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Magnetic resonance imaging of the spine
G M Miller1, G S Forbes, B M Onofrio
1Department of Diagnostic Radiology, Mayo Clinic, Rochester, MN 55905.
Abstract:
Magnetic resonance (MR) imaging offers the advantages of multiplanar capabilities, physiologic as well as anatomic imaging, and some tissue specificity. Since mid-1985, we have performed more than 2,800 MR examinations of the spine, and gadolinium has been used as a contrast agent in many MR studies since its release by the Food and Drug Administration last year. Although MR imaging has been promoted as the procedure of choice for all clinical indications, on the basis of our experience myelography still plays an important role in the imaging of many spinal disorders, including disk disease. Some pathologic conditions such as intraspinal vascular malformations and leptomeningeal metastatic lesions are best imaged by myelography. MR studies have been most useful in evaluating intraspinal neoplasms, spinal cord parenchymal lesions, infections, congenital abnormalities, and "postoperative failed back syndromes."
Insights
Magnetic resonance (MR) imaging is valuable for spinal conditions, but myelography remains crucial for specific disorders like disk disease and vascular malformations. Both imaging techniques play vital roles in diagnosing spinal pathologies.
Area of Science:
- Radiology
- Medical Imaging
- Neurology
Background:
- Magnetic resonance (MR) imaging provides multiplanar, physiologic, and anatomic imaging with tissue specificity.
- Gadolinium-based contrast agents have become widely used in MR studies.
- Over 2,800 spinal MR examinations have been performed since mid-1985.
Purpose of the Study:
- To evaluate the comparative roles of MR imaging and myelography in diagnosing spinal disorders.
- To highlight specific conditions where myelography remains the preferred imaging modality.
Main Methods:
- Retrospective review of over 2,800 spinal MR examinations.
- Comparison of MR imaging findings with myelography results for various spinal pathologies.
- Clinical experience with both imaging modalities since 1985 and the introduction of gadolinium contrast.
Main Results:
- MR imaging is highly effective for intraspinal neoplasms, spinal cord lesions, infections, congenital abnormalities, and failed back syndromes.
- Myelography is superior for imaging certain conditions, including intraspinal vascular malformations and leptomeningeal metastatic lesions.
- Disk disease diagnosis benefits from both MR imaging and myelography, with myelography retaining an important role.
Conclusions:
- While MR imaging is a powerful tool for spinal diagnostics, myelography remains an essential complementary technique.
- The choice between MR imaging and myelography depends on the specific clinical indication and suspected pathology.
- A combined approach utilizing both MR imaging and myelography ensures comprehensive evaluation of spinal disorders.