A controlled study on the anatomy of cervical extraforaminal ligaments and three-dimensional fast-imaging employing a steady-state acquisition sequence.
To evaluate the utility of magnetic resonance three-dimensional fast-imaging employing a steady-state acquisition (MR 3D-FIESTA) sequence to study cervical EFLs using the anatomical results of cadavers as the gold standard.



Part I: The cervical regions of five embalmed adult cadavers were scanned using the MR 3D-FIESTA sequence. Ligamentous structures in the intervertebral foramina (IVFs) between C4 and T1 in the MRI scans were identified by a radiologist. Part II: After the specimens were scanned, gross and microscopic anatomical studies were conducted on the IVFs between C4 and T1 in the specimens by an anatomist. Part III: Using the anatomical results of the cadavers as the gold standard, the utility of the MR 3D-FIESTA sequence for imaging cervical EFLs was evaluated. Specificity, sensitivity, positive and negative predictive values (PPV and NPV, respectively) and accuracy were calculated.



The occurrence rate of transforaminal ligaments (TFLs) in the IVFs between C4 and T1 was 42.5%. The results obtained by the radiologist using the MR 3D-FIESTA sequence to identify TFLs are as follows: specificity 96.2%, sensitivity 76.5%, PPV 92.9%, NPV 86.2%, and accuracy 88.4%.



MR 3D-FIESTA sequences clearly showed cervical EFLs. In the 3D-FIESTA sequence scans that the radiologist believed to indicate the presence of a cervical TFL, the probability that the TFL existed was approximately 93%. When the radiologist believed that no TFL was present in the 3D-FIESTA sequence scan, the probability that a TFL existed was 14%.
Department of Medical Imaging Center, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China.|Department of Imaging Medicine, Inner Mongolia Autonomous Region People's Hospital, Hohhot, 010017, China.
Junlin
J
Li
Department of Orthopedics, Zhujiang Hospital, Southern Medical University, Guangzhou, China.
Benchao
B
Shi
Department of Medical Imaging Center, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China. qsj2464@163.com].
Shijun
S
Qiu
Anatomical Institute of Minimally Invasive Surgery, Southern Medical University, Guangzhou, 510515, China. dingzih@126.com.
Zihai
Z
Ding
Department of Ultrasonic Medicine, Inner Mongolia Autonomous Region People's Hospital, Hohhot, 010017, China.
Lina
L
Wang
D000328:Adult; D000368:Aged; D002102:Cadaver; D002574:Cervical Vertebrae / Q000033:anatomy & histology / Q000000981:diagnostic imaging*; D000013:Congenital Abnormalities / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods*; D008022:Ligaments / Q000002:abnormalities / Q000033:anatomy & histology / Q000000981:diagnostic imaging*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity; D013904:Thoracic Vertebrae / Q000033:anatomy & histology / Q000000981:diagnostic imaging*
Cervical vertebra; Extraforaminal ligament; MR 3D-FIESTA sequence; Transforaminal ligament