Andreas Gottschalk MD, Presenter: Nothing to Disclose

Volker Rasche MD, PhD, Abstract Co-Author: Nothing to Disclose

Uwe Max Mauer MD, Abstract Co-Author: Nothing to Disclose

Silke Steinhoff, Abstract Co-Author: Nothing to Disclose

Burkhardt Danz MD, Abstract Co-Author: Nothing to Disclose

Bernd Schmitz MD, Abstract Co-Author: Nothing to Disclose

Arachnoid adhesions are moved by pulsatile cerebrospinal fluid flow. Therefore it is nearly impossible to visualize them directly using standard MRI sequences. The aim of this study was to evaluate the diagnostic value of cardiac gated cine steady state free precession MRI for pre- and postoperative diagnostics of arachnoid adhesions in the spinal subarachnoid space in patients with idiopathic syringomyelia.

15 patients with idiopathic syringomyelia were examined at 1.5 T MRI. The standardized examination protocol, including cardiac-gated phase-contrast cerebrospinal fluid flow studies, was completed by a retrospectively cardiac-gated cine balanced fast field echo (BFFE) sequence, which was planned in the median sagittal plane of the spinal cord. After evaluation of the routine MRI cardiac-gated cine balanced fast field echo sequence was analyzed to search for arachnoid adhesions. Another 5 patients underwent additional sagittal and tranverse cardiac-gated cine balanced fast field echo sequences pre- and postoperatively at 3T MRI at height of cerebrospinal fluid flow blockage.  

In 73.3% (11/15) of the patients examined at 1.5 T MRI membrane typical structures at height of cerebrospinal flow blockage could be visualized dynamically by using sagittal cardiac-gated cine balanced fast field echo sequences. Cardiac-gated cine balanced fast field echo MRI performed at 3T enabled in all cases a high resolution visualization of the arachnoid adhesions preoperatively as well as after surgical decompression. Arachnoid adhesions detected with this technique could be verified operatively. Not everyone of the arachnoid adhesions detected with cardiac-gated cine balanced fast field echo MRI caused a blockage of cerebrospinal fluid flow.  

Cardiac gated cine steady state free precession MRI represents a helpful and meaningful technique for pre- and postoperative diagnostics of arachnoid adhesions in the spinal subarachnoid space in patients with idiopathic syringomyelia.  

Cardiac-gated cine balanced fast field echo MRI enable dynamic visualization of arachnoid adhesions preoperatively as well as after surgical decompression in patients with idiopathic syringomyelia.

Gottschalk, A, Rasche, V, Mauer, U, Steinhoff, S, Danz, B, Schmitz, B, Dynamic Visualization of Arachnoid Adhesions in Patients with Idiopathic Syringomyelia Using Cardiac-gated Cine Steady State Free Precession MRI at 1.5 T and 3T.  Radiological Society of North America 2009 Scientific Assembly and Annual Meeting, November 29 - December 4, 2009 ,Chicago IL. http://archive.rsna.org/2009/8013098.html