High-Resolution CINE MRI for the Visualization of Arachnoid Adhesions

Arachnoid adhesions are a common underlying cause for the development of idiopathic syringomyelia by causing CSF flow blockages. There is no direct geometrical relation between the location of the syringomyelia and the responsible arachnoid adhesion. For minimization of the trauma during the surgical intervention, the precise identification of the location of the culprit adhesion appears mandatory. Although MRI has been shown to visualize CSF flow blockages by phase-contrast flow imaging, the direct visualization of the arachnoid membranes with sufficient image quality has not been reported. The major hurdles for direct visualization of the arachnoid membranes are the required high spatial resolution in combination with the need for cardiac phase resolved imaging to avoid motion blur introduced by the pulsatile CSF flow. The aim of this study was to evaluate the value of cardiac gated cine steady state free precession MRI for preand postoperative direct visualization of arachnoid adhesions in the spinal subarachnoid space in patients with idiopathic syringomyelia.