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R. Rupp, N. A. Ebraheim, E. R. Savolaine and W. T. Jackson, “Magnetic Resonance Imaging Evaluation of the Spine with Metal Implants: General Safety and Superior Imaging with Titanium,” Spine, Vol. 18, No. 3, 1993, pp. 379-385.

has been cited by the following article:

• TITLE: Score Evaluation of MRI Sequence Type Related Artifacts after Interbody Fusion with Metallic Implants—A Spine Specimen Study

  AUTHORS: Thorsten Ernstberger, Gottfried Buchhorn, Gabert Heidrich

  KEYWORDS: Metallic Intervertebral Disc Spacer; Artifact Score; MRI; Susceptibility Artifacts

  JOURNAL NAME: Open Journal of Medical Imaging, Vol.2 No.2, June 13, 2012

  ABSTRACT: Introduction: According to anterior spine fusion intervertebral disc spacers made of titanium or cobalt-chromium al-loys are of special interest. With regard to postoperative problems implant related artifacts can lead to a decreased MRI evaluation. The focus of this study was to compare the respective implant artifact artifact range dependend on different MRI sequences. To simplify artifact evaluation we introduced in this study a new developed 0-1-2 score. Material and Methods: We performed an MRI artifact evaluation of 2 different metallic intervertebral disc spacers (cobalt-chromium and titanium alloy). A carcass porcine spine was employed. Considering 12 defined spinal regions of interest we evaluated the respective implant artifact properties independent from the total artifact volume by using a new developed 0-1-2 score. The artifact range was documented for 15 different MRI-sequences. Results: For the titanium spacer as well as the cobalt-chromium-spacer an MRI evaluation of the implant/disc space situation could not be carried out. In contrast to the cobalt chromium spacer the titanium spacer allowed a good differentiation of the spinal canal opposite to the implant. Optimal MRI imaging results for both metallic intervertebral disc spacers could be achieved considering TSE sequences. Conclusion: A comparison of these two metallic spacers showed in all examined sequences clear advantages in favour of the titanium spacer. The best MRI representation of both tested implants by reducing implant related artifacts could be achieved with fast spin echo (TSE-) sequences. In spite of the use of TSE sequences a variability of susceptibility artifacts has to be included with regard to implant shape and material. With regard to the results of this study the easy use of a new developed artifact score represented a useful help to compare implant related MRI artifact properties independent from the actual implant related total artifact volume.