Journal of radiological science and technology (대한방사선기술학회지:방사선기술과학)

Korean Society of Radiological Science (대한방사선과학회)
권호 표지
DOI QR코드

DOI QR Code

A Comparison for Cervical Neural Foraminal Area by 3-dimensional CT in Normal Adults

3차원 컴퓨터단층촬영상을 이용한 정상 성인의 경추 신경공 면적 비교

  • Kim, Yon-Min (Department of Radiotechnology, Wonkwang Health Science University)
  • 김연민 (원광보건대학교 방사선과)
  • Received : 2021.12.08
  • Accepted : 2021.12.20
  • Published : 2021.12.31
Download PDF
⟨ Previous Next ⟩

Abstract

Cervical foraminal stenosis is a disease in which the nerves that pass from the spinal canal to the limbs are narrowed and the nerves are compressed or damaged. Due to the lack of an imaging method that provides quantitatively stenosis, this study attempted to evaluate the area of the cervical vertebrae by reconstructing a three-dimensional computed tomography image, and to determine the area of the neural foramen in normal adults to calculate the stenosis rate. Using a three-dimensional image processing program, the surrounding bones including the posterior spinous process, lateral process, and lamellar bones of the cervical vertebra were removed so that the neural foramen could be observed well. A region of interest including the neural foraminal area of the three-dimensional image was set using ImageJ, and the number of pixels in the neural foraminal area was measured. The neural foraminal area was calculated by multiplying the number of measured pixels by the pixel size. To measure the largest neural foraminal area, it was measured between 40~50 degrees in the opposite direction and 15~20 degrees toward the head. The average area of the right C2-3 foramen was 44.32 mm2, C3-4 area was 34.69 mm2, C4-5 area was 36.41 mm2, C5-6 area was 35.22 mm2, C6-7 area was 36.03 mm2. The average area of the left C2-3 foramen was 42.71 mm2, C3-4 area was 32.23 mm2, C5-6 area was 34.56 mm2, and C6-7 area was 31.89 mm2. By creating a reference table based on the neural foramen area of normal adults, the stenosis rate of patients with neural foraminal stenosis could be quantitatively calculated. It is expected that this method can be used as basic data for the diagnosis of cervical vertebral foraminal stenosis.

Keywords

Acknowledgement

This paper was supported by Wonkwang Health Science University in 2021

References

  1. Choi YK. Lumbar foraminal neuropathy: An update on non-surgical management. The Korean Journal of Pain. 2019;32(3):147-59. https://doi.org/10.3344/kjp.2019.32.3.147
  2. Marc AC, Blair AB. Nonoperative Management of Cervical Radiculopathy. American Family Physician. 2016;93(9):746-54.
  3. Kim MS, Lee DG, Chang MC. Outcome of transforaminal epidural steroid injection according to severity of cervical foraminal stenosis. World Neurosurgery. 2018;110:398-403.
  4. Wainner RS, Gill H. Diagnosis and nonoperative management of cervical radiculopathy. Journal of Orthopaedic & Sports Physical Therapy. 2000;30:28-44.
  5. Abbed KM, Coumans JV. Cervical radiculopathy: Pathophysiology, presentation, and clinical evaluation. Neurosurgery. 2007;60(Suppl-1):S28-S34.
  6. Mun JU, Cho HR, Kim SH, Yoo JI, Kang KN, Yoon SH, et al. Uncinate Process Area as a New Sensitive Morphological Parameter to Predict Cervical Neural Foraminal Stenosis. Pain Physician. 2019;22:105-10.
  7. Yousem DM, Atlas SW, Goldberg HI, Grossman RI. Degenerative narrowing of the cervical spine neural foramina: Evaluation with high-reolution 3DFT gradient-echo MR imaging. American Journal of Neuroradiology. 1991;12(2):229-36.
  8. Marcelis S, Seragini FC, Taylor JA, Huang GS, Park YH, Resnick D. Cervical spine: Comparison of 45 degrees and 55 degrees anteroposterior oblique radiographic projections. Radiology. 1993;188(1):253-6. https://doi.org/10.1148/radiology.188.1.8511307
  9. Ahn BJ. The Study Intervertebral Foramen Image for the Cervical spine of Posterior Anterior Oblique for the Angle. Journal of the Korean Society of Radiology. 2015;9(4):197-203. https://doi.org/10.7742/JKSR.2015.9.4.197
  10. Shin MJ. Imaging of the Cervical Spine. Journal of Korean Society of Spine Surgery. 1999;6(2):81-4.
  11. Schell A, Rhee JM, Holbrook J, Lenehan E, Park KY. Assessing Foraminal Stenosis in the Cervical Spine: A Comparison of Three-Dimensional Computed Tomographic Surface Reconstruction to Two-Dimensional Modalities. Global Spine Journal. 2017;7(3):266-71. https://doi.org/10.1177/2192568217699190
  12. Kim YM. A Measurement Method for Cervical Neural Foraminal Stenosis Ratio using 3-dimensional CT. Journal of the Korean Society of Radiology. 2020;14(7):975-80. https://doi.org/10.7742/JKSR.2020.14.7.975
  13. Shim JH, Park CK, Lee JH, Choi JW, Lee DC, Kim DH, et al. A comparison of angled sagittal MRI and conventional MRI in the diagnosis of herniated disc and stenosis in the cervical foramen. European Spine Journal. 2009;18(8):1109-16. https://doi.org/10.1007/s00586-009-0932-x
  14. Kim SJ, Lee JW, Chai JW, Yoo HJ, Kang Y, Seo JW, et al. A New MRI Grading System for Cervical Foraminal Stenosis Based on Axial T2-Weighted Images. Korean Journal of Radiology. 2015;16(6):1294-302. https://doi.org/10.3348/kjr.2015.16.6.1294
  15. Park HJ, Kim SS, Lee SY, Park NH, Chung EC, Rho MH, et al. A practical MRI grading system for cervical foraminal stenosis based on oblique sagittal images. The British Journal of Radiology. 2013;86:1025.
  16. Kim YK, Park SH, Kim YM. Comparison of Bone Volume Measurements Using Conventional Single and Dual Energy Computed Tomography. Journal of Radiological Science and Technology. 2017;40(2):253-9. https://doi.org/10.17946/JRST.2017.40.2.10
  17. Seoung YH. Comparison of Hounsfield Units by Changing in Size of Physical Area and Setting Size of Region of Interest by Using the CT Phantom Made with a 3D Printer. Journal of Radiological Science and Technology. 2015;38(4):421-7. https://doi.org/10.17946/JRST.2015.38.4.12