0.6 T MR IMAGING OF THE CERVICAL-SPINE - MULTISLICE AND MULTIECHO TECHNIQUES

Abstract

During a 6 mo. period, 50 patients with signs and symptoms referable to the cervical spine were studied with a 0.6 T superconducting magnetic resonance (MR) imaging unit. The last 23 of these 50 patients were studied with combined multislice and multiecho techniques. In 38 of the 50 patients, abnormalities were demonstrated on MR images. Intramedullary lesions included syringomyelia (3 cases), primary tumors (3), metastatic neoplasm (1), cord atrophy secondary to trauma (1) and multiple sclerosis (1). Intradural, extramedullary lesions included 2 neurofibromas and 2 Chiari malformations. The rest of the lesions were extradural: degenerative changes (10), spinal stenosis with cord compression (5), disk degeneration and/or herniation (5), postoperative changes (4), metastases to bone/epidural disease (3) and neurofibromatosis (1). Two patients had more than 1 abnormality. The MR findings were compared with available routine radiographs, computed tomographic (CT) scans with and without metrizamide and myelograms. MR imaging was consistently better than routine CT scanning in the detection of lesions of the spinal cord and in directly imaging the effects on the spinal cord of extrinsic abnormalities such as spinal stenosis. Metrizamide-enhanced CT scanning detected all cases of syringomyelia, but it involved an invasive procedure. Myelography alone was slightly less sensitive and considerably less specific than MR in detecting intramedullary lesions and in detecting intramedullary lesions and in distinguishing cord neoplasms from syringomyelia. Multislice, multiecho techniques with up to 240 ms echo times (TE) were particularly helpful in the detection and characterization of extradural processes. The addition of this technique to standard spin-echo 500 ms repetition-time (TR), 30 ms TE sagittal and transverse multislice studies and transverse 2000 ms TR, 60 ms TE multislice studies provides an examination of the cervical spine that optimizes the detection rate when the disease process is unknown. After plain radiography, MR is the imaging procedure of choice for screening suspected disease of the cervical spinal canal.