Spinal Primary Neoplasia/Metastasis

J. Randy Jinkins1, David D. Stark1

1 Downstate Medical Center, State University of New York, Brooklyn, New York
Publication Name:  Current Protocols in Magnetic Resonance Imaging
Unit Number:  Unit A8.5
DOI:  10.1002/0471142719.mia0805s02
Online Posting Date:  November, 2001
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This unit presents a basic protocol for conventional and fast spin echo imaging of spine for visualization of the spinal compartment to assess the extent and degree of spinal cord or cauda equina compression frequently associated with primary and metastatic neoplasia. An alternate protocol is presented for the cases e.g., neurofibromatosis with multiple bilateral neoplasms extending through the neural foramina, where a coronal acquisition may be helpful to analyze the perispinal tissues for tumor extension either inward to, or outward from, the central spinal canal.

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Table of Contents

  • Basic Protocol 1: Conventional and Fast Spin Echo
  • Alternate Protocol 1: Coronal, Contrast Enhances Acquisition
  • Commentary
  • Literature Cited
  • Figures
  • Tables
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Basic Protocol 1: Conventional and Fast Spin Echo

  • Normal saline (0.9% NaCl), sterile
  • Extravascular contrast agent (e.g., Magnevist, Omniscan, or Prohance)
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Literature Cited

Literature Cited
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   Avrahami, E., Tadmor, R., Dally, O., and Hadar, H. 1989. Early MR demonstration of spinal metastases in patients with normal radiographs and CT and radionuclide bone scans. J. Comput. Assist. Tomogr. 13(4):598‐602.
   Beltran, J., Noto, A.M., Chakeres, D.W., and Christoforidis, A.J. 1987. Tumors of the osseous spine: Staging with MR imaging versus CT. Radiology 162:565‐569.
   Carmody, R.F., Yang, P.J., Seeley, G.W., Seeger, J.F., Unger, E.C., and Johnson, J.E. 1989. Spinal cord compression due to metastatic disease: Diagnosis with MR imaging versus myelography. Radiology 173:225‐229.
   Coletti, P.M., Dang, H.T., Deseran, M.W., Kerr, R.M., Boswell, W.D., and Ralls, P.W. 1991. Spinal MR imaging in suspected metastases: Correlation with skeletal scintigraphy. Magn. Res. Imag. 9:335‐349.
   Colman, L.K., Porter, B.A., Redmond, J., III., Olson, D.O., Stimac, G.K., Dunning, D.M., and Friedl, K.E. 1988. Early diagnosis of spinal metastases by CT and MR studies. J. Comput. Assist. Tomogr. 12:423‐426.
   Daffner, R.H., Lupetin, A.R., Dash, N., Deeb, Z.L., Sefczek, R.J., and Schapiro, R.L. 1986. MRI in the detection of malignant infiltration of bone marrow. Am. J. Roentgenol. 146:353‐358.
   Jinkins, J.R. and Leite da Costa, C. 1998. Differential diagnosis of primary or secondary paraspinal abnormalities originating in the spine, perispinous tissues, or remote sources. In Neurodiagnostic Imaging Pattern Analysis and Differential Diagnosis (J. R. Jinkins and C. Da Costa Leite, ed.) pp. 773‐779. Lippincott‐Raven, Philadelphia.
   Mehta, R.C., Marks, M.P., Hinks, R.S., Glover, G.H., and Enzmann, D.R. 1995. MR evaluation of vertebral metastases:T1‐weighted, short‐inversion‐time inversion recovery, fast spin ‐ echo, and inversion ‐ recovery fast spin‐echo sequences. Am. J. Neuroradiol. 16:281‐288.
   Ragland, R.L., Knorr, J.R., Kamath, S.V., Landis, E.S., Tenreiro‐Picon, O.R., and Weyreuther, M. 1996. Magnetic resonance patterns of epidural impression from spinal metastases: review of 200 cases. Int. J. Neuroradiol. 1:69‐72.
   Shellock, F.G. 1996. Pocket Guide to MR Procedures and Metallic Objects. Lippincott‐Raven, Philadelphia.
   Sugimura, K., Kajitani, A., Okizuka, H., Sugihara, M., Mizutani, M., and Ishida, T. 1991. Assessing response to therapy of spinal metastases with gadolinium ‐ enhanced MR imaging. J. Magn. Reson. Imag. 1:481‐484.
   Sze, G., Krol, G., Zimmerman, R.D., and Deck, M.D. 1988. Malignant extradural spinal tumors: MR imaging with Gd‐DTPA. Radiology 167:217‐223.
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