MRI and Anatomical Determinants Affecting Neuroforaminal Stenosis Evaluation: A Descriptive Observational Study

Area of Science:

• Radiology
• Spine Imaging
• Anatomy

Background:

• Neuroforaminal stenosis (NFS) is a common cause of disability in aging populations.
• Accurate classification of NFS using magnetic resonance imaging (MRI) is crucial but challenging.
• Existing MRI classification methods have yielded contradictory findings.

Purpose of the Study:

• To evaluate if in-plane, anatomically conformed 2D MRI views of the neuroforamen offer more accurate characterization of NFS than traditional views.
• To assess these imaging techniques in healthy individuals with and without simulated scoliosis.

Main Methods:

• An observational study involving four volunteers undergoing lumbar spine MRI.
• Scans were performed in both supine and hip-tilted positions to simulate degenerative lumbar scoliosis.
• Anatomically oriented cuts (axial with endplate correction, coronal obliques) and standard axial/sagittal views were acquired.

Main Results:

• Anatomically oriented axial and coronal oblique views showed the highest correlation with true neuroforaminal caliber.
• Deviations from anatomical congruence led to inaccurate measurements of neuroforaminal size.
• Hip-tilt positioning negatively impacted the characterization of neuroforamina, with coronal views reliable only at mid-pedicular lines and standard axial views at the upper one-third.

Conclusions:

• Anatomically oriented MRI cuts are recommended to minimize errors in neuroforaminal analysis.
• When patient anatomy or position compromises anatomical congruence, simultaneous dynamic review of oblique, axial, and coronal images is advised for accurate foraminal characterization.