MRI images at a 45-degree angle through the cervical neural foramina: a technique for improved visualization

Traditional MRI imaging of the cervical neural foramina (NF) generally utilizes sagittal and axial views to delineate pathology. These views may not fully delineate NF pathology. Enhanced imaging and visualization of this area would benefit all interventionalists. The spinal interventionalist, in particular, routinely utilizes approximately a 45-degree fluoroscopic en face view for placement of needles for a cervical transforaminal epidural. The interventionalist relies on axial MRI views to identify NF pathology that can be conceptually more difficult to analyze. Routine 45-degree oblique views through the NF, along with traditional axial views for correlation, more clearly demonstrate NF pathology.

Two cases are presented in which the 45-degree oblique views more clearly demonstrate neural foramina pathology.

These clinical cases demonstrate the clinical utility of the cervical spine MRI 45 degree oblique technique and show cervical NF pathology that is not as easily identified on routine axial and sagittal sequences. We advocate the routine acquisition and examination of 45-degree cuts to help spinal practitioners better delineate NF pathology.