MRI CERVICAL SPINE

MRI Cervical Spine is a non-invasive imaging technique that uses strong magnetic fields and radio waves to produce detailed images of the cervical region of the spine, including vertebrae, intervertebral discs, spinal cord, nerve roots, ligaments, and surrounding soft tissues. It does not use ionizing radiation, making it safe for repeated evaluations. MRI provides superior soft tissue contrast compared to CT scans, making it the preferred modality for diagnosing spinal cord disorders, disc herniations, tumors, infections, trauma, and degenerative changes in the neck.

Purpose of MRI Cervical Spine

1. Neck pain evaluation

• Identifies causes of persistent or unexplained neck pain.
• Differentiates between muscle strain, disc disease, or nerve compression.

2. Spinal cord abnormalities

• Detects multiple sclerosis lesions, spinal cord compression, or myelitis.
• Evaluates post-traumatic cord injury and swelling.

3. Disc disorders

• Diagnoses herniated or bulging discs causing nerve irritation.
• Evaluates degenerative disc disease and associated inflammation.

4. Nerve root compression

• Assesses foraminal stenosis caused by osteophytes or disc material.
• Determines the severity of nerve involvement.

5. Trauma assessment

• Detects ligamentous injury, spinal cord contusion, or hematoma.
• Identifies fractures not visible on plain X-rays.

6. Tumors and cysts

• Detects benign or malignant growths within or around the spinal cord.
• Identifies cystic lesions such as arachnoid or synovial cysts.

7. Inflammatory and infectious diseases

• Evaluates spondylodiscitis, epidural abscesses, and tuberculosis of the spine.
• Detects autoimmune disorders affecting the cervical cord.

8. Pre-surgical and post-surgical evaluation

• Assists in surgical planning for decompression or fusion procedures.
• Monitors outcomes and detects complications after surgery.

Procedure for MRI Cervical Spine

Before the scan

• Medical history is reviewed, especially for prior neck surgery, injuries, or neurological symptoms.
• Patients should inform the radiology team about metallic implants, pacemakers, or prior injuries involving metal fragments.
• All jewelry, watches, and metallic accessories must be removed.
• Fasting may be required if intravenous contrast will be used.
• Sedation may be arranged for anxious patients or children.

During the scan

• The patient lies on their back with the head positioned inside a dedicated head-and-neck coil.
• Immobilization devices may be used to minimize movement.
• Multiple sequences are obtained in sagittal, axial, and sometimes coronal planes.
• Fat suppression and contrast-enhanced images may be acquired depending on the indication.
• The scan typically lasts 20 to 40 minutes.

After the scan

• No recovery time is needed unless sedation was given.
• If contrast was used, patients should drink fluids to aid in elimination.
• A radiologist reviews the images and prepares a detailed report for the referring physician.

MRI Cervical Spine Sequences and Techniques

T1-weighted sequences

• Provide clear anatomy of vertebrae and discs.
• Useful in detecting fat-containing lesions and bone marrow changes.

T2-weighted sequences

• Highlight cerebrospinal fluid and detect edema or inflammation.
• Essential for visualizing disc herniations, cysts, and fluid-filled structures.

STIR (Short Tau Inversion Recovery)

• Suppresses fat signal to enhance visibility of edema and inflammation.
• Commonly used for detecting ligamentous injury and tumor spread.

Gradient echo sequences

• Sensitive for detecting small hemorrhages or calcifications.
• Helpful in trauma evaluation.

Contrast-enhanced T1 sequences

• Used for detecting tumors, infections, and inflammatory lesions.
• Helps differentiate scar tissue from recurrent disc material after surgery.

Common Conditions Diagnosed with MRI Cervical Spine

Cervical disc herniation

• Protrusion or extrusion of disc material compressing the spinal cord or nerve roots.
• May cause neck pain, radiculopathy, or myelopathy.

Cervical spondylosis

• Age-related degeneration of discs and joints leading to stiffness, pain, and nerve compression.
• Often associated with osteophyte formation.

Spinal stenosis

• Narrowing of the spinal canal causing cord or nerve root compression.
• Symptoms include numbness, weakness, and balance problems.

Multiple sclerosis

• Plaque-like lesions in the cervical cord seen as high signal on T2-weighted images.
• May cause weakness, visual problems, and sensory loss.

Cervical myelopathy

• Compression of the spinal cord leading to loss of coordination, bladder issues, and weakness.
• Can be caused by disc herniation, tumors, or trauma.

Tumors

• Intramedullary tumors such as ependymomas and astrocytomas.
• Extramedullary tumors like meningiomas and schwannomas.

Trauma

• Ligament tears, fractures, cord contusion, or epidural hematomas.
• Important for guiding surgical or conservative management.

Infections

• Discitis and osteomyelitis causing destruction of vertebrae and discs.
• Epidural abscess presenting with fever, pain, and neurological deficits.

Advantages of MRI Cervical Spine

• Superior visualization of spinal cord and soft tissues compared to X-ray or CT.
• No radiation exposure, making it safe for repeated use.
• Excellent for detecting early disease changes before they appear on other imaging.
• Allows multiplanar imaging for a complete assessment.
• Sensitive for identifying subtle spinal cord lesions and inflammation.

Limitations and Considerations

Motion artifacts

• Movement from swallowing, breathing, or patient discomfort can affect image quality.

Metallic implants

• Surgical hardware or dental fillings can create artifacts, reducing visibility of nearby structures.

Claustrophobia

• Some patients may feel uncomfortable inside the MRI scanner and require sedation.

Contrast considerations

• Gadolinium contrast may rarely cause allergic reactions.
• Kidney function should be evaluated in at-risk patients before contrast use.

Patient Preparation Tips

• Wear loose, comfortable clothing without metal fasteners.
• Inform the radiology team of any implants, prior injuries, or health conditions.
• Practice relaxation techniques to reduce movement during the scan.
• Follow fasting instructions if contrast is planned.

Conclusion

MRI Cervical Spine is a vital diagnostic tool for evaluating disorders of the neck and upper spinal cord. It provides unparalleled detail of both bone and soft tissue structures, enabling accurate diagnosis of disc disease, spinal cord lesions, tumors, infections, trauma, and degenerative conditions. With its ability to detect subtle abnormalities and guide treatment planning, it is indispensable for neurologists, orthopedic surgeons, and spine specialists. By offering clear, radiation-free images in multiple planes, MRI Cervical Spine ensures precise assessment, timely diagnosis, and effective patient management.