Peter Schmidt MD, Presenter: 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 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 still 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 healthy subjects.

We assessed the MR apperance of the alar ligaments in 116 healthy subjects with no history of cervical trauma (mean age 28,8 years, range 18 - 89 years, 59 women, 57 men). 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) could be detected in all subjects. Evaluating the criteria detectibility, signalintensity, homogeneity, shape, orientation and symmetry of these ligaments revealed a high range of natural variation, the inter-observer correlation was high (kappa ranging from 0.65 to 0.89).

MRI  imaging of the internal craniocervical ligaments using the new SPACE-sequence allows high-resolution imaging of these ligaments. The 3 D data set allowed reconstruction of images in any desired orientation, what proved to be very useful for the depiction of the complete extent of these ligaments.

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, Ragoschke-Schumm, A, Mentzel, H, Kaiser, W, Mayer, T, MR Imaging of the Internal Craniocervical Ligaments Using a New Magnetic Resonance Imaging Sequence: Three-dimensional Turbo Spin-Echo with Variable Flip-Angle Distribution.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11015390.html