Abstract
This study was designed to compare the accuracy of magnetic resonance imaging (MRI), myelography and computed tomography in the assessment of degenerative cervical spinal stenosis. We prospectively examined a total of 75 spinal segments in 18 patients with suspected cervical spinal canal stenosis, using sagittal spin-echo and axial gradient-echo sequences generated by a 1.5 Tesla imager, conventional myelography, and computed tomography with intrathecal contrast medium (CT-myelography). The degree of stenosis was often overestimated using MRI. This error was most prominent in cases of severe stenosis but was significant with minor to moderate stenosis. In these cases, the clinical consequences of such an overestimation can be serious, because treatment is misdirected. The error is probably caused by pulsation of the cerebrospinal fluid and truncation artefact (Gibbs phenomenon). MRI at 1.5 Tesla is thus frequently inadequate for diagnostic assessment of degenerative cervical spinal stenosis. Myelography and myelographic CT are still useful for decisions on operative treatment, especially in cases of moderate stenosis. This may, however, not apply to imagers operating at 0.5 Tesla as below.
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References
Masaryk TJ, Modic MT, Geisinger MA et al (1986) Cervical myelopathy. A comparision of magnetic resonance and myelography. J Comput Assist Tomogr 10: 184–187
Modic MT, Ross JS, Masaryk TJ (1989) Imaging of degenerative disease of the cervical spine. Clin Orthop Rel Res 239: 109–120
Larsson EM, Holtås S, Cronqvist S, Brandt L (1989) Comparision of myelography, CT myelography and magnetic resonance imaging in cervical spondylosis and disk herniation. Acta Radiol 30: 233–239
Warmuth-Metz M, Hofmann E, Becker T, Kapp B (1992) Vergleichende Messungen des zervikalen Spinalkanals mit der Kernspintomographie (MRT) und der postmyelographischen CT (PMCT). Klin Neuroradiol 2: 85–91
Nordquist L (1964) The sagittal diameter of the spinal cord and subarachnoid space in different age groups. (A roentgenologic post-mortem study). Acta Radiol 227 (Suppl): 1–96
Yu YL, du Boulay GH, Stevens JM, Kendall BE (1985) Morphology and measurements of the cervical spinal cord in computer-assisted myelography. Neuroradiology 27: 399–402
Sherman JL, Nassaux PY, Citrin CM (1990) Measurements of the normal cervical spinal cord on MR Imaging. AJNR 11: 369–372
Czervionke LF, Czervionke JM, Daniels DL, Haughton VM (1988) Characteristic features of MR truncation artifacts. AJNR 9: 815–824
Breger RK, Czervionke LF, Kass EG, Yu S, Ho PSP, Strandt JA, Kneeland JB, Haughton VM (1988) Truncation artifact in MR images of the intervertebral disk. AJNR 9: 825–828
Sherman JL, Citrin CM, Gangarosa RE, Bowen BJ (1986) The MR appearance of CSF pulsation in the spinal canal. AJNR 7: 879–884
Rubin JR, Enzmann DR (1987) Imaging of spinal CFS pulsation by 2DFT MR: significance during clinical imaging. AJNR 8: 297–306
du Boulay GH (1966) Pulsatile movements in the CSF pathways. Br J Radiol 39: 255–262
Di Chiro G, Fisher RI (1964) Contrast radiography of the spinal cord. Arch Neurol 11: 125–143
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Reul, J., Gievers, B., Weis, J. et al. Assessment of the narrow cervical spinal canal: A prospective comparison of MRI, myelography and CT-myelography. Neuroradiology 37, 187–191 (1995). https://doi.org/10.1007/BF01578255
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DOI: https://doi.org/10.1007/BF01578255