High field, thin section nuclear magnetic resonance imaging of the cervical spine

The recent development of contiguous thin section (2 mm) imaging utilizing a high field (1.5 tesla magnetic resonance imaging) (MR) system has remarkably improved the precision of spinal cord diagnosis. Imaging was performed using three-dimensional data acquisition which generated twelve contiguous T1-weighted sections. Each section is reconstructed from a true 512×512 data matrix. Sixty patients with cervical cord lesions were evaluated with this technique and the results compared with conventional cervical myelography and CT scanning. The normal MRI anatomy of the cervical spinal cord on the thin-section technique shows the medullary gray and white matter. A description of this anatomy will be provided. In cases of syringohydromyelia MRA has demonstrated with accuracy the size and location of spinal cord cavities that were not detected by metrizamide CT scanning. Associated Arnold-Chiari malformations can be clearly delineated. Patients with spinal cord tumors were examined with both the T1-weighted thin-section technique and the T2-weighted multislice technique. Spinal cord cavities and cysts associated with tumors did not as a rule fill with metrizamide. High-field, thin-section studies outlined each of these lesions. The differentiation between intradural and extradural masses can be difficult on MRI and presents one of the limitations of this method in its current state as compared with metrizamide CT scanning. A complete discussion of the MRI findings of a number of pathological entities will be discussed.