Clinical feasibility of 2D dynamic sagittal HASTE flexion-extension imaging of the cervical spine for the assessment of spondylolisthesis and cervical cord impingement

Abstract

To assess the utility of a 2D dynamic HASTE sequence in assessment of cervical spine flexion-extension, specifically (1) comparing dynamic spondylolisthesis to radiographs and (2) assessing dynamic contact upon or deformity of the cord. Methods: : Patients with a dynamic flexion-extension sagittal 2D HASTE sequence in addition to routine cervical spine sequences were identified. Static and dynamic listhesis was first determined on flexion-extension radiographs reviewed in consensus. Blinded assessment of the dynamic HASTE sequence was independently performed by 2 radiologists for (1) listhesis and translation during flexion-extension and (2) dynamic spinal cord impingement (cord contact or deformity between neutral, flexion and extension). Results: 32 scans in 32 patients (9 males, 23 females) met inclusion criteria acquired on 1.5 T (n = 15) and 3 T (n = 17) scanners. The mean acquisition time was 51.8 s (range 20-95 seconds). Dynamic translation was seen in 14 patients on flexion-extension radiographs compared to 12 (reader 1) and 13 (reader 2) patients on HASTE, with 90.6 % agreement (K = 0.83; p = 0.789). In all cases dynamic listhesis was ≤3 mm translation with one patient showing dynamic listhesis in the range 4− 6 mm. Four cases (13 %) demonstrated deformity of the cord between flexion-extension, not present in the neutral position. For cord impingement there was strong interreader agreement (K = 0.93) and the paired sample Wilcoxon signed rank test found no significant difference between the impingement scores of the two readers (p = 0.787). Conclusions: : A sagittal dynamic flexion-extension HASTE sequence provides a rapid addition to standard MRI cervical spine protocols, which may useful for assessment of dynamic spondylolisthesis and cord deformity.

Extended and weightbearing wrist 3-T MRI using a novel harness and flexible 24-channel glove coil to evaluate carpal kinematics: a pilot study in 10 volunteers

“…However, in our volunteer cohort, participants were able to slow wrist motion, upon verbal instruction, in order to reduce blurring to an acceptable level. Further, in previous spine work the HASTE sequence has been shown to be robust for kinematic evaluation compared to other GRE techniques (30,31). It is acknowledged that the HASTE images acquired in this study were used only for determining dynamic dorsal extension angulation at the cost of signal-to-noise and spatial resolution.…”

Editorial Commentary: Real-Time Dynamic Magnetic Resonance Imaging of the Patellofemoral Joint: Ready for Prime Time?

“…The clinical utility of dynamic MRI in the musculoskeletal system is wide-ranging, from patellofemoral kinematics [1][2][3] to imaging of the hip in femoroacetabular impingement 4 and also dynamic spine imaging. 5,6 Especially when combined with thorough clinical evaluation, confirmation of abnormal joint kinematics by real-time MRI may be of considerable value in supporting therapeutic measures such as surgery or physical therapy. The video format of dynamic MRI is also ideal for advancing patient-centered care, improving patient literacy on their condition, and offering a potential catalyst for shared decision-making between surgeons and their patients.…”