MR imaging of the spine: recent advances in pulse sequences and special techniques

A number of new techniques have been developed to enhance MR imaging of the spine. Fat-suppression techniques used in conjunction with gadolinium-based contrast material improve visualization of enhancing inflammatory and neoplastic diseases. Fast spin-echo (FSE) sequences can be used to decrease imaging times, to increase resolution, or to improve signal-to-noise ratios on T2-weighted images. In general, FSE images provide a better myelographic effect with reduced magnetic susceptibility compared with gradient-recalled echo (GRE) techniques. With volume GRE sequences, thin contiguous sections can be obtained, and images can be reformatted into multiple planes from a single data set. High-contrast imaging can be accomplished by using three-dimensional (3D) turbo-fast low-angle shot (FLASH) or magnetization prepared rapid acquisition gradient-echo (MP RAGE) techniques with gadolinium contrast enhancement. Finally, CSF flow dynamics within the subarachnoid space and within cystic lesions can be elucidated with phase-contrast techniques. Judicious selection of these methods and other innovative MR techniques is necessary to maximize the potential of MR in diagnosis of spinal disease.