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MR artifacts after anterior cervical diskectomy and fusion: a cadaver study
V E Toro1, A Goodrich, D W Lundy
1Department of Radiology, Medical College of Georgia, Augusta 30912-3910.
Objective:
To identify the source of metallic artifacts observed on cervical spine MR studies following anterior cervical diskectomy and fusion (ACD&F), preoperative and postoperative MR studies were done on cadavers using standard spin echo T1, T2, and GRASS imaging.
Materials And Methods:
An ACD&F was performed on each cadaver at various levels using different combinations of drill burrs, curettes, and suction tips.
Results:
Results showed that contact between the drill burr and suction tip produced the worst artifacts; however, artifacts still occurred in cases in which the suction tip was not introduced.
Conclusion:
This observation suggests that metal flakes from the curettes also produced artifacts. Image distortion was greater on GRASS imaging than on the spin echo imaging.
Insights
Metallic artifacts on cervical spine MRI after anterior cervical diskectomy and fusion (ACD&F) stem from surgical instruments. Even without suction tips, curettes can cause image distortion, especially with GRASS imaging.
Area of Science:
- Neurosurgery
- Radiology
- Medical Imaging
Background:
- Metallic artifacts complicate postoperative cervical spine MRI.
- Anterior cervical diskectomy and fusion (ACD&F) is a common spinal procedure.
- Understanding artifact sources is crucial for accurate imaging interpretation.
Purpose of the Study:
- To determine the origin of metallic artifacts on cervical spine MRI post-ACD&F.
- To evaluate the impact of different surgical instruments on artifact generation.
Main Methods:
- Cadaveric cervical spine MR studies were performed pre- and post-ACD&F.
- Standard spin echo (T1, T2) and GRASS imaging sequences were utilized.
- ACD&F involved various combinations of drill burrs, curettes, and suction tips.
Main Results:
- Drill burr and suction tip contact resulted in the most severe artifacts.
- Artifacts were also observed when the suction tip was not used.
- Metal flakes from curettes likely contribute to image distortion.
Conclusions:
- Surgical instruments, including curettes, are sources of metallic artifacts in cervical spine MRI.
- GRASS imaging sequences are more susceptible to image distortion than spin echo sequences.