Magnetic resonance imaging of the spine: applications and limitations

MRI is a unique, noninvasive imaging modality that has already received wide application in the evaluation of abnormalities involving the spinal axis. It is the procedure of choice in the evaluation of suspected syringomyelia, Chiari malformation, and disk space infection. MRI is the only imaging modality presently capable of imaging multiple sclerosis plaques involving the spinal cord and is the only noninvasive modality that can diagnose nonherniated degenerated disks. MRI may provide valuable information in degenerative diseases of the spine, tumors of the spinal axis, and other congenital abnormalities, as either a primary or adjuvant imaging modality. Further investigation is needed to define the role of MRI in the evaluation of the traumatized and postoperative spine. Surface coil techniques hold promise in alleviating the present shortcomings of MRI, which are related primarily to slice thickness and attendant partial volume averaging. Chemical shift imaging may also be useful in accentuating subtle contrast differences between tissues and therefore highlighting abnormalities.