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The iliolumbar ligament: three-dimensional volume imaging and computer reformatting by magnetic resonance: a
J M Hartford1, G M McCullen, R Harris
1Division of Orthopaedic Surgery, University of Kentucky Medical Center, Lexington, Kentucky 40536-0284, USA. hartfor@pop.uky.edu
Study Design:
An assessment of magnetic resonance imaging techniques of the iliolumbar ligament.
Objectives:
To identify a technique to better image the iliolumbar ligament.
Summary Of Background Data:
The iliolumbar ligament plays an important role in providing lumbosacral stability. Two-dimensional magnetic resonance imaging of the lumbar spine only provides a fragmented representation of the ligament.
Methods:
A two-part study was performed. In the first part, three cadaver pelvi were dissected, and the individual bands of the iliolumbar ligament were identified. Computer reformatting of magnetic resonance three-dimensional volume images then were performed, correlating the structural characteristics of the iliolumbar ligament to its magnetic resonance image. In the second part of the study, the lumbosacral region of three groups of patients were evaluated. Group I was studied with routine magnetic resonance imaging techniques of the intervertebral disc regions. Group II was studied with routine contiguous axial magnetic resonance imaging of the lumbosacral spine. Group III was studied with computer reformatting of three-dimensional volume images of the lumbosacral spine.
Results:
Accurate imaging of the iliolumbar ligament of cadaver specimens was achieved with three-dimensional volume imaging and computer reformatting. Routine imaging of the intervertebral disc region as well as contiguous axial imaging of the spine depicted only limited segments of the iliolumbar ligament. Three-dimensional volume imaging and computer reformatting allowed precise imaging of the iliolumbar ligament in all patients, demonstrating the ligament orientation as well as length, width, and depth.
Conclusion:
Only images of the iliolumbar ligament obtained through computer reformatting of three-dimensional volume averaging from L3 to the sacral ala correlated with the ligament's structural characteristics.