Contribution of THRIVE Sequence in Magnetic Resonance Myelography with Intrathecal Gadolinium

Abstract

Magnetic Resonance Myelography with Intrathecal Gadolinium (IG-MRM) is an examination method to investigate the etiology of spontaneous intracranial hypotension (SIH). In the examination, the fat supressed 2-dimensional T1-weighted turbo spin echo (2D-T1W TSE) sequence is generally preferred. “T1-weighted high-resolution isotropic volume examination” (THRIVE) sequence is a new generation 3D gradient echo (GRE) imaging technique that offers high resolution fat-suppressed T1 imaging. We aimed to evaluate the diagnostic success of the THRIVE sequence in detecting IG-MRM findings associated with intracranial hypotension by comparing it with the 2D-T1W TSE. Sixteen patients who were diagnosed with SID according to their clinical and radiological findings and underwent IG-MRM between March 2018 and November 2019 were included. 2D-T1A TSE and THRIVE sequences were compared for cerebrospinal fluid (CSF) opacification grade at the cervical, thoracic, and lumbar levels, and counts of epidural CSF collections, dural defects, and meningeal diverticula. CSF opacification grades in THRIVE sequence at cervical and thoracic levels were significantly lower than 2D-T1W TSE (p0.05). Small dural defects and meningeal diverticula may be detected more easily using THRIVE sequence in IG-MRM of SIH cases when compared with routine sequences. However, since THRIVE is a gradient echo-based sequence, CSF areas may not be sufficiently opacified, especially at the cervical and thoracic level.