[Nuclear magnetic resonance tomography of the spine and spinal cord compared with computed tomography and myelography]

Emergency Magnetic Resonance Examination of Patients with Spinal Cord Symptoms

Eighteen consecutive patients with spinal cord symptoms of sudden or relatively sudden onset were examined with magnetic resonance imaging (MRI). The examinations were performed on a 0.3 tesla permanent/resistive imaging system using solenoidal surface coils. MRI revealed epidural tumour in five patients, intramedullary tumour in one, epidural abscess in one, myelitis in two, spontaneous intraspinal epidural haematoma in two, disc herniation in two, traumatic lesions in four and no abnormality in one patient. MRI was found to be capable of non-invasively and painlessly detecting and exactly defining the extent of intraspinal and paraspinal lesions. In some cases the nature of the lesion could be inferred from specific signal characteristics, which is a unique property of MRI. The results strongly suggest that MRI is superior to myelography and other imaging methods and should be regarded as the examination of choice in the emergency examination of patients with spinal cord symptoms.

[Imaging cervical myelo- and radiculopathy]

PURPOSE

This article gives an overview of the diagnostic possibilities available in the diagnosis of cervical myelo- and radiculopathy. We compared conventional myelography, CTM, and MRI.

MATERIAL AND METHODS

Twenty-five patients with clinical evidence of cervical myelo- or radiculopathy were included. Sagittal and transverse T1-weighted (T1w) TSE and T2-weighted (T2w) TSE sequences were compared with myelography and CTM. Statistical analysis was performed using Wilcoxon's -test.

RESULTS

Disc herniation could be depicted in CTM as well as in MRI. The extent of herniation did not differ between CTM and T1w. The extent of herniation seemed higher on T2w than on T1w (p <0.001). Foraminal encroachment was easier to diagnose in CTM. When regarding transverse T1w and T2w images simultaneously, a missing root in MRI corresponded to a missing root in CTM and conventional myelography and vice versa. Our data demonstrated the relative inability of MRI to determine whether the compression is by soft tissue or bony structures.

CONCLUSION

The present study proposes that MRI, when available, should be the imaging method of first choice in patients with suspected radiculo- and myelopathy.

The myelon in cervical spinal canal stenosis: imaging by X-ray and MRI

Methods which produce findings relevant to diagnosis and therapy of cervical vertebral canal stenosis are described. Especially MRI provides insights into the structure of the myelon; abnormal image signals may possibly correlate with cervical myelopathy based on disorders of microcirculation.