Jeanette Henkelmann1, Dina Wiersbicki2, Hanno Steinke2, Timm Denecke1, Christoph-Eckhard Heyde3, Anna Voelker4. 1. Department of Diagnostic and Interventional Radiology, University Hospital Leipzig, Liebigstraße 20, 04103, Leipzig, Germany. 2. Institute of Anatomy, Leipzig University, Liebigstraße. 13, 04103, Leipzig, Germany. 3. Department of Orthopedics, Trauma and Plastic Surgery, University Hospital Leipzig, Liebigstraße 20, 04103, Leipzig, Germany. 4. Department of Orthopedics, Trauma and Plastic Surgery, University Hospital Leipzig, Liebigstraße 20, 04103, Leipzig, Germany. anna.voelker@medizin.uni-leipzig.de.
Abstract
PURPOSE: Intraforaminal ligaments (IFL) are of great interest to anatomists and clinicians to fully understand the detailed anatomy of the neuroforamina and to diagnose unclear radicular symptoms. Studies published until now have described radiological imaging of the IFLs using magnetic resonance imaging (MRI) on donor bodies. In the present study, we investigated the detectability of lumbar IFLs in vivo in adults using the high spatial resolution of the constructive interference in steady state (CISS) sequence. METHODS: A total of 14 patients were studied using a 1.5 T MRI scanner. The lumbar spine was imaged using the parasagittal CISS sequence, and the detectability of the IFLs was assessed for each lumbar level. All image datasets were analyzed by a radiologist, an orthopedic surgeon, and an anatomist. Interrater reliability was expressed as Fleiss' Kappa. Using a single data set, a three-dimensional (3D) model was created to map the location of the IFLs within the intervertebral foramen (IF) and the immediate surrounding vessels. RESULTS: Overall, the radiologist was able to detect IFLs in 60% of all imaged IFs, the orthopedic surgeon in 62%, and the anatomist in 66%. Fleiss' Kappa for the various segments varies from 0.71 for L4/5 up to 0.90 for L3/4. CONCLUSION: Lumbar IFLs were successfully detected in vivo in every patient. The detection frequency varied from 42-86% per IF. We demonstrated reproducible imaging of the IFLs on MRI, with good interrater reliability. The present study was a launching point for further clinical studies investigating the potential impact of altered IFLs on radicular pain.
PURPOSE: Intraforaminal ligaments (IFL) are of great interest to anatomists and clinicians to fully understand the detailed anatomy of the neuroforamina and to diagnose unclear radicular symptoms. Studies published until now have described radiological imaging of the IFLs using magnetic resonance imaging (MRI) on donor bodies. In the present study, we investigated the detectability of lumbar IFLs in vivo in adults using the high spatial resolution of the constructive interference in steady state (CISS) sequence. METHODS: A total of 14 patients were studied using a 1.5 T MRI scanner. The lumbar spine was imaged using the parasagittal CISS sequence, and the detectability of the IFLs was assessed for each lumbar level. All image datasets were analyzed by a radiologist, an orthopedic surgeon, and an anatomist. Interrater reliability was expressed as Fleiss' Kappa. Using a single data set, a three-dimensional (3D) model was created to map the location of the IFLs within the intervertebral foramen (IF) and the immediate surrounding vessels. RESULTS: Overall, the radiologist was able to detect IFLs in 60% of all imaged IFs, the orthopedic surgeon in 62%, and the anatomist in 66%. Fleiss' Kappa for the various segments varies from 0.71 for L4/5 up to 0.90 for L3/4. CONCLUSION: Lumbar IFLs were successfully detected in vivo in every patient. The detection frequency varied from 42-86% per IF. We demonstrated reproducible imaging of the IFLs on MRI, with good interrater reliability. The present study was a launching point for further clinical studies investigating the potential impact of altered IFLs on radicular pain.
Authors: B H Nowicki; V M Haughton; T A Schmidt; T H Lim; H S An; L H Riley; L Yu; J W Hong Journal: AJNR Am J Neuroradiol Date: 1996-10 Impact factor: 3.825
Authors: Dušica L Marić; Bojana Krstonošić; Mirela Erić; Dušan M Marić; Milan Stanković; Nebojša T Milošević Journal: Surg Radiol Anat Date: 2014-06-13 Impact factor: 1.246