Cutting-Edge Imaging of the Spine

Abstract

Damage to the spinal cord may be caused by a wide range of pathologies and generally results in profound functional disability. Therefore, a reliable diagnostic workup of the spine is very important because even relatively small lesions in this part of the central nervous system can have a profound clinical impact. This is primarily due to the dense arrangement of long fiber tracts extending to and from the extremities within the spinal cord. Because of its inherent sensitivity to soft tissues and its capability of displaying long segments of the vertebral column in one examination, MRI has become the method of choice for the detection and diagnosis of many disorders in the spine. A variety of innovative MRI methods have been developed to improve neuroimaging. Nevertheless, the application of these new methods to the spinal cord is, compared to its cephalad cousin, still not used that frequently. These techniques include the development of better pulse sequences and new MR contrast parameters that offer a wider spectrum of biophysical parameters in deriving a diagnosis. Overall, these new "cutting-edge" technologies have the potential to profoundly impact the ease and confidence of spinal disease interpretation and offer a more efficient diagnostic work-up of patients suffering from spinal disease.

Gamma Knife Radiosurgery for Recurrent Glossopharyngeal Neuralgia after Microvascular Decompression

“…The intracranial cisternal nerve portion is very short and close to the vagus and accessory nerves. We have used the COSMIC pulse sequence, which provides a high contrast between the cerebrospinal fluid and soft tissue and may serve as a myelographic type sequence [18]. …”

Primary non‑Hodgkin lymphoma of the right femur and subsequent metastasis to the left femur: A case report and literature review

“…PLB typically presents with localized ostealgia and primarily invades the bone, with or without cortical invasion or soft tissue extension. Regional lymph nodes or remote organs are not typically affected (2,8,9). In addition to pathological fractures, patients with PLB may present with systemic symptoms, including fever, emaciation and night sweats (10).…”

Neuroradiology Back to the Future: Spine Imaging

“…79 Many of these newer techniques have had limited application in the spine due to technical difficulties that limit image quality, including the high magnetic susceptibility of the structures surrounding the spinal canal, the relatively small size of spinal canal structures, the large craniocaudal extent of the spine, CSF and vascular pulsation, respiration, and swallowing. 80 DWI has been applied to the spinal cord and may be helpful in detecting acute cord ischemia as well as other cord lesions. 81 MRA of the spine has been shown to be helpful in assessing the spinal vasculature and vascular malformations, particularly as a guide for further endovascular assessment and follow-up after treatment.…”