Calcified synovial cyst of the cervical spine: CT and MR evaluation

A case of calcified synovial cyst of the cervical spine was diagnosed by a combination of imaging modalities. Curvilinear calcification associated with posterior elements, well seen by CT, suggested the correct diagnosis. Magnetic resonance showed a curvilinear region of low signal intensity corresponding to the calcification.     

Comparison of MR and CT myelography in imaging the cervical and thoracic spine

MR imaging and CT myelography were compared in a retrospective study of 38 patients with suspected lesions of the cervical and thoracic spinal canal and cord. Twenty-eight abnormal cases were found, including spondylosis (9), tumors (8), intramedullary cavities (3), arachnoiditis (3), disk-space-centered infection or osteomyelitis (2), nonneoplastic cord swelling (2), and CSF-borne metastasis (1). MR was equal or superior to CT myelography in depicting cases of cord enlargement, cord compression, and cord atrophy, providing better tissue characterization, no shoulder artifact, and no limitation caused by CSF block. CT myelography was superior to MR in depicting cases of spondylosis and arachnoiditis. It showed superior spatial resolution, which was most pronounced when comparing axial images and hence particularly superior in detecting the lateral extent of disk herniation. Use of surface coils and thin imaging sections is essential for accurate and complete MR evaluation of the cervical and thoracic spine.     

MR imaging of the cervical spine: techniques for two- and three-dimensional imaging.

This review briefly describes two-dimensional (2D) and three-dimensional (3D) MR imaging of the cervical spine and focuses on the current and potential clinical usefulness of 3D sequences in the evaluation of cervical spine abnormalities. The practical advantages of 3D imaging are several, and include an increase in signal-to-noise ratio over 2D imaging, thin contiguous slices, more accurate slice thickness, and optimal computer postprocessing. Different 3D techniques can provide either high- or low-signal-intensity CSF, with excellent suppression of CSF pulsation artifacts.     

Selective three-dimensional MR imaging of the spine

A recently developed selective three-dimensional (3D) Fourier transform imaging technique offers several advantages over conventional two-dimensional multislice magnetic resonance imaging of the spine. These advantages include improved signal-to-noise ratio, thinner slices without gaps, and shorter echo time/repetition time pulse sequences. Five normal volunteers and 30 patients with a variety of spinal pathology were examined using surface coils. The 3D technique appears very promising and could become the major method for imaging the spine.     

颅颌面CT与MR图像的配准

目的 :实现颅颌面CT MR医学图像的配准。材料和方法 :基于轮廓特征的奇异值分解 迭代最近点法 (SingularValueDecomposition IterativeClosestPoint ,SVD ICP)。结果 :该配准操作简便、图像满意、可靠性好 ,尚可以用于任意维度向量集合的匹配。结论 :在临床实践中颅颌面CT MR医学图像的配准是可行的 ,为进一步实现图像的融合奠定了基础     

MR myelography of the cervical spine.

In previous studies, magnetic resonance (MR) myelography was not effective in the cervical region. However, effective cervical MR myelography is possible with a modified fast spin-echo sequence (8,000/360 [repetition time msec/effective echo time msec], four signals averaged, echo train length of 24). In a clinical study of this protocol, MR myelography was performed as an additional sequence following conventional MR imaging; composite images were obtained with a maximum-intensity projection algorithm. The MR myelographic sequence added only 8.5 minutes to the total imaging time and yielded information not provided by MR imaging in 13% of patients. MR myelography was especially valuable in demonstrating abnormal intraspinal vascularity and in guiding patient treatment by providing detailed preoperative information about intradural masses and posttraumatic and postoperative diverticulum and meningocele. This MR myelographic technique is a useful adjunct to MR imaging, especially in cases in which the more detailed information provided will be helpful in the analysis of complex intraspinal disease.     

Osteochondroma of the cervical spine MR findings

We report two cases of osteochondroma in the region of the cervical spine. The magnetic resonance (MR) images well demonstrated the relationship of the tumor, the spinal cord, and adjacent soft tissue, but correct diagnosis by MR imaging was difficult in one patient due to unusual gadolinium enhancement. Computed tomography played an important role in these patients by demonstrating the exact origin and nature of the tumor.     

Oblique plane MR imaging of the cervical spine

Surface coil magnetic resonance (MR) imaging of the spine in conventional sagittal and parasagittal planes has been reported to show the cervical tissues with great clarity. Theoretically, an imaging plane perpendicular to the cervical neural foramina would be particularly effective for demonstrating the cervical spinal nerves and roots. We correlated MR images and cryomicrotome sections of the cervical spine to analyze the MR appearance of the neural foramina in this view. The normal MR appearances of the dorsal and ventral roots in cross section and, for the first time, the interradicular cleft were identified. New criteria for diagnosis of nerve root compression were suggested by the anatomic observations.     

MR imaging in cervical spine trauma

Continual improvements in MR imaging, technology and MR imaging-compatible monitoring and fixation devices have allowed the incorporation of this relatively new imaging modality into standard algorithms for cervical spine trauma assessment. The ability of MR imaging to define the type of spinal cord injury, the cause and severity of spinal cord compression, and the stability of the spinal column is unmatched. The heavy reliance of the spinal surgeon on MR imaging for decisions regarding the type of therapy, the timing, the approach of surgical intervention, and for predicting patient outcome attests to the usefulness of this modality.     

Postoperative cervical spine: MR assessment

The purpose of this article is to describe the variety of magnetic resonance (MR) findings in the cervical spine following anterior diskectomy and fusion (ADF), corpectomy, and postoperative complications. Toward that end, we retrospectively reviewed MR in 73 postoperative cervical spine patients and correlated the MR with their initial operative reports. Patients imaged within 1 month of ADF showed bone grafts as discrete rectangular areas of altered signal intensity within the central portions of the disk spaces. A spectrum of graft and vertebral body signal changes are seen up to 2 years following ADF. Patients studied greater than 2 years following ADF generally showed solid bony fusions without evidence of the graft or the original disk space. Bony canal stenosis at the operative site (19 of 73 cases) and disk herniations above or below the fusion sites (21 of 73 cases) were the most common postoperative findings. Hypertrophic bone was visualized as anterior extradural defect that was isointense (nine cases), hyperintense (four cases), or hypointense (eight cases) to the vertebral body on T1-weighted images. Disk herniations were evenly distributed above and below the fusion levels.     

Hereditary multiple exostoses and cervical cord compression: CT and MR studies

Hereditary multiple exostoses usually involve the long bones, but occasionally the spine. When the spine is involved, serious neurologic deficits may occur. We report a case of a 12-year-old girl with an exostosis in the cervical spine (C5), which caused a spastic quadriplegia.     

Anterolateral cervical meningocele in association with neurofibromatosis: MR and CT studies

Cervical anterolateral meningocele is rarer than its counterpart in the thoracic region. All of the previously described patients and the present case had associated neurofibromatosis. The magnetic resonance appearance is diagnostic.     

Melorheostosis involving the cervical and upper thoracic spine: radiographic, CT, and MR imaging findings

Melorheostosis, an uncommon mesenchymal dysplasia, rarely affects the axial skeleton. We describe the imaging findings of melorheostosis involving the cervical and upper thoracic spine. Radiographs and CT showed unilateral well-marginated undulating zones of cortical hyperostosis involving multiple vertebrae that were contiguous with a coalescent ossified right paravertebral mass. MR imaging showed zones of signal intensity void on all pulse sequences without contrast enhancement. Conservative management was elected because of lack of interval clinical and imaging changes for 8 years.     

MR imaging of the cervical spine in rheumatoid arthritis

The cervical spine was examined with MR imaging and conventional radiography in 23 patients with severe rheumatoid arthritis. All patients had neck pain and 17 also had neurologic symptoms. MR provided detailed information about soft-tissue lesions, vertebral dislocation, and narrowing of the spinal canal. Pannus surrounding the odontoid process was revealed in 14 patients, all with horizontal atlantoaxial subluxation. Compression of the medulla and/or spinal cord, caused by dislocated vertebrae and/or the soft-tissue mass around the odontoid process, was seen in 15 patients. When there was more than one dislocation the most important level could be determined. Posterior occipitocervical fusion had been performed in six of the patients, and in only two of these was adequate analysis of the upper cervical spine impossible because of artifacts from metal (stainless steel wires and pins). Sagittal MR in the neutral position combined with conventional radiography, including lateral views in flexion and extension, provided all the information necessary for further clinical management of rheumatoid arthritis of the cervical spine.     

MR imaging of the cervical spine: neurovascular anatomy

High-resolution surface-coil MR imaging reveals intricate anatomic detail of the cervical spinal canal and its neurovascular contents. Appreciation of the normal neurovascular anatomy provides a scientific foundation for the detection of disease. Sagittal, axial, and oblique MR images of normal subjects were correlated with comparable anatomic sections obtained with a cryomicrotome whole-organ sectioning technique. The anterior epidural venous plexus is a prominent structure in the cervical spinal canal and was consistently identified both with cryomicrotomy and with MR in sagittal and axial planes. Epidural veins can be displaced and distorted in patients with cervical disk disease. Nerve roots including dorsal and ventral rootlets were consistently identified on axial images coursing through the subarachnoid space. Oblique-plane imaging showed nerve roots "en face" in their respective foramina; this may be a useful imaging technique in the diagnosis of nerve root impingement.     

MR imaging in acute cervical spine trauma

Fourteen patients with cervical spine injuries, 12 with resultant neurological deficits, were scanned with magnetic resonance (MR) imaging within 7 days following injury. Useful information concerning the status of the spinal canal and disks was obtained in most cases. In addition, MR was able to suggest the nature of the pathological changes within the spinal cord, as well as hemorrhage and edema in the extraspinal soft tissues. These observations indicate that following acute cervical spine trauma, MR is a valuable technique in assessing injury to the spinal cord, surrounding soft tissues, vertebra, and disks.     

CT引导下颈椎病变穿刺活检

目的：探讨ＣＴ引导下颈椎病变穿刺活检的方法、途径、取材部位、穿刺针选用及适应证的选择等有关问题。材料与方法：１０例颈椎病变病人，病变范围Ｃ１～７，累及椎体、椎板、横突、棘突、椎间孔各部。ＣＴ扫描确定穿刺平面及穿刺路径，局麻进针，操作过程中ＣＴ监视穿刺针走向，达预定位置后取材。结果：１０例病人除１例骨巨细胞瘤放疗后活检未见肿瘤细胞，９例有明确的组织学诊断，诊断正确率９０％。无并发症出现。结论：ＣＴ引导下颈椎病变穿刺活检能清楚显示颈部复杂的解剖结构及穿刺针的位置，安全可靠，并发症极少，操作简便，诊断正确率高。可得到明确病理诊断，为临床制定治疗方案提供依据，值得推广。