Magnetic Resonance Imaging of the Cervical Spine

Magnetic resonance imaging (MRI) has been shown to be highly successful in imaging pathologic processes involving the cervical spine. MRI allows for high-resolution, multiplanar imaging of not only the osseous structures of the cervical spine but also the soft-tissue structures, including the intervertebral discs, spinal cord, and nerve roots 1-3. The purposes of this paper are to: 1. Update orthopaedic surgeons on the applications and indications for MRI of the cervical spine. 2. Define the normal MRI anatomy of the cervical spine. 3. Illustrate the spectrum of cervical spinal disease detectable by MRI. ### Process of Image Production 4 ( Fig. 1 ) Figs. 1-A, 1-B, and 1-C: Figs. 1-A, 1-B, and 1-C Process of image production. (Reprinted from: Khanna AJ, Cosgarea AJ, Mont MA, Andres BM, Domb BG, Evans PJ, Bluemke DA, Frassica FJ. Magnetic resonance imaging of the knee. Current techniques and spectrum of disease. J Bone Joint Surg Am. 2001;83[Suppl 2 Pt 2]:128.) Fig. 1-A Alignment of the protons within a patient, with the external magnetic field (Bo) applied by the superconducting magnet in a typical magnetic resonance imaging scanner. Fig. 1-B Application of a radiofrequency pulse to the patient, which often aligns the net magnetization vector of the patient at a 90° angle to the external magnetic field. Fig. 1-C The longitudinal relaxation of the protons, which is measured to determine the characteristics of a tissue on a T1-weighted image. Figs. 2-A through 2-D Types of pulse sequences. Fig. 2-A Sagittal T1-weighted image. Fig. 2-B Sagittal T2-weighted image. Fig. 2-C Sagittal fat-suppressed T2-weighted image. Fig. 2-D Sagittal gradient echo image. Sagittal T1-weighted images show normal anatomy of the cervical spine from midline (Fig. 3-A) to lateral (Fig. 3-C). Midline (Fig. 4-A) and parasagittal (Fig. 4-B) sagittal T2-weighted images show normal anatomy of the cervical spine. PLL = posterior longitudinal ligament; CSF = cerebrospinal fluid. …