Magnetic resonance imaging of the ligaments of the craniocervical region at 3Tesla magnetic resonance unit: Quantitative and qualitative assessment
2012
Purpose: The assessment of
the morphology and dimensions of the craniocervical ligaments using a 3 Tesla
(T) Magnetic Resonance (MR) scanner, the correlatation of our results with
those from cadaveric and other MR studies and the detection of the most
appropriate sequence for the best imaging of the craniovertebral junction
ligaments. Methods: 58 healthy volunteers (mean age 45 years) underwent a
Magnetic Resonance Imaging (MRI) of the cervical spine at 3T MR unit. The MRI
protocol included axial, coronal and sagittal Proton-Density (PD) sequences and
sagittal T1 Fluid Attenuated Inversion Recovery (FLAIR) and T2 sequences. The
images were evaluated by two radiologists and the posterior atlantoocipital
ligament, the anterior atlantoocipital ligament, the transverse ligament and
the apical ligament were anatomically detected, described and measured. Results:
The transverse ligament was identified at 93.1%, the apical ligament was
identified at 60.34%, the posterior at- lantooccipital membrane was identified
at 94.8% and the anterior atlantooccipital membrane was identified at 96.5% of
the cases. All ligaments appeared with low signal intensity, except the
anterior atlantooc-cipital ligament which appeared with intermediate signal
intensity. Their length, width and thickness were measured and, in general,
correlated well with other anatomic and MR studies. Conclusion: Reliable
assessment of the morphology and signal intensity of the craniocervical
ligaments can be achieved with PD sequence at 3T MR imaging. The sagittal plane
provides better delineation of the craniocervical (CC) ligaments but the axial
and coronal planes are of paramount importance in the assessment of the transverse
and apical ligaments.
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