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High-resolution in vivo MR imaging of intraspinal cervical nerve rootlets at 3 and 7 Tesla

  • Musculoskeletal
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

Objectives

No routine imaging technology allows reliable visualization of nerve rootlets inside the spinal canal with positive contrast. The stronger MR signal at 7 T, with optimized protocols, may offer a solution. The purpose was to evaluate the potential of 3D Dual-Echo Steady-State (DESS) MR imaging of the cervical spine at 3 and 7 T in assessing the micro-anatomy of the nerve rootlets.

Materials/methods

This prospective study was approved by the local ethics committee. Twenty-one patients, clinically referred to cervical-spine MRI, underwent additional MR exams at 3 T and 7 T, each of which consisted of a single 3D-DESS series with equal acquisition times. Artifacts, visualization quality, and number of identified rootlets (C2 to C8) were rated by two musculoskeletal radiologists. Results were compared by Wilcoxon tests. Interobserver reliability was assessed using weighted κ statistics and intraclass correlation coefficient (ICC).

Results

Intraspinal rootlets could successfully be visualized at both field strengths. Rating differences for artifacts and quality of rootlet depiction were not significant for the two field strengths. The mean number of identified rootlets was larger for 7-T than for 3-T MR for every assessed nerve; however, this difference was not statistically significant using the Bonferroni correction (p values ranging from 0.002 to 0.53). Interobserver agreement was substantial to almost perfect (weighted κ values of 0.69 and 0.82). The ICC for the number of identified rootlets was 0.80.

Conclusion

Non-invasive 3D-DESS MR-imaging at 3 and 7 T has the potential to provide precise assessments of the micro-anatomy of intraspinal cervical nerve roots.

Key Points

• Cervical rootlets can be successfully visualized with positive contrast using 3D-DESS MR-imaging.

• 3D-DESS MR-imaging at 3 and 7 T provides precise assessments of the micro-anatomy of cervical nerves.

• The mean number of identified cervical rootlets using 3D-DESS was larger for 7 T than for 3 T MR; however, this difference was not statistically significant.

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Abbreviations

CSF:

Cerebrospinal fluid

DESS:

Dual echo steady state

ICC:

Intraclass correlation coefficient

MIP:

Maximum intensity projection

MPR:

Multiplanar reformat

SAR:

Specific absorption rate

STIR :

Short tau inversion recovery

TE:

Echo time

TR:

Repetition time

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Funding

The authors state that this work has not received any funding.

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Authors and Affiliations

  1. Department of Radiology, Balgrist University Hospital, University of Zurich, Zurich, Switzerland

    Julien Galley, Reto Sutter & Christoph Germann

  2. Department of Radiology, HFR, University of Fribourg, Fribourg, Switzerland

    Julien Galley

  3. Department of Orthopedic Surgery, Balgrist University Hospital, University of Zurich, Zurich, Switzerland

    Florian Wanivenhaus

  4. Swiss Center for Musculoskeletal Imaging (SCMI), Balgrist Campus AG, Zurich, Switzerland

    Daniel Nanz

  5. University of Zurich, Zurich, Switzerland

    Daniel Nanz

Authors
  1. Julien Galley
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  2. Reto Sutter
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  3. Christoph Germann
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  4. Florian Wanivenhaus
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  5. Daniel Nanz
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Corresponding author

Correspondence to Julien Galley.

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Guarantor

The scientific guarantor of this publication is Daniel Nanz.

Conflict of interest

Balgrist University Hospital of Zurich as well as Balgrist Campus AG each has a research agreement with Siemens Healthcare AG.

Statistics and biometry

One of the authors has significant statistical expertise.

No complex statistical methods were necessary for this paper.

Informed consent

Written informed consent was obtained from all subjects (patients) in this study.

Ethical approval

Institutional Review Board approval was obtained.

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• Prospective

• performed at one institution

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Galley, J., Sutter, R., Germann, C. et al. High-resolution in vivo MR imaging of intraspinal cervical nerve rootlets at 3 and 7 Tesla. Eur Radiol 31, 4625–4633 (2021). https://doi.org/10.1007/s00330-020-07557-3

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  • DOI: https://doi.org/10.1007/s00330-020-07557-3

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