Dynamic visualization of arachnoid adhesions in a patient with idiopathic syringomyelia using high‐resolution cine magnetic resonance imaging at 3T

Abstract

A 39-year-old female patient with thoracic syringomyelia underwent routine magnetic resonance imaging (MRI) and 3 T MRI to investigate the value of retrospectively cardiac-gated cine steady-state free precession (SSFP) MRI in the preoperative and postoperative diagnosis of arachnoid membranes in the spinal subarachnoid space. Therefore, 3T MRI included sagittal and transverse retrospectively cardiac-gated cine balanced fast-field echo (balanced-FFE) sequences both preoperatively and after microsurgical lysis of arachnoid adhesions and expansive duraplasty. Arachnoid membranes were detected and this result was correlated with intraoperative findings and the results of routine cardiac-gated phase-contrast cerebrospinal fluid (CSF) flow MRI. Retrospectively cardiac-gated cine SSFP MRI enabled imaging of arachnoid membranes with high spatial resolution and sufficient contrast to delineate them from hyperintense CSF preoperatively and postoperatively. The images were largely unaffected by artifacts. Surgery confirmed the presence of arachnoid adhesions in the upper thoracic spine. Not all arachnoid membranes that were seen on cine balanced-FFE sequences caused significant spinal CSF flow blockages in cardiac-gated phase-contrast CSF flow studies. In conclusion, retrospectively cardiac-gated cine SSFP MRI may become a valuable tool for the preoperative detection of arachnoid adhesions and the postoperative evaluation of microsurgical adhesiolysis in patients with idiopathic syringomyelia.

Familial Adhesive Arachnoiditis Associated with Syringomyelia

“…Nevertheless, this sequence is very sensitive to motion caused by swallowing and breathing. 34 Gottschalk et al 34 suggested that cardiac-gated cine steady-state free precession MR imaging has a certain value in the evaluation of idiopathic syringomyelia and the detection of the arachnoid membranes. For the imaging of future patients, we would suggest the use of sagittal T2, T2*, T1, and postgadolinium T1-weighted sequences from C0 to the cauda equina, a midline sagittal cardiac-gated phase-contrast MR imaging completed by axial balanced turbofield echo at the level of the anomalies.…”

Dorsal spinal arachnoid web diagnosed with the quantitative measurement of cerebrospinal fluid flow on magnetic resonance imaging

“…12 Myelography with CT and cardiac-gated phase-contrast cine-mode MRI in the sagittal plane are likewise not always useful. 9,10,12,22 Therefore, it would be beneficial to find a better method to diagnose and localize arachnoid webs.…”

Assessment of cerebellar pulsation in dogs with and without Chiari-like malformation and syringomyelia using cardiac-gated cine magnetic resonance imaging

“…Steady-state free precession imaging is favoured over phase contrast imaging that suffers from low resolution and limited ability to assess tissue margins, forcing previous studies to utilise a tonsillar motion index (Pujol et al, 1995). A similar technique has been used to assess arachnoid adhesions in humans (Gottschalk et al, 2010) and further applications may be found in veterinary medicine; however, further study to establish the repeatability and reliability should be conducted.…”