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Objective <p>To evaluate image quality of decubitus lumbar spine MRI using a flexible coil with or without Periodically Rotated Overlapping Parallel Lines with Enhanced Reconstruction (PROPELLER) sequence compared to that of the conventional supine lumbar spine MRI.</p> Materials and methods <p>This study was conducted on patients who underwent decubitus lumbar spine MRI applying a flexible coil at a single center between February 1 and March 11, 2025, and had a Numeric Rating Scale (NRS) pain score ≥ 5, while examining supine MRI. Signal-to-noise ratio (SNR) in T2-weighted fast-spin-echo (FSE) sequence for supine, decubitus, and PROPELLER sequence at decubitus position were measured and compared using the Wilcoxon signed-rank test. Two radiologists independently evaluated the subjective image quality of each spine MRI.</p> Results <p>A total of 35 patients (mean age, 66 ± 13&#xa0;years) were included in our study. On T2-weighted sagittal images, cerebrospinal fluid (CSF) SNR was highest in the supine<sub><i>FSE</i></sub> (589.3, 95% CI: 482.1–695.1) and significantly lower in both decubitus<sub><i>FSE</i></sub> (431.2, 95% CI: 365.9–479.9) and decubitus<sub><i>PROPELLER</i></sub> (417.8, 95% CI: 389.2–439.1) (<i>p</i> &lt; 0.001). On T2-weighted axial images, SNR<sub><i>CSF</i></sub> values of supine<sub><i>FSE</i></sub> (284.6, 95% CI: 256.4–331.0) and decubitus<sub><i>PROPELLER</i></sub> (245.0, 95% CI: 215.7–336.1) were both statistically higher than that of decubitus<sub><i>FSE</i></sub> (176.1, 95% CI: 135.9–209.2) (<i>p</i> &lt; 0.001). In qualitative analysis, there was no statistical difference across supine<sub><i>FSE</i></sub>, decubitus<sub><i>FSE</i></sub>, and decubitus<sub><i>PROPELLER</i></sub><i>.</i></p> Conclusion <p>Image quality of decubitus lumbar spine MRI using a flexible coil was clinically feasible with acceptable image quality. PROPELLER sequence improved SNR<sub><i>CSF</i></sub> on axial images in decubitus position.</p>

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Image quality evaluation of decubitus lumbar spine MRI using a flexible coil and PROPELLER sequence: comparison with conventional supine MRI

  • 期刊论文

  • 发表日期：

    2026年4月13日

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  • Soung mo Kang,
  • Yoonah Do,
  • Choong Guen Chee,
  • Youngjune Kim,
  • Eugene Lee,
  • Yeo Ju Kim,
  • Joon Woo Lee

摘要

Objective

To evaluate image quality of decubitus lumbar spine MRI using a flexible coil with or without Periodically Rotated Overlapping Parallel Lines with Enhanced Reconstruction (PROPELLER) sequence compared to that of the conventional supine lumbar spine MRI.

Materials and methods

This study was conducted on patients who underwent decubitus lumbar spine MRI applying a flexible coil at a single center between February 1 and March 11, 2025, and had a Numeric Rating Scale (NRS) pain score ≥ 5, while examining supine MRI. Signal-to-noise ratio (SNR) in T2-weighted fast-spin-echo (FSE) sequence for supine, decubitus, and PROPELLER sequence at decubitus position were measured and compared using the Wilcoxon signed-rank test. Two radiologists independently evaluated the subjective image quality of each spine MRI.

Results

A total of 35 patients (mean age, 66 ± 13 years) were included in our study. On T2-weighted sagittal images, cerebrospinal fluid (CSF) SNR was highest in the supineFSE (589.3, 95% CI: 482.1–695.1) and significantly lower in both decubitusFSE (431.2, 95% CI: 365.9–479.9) and decubitusPROPELLER (417.8, 95% CI: 389.2–439.1) (p < 0.001). On T2-weighted axial images, SNRCSF values of supineFSE (284.6, 95% CI: 256.4–331.0) and decubitusPROPELLER (245.0, 95% CI: 215.7–336.1) were both statistically higher than that of decubitusFSE (176.1, 95% CI: 135.9–209.2) (p < 0.001). In qualitative analysis, there was no statistical difference across supineFSE, decubitusFSE, and decubitusPROPELLER.

Conclusion

Image quality of decubitus lumbar spine MRI using a flexible coil was clinically feasible with acceptable image quality. PROPELLER sequence improved SNRCSF on axial images in decubitus position.