MRI of the Cervico-Dorsal Spine is a special MRI technique that can be used for the neck (cervical) and upper back (thoracic or dorsal) at the same time. The movement of the cervical spine is greater than that of the thoracic spine, increasing the importance of this study as the boundary between these two regions.

Conducts higher resolution magnetic resonance imaging (MRI) of the intervertebral discs, spinal cord, nerve roots, ligaments, muscles and soft tissues surrounding the vertebrae without any exposure to ionizing radiation. Rotational MRI is a good option for general screening for all possible types of disc disease, all abnormalities of the spinal column, tumours, trauma, infection, inflammatory conditions or congenital defects which are not well delineated through X-ray and CT scans.

Procedure for MRI of Cervico-Dorsal Spine

Before the Scan

• A thorough medical history is taken to learn about previous injuries, surgeries, neurological symptoms, and existing medical conditions.
• Patients are asked to remove anything with metal, including jewelry, watches, belts, hairpins, and hearing aids.
• Implants, pacemakers, aneurysm clips, and surgical hardware should be exposed so that they are safe for MRI.
• In some cases, it may be recommended to fast in preparation for contrast-enhanced imaging.
• If the patient is uncomfortable or very anxious, he or she may be given mild sedation.

During the Scan

• The patient is comfortably placed in an MRI machine on his back with the head and upper skeleton of his spine inside a coil.
• The use of positioning supports is provided to minimize motion and enhance comfort.
• Images are obtained in three different planes: sagittal, axial, and coronal to examine the cervical and dorsal spine in detail.
• Specialized imaging techniques like STIR and fat suppression techniques can enhance the visibility of inflammation, edema, and lesions.
• Gadolinium contrast is given by intravenous injection in order to better evaluate a tumour, infection, or inflammatory abnormality, if necessary.
• The exam normally lasts for about 25-45 minutes.

After the Scan

• Patients will be able to return to normal activities right away, unless they were sedated.
• A few changes to the protocol are suggested after contrast increase hydration at the end.
• A diagnosis, along with a detailed report from a radiologist, is sent to the referring physician.

MRI Sequences and Techniques Used

T1-Weighted Sequences

Approvision with anatomical visualization of vertebral bodies, bone marrow, discs, and fat-filled structures.

T2-Weighted Sequences

Emphasize CSF and intraventricular spaces, CSF changes, cysts, disc abnormalities, and intramedullary lesions of the spinal cord.

STIR (Short Tau Inversion Recovery)

Strong suppression of fat by sequences for better detection of inflammation, bone marrow edema, trauma, and tumours.

Contrast-Enhanced T1 Sequences

Evaluation of tumours, infections, inflammatory diseases, and postoperatively.

Diffusion-Weighted Imaging (DWI)

May participate in the detection of acute ischemia, infection, and some tumours.

Gradient Echo Sequences

Highly sensitive to the presence of hemorrhage, calcification, and/or small vascular abnormalities.

Common Conditions Diagnosed with MRI of Cervico-Dorsal Spine

Disc Herniation

Finding a bulging, slipped, or worn-out disc that is compressing the nerve root or the spinal cord.

Spinal Cord Compression

Evaluation of spinal cord compression related to trauma, tumours, disc disease, or degeneration.

Multiple Sclerosis

Demyelinating plaques will show as hyperintense on T2-weighted compared to the normal signal loss.

Transverse Myelitis

The presence of inflammation in the spinal cord with abnormal signals and swelling.

Metastatic Lesions 

The early identification of the spread of metastases from breast, lung, or prostate cancer.

Osteomyelitis and Spondylodiscitis

Diagnosis of the condition where there are infections of the spine and between the vertebrae.

Syringomyelia

The identification of progressively expanding areas filled with fluid in the spinal cord.

Fractures

Ability to recognize compression fracture, burst fracture, ligament injury, and occult trauma.

Advantages of MRI of Cervico-Dorsal Spine

• Multiplanar imaging with high resolution of the cervical and dorsal parts of the backbone.
• Excellent imaging of soft tissues, nerve roots, discs, and spinal cord.
• No exposure to ionizing radiation.
• Early identification of inflammatory, neoplastic, infectious, and demyelinating diseases.
• A thorough neuroblock examination can be performed in one exam.

Limitations and Considerations

Metallic Artifacts

Images may be distorted, and diagnostic clarity is decreased if there are metal implants or surgical hardware.

Motion Artifacts

Movement of human patients, such as swallowing or breathing, during the scan may affect the image quality.

Contrast Agent Risks

Gadolinium contrast is sometimes used and may cause rare allergic reactions or kidney problems.

Claustrophobia

Open MRI systems or sedation may be required for some comfort for certain patients.

Patient Preparation Tips

• Clothing should be comfortable, loose, and not have any metal.
• Please make sure jewelry and metal accessories are removed before the scan.
• Let the MRI technologist/s know of implants, surgeries, or medical devices.
• Stay completely still as the exam is performed for a better picture.
• If considering having a contrast-enhanced MRI, follow the fasting protocol.

Conclusion

MRI of the Cervico-Dorsal Spine is an advanced diagnostic imaging study to detect abnormal or diseased structures and/or conditions of the neck and upper thoracic (cervical-dorsal) spine. It is particularly useful in instances when symptoms occur in both regions and disease processes involve the cervico-thoracic junction. MRI is an important tool in the diagnosis of disc disease and trauma, disorders of the spinal cord, tumours, infection, and inflammatory conditions, especially for its capacity to produce high-resolution, multiplanar images without the use of radiation. Rapid and correct diagnosis directs the treatment and prevents chronic neurological sequelae.