MR imaging of the cervical spine: neurovascular anatomy

High-resolution surface-coil MR imaging reveals intricate anatomic detail of the cervical spinal canal and its neurovascular contents. Appreciation of the normal neurovascular anatomy provides a scientific foundation for the detection of disease. Sagittal, axial, and oblique MR images of normal subjects were correlated with comparable anatomic sections obtained with a cryomicrotome whole-organ sectioning technique. The anterior epidural venous plexus is a prominent structure in the cervical spinal canal and was consistently identified both with cryomicrotomy and with MR in sagittal and axial planes. Epidural veins can be displaced and distorted in patients with cervical disk disease. Nerve roots including dorsal and ventral rootlets were consistently identified on axial images coursing through the subarachnoid space. Oblique-plane imaging showed nerve roots "en face" in their respective foramina; this may be a useful imaging technique in the diagnosis of nerve root impingement.