Magnetic resonance imaging (MRI) of the spinal cord is not done in isolation. In addition to the spinal canal itself, spinal structures and nerves are visible in the image. MRI is an effective way to diagnose diseases of internal organs. More about him in the article.
The essence of the method
The essence of MRI is to use the phenomenon of nuclear magnetic resonance. This means that the electromagnetic waves that are created in the tomograph are able to capture the concentration of ions in the internal organs and tissues of the body. The highest concentration in the human body is inherent to hydrogen ions. Under the influence of a magnetic field they begin to "vibrate". This process is accompanied by the release of energy.
The generated energy is captured by the software on the computer and displayed on the monitor. Images are clear, so you can see the pathology of the internal organs in the early stages.
MRI of the brain and spinal cord is one of the most informative methods for diagnosing diseases of the central nervous system.
What can be seen with MRI
Using MRI of the spinal cord and spine, you can see the following:
- the structure of the bodies and processes of the vertebrae;
- the structure of the intervertebral discs;
- herniated discs;
- inflammatory processes in the spine and spinal cord;
- cracks vertebral fractures;
- neoplasms of the spine and spinal cord;
- pinched nerves and roots of the spinal cord.
As can be seen from the list above, the list of diseases that can be diagnosed with MRI is really wide.
Main indications
Despite the high information content of spinal cord MRI, this diagnostic method is not prescribed to everyone. Only after a thorough conversation with the patient and his examination, conducting basic laboratory tests, if necessary, the doctor writes out a referral for MRI.
The main indications for this procedure are as follows:
- congenital malformations of the spine or spinal cord;
- traumatic damage to the spinal canal or vertebrae;
- herniated discs;
- suspicion of the presence of a primary tumor of the spinal cord or metastasis of tumors of other organs;
- violation of the blood supply to the spinal cord;
- osteomyelitis is an inflammatory disease characterized by destruction of bone tissue;
- multiple sclerosis - a disease of the central nervous system in which the destruction of the myelin sheath of the nerves occurs;
- back pain, the cause of which could not be determined.
Sometimes there is a need for an MRI of the cervical spinal cord when a person complains of a headache. This is due to the fact that a hernia of the cervical spine compresses the roots of the spinal cord, and gives pain to the head.
Contraindications to the procedure
There are conditions in which an MRI scan is strictly contraindicated. They are divided into absolute and relative. In the first case, MRI is excluded in any circumstances. In the second, the doctor individually decides on the possibility of a tomogram. The decision is made in favor of MRI if the possible negative consequences are lower than the intended benefits of the method.
There is one absolute contraindication - the presence of any metal objects in the body:
- pacemaker;
- joint prosthesis;
- vascular clips;
- an insulin pump and more.
Relative contraindications for MRI of the spinal cord include:
- body weight more than 130 kg;
- claustrophobia;
- mental illnesses that prevent the patient from being stationary for a long time;
- hyperkinetic syndrome - the appearance of involuntary movements associated with the disease of specialized brain structures (basal ganglia);
- severe diseases of the cardiovascular system, which led to impaired heart function.
Is it possible to do an MRI scan for a child?
The question of the advisability of diagnosing diseases with a tomogram for children and pregnant women is still debatable. Many doctors adhere to the same principle as for relative contraindications: do MRI of the spinal cord of a child with caution if the intended benefit exceeds the harm.
For all the time of the MRI scan, children did not experience any complications. Particular care should be taken with women in the first trimester of pregnancy. It is during this period that all the internal organs of the fetus are laid. But if there is such a need, doctors prescribe MRI at the very beginning of pregnancy.
Varieties of procedure
There are several classifications of spinal cord MRI. One of them takes into account the segment of the spine and spinal cord, which is being examined:
- cervical;
- thoracic;
- lumbar;
- sacral;
- mixed options: cervicothoracic, lumbosacral.
The second classification is based on whether the contrast agent is introduced into the body. Thus, there may be an MRI scan without contrast and with it.
Contrast features
Spinal cord MRI with contrast increases the diagnostic value of the method. This is especially important if there is a suspicion of the presence of neoplasms in the spinal canal. Tumor and healthy tissue accumulate contrast in different ways. This difference is captured on the image, which allows you to diagnose oncology at an early stage.
The contrast agent used in MRI is based on gadolinium. It is absolutely safe for the body and extremely rarely causes allergic reactions. But in any case, before taking a picture, you need to conduct a test with contrast. To do this, a small amount of the substance is administered subcutaneously. After the doctor monitors the reaction of the skin. The appearance of itching, rash or redness indicates the presence of hypersensitivity. So, the use of contrast must be abandoned.
Stages of MRI
Carrying out a tomogram does not require special preparation. The main thing is to remove all metal jewelry, removable dentures, a hearing aid and more. The presence of metal can lead not only to a violation of image quality, but also to damage to the tomograph.
The patient lies on a special table, his arms and legs are tied with straps. The head is also fixed. This is necessary to ensure complete immobility.
Next, the table moves to the tomograph itself. The fact that the tomograph is turned on can be understood by the cod and tapping that it emits during operation. Even people who have never suffered from claustrophobia can have an attack during the procedure. There is very little space in the device, but the sound is loud and unpleasant.
Therefore, the doctor must explain to the patient about the specifics of the procedure and convince of its safety. If the patient is too worried, the doctor prescribes sedative medications.
During the examination, the diagnostician is in the next room behind a glass partition. He is always in touch with the patient, so do not panic.
The duration of an MRI scan depends on the spine being examined. The average duration of conventional tomography is 40 minutes, with the introduction of contrast - an hour and a half.
Conclusion and recommendations of doctors
After the MRI of the spinal cord of the thoracic region or other segments has come to an end, the doctor describes the picture and issues an opinion.
In conclusion, he first describes in detail the seen structures of the spinal cord and spine, their relationship to each other, whether there is a pathology.
Below, he makes an estimated diagnosis based on the signs that are on the MRI image. But the final clinical diagnosis can only be made by the attending physician. To accurately determine the nature of the pathology, MRI alone is not enough. The diagnosis is made comprehensively on the basis of the clinic, complaints, examination data and other examination methods.
Only after the diagnosis is made, the doctor prescribes treatment and gives appropriate recommendations. Sometimes there is a need for additional consultation of other specialists:
- neurologist;
- neurosurgeon;
- traumatologist.
Spinal cord MRI is a truly effective method for diagnosing diseases of this section of the central nervous system. But you do not need to be diagnosed only according to MRI. There should always be an integrated approach!