• Nico Papinutto, Ilaria Perretti, Jacob Mallott, Shuiting Cheng, Tiffany Cooper, Refujia Gomez, William A Stern, Anna Pichiecchio, Eduardo Caverzasi, and Roland G Henry.
• Weill Institute for Neurosciences, Department of Neurology, University of California, San Francisco, San Francisco, California, USA.
• J Neuroimaging. 2024 Nov 1; 34 (6): 639645639-645.

Background And PurposeSpinal cord (SC) cross-sectional areas (CSAs) assessed with MRI have proven to be extremely valuable imaging markers in several diseases. Among the challenges is the delineation of vertebral levels to determine level-dependent changes in cord atrophy. With this study, we aimed to (1) test the hypothesis that there is proportionality in the position of the first six intervertebral discs and the length of the upper portion of the SC and (2) show that a proportionality approach can simplify the CSA assessment across vertebrae offering good reliability.MethodsForty-six volunteers underwent standard T2-weighted and T1-weighted cervical SC MRI acquisitions. The distance between the obex and the intervertebral discs (from C2-C3 to T1-T2) was measured on the T2-weighted acquisitions of the entire cohort. In a test-retest experiment on 12 subjects, the % disc position values were used to define vertebral levels, and a comparison was performed with manual vertebrae assignment in terms of mean CSA and its coefficient of variation.ResultsThe mean upper cord length for the cohort was 144.0 ± 13.1 mm. The discs' level % position in the upper cord was found to be fairly consistent, with standard deviations of 0.8%-1.7%. The mean vertebral CSA obtained with the proportionality method was substantially equivalent to the manual approach in terms of mean CSA values and test-retest reliability.ConclusionsWith this study, we propose a proportionality method for the assignment of cervical SC vertebral levels that can simplify the processing of MRI datasets in the context of CSA measurements.© 2024 The Author(s). Journal of Neuroimaging published by Wiley Periodicals LLC on behalf of American Society of Neuroimaging.

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