1.5 and 3 T. The signal‐to‐noise ratio efficiency (SNR per unit‐time and unit‐volume) of several tissues was measured, along with four intertissue contrast‐to‐noise ratios; nerve‐ganglia:fat, intradural‐nerves:cerebrospinal fluid, nerve‐ganglia:muscle, and muscle:fat. Patients with degenerative and traumatic spine disorders were imaged at both MRI fields to demonstrate WB‐SSFP clinical advantages and disadvantages. At 3 T, WB‐SSFP provided spinal contrast‐to‐noise ratios 3.7–5.2 times that of fast spin echo. At 1.5 T, WB‐SSFP contrast‐to‐noise ratio was 3–3.5 times that of fast spin echo, excluding a 1.7 ratio for intradural‐nerves:cerebrospinal fluid. WB‐SSFP signal‐to‐noise ratio efficiency was also higher. Three‐dimensional WB‐SSFP disadvantages relative to 2D fast spin echo are reduced edema hyperintensity, reduced muscle signal, and higher motion sensitivity. WB‐SSFP's high resolution and contrast‐to‐noise ratio improved visualization of intradural nerve bundles, foraminal nerve roots, and extradural nerve bundles, improving detection of nerve compression in radiculopathy and spinal‐stenosis. WB‐SSFP's high resolution permitted reformatting into orthogonal planes, providing distinct advantages in gauging fine spine pathology. Magn Reson Med, 2012. © 2012 Wiley Periodicals, Inc.