*Corresponding author: Behice Kaniye Yilmaz, Department of Physical Therapy, Jubail General Hospital, King Abdullah, Al Jubail, Saudi Arabia, Tel: +0090(505)2625475; Fax: +0090(212)5896229; Email: behiceyilmaz@gmail. com Citation: Can TS, Yilmaz BK, Özdemir S (2019) Is There A Need for Servi- cothoracic Survey Images for Vertebral Enumeration in LSTV; MRI Study. J Nucl Med Radiol Radiat Ther 4: 016. Received: November 22, 2019; Accepted: December 09, 2019; Published: De- cember 16, 2019 Copyright: © 2019 Can TS, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestrict- ed use, distribution, and reproduction in any medium, provided the original author and source are credited. Introduction Lumbosacral transitional vertebrae (LSTV) is an anatomic varia- tion involving the lumbarization of the frst sacral vertebra (S1) and the sacralization of the ffth lumbar vertebra (L5) [1-3]. Castellvi et al. defned four different subtypes [4]. Although the presence of LSTV can be recognized by x-ray, Computed Tomography (CT), and Mag- netic Resonance Imaging (MRI), multiplanar imaging with CT can demonstrate the LSTV anatomy with higher reliability due to its high- er spatial resolution and multiplanar slicing ability. However, LSTV is usually an incidental fnding in spinal imaging and identifying LSTV has great importance in the planning of surgery at the right level, especially in patients who are candidates for lumbar spinal surgery for various reasons such as trauma, tumor and disc dis- ease [5]. MRI is a frequently used imaging modality in the diagnosis of low back pain and degenerative disc diseases and before spinal surgery. It is possible to determine the exact level of the surgical in- tervention when the whole spine survey images are included to the MRI studies. However, the detection of the correct level in MRI ex- aminations, especially when only the lumbar region is displayed is a controversial issue. Several studies have been conducted on this case, but no standard has been established yet [6-8]. In this study, we aimed to determine whether various anatomical and vascular structures that are easily visible in MRI examinations can be used as a marker for vertebrae numbering by evaluating and comparing the patients with normal lumbosacral junction anatomy. Materials and Methods MRI examinations of 1332 adult patients who underwent lumbar spinal MRI between October 2018 and January 2019 with the pre- liminary diagnosis of lumbar radiculopathy and low back pain in our clinic were evaluated retrospectively. Ethics Committee Approval was received for the study. Three hundred seventy-four patients with a history of spinal trauma, surgery, infection, and spondylolisthesis were excluded; hence, these pathologies could lead to a change in the lumbosacral junction anatomy. Also, patients who had advanced abdominal aortic tortuosity (n=23), abdominal aortic aneurysm (n=27), nephrectomy history (n=3), ectopic kidney (n=4) and horseshoe kidney (n=2) were also excluded because the patients could mislead the determination of vascular landmarks. As a result, 899 patients were evaluated for the presence of LSTV in the study. All patients underwent standard lumbar spinal MRI protocol using a spinal coil with 1.5 Tesla MRI (Philips Achieva, Best, and Netherlands). Examination protocol: Axial T2-weighted fast spin echo; TR: 3800 ms, TE: 100 ms, Sagittal T1-weighted spin echo; TR: 500ms, TE: 10ms, Sagittal T2-weighted fast spin echo; TR: 2500ms, Can TS, et al., J Nucl Med Radiol Radiat Ther 2019, 4: 016 DOI: 10.24966/NMRR-7419/100016 HSOA Journal of Nuclear Medicine, Radiology & Radiation Therapy Case Report Tuba Selçuk Can, Behice Kaniye Yilmaz* and Sevim Özdemir Radiology Department, Haseki Research and Training Hospital, İstanbul, Turkey Is There A Need for Servicotho- racic Survey Images for Verte- bral Enumeration in LSTV; MRI Study Abstract Objectives: In this study we aimed to evaluate any reliable marker on MRI studies for vertebral enumeration without any need to whole spine imaging. Background: Lumbosacral transitional vertebra (LSTV) is an ana- tomical variation that is mostly incidentally detected in routine spinal magnetic resonance imaging (MRI) studies. Its detection and aware- ness have great importance especially for planning of an interven- tional procedure. Methods: We retrospectively evaluated 899 lumbar MRI examina- tions. Vertebral levels of aortic bifurcation (AB), celiac trunk (CT), superior mesenteric artery (SMA), right renal artery (RRA), left renal artery (LRA), inferior vena cava (IVC) confuence), 12th costoverte- bral junction and the origin level of psoas muscle were evaluated. Results: The incidence of LSTV was 10.3%. The visibility of these anatomical structures were AB; 100%, CT; 96.8%, SMA; 96.8%, LRA; 96.8%, RRA; 95.7%, IVC confuence; 77.4%, ILL; 30.1%, 12. costovertebral junction; 11.8%, PO; 97.8%. Conclusion: Vascular landmarks were detected to be more proxi- mally located in LSTV group. As a result there was not any reliable anatomical landmark to predict the correct enumeration of the ver- tebrae. Keywords: Landmarks; Lumbosacral transitional vertebrae; Verte- bral