Magnetic resonance imaging of the cervical and thoracic spine and the spinal cord

Magnetic resonance imaging (MR), using a 0.3 T resistive scanner with an iron core and a vertical magnetic field, was evaluated in patients with different diseases affecting the cervical and thoracic spine and the spinal cord. The results indicate that MR is well suited as the procedure of choice for emergency examination of patients with spinal cord symptoms, for examination of patients with suspected spinal multiple sclerosis and for pre-operative evaluation of patients with rheumatoid arthritis with neurological symptoms emanating from the cranio-cervical junction. In patients with cervical radiculapathy and/or myelopathy, caused by spondylosis or disk herniation, MR was found to be equivalent with myelography and CT myelography but MR has several practical advantages. MR at 0.3 T using a vertical magnetic field provided information comparable to that reported from examinations performed with superconducting MR scanners. In order to optimize the MR examinations of the spine, the signal characteristics of different coils available when using a vertical magnetic field were determined by phantom studies. Recommendations for optimal coil selection for different levels of the cervical and thoracic spine are given. In addition, the paramagnetic contrast medium gadolinium-DTPA was administered intravenously to patients with suspected spinal multiple sclerosis. Enhancement of clinically active lesions in the cervical spinal cord was observed. Serial MR examinations with gadolinium-DTPA showed that a decrease in enhancement could be correlated with decrease in clinical symptoms and signs. (author)