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Rofo 2014; 186(11): 1016-1021
DOI: 10.1055/s-0034-1366429
Neuroradiology
© Georg Thieme Verlag KG Stuttgart · New York

Spinal Cord Motion: Influence of Respiration and Cardiac Cycle

Rückenmarksbewegungen: Bestimmung des Einflusses von Atmung und Herzzyklus mittels MRT
S. Winklhofer
1   Department of Neuroradiology, RWTH Aachen University Hospital, Aachen, Germany
2   Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Switzerland
,
F. Schoth
3   Department of Diagnostic Radiology, RWTH Aachen University Hospital, Germany
,
P. Stolzmann
2   Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Switzerland
,
T. Krings
4   Division of Neuroradiology, Department of Medical Imaging, Toronto Western Hospital, UHN, Toronto, Ontario, Canada
,
M. Mull
1   Department of Neuroradiology, RWTH Aachen University Hospital, Aachen, Germany
,
M. Wiesmann
1   Department of Neuroradiology, RWTH Aachen University Hospital, Aachen, Germany
,
C. P. Stracke
1   Department of Neuroradiology, RWTH Aachen University Hospital, Aachen, Germany
5   Department of Neuroradiology, Alfried-Krupp-Hospital, Essen, Germany
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Publikationsverlauf

18. Januar 2014

21. März 2014

Publikationsdatum:
22. April 2014 (online)

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Abstract

Purpose: To assess physiological spinal cord motion during the cardiac cycle compared with the influence of respiration based on magnetic resonance imaging (MRI) measurements.

Materials and Methods: Anterior-posterior spinal cord motion within the spinal canal was assessed in 16 healthy volunteers (median age, 25 years) by cardiac-triggered and cardiac-gated gradient echo pulse sequence MRI. Image acquisition was performed during breath-holding, normal breathing, and forced breathing. Normal spinal cord motion values were computed using descriptive statistics. Breathing-dependent differences were assessed using the Wilcoxon signed-rank test and compared with the cardiac-based cord motion.

Results: A normal value table was set up for the spinal cord motion of each vertebral cervico-thoracic-lumbar segment. Significant differences in cord motion were found between cardiac-based motion while breath-holding and the two breathing modalities (P < 0.01 each). Spinal cord motion was found to be highest during forced breathing, with a maximum in the lower cervical spinal segments (C5; mean, 2.1 mm ± 1.17). Image acquisition during breath-holding revealed the lowest motion.

Conclusion: MRI permits the demonstration and evaluation of cardiac and respiration-dependent spinal cord motion within the spinal canal from the cervical to lumbar segments. Breathing conditions have a considerably greater impact than cardiac activity on spinal cord motion.

Key points:

• Cardiac-triggered and ECG-gated MRI allows for demonstration of the smallest spinal cord motions.

• Respiratory influences seem to have the highest impact on spine motion.

• In contrast, the influence of the cardiac cycle seems to be small.

• The smallest spinal cord motions were measured during breath-hold.

Citation Format:

• Winklhofer S, Schoth F, Stolzmann P et al. Spinal Cord Motion: Influence of Respiration and Cardiac Cycle. Fortschr Röntgenstr 2014; 186: 1016 – 1021

Zusammenfassung

Ziel: Ziel der Studie war es, mittels MRT (Magnetresonanztomografie), den Einfluss des Herzzyklus auf die physiologische Rückenmarksbewegung mit dem Einfluss der Atmung zu vergleichen.

Material und Methoden: Bei 16 gesunden, freiwilligen Probanden (Altersemedian 25 Jahre) wurden Rückenmarksbewegungen innerhalb des Spinalkanals mittels Herz-getriggerten und EKG-synchronisierten Gradienten Echo-Puls MRT-Sequenzen untersucht. Die Aufnahmen wurden während Atemanhalten, normalem Atmen und kräftigem Atmen durchgeführt. Normwerte für die Rückenmarksbewegung wurden mittels deskriptiver Statistik berechnet. Atemabhängige Unterschiede wurden mittels des Wilcoxon-Vorzeichen-Rang-Testes ermittelt und mit der Herzzyklus-bedingten Rückenmarksbewegung verglichen.

Ergebnisse: Eine Normwerttabelle für zervikale, thorakale und lumbale Rückenmarksbewegungen auf Höhe eines jeden Wirbelsegmentes wurde erstellt. Signifikante Unterschiede im Ausmaß der Rückenmarksbewegung zeigten sich zwischen den Untersuchungen während des Atemstillstandes (Herzzyklus-bedingten Bewegung) und den beiden atemabhängigen Aufnahmen (jeweils p < 0,01). Die größten Rückenmarksbewegungen wurden während kräftigem Atmen detektiert, mit Höchstwerten auf Höhe der unteren Zervikalsegmente (C5; Mittelwert 2,1 mm ± 1,17). Die Aufnahmen während Atemanhalten ergaben die niedrigsten Werte an Rückenmarksbewegung.

Schlussfolgerung: MRT erlaubt die Darstellung und Beurteilung von herzzyklus-, und atemabhängigen Rückenmarksbewegungen innerhalb des Spinalkanals von zervikalen bis lumbalen Wirbelsegmenten. Atembedingte Einflüsse haben, im Vergleich zu herzzyklus-bedingten Einflüssen, hierbei scheinbar eine deutlich größere Auswirkung auf die Rückenmarksbewegung.

Kernaussagen:

• MRT mit Herz-getriggerten und EKG-synchronisierten Echo-Puls-Sequenzen ermöglicht die Darstellung kleinster Rückenmarksbewegungen.

• Atemabhängige Einflüsse scheinen die größte Auswirkung auf den Bewegungsumfang zu haben.

• Der Einfluss des Herzzyklus auf die Rückenmarksbewegungen scheint dagegen gering zu sein.

• Die geringsten Rückenmarksbewegungen wurden bei Atemanhalten registriert.

Key words

spinal cord - MR imaging - CNS
 

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