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Intramedullary Spine Disease

William G. Bradley¹

¹Long Beach Memorial Medical Center, Long Beach, California

Publication Name:

Current Protocols in Magnetic Resonance Imaging

Unit Number:

Unit A9.1

DOI:

10.1002/0471142719.mia0901s00

Online Posting Date:

May, 2001

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Abstract

One of the most significant impacts of magnetic resonance (MRI) has been its ability to exquisitely depict normal and pathologic anatomy of the spine. This unit presents a Basic Protocol that deals with intramedullary disease, i.e., that involving the cord. An Alternate Protocol is presented for cases of extramedullary-intradural disease.

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Unit Introduction
Basic Protocol: Myelopathy
Alternate Protocol: Trauma
Commentary
Bibliography
Figures
Tables

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Materials

Basic Protocol: Myelopathy

Materials

Normal saline (0.9% NaCl; 500-ml bag)
K-50 tubing
23- to 25-G butterfly needle
Intravenous MRI contrast agent (e.g., Magnevist, Omniscan, Prohance, or OptiMark at a dose of 0.1 mmol/kg for high field or 0.2 mmol/kg for low field).

NOTE: Be sure that technicians and nurses always have immediate access to any emergency equipment that may be relevant to a given study, or that may be needed for a particular patient—i.e., crash carts and oxygen.

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Figures

Figure A9.1.1

Scout images (A) transverse, (B) coronal, and (C) sagittal.

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Figure A9.1.2

Sagittal T₁-weighted spin echo image.

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Figure A9.1.3

Sagittal T₂-weighted fast spin echo image.

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Figure A9.1.4

Transverse T₂^*-weighted gradient echo image.

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Figure A9.1.5

Transverse T₁-weighted spin echo image.

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Figure A9.1.6

Post-contrast T₁-weighted spin echo images: (A) sagittal and (B) transverse.

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Literature Cited

Literature Cited
	Davis, S.J., Teresi, L.M., Bradley, W.G., Ziemba, M.A., and Blaze, A.E. 1991. Cervical spine hyperextension injuries: MR findings. Radiology 180:245-251.
	Fischbein, N.J., Dillon, W.P., Cobbs, C., and Weinstein, P.R. 1999. The “presyrinx” state: A reversible myelopathic condition that may precede syringomyelia. A.J.N.R 20:7-20.
	Hashemi, R.H., Bradley, W.G., Chen, D.-Y., Jordan, J.E., Queralt, J.A., Cheng, A.E., and Henrie, J.N. 1995. Suspected multiple sclerosis: MR imaging with a thin-section fast-FLAIR pulse sequence. Radiology 196:505-510.
	Haughton, V.M., Daniels, D.L., Czervionke, L.F., Williams, A.L., and Rand, S.D. 1999. servical spine. In Magnetic Resonance Imaging 3rd edition. (D.D. Stark and W.G. Bradley, eds.) pp. 1833-1850. Mosby, St. Louis.
	Najem, E.S., Bazan, C. III, and Jinkins, J.R. 1999. Thoracic Spine. In Magnetic Resonance Imaging 3rd edition. (D.D. Stark and W.G. Bradley, eds.) pp. 1851-1882. Mosby, St. Louis.
	Palmer, S., Bradley, W.G., Chen, D.-Y., and Patel, S. 1999. Subcallosal striations: An early finding of MS on sagittal, thin slice, fast FLAIR images. Radiology 210:149-153.
	Shellock, F.G. 1996. Pocket Guide to MR Procedures and Metallic Objects. Lippincott-Raven, Philadelphia.
Key References
	Shellock, 1996. See above.
Covers a number of important patient management issues related to MR imaging, including recommended safety procedures, a list of metallic implants that have been tested for MR compatibility, and a list of other sources on MR safety.