MR Myelogram: Is There any Role for Diagnosis of Spinal and Extra-Spinal Disorders?

Abstract

Objectives: The objective of this presentation is to point out some diagnostic clues and presentations of MR myelograms in routine spinal MRI which may help radiologists and clinicians with better detection or description of spinal and extra-spinal pathologies. Patients and Methods: We collected more than 100 cases of spinal MRI from teaching files of five institutions during the past 10 years. All patients presented with symptoms and signs related to spinal disorders. Results: Imaging evaluation of patients with the possibility of spinal disk disorders can sometimes be very challenging, as low back pain or pain in the thoracic and cervical regions which is usually caused by intervertebral disks abnormalities, could also be triggered by a wide spectrum of pathologies in neighboring structures. In this presentation, with a view to updating the current therapeutic and diagnostic approaches, we have categorized and classified these potential pain sources and other incidental findings in MR myelograms of a number of patients as below: 1) infections 2) kidney, bladder and prostate problems 3) cholelithiasis 4) pleural effusion or chest infections 5) ovarian cysts or cystic masses 6) tumors 7) nondiscogenic lesions such as spinal arachnoid or other developmental cysts 8) miscellaneous (e.g., ascites) 9) trauma Conclusions: In this educational presentation, we will present a large collection of pathologies in MR myelograms of a number of patients presenting with pain in and around spinal region who referred to us to rule out disk abnormalities. Awareness, understanding, and recognition of these presentations may permit the radiologists to play a significant role in avoidance of unnecessary medical and surgical interventions or unnecessary diagnostic evaluation procedures.