Contrast-enhanced magnetic resonance imaging of the spine

MRI of the spine and its contents is fast becoming the study of choice over CT myelography for the evaluation of spinal pathology. MRI is able to generate sagittal and coronal images in addition to axial images, to image the entire spine, and to produce a myelogramlike picture. These capabilities give MRI a distinct advantage over CT myelography not only because no intrathecal contrast injection is needed but also because intramedullary lesions, edema, and syrinx may be differentiated from each other by conventional, noncontrast, spin-echo MRI. This article reviews the current philosophies regarding contrast-enhanced MRI with gadopentate dimeglumine in the evaluation of the spine and its contents. It will provide an imaging strategy and approach to evaluation, briefly discuss spin-echo and gradient-echo pulse sequences, and give contrast indications focusing on disorders that benefit from the use of injected, intravenous gadopentate dimeglumine. Potential imaging artifacts related to spin-echo and gradient-echo imaging pertinent to imaging of the spine will also be discussed.