Dataset Information

Magnetic resonance imaging evaluation after implantation of a titanium cervical disc prosthesis: a comparison of 1.5 and 3 Tesla magnet strength.

ABSTRACT: Cervical disc prostheses induce significant amount of artifact in magnetic resonance imaging which may complicate radiologic follow-up after surgery. The purpose of this study was to investigate as to what extent the artifact, induced by the frequently used Discover(®) cervical disc prosthesis, impedes interpretation of the MR images at operated and adjacent levels in 1.5 and 3 Tesla MR.Ten subsequent patients were investigated in both 1.5 and 3 Tesla MR with standard image sequences one year following anterior cervical discectomy with arthroplasty.Two neuroradiologists evaluated the images by consensus. Emphasis was made on signal changes in medulla at all levels and visualization of root canals at operated and adjacent levels. A "blur artifact ratio" was calculated and defined as the height of the artifact on T1 sagittal images related to the operated level.The artifacts induced in 1.5 and 3 Tesla MR were of entirely different character and evaluation of the spinal cord at operated level was impossible in both magnets. Artifacts also made the root canals difficult to assess at operated level and more pronounced in the 3 Tesla MR. At the adjacent levels however, the spinal cord and root canals were completely visualized in all patients. The "blur artifact" induced at operated level was also more pronounced in the 3 Tesla MR.The artifact induced by the Discover(®) titanium disc prosthesis in both 1.5 and 3 Tesla MR, makes interpretation of the spinal cord impossible and visualization of the root canals difficult at operated level. Adjusting the MR sequences to produce the least amount of artifact is important.

SUBMITTER: Sundseth J

PROVIDER: S-EPMC3804698 | biostudies-other | 2013 Oct

REPOSITORIES: biostudies-other

ACCESS DATA

Publications

Magnetic resonance imaging evaluation after implantation of a titanium cervical disc prosthesis: a comparison of 1.5 and 3 Tesla magnet strength.

Sundseth Jarle J Jacobsen Eva A EA Kolstad Frode F Nygaard Oystein P OP Zwart John A JA Hol Per K PK

European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society 20130906 10

<h4>Purpose</h4>Cervical disc prostheses induce significant amount of artifact in magnetic resonance imaging which may complicate radiologic follow-up after surgery. The purpose of this study was to investigate as to what extent the artifact, induced by the frequently used Discover(®) cervical disc prosthesis, impedes interpretation of the MR images at operated and adjacent levels in 1.5 and 3 Tesla MR.<h4>Methods</h4>Ten subsequent patients were investigated in both 1.5 and 3 Tesla MR with stan ...[more]

PMID: 24061966

Similar Datasets

Project description:When surgically treating cervical degenerative disc disease, the most commonly performed procedure is anterior cervical discectomy. This procedure is performed with, or without fusion promoting methods. For both options the rate of fusion is high and there is much debate whether fusion of the treated segment is a contributing factor to accelerated degeneration of adjacent motion segments. In an effort to prevent degeneration of adjacent segments (ASDeg) due to loss of mobility at the operated level, cervical disc arthroplasty (CDA) was introduced. To evaluate the effectiveness of CDA in preventing ASDeg long term studies are necessary. However, prevention of ASDeg is based on the premise that mobile disc prostheses preserve cervical spine motion in a physiological way. In this article the authors describe a short term protocol for a study that aims to investigate whether CDA reaches the intended goal: restoration or preservation of physiological cervical spine motion. To this end, a technique is used to establish the sequence of contributions of cervical motion segments to flexion/extension of the spine.24 subjects between 18 and 55 years old, with radicular symptoms due to a herniated disc between C5 and C7, refractory to conservative therapy are randomized to simple discectomy, or CDA. These groups are preceded by a pilot group of three subjects receiving CDA. Fluoroscopic flexion-extension recordings are acquired preoperatively, and at three and 12 months postoperative. At these same time points, patient reported outcomes are collected, and a neurological examination is performed by and independent physician.Studies investigating arthroplasty determine mobility by measuring segmental range of motion (sROM), which gives no information other than presence, and quantity, of mobility. SROM suffer from high variability. The authors therefore chose to use a method previously used in healthy controls, to describe the dynamic process of cervical spine motion in more detail. Determining cervical spine motion patterns has been reported to be more consistent than sROM. If a physiological motion pattern is absent after surgery in the CDA group, prevention of future ASDeg is less likely. Radiological outcomes will be correlated to clinical outcomes.NCT00868335.

Project description:BACKGROUND:Cardiovascular magnetic resonance (CMR) fluoroscopy allows for simultaneous measurement of cardiac function, flow and chamber pressure during diagnostic heart catheterization. To date, commercial metallic guidewires were considered contraindicated during CMR fluoroscopy due to concerns over radiofrequency (RF)-induced heating. The inability to use metallic guidewires hampers catheter navigation in patients with challenging anatomy. Here we use low specific absorption rate (SAR) imaging from gradient echo spiral acquisitions and a commercial nitinol guidewire for CMR fluoroscopy right heart catheterization in patients. METHODS:The low-SAR imaging protocol used a reduced flip angle gradient echo acquisition (10° vs 45°) and a longer repetition time (TR) spiral readout (10 ms vs 2.98 ms). Temperature was measured in vitro in the ASTM 2182 gel phantom and post-mortem animal experiments to ensure freedom from heating with the selected guidewire (150 cm?×?0.035? angled-tip nitinol Terumo Glidewire). Seven patients underwent CMR fluoroscopy catheterization. Time to enter each chamber (superior vena cava, main pulmonary artery, and each branch pulmonary artery) was recorded and device visibility and confidence in catheter and guidewire position were scored on a Likert-type scale. RESULTS:Negligible heating (<?0.07°C) was observed under all in vitro conditions using this guidewire and imaging approach. In patients, chamber entry was successful in 100% of attempts with a guidewire compared to 94% without a guidewire, with failures to reach the branch pulmonary arteries. Time-to-enter each chamber was similar (p=NS) for the two approaches. The guidewire imparted useful catheter shaft conspicuity and enabled interactive modification of catheter shaft stiffness, however, the guidewire tip visibility was poor. CONCLUSIONS:Under specific conditions, trained operators can apply low-SAR imaging and using a specific fully-insulated metallic nitinol guidewire (150 cm?×?0.035" Terumo Glidewire) to augment clinical CMR fluoroscopy right heart catheterization. TRIAL REGISTRATION:Clinicaltrials.gov NCT03152773 , registered May 15, 2017.

Project description:BackgroundThe newly designed cervical disc prosthesis, Pretic-I, had been finished its limited clinical use for over 5 years. At a short-term follow-up of 2 years, we obtained satisfactory clinical results. The long-term clinical efficacy and safety of Pretic-I will now be analyzed.MethodsPeri-operative parameters included intra-operative blood loss, operation time, off-bed time. Clinical parameters included visual analogue scale (VAS) for arm and neck, neck disability index (NDI), and Japanese Orthopaedic Association (JOA) score. Radiological parameters included C2-7 Cobb angle, Shell angle, and the range of motion (ROM) of C2-7, functional segment unit (FSU), and adjacent FSU. The CDA-related complications included adjacent segment degeneration (ASDeg), adjacent segment disease (ASDis), heterotopic ossification (HO), prosthesis subsidence, prosthesis displacement, and dysphagia.ResultsA total 64 patients from two independent centers received a single-level CDA with Discover (n = 32) and Pretic-I (n = 32), and all of patients finished a 5-year follow-up. There're no significant differences between two groups in peri-operative parameters. The clinical parameters improved greatly in Pretic-I group (p<0.0001), and there's no statistical difference from Discover group. Furthermore, Pretic-I could slightly improve the cervical curvature (15.08 ± 11.75 to 18.00 ± 10.61, p = 0.3079) and perfectly maintain the Shell angle (3.03 ± 3.68 to 2.23 ± 4.10, p = 0.1988), cervical ROM (52.48 ± 14.31 to 53.30 ± 11.71, p = 0.8062) and FSU ROM (12.20 ± 4.52 to 10.73 ± 4.45, p = 0.2002). The incidence of high-grade HO (Grade III-IV) at the final follow-up was significantly lower in Pretic-I group than in Discover group (12.50% vs. 34.38%, p = 0.0389, Statistical Power = 95.36%). The incidences of other CDA-related complications in Pretic-I group were also well-accepted, comparable to the Discover group, without significant differences.ConclusionCDA with Pretic-I demonstrated a well-accepted and sustained clinical outcome, with a significantly lower incidence of high-grade HO. This newly designed prosthesis is expected to become an alternative choice for cervical disc prosthesis in the future.

Dataset Information

Magnetic resonance imaging evaluation after implantation of a titanium cervical disc prosthesis: a comparison of 1.5 and 3 Tesla magnet strength.

Publications

Magnetic resonance imaging evaluation after implantation of a titanium cervical disc prosthesis: a comparison of 1.5 and 3 Tesla magnet strength.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets