The application of magnetic resonance in spinal cord disorders

The introduction of the proton magnetic resonance imaging into clinical practice shows significant diagnostic potentials, and throws a new light on pathological changes involving the spinal cord, in particular on those related to trauma and its sequelae. The initial experience concerning the use of the proton magnetic resonance imaging in 28 patients, in whom paraplegia or quadriplegia developed following an injury to the spine, indicates that magnetic resonance imaging has specific advantages over other investigative modalities. Magnetic resonance imaging techniques permit, in most instances, a distinct demarcation of the spinal cord in its entire length or in segments, without ionising radiation or intrathecal introduction of contrast media. A significant superiority of magnetic resonance imaging is the feasibility to apply multiplanar imaging of the spinal cord without moving the paralysed patient and the possibility to repeat the imaging, even on an outpatient basis, without a major discomfort to the patient. Most of the post-traumatic lesions can be identified in magnetic resonance images, however, the application of paramagnetic enhancers may have to be considered in order to achieve a distinct delineation of a lesion from the surrounding normal spinal cord tissue in selected cases. Despite some current limitations, magnetic resonance imaging has opened new avenues to obtain information about the anatomy, and, in particular, the biochemistry of the spinal cord.