MR imaging of cervical spine motion with HASTE

doi:10.1016/S0730-725X(98)00176-3

Magnetic Resonance Imaging

Volume 17, Issue 3, April 1999, Pages 371-381

https://doi.org/10.1016/S0730-725X(98)00176-3 Get rights and content

Abstract

The HASTE (half-Fourier acquisition single-shot turbo spin-echo) technique delivers images with T2-weighting in about half a second and could be ideal for fast dynamic studies when T2-weighting is needed. We evaluated cardiac-triggered HASTE to study cervical spine flexion/extension. The cervical spines of ten asymptomatic volunteers were studied during flexion/extension motion on a 1.5 Tesla imager using a cardiac triggered version of the HASTE technique. Midline sagittal images were acquired every 2 to 3 s during neck flexion and extension. Image quality was compared to traditional T2-weighted Turbo spin-echo. The study duration per flexion/extension was typically less than 20 seconds and well tolerated. The cardiac-gated T2-weighted HASTE images compared favorably to the traditional T2-weighted TSE images in quality and overall anatomic detail. Range of motion averaged: flexion 30° (range 8°–48°) and extension 23° (range 0°–57°). Greatest motion occurred in the lower cervical spine (C4–C7). At the intervertebral discs the canal diameter, anterior and posterior CSF spaces were widest in neutral position and decreased with flexion and extension. Therefore, Cardiac-gated T2 HASTE sequences provide diagnostic and time-efficient dynamic MR images of cervical spine motion.

Introduction

Motion of the cervical spine has been studied using flexion-extension static radiography, live fluoroscopy, and cineradiography.1, 2, 3, 4, 5, 6, 7, 8, 9 Cervical spine motion and changes in CSF spaces have been described in several disease processes such rheumatoid arthritis, spinal stenosis, post-traumatic and degenerative instability.10, 11, 12, 13, 14, 15, 16, 17, 18, 19 Previous techniques have relied on radiographs that require radiation, are often inadequate, and reveal predominately bony pathology. Because of the lack of a fast, reliable, safe and noninvasive imaging technique cervical spine motion is not routinely evaluated in patients with minimal clinical symptoms.

MRI of the cervical spine (C-spine) is now well established in clinical practice. It is a noninvasive procedure which can often replace myelography. MRI has also been used to study motion of joints such as the knee, the shoulder joint, the temporomandibular joint and even the C-spine.10, 11, 12, 13, 14, 15, 16, 20, 21, 22, 23, 24, 25, 26, 27, 28 These early kinematic studies can be time consuming and can take up to several minutes per image acquisition.

The purpose of this study was to evaluate an ultrafast heavily T2-weighted MRI techniques that can be performed in less than one heart beat to study motion of the C-spine. Specifically, we evaluated a cardiac-triggered half-Fourier acquisition single-shot turbo spin-echo (HASTE) technique with T2-weighting. HASTE was developed for cardiac and abdominal applications, but can be used elsewhere in the body.29, 30, 38, 39, 40 We evaluated the use of the HASTE technique to study cervical spine motion in a group of ten normal subjects.

Section snippets

Subjects

The cervical spines of ten normal volunteers were studied using MRI. The normal volunteers were recruited from the local community. The average age of the normal volunteers was 29 ± 2 years (range 19 to 31 years). This research was approved by the UCLA Human Subjects Protection Committee, and all subjects signed a consent form.

MRI technique

Imaging was performed on a 1.5 T MR commercial imager (Magnetom VISION, Siemens Medical Systems, Inc., NJ, Iselin) with gradient switching capability of 25 mT/m in a rise

Results

Our study evaluated how well the HASTE technique can image C-spine motion, the image quality and the accuracy of dynamic C-spine evaluations using HASTE. This allows us to speculate on the potential for time-efficient clinical studies of C-spine dynamics.

Discussion

Knowledge of the complex motion patterns of the cervical spine can improve the clinical management of patients with trauma, degenerative diseases of the spine, and many other pathologies. Abnormal motion in flexion/extension is often indicates the need for surgical interventions. Dynamic MRI of the C-spine can evaluate the soft tissues as well as bony architecture with relation to cervical motion and allow treatment to be better tailored to a patient’s disease process.10, 11, 12, 13, 14, 15, 16

Conclusions

The cardiac-gated T2-weighted HASTE MR sequence offers a fast and reliable alternative to the use of slower T2-weighted TSE sequences for the study of cervical motion. This study typically can be performed in less than 10 min for midline sagittal plane motion. More work is needed to evaluate the impact of ultrafast dynamic studies of the cervical spine on patient care.

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Citation Excerpt :
Moreover, rapid MRI of the brain can be obtained without anesthesia, thus avoiding the associated risks of anesthesia and potential long-term concerns.6 Several authors have published their experience with T2 HASTE sequences in other body parts, such as the abdomen7,8 and spine; applications in the spine include lumbar spine myelography,9 cervical and lumbar spine motion imaging,10,11 functional imaging of the spine12 and evaluation of Chiari I malformation.13,14 T2 HASTE sequences are also widely used in fetal and placental imaging.15-18
The use of nonsedated T2-weighted Half-Fourier Acquisition Single-shot Turbo spin Echo magnetic resonance imaging (MRI) sequences in screening for spinal cord syrinx in neonates with spinal dysraphism has not been reported in the literature. We sought to review our experience using T2-weighted Half-Fourier Acquisition Single-shot Turbo spin Echo imaging of the spine (i.e., rapid spine MRI) in nonsedated neonates for detecting spinal cord syrinx in neonates with spinal dysraphism.
We performed a retrospective search of our radiology database for neonates with spinal dysraphism who had rapid spine MRI between May 2017 and February 2020. The images were reviewed in conjunction with clinical findings and standard spine imaging, when available.
Thirty studies (in 29 neonates) fulfilled our inclusion criteria. Of the 26 neonates with myelomeningocele, 5 of them (19%) had spinal cord syrinx identified on neonatal rapid spine MRI. An additional 2 patients developed syrinx by 2 years of age. Potential pitfalls identified in interpreting rapid spine MRI include motion artifacts and distinguishing a severe holocord syrinx from a truncated spinal cord.
Rapid spine MRI acquired without sedation or anesthesia may be used as a screening technique to detect spinal cord syrinx in neonates with spinal dysraphism.
The increased range of cervical flexed motion detected by radiographs in Hirayama disease
2011, European Journal of Radiology
Citation Excerpt :
For measurement of segmental ROCFM, a line was drawn through the center of each vertebra perpendicular to the long axis of each vertebrae from C3 to C7. The angles formed by every two lines were referred as “inter-segmental angles” [16]. Each angle from segment C3/4 to C6/7 was measured and the four angles as a group (∠A–∠D) indicated segmental ROCFM [17,18] (Fig. 1).
Cervical flexion movement is supposed to play an important role in the pathogenesis of Hirayama disease. But there is no report on the range of cervical flexed motion in this disease. The purpose of current study was to compare the range of cervical flexed motion in patients with Hirayama disease with the one in healthy controls using conventional lateral flexion radiographs of the cervical spine, and to investigate the diagnostic value of radiographs for Hirayama disease.
This prospective study was approved by a local institutional review board and written informed consent was obtained. From August 2007 to March 2009, conventional flexion cervical radiographs and flexion cervical MRI were performed on 31 Hirayama disease patients (all men, age range, 16–24 years, mean age, 19.52 ± 2.29 years) and 40 control subjects (all men, age range, 16–25 years, mean age, 23.10 ± 2.20 years). The segmental and overall range of cervical flexed motion was quantitatively measured. Receiver operating characteristic curve was calculated and the diagnostic accuracy was qualified by using the area under the curve Az.
Both the segmental and overall range of cervical flexed motion of patients determined by flexion cervical radiographs was greater than that of controls. The Az value was 0.90, indicating a moderate to good ability of conventional flexion radiographs in the diagnosis of Hirayama disease.
Hirayama disease patients have an increased flexed motion range of cervical spine which would contribute to the pathophysiological change and determine its treatment. Conventional flexion radiographs might be suitable to be used as first line radiographic examination, followed by MRI in cases of suspected Hirayama disease.
Development of a Computerized Intervertebral Motion Analysis of the Cervical Spine for Clinical Application
2007, Journal of Manipulative and Physiological Therapeutics
The objective of this study was to develop a measurement method that could be implemented in chiropractic for the evaluation of angular and translational intervertebral motion of the cervical spine.
Flexion-extension radiographs were digitized with a scanner at a ratio of 1:1 and imported into a software, allowing segmental motion measurements. The measurements were obtained by selecting the most anteroinferior point and the most posteroinferior point of a vertebral body (anterior and posterior arch, respectively, for C1), with the origin of the reference frame set at the most posteroinferior point of the vertebral body below. The same procedure was performed for both the flexion and extension radiographs, and the coordinates of the 2 points were used to calculate the angular movement and the translation between the 2 vertebrae.
This method provides a measure of intervertebral angular and translational movement. It uses a different reference frame for each joint instead of the same reference frame for all joints and thus provides a measure of motion in the plane of each articulation. The calculated values obtained are comparable to other studies on intervertebral motion and support further development to validate the method.
The present study proposes a computerized procedure to evaluate intervertebral motion of the cervical spine. This procedure needs to be validated with a reliability study but could provide a valuable tool for doctors of chiropractic and further spinal research.
Magnetization transfer, HASTE, and FLAIR imaging
2003, Magnetic Resonance Imaging Clinics of North America
Utility of a 2D kinematic HASTE sequence in magnetic resonance imaging assessment of adjacent segment degeneration following anterior cervical discectomy and fusion
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Original ContributionsMR imaging of cervical spine motion with HASTE

Abstract

Introduction

Section snippets

Subjects

MRI technique

Results

Discussion

Conclusions

Magn. Reson. Imaging

Clin. Biomech.

The range and nature of flexion-extension motion in the cervical spine

Spine

Examining motion in the cervical spine. I. Imaging systems and measurement techniques

J. Biomed. Engineering

Clinical validation of functional flexion/extension radiographs of the cervical spine

Spine

Cervical spine motion in the sagittal plane. II. Position of segmental averaged instantaneous centers of rotation—a cineradiographic study

Spine

In vivo flexion/extension of the normal cervical spine

J. Orthopaedic Res.

Cervical spine motion in the sagittal planeKinematic and geometric parameters

J. Biomech.

Normal movements of the cervical spine

Am. J. Roentgenol.

Normal and selected abnormal motion of the cervical spine from the second cervical vertebra to the seventh cervical vertebra based on cineroentgenography

J. Bone Joint Surg.

Cineroentgenography of the normal cervical spine

J. Bone Joint Surg.

Kinematic MRI in degenerative cervical spine changes

Rofo. Fortschritte auf dem Gebiete der Rontgenstrahlen und der Neuen Bildgebenden Verfahren

Three-dimensional motion of the upper cervical spine in rheumatoid arthritis

Spine

Dynamic MR of the cervical spineLow cost technique for rapid-scanning MR facilities

Ajr. Am. J. Roentgenology

Dynamic MR imaging of the cervical cord in patients with cervical spondylosis and ossification of the posterior longitudinal ligament—Significance of dynamic cord compression

Rinsho Shinkeigaku. Clin. Neurol.

Dynamic motion study of the cervical spine using ultra-fast gradient echo with RF-spoiled GRASS—evaluation of cervical instability

Nippon Igaku Hoshasen Gakkai Zasshi. Nippon Acta Radiologica

Flexion-extension MRI of the upper rheumatoid cervical spine

Orthopedics

The Importance of functional magnetic resonance imaging in the planning of stabilising operations on the cervical spine in rheumatoid patients

Arch Orthop. Trauma Surg.

Cervical rheumatoid arthritisValue of flexion and extension views in imaging

Radiology

CT-functional diagnostics of the rotatory instability of the upper cervical spine part 2. An evaluation on healthy adults and patients with suspected instability

Spine

Original Contributions
MR imaging of cervical spine motion with HASTE