3-D MRI/CT fusion imaging of the lumbar spine

• DOI: 10.1007/s00256-009-0788-5
• Publication Date: 2009-09-08T17:58:01Z
• Authors: Yuki Yamanaka; Junji Kamogawa; Ryosuke Katagi; Kazuaki Kodama; Hiroshi Misaki; Kazuo Kamada; Shunsuke Okuda; Tadao Morino; Tadanori Ogata; Haruyasu Yamamoto
• Keywords: Male; Lumbar Vertebrae; Nerve Compression Syndromes; Reproducibility of Results; Magnetic Resonance Imaging; Sensitivity and Specificity; 03 medical and health sciences; Imaging, Three-Dimensional; 0302 clinical medicine; Subtraction Technique; Feasibility Studies; Humans; Female; Spinal Nerve Roots; Tomography, X-Ray Computed; Aged

The objective was to demonstrate the feasibility of MRI/CT fusion in demonstrating lumbar nerve root compromise.We combined 3-dimensional (3-D) computed tomography (CT) imaging of bone with 3-D magnetic resonance imaging (MRI) of neural architecture (cauda equina and nerve roots) for two patients using VirtualPlace software.Although the pathological condition of nerve roots could not be assessed using MRI, myelography or CT myelography, 3-D MRI/CT fusion imaging enabled unambiguous, 3-D confirmation of the pathological state and courses of nerve roots, both inside and outside the foraminal arch, as well as thickening of the ligamentum flavum and the locations, forms and numbers of dorsal root ganglia. Positional relationships between intervertebral discs or bony spurs and nerve roots could also be depicted.Use of 3-D MRI/CT fusion imaging for the lumbar vertebral region successfully revealed the relationship between bone construction (bones, intervertebral joints, and intervertebral disks) and neural architecture (cauda equina and nerve roots) on a single film, three-dimensionally and in color. Such images may be useful in elucidating complex neurological conditions such as degenerative lumbar scoliosis(DLS), as well as in diagnosis and the planning of minimally invasive surgery.