Peter Schmidt MD, Presenter: Nothing to Disclose

Wolfram Weschenfelder, Abstract Co-Author: Nothing to Disclose

Andreas Ragoschke-Schumm, Abstract Co-Author: Nothing to Disclose

Hans Joachim Mentzel MD, Abstract Co-Author: Research Consultant, Bayer AG Novartis, GE, Falk Research Consultant, Novartis AG Research Consultant, General Electric Company Research Consultant, Falk Research grant, Novartis AG Research grant, BeamMed Ltd

Werner Alois Kaiser MD, PhD, Abstract Co-Author: Researcher, Siemens AG Researcher, Bayer AG Researcher, General Electric Company Researcher, Suros Surgical Systems, Inc Researcher, C. R. Bard, Inc Researcher, Boston Scientific Corporation Researcher, Galil Medical Ltd Researcher, Koninklijke Philips Electronics NV Researcher, Confirma, Inc Researcher, CAD Sciences LLC Researcher, Carl Zeiss Stiftung

Thomas E Mayer, Abstract Co-Author: Nothing to Disclose

As only little data of 3 Tesla MR imaging of the internal craniocervical ligament imaging is yet available and the involvement of the internal craniocervical ligaments in whiplash-injury associated disorders is discussed controversely, the purpose of this study was to assess the morphology and visibility of these ligamentous structures with a new isotropic three-dimensional turbo-spin-echo (TSE) technique  in patients with whiplash-injury and compare it to healthy controls.  

We assessed the MR apperance of the alar ligaments in 39 subjects with a history of car related whiplash-injury (mean age 39,8 years, range 21 - 66 years) and 50 age-matched healthy controls. MR imaging was performed using a 3.0 T scanner (Siemens) with T2-weighted turbo spin echo 3 D sequence with 0.8 mm isotropical voxels (acquisition time, 461 seconds; acquisition type, 3D; repetition time, 3000 ms; echo time 354 ms; number of averages, 1; number of slices, 176; slice thickness, 0.8 mm; matrix, 256 x 256; field of view, 210 mm). Subjets were scanned in neutral postion of the head. Two neuroradiologists, blind to participants clinical status, separately reviewed the images on a 3D imaging and postprocessing workstation to determine homogeneity, symmetry, signal intensity, shape and spatial orientation of the alar ligaments.Interobserver correlation was assessed with kappa statistics.  

The ligamentous structures (alar ligament, transverse ligament, tectorial membranes) were detected in all patients and subjects of the controll group. No significant differences were detectable in the MRI presentation of the ligaments in patients with whiplash-injury compared to healthy controls when evaluating shape, orientation, symmetry, homogeneity and  signalintensity of the ligaments. The inter-observer correlation was high for all detectibility, signalintensity, homogeneity, shape, orientation, symmetry (kappa ranging from 0.74 to 0.88).

MRI of the internal craniocervical ligaments using the SPACE-sequence allows high-resolution imaging of the ligaments in all orientations. These ligaments did not reveal additional findings of structural alterations in patients after whiplash-injury compared to healthy controls.

Our findings limit the relevance of structural alterations in the identification of the source of neck pain in symptomatic patients after whiplash injury.  

Schmidt, P, Weschenfelder, W, Ragoschke-Schumm, A, Mentzel, H, Kaiser, W, Mayer, T, Assessment of the Internal Craniocervical Ligaments in Patients with Whiplash-associated Disorders (WAD) Using a New Magnetic Resonance Imaging Sequence: Three-dimensional Turbo Spin-Echo with Variable Flip- Angle Distribution (SPACE).  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11014704.html