Identification and numbering of lumbar vertebrae using various anatomical landmarks on MRI of lumbosacral spine

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Congress:

ECR 2015

Poster Number:

C-2125

Type:

Scientific Exhibit

Keywords:

Musculoskeletal bone, Musculoskeletal spine, Musculoskeletal system, MR, Imaging sequences, Image verification

Authors:

S. Patil¹, A. M. Khan¹, A. Gupta²; ¹Birmingham/UK, ²Wolverhampton/UK

DOI:

10.1594/ecr2015/C-2125

DOI-Link:

https://dx.doi.org/10.1594/ecr2015/C-2125

Fig. 1: IVC confluence and Aortic bifurcation

Fig. 2: Origin of renal arteries

Fig. 3: Iliolumbar ligament

Fig. 4: Conus medullaris

Aims and objectives

To look at the usefulness of anatomical landmarks in numbering of lumbosacral vertebrae in MRI reporting. Comparison of outcome results with the available published literature.

Methods and materials

This is a prospective study done at single centre. 100 unreported MRI scans of lumbosacral spine were reviewed. There were 43 females and 57 males in the study. The age range was 20-83 (mean 53.2). Six anatomical landmarks were identified on each scan; 1.Aortic bifurcation, 2.Origin of right renal artery, 3.Origin of left renal artery, 4.Conus medullaris, 5.Iliolumbar ligament, 6.Confluence of IVC

Results

Landmark Our study Literature Aortic Bifurcation L3/4 7 (7%) L4 80 (80%) L4/5 12 (12%) L5 1 (1%) L4 - 83%1 IVC confluence L4 30 (30%) L4/5 48 (48%) L5 22 (22%) L4/5 disc -37%2 Left renal artery origin L1 58 (58%) L1/2 25 (25%) L2 14 (14%) Not identified 3 (3%) - Right renal artery origin T12/L1 3 (3%) L1 54 (54%) L1/2 31 (31%) L2 10 (10%) Not identified 2 (2%) L1 - 52%1 Conus medullaris T11-12 4 (4%) T12 12 (12%) T12/L1...

Conclusion

Importance of accurate enumeration of lumbosacral spine transitional vertebrae and communication will help to avoid complications. Aortic bifurcation was easy and reliable identification in our study. Aortic bifurcation, IVC confluence, iliolumbar ligament, conus medullaris, origin of right renal artery and left renal arteries are useful landmarks for predicting the presence of lumbosacral spine transitional vertebrae on MRI.

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References

1.Using MRI to evaluate anatomic significance of aortic bifurcation, right renal artery and conus medullaris when locating lumbar vertebral segments; Lee et al; AJR:182, May 2004. 2. Identification and prediction of transitional vertebrae on imaging studies: Anatomical significance of paraspinal structures: Lee et al ; Clinical anatomy 20:905-914 (2007). 3. Numbering of lumbosacral transitional vertebrae on MRI: role of iliolumbar ligaments : Hughes RJ, Saiuddin A. AJR 2006;187:W59-W66. 4. Numbering of lumbosacral transitional vertebrae on MRI: Role of the iliolumbar ligaments Richard J. Hughes and...