Dynamic magnetic resonance imaging evaluation of craniovertebral junction abnormalities

Area of Science:

• Radiology
• Neurology
• Orthopedics

Background:

• Craniovertebral junction (CVJ) abnormalities can lead to significant neurological deficits.
• Accurate assessment of CVJ instability and cord compression is vital for effective treatment planning.

Purpose of the Study:

• To assess the diagnostic utility of dynamic magnetic resonance imaging (MRI) in evaluating craniovertebral junction (CVJ) abnormalities.
• To determine the role of dynamic MRI in detecting spinal cord compression and atlantoaxial instability (AAI) in various positions.

Main Methods:

• Twenty-five patients with suspected CVJ abnormalities underwent dynamic MRI.
• Dynamic MRI was performed in neutral, flexion, and extension positions.
• Computed tomography (CT) scans were used for comparison in 20 patients.

Main Results:

• Dynamic MRI identified 15 cases of atlantoaxial instability (AAI), including 5 mobile cases.
• Twenty-one patients exhibited spinal canal narrowing, with five showing increased narrowing during flexion/extension.
• Direct spinal cord compression was detected in flexion (2 patients) and extension (1 patient), which was not apparent in the neutral position.

Conclusions:

• Dynamic MRI is highly effective in diagnosing CVJ abnormalities, particularly mobile AAI.
• The technique accurately detects spinal cord compression that may only be evident in dynamic positions.
• Dynamic MRI is an invaluable tool for the comprehensive evaluation of CVJ pathologies.