Abstract
In this article, we illustrate the main advanced magnetic resonance imaging (MRI) techniques used for imaging of the spine and spinal cord in children and adults. This work focuses on daily clinical practice and aims to address the most common questions and needs of radiologists. We will also provide tips to solve common problems with which we were confronted. The main clinical indications for each MR technique, possible pitfalls and the challenges faced in spine imaging because of anatomical and physical constraints will be discussed. The major advanced MRI techniques dealt with in this article are CSF, (cerebrosopinal fluid) flow, diffusion, diffusion tensor imaging (DTI), MRA, dynamic contrast-enhanced T1-weighted perfusion, MR angiography, susceptibility-weighted imaging (SWI), functional imaging (fMRI) and spectroscopy.Teaching Points• DWI is essential to diagnose cord ischaemia in the acute stage.• MRA is useful to guide surgical planning or endovascular embolisation of AVMs.• Three Tesla is superior to 1.5 T for spine MR angiography and spectroscopy.• Advanced sequences should only be used together with conventional morphological sequences.
Highlights
Advanced magnetic resonance imaging (MRI) techniques applied to the spinal cord have remained difficult to put into practice until recently
Three Tesla is superior to 1.5 T for spine MR angiography and spectroscopy
Advanced MRI techniques applied to the spinal cord have remained difficult to put into practice until recently
Summary
Advanced MRI techniques applied to the spinal cord have remained difficult to put into practice until recently. High field strength offers a real added value for MRA and spectroscopy; it produces higher SNRs and faster acquisition minimising motion artefacts The application of this sequence in spinal cord imaging is for depicting cystic lesions, such as arachnoid or leptomeningeal cysts (Fig. 1), the latter often resulting from haematomas after trauma, which breakdown into haemosiderin and its derivatives and may cause arachnoiditis [2, 3]. Its use is possible but has not been extended to daily clinical practice because of limitations in spatial resolution and multiple artefacts due to phase-encoding directions, bone-tissue interfaces, flow and increased noise This sequence is sensitive to subtle changes of the local magnetic susceptibility variances, decreased signal-to-noise ratios, etc. Funding The authors state that this work has not received any funding
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