Is any landmark reliable in vertebral enumeration? A study of 3.0-Tesla lumbar MRI comparing skeletal, neural, and vascular markers

Clin Imaging. 2014 Nov-Dec;38(6):792-6. doi: 10.1016/j.clinimag.2014.05.001. Epub 2014 May 12.

Abstract

Purpose: This study aimed to determine the reliability of the iliolumbar ligament (ILL), 12th costa, aortic bifurcation (AB), right renal artery (RRA), and conus medullaris (CM) for numbering of vertebral segments.

Subjects and methods: Five hundred five patients underwent routine lumbar MRI examinations including a cervicothoracic sagittal scout and T1 and T2-weighted sagittal and axial turbo spin echo images. Images were evaluated by two radiologists separately.

Results: The identifiability of ILL and 12th costa were 85.7% and 48.1%. AB, RRA, and CM were located more caudally in lumbarized S1 and more cranially in sacralized L5 cases.

Conclusion: Landmarks suggested by previous studies are not reliable alternatives to cervicothoracic scout images due to wide ranges of distribution and inconsistencies in identification.

Keywords: Aortic bifurcation; Iliolumbar ligament; Lumbosacral transitional vertebrae; Magnetic resonance imaging; Renal artery.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Aorta, Abdominal / anatomy & histology
  • Female
  • Humans
  • Lumbar Vertebrae / anatomy & histology*
  • Lumbar Vertebrae / blood supply
  • Magnetic Resonance Imaging / methods*
  • Male
  • Middle Aged
  • Observer Variation
  • Prospective Studies
  • Renal Artery / anatomy & histology
  • Reproducibility of Results
  • Spinal Cord / anatomy & histology
  • Young Adult