Identification and numbering of lumbar vertebrae using various anatomical landmarks on MRI of lumbosacral spine

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1 Identification and numbering of lumbar vertebrae using various anatomical landmarks on MRI of lumbosacral spine Poster No.: C-2125 Congress: ECR 2015 Type: Authors: Scientific Exhibit S. patil 1, A. M. khan 1, A. Gupta 2 ; 1 Birmingham/UK, 2 Wolverhampton/UK Keywords: DOI: Musculoskeletal bone, Musculoskeletal spine, Musculoskeletal system, MR, Imaging sequences, Image verification /ecr2015/C-2125 Any information contained in this pdf file is automatically generated from digital material submitted to EPOS by third parties in the form of scientific presentations. References to any names, marks, products, or services of third parties or hypertext links to thirdparty sites or information are provided solely as a convenience to you and do not in any way constitute or imply ECR's endorsement, sponsorship or recommendation of the third party, information, product or service. ECR is not responsible for the content of these pages and does not make any representations regarding the content or accuracy of material in this file. As per copyright regulations, any unauthorised use of the material or parts thereof as well as commercial reproduction or multiple distribution by any traditional or electronically based reproduction/publication method ist strictly prohibited. You agree to defend, indemnify, and hold ECR harmless from and against any and all claims, damages, costs, and expenses, including attorneys' fees, arising from or related to your use of these pages. Please note: Links to movies, ppt slideshows and any other multimedia files are not available in the pdf version of presentations. Page 1 of 8

2 Aims and objectives 1. To look at the usefulness of anatomical landmarks in numbering of lumbosacral vertebrae in MRI reporting. 2. Comparison of outcome results with the available published literature. Methods and materials This is a prospective study done at single centre. 100 unreported MRI scans of lumbosacral spine were reviewed. There were 43 females and 57 males in the study. The age range was (mean 53.2). Six anatomical landmarks were identified on each scan; 1.Aortic bifurcation, 2.Origin of right renal artery, 3.Origin of left renal artery, 4.Conus medullaris, 5.Iliolumbar ligament, 6.Confluence of IVC Images for this section: Page 2 of 8

3 Fig. 1: IVC confluence and Aortic bifurcation Page 3 of 8

4 Fig. 2: Origin of renal arteries Page 4 of 8

5 Fig. 3: Iliolumbar ligament Page 5 of 8

6 Fig. 4: Conus medullaris Page 6 of 8

7 Results Landmark Our study Literature Aortic Bifurcation L3/4 7 (7%) L4 80 (80%) L4/5 12 (12%) L5 1 (1%) IVC confluence L4 30 (30%) L4/5 48 (48%) L5 22 (22%) Left renal artery origin L1 58 (58%) L4-83% 1 L4/5 disc -37% 2 - L1/2 25 (25%) L2 14 (14%) Not 3 (3%) identified Right renal artery origin T12/L1 3 (3%) L1 54 (54%) L1/2 31 (31%) L2 10 (10%) Not 2 (2%) L1-52% 1 identified Conus medullaris T (4%) T12 12 (12%) T12/L1 45 (45%) L1 36 (36%) L1/2 1 (1%) L2 2 (2%) Variable 1 At T11/12-6% 1 Iliolumbar ligament origin L4 2 (2%) L5 90 (90%) Not 8 (8%) L5-83% 3,4 Page 7 of 8

8 idetified Conclusion Importance of accurate enumeration of lumbosacral spine transitional vertebrae and communication will help to avoid complications. Aortic bifurcation was easy and reliable identification in our study. Aortic bifurcation, IVC confluence, iliolumbar ligament, conus medullaris, origin of right renal artery and left renal arteries are useful landmarks for predicting the presence of lumbosacral spine transitional vertebrae on MRI. Personal information References 1.Using MRI to evaluate anatomic significance of aortic bifurcation, right renal artery and conus medullaris when locating lumbar vertebral segments; Lee et al; AJR:182, May Identification and prediction of transitional vertebrae on imaging studies: Anatomical significance of paraspinal structures: Lee et al ; Clinical anatomy 20: (2007). 3. Numbering of lumbosacral transitional vertebrae on MRI: role of iliolumbar ligaments : Hughes RJ, Saiuddin A. AJR 2006;187:W59-W Numbering of lumbosacral transitional vertebrae on MRI: Role of the iliolumbar ligaments Richard J. Hughes and Asif Saifuddin; AJR, February 2007, volume 188, nuumber Lumbosacral Transitional vertebrae:classification, imaging findings and clinica relevance; Konina GP and Walza DM; AJNR : Page 8 of 8