Magnetic resonance imaging has become an increasingly beneficial tool for the radiologic evaluation of complex spine diseases. However, due to the many variables implicit in MR imaging technique, considerable experience and expertise are necessary to diagnose with confidence.
This book provides a comprehensive and practical overview of the field, and gives you the information to competently utilize MRI for the diagnosis of diseases of the spine and spinal cord.
More than 1,300 high-quality images help you
recognize and distinguish normal findings from pathologic spinal disorders and
common MR artifacts
Systematic tables of indications and differential
diagnoses summarize each disorder and help you in planning treatment
Problem-solving tips and tricks provide details on
various imaging techniques, as well as the advantages and disadvantages of
different MRI sequences
Concise chapter summaries provide quick and easy access to the most current MR imaging information
Of great interest to radiologists, neuroradiologists, trauma surgeons, orthopedic surgeons, and neurosurgeons, this extensively illustrated work is an essential diagnostic reference for evaluating spinal disorders.
Professor, Department of Radiology, St. Josefs-Hospital, Dortmund, Germany
1 PHYSICS AND ITS APPLICATION K.-H. Trummler and P. Kreisler 1.1 Basic Principles 1.1.1 Protons in a magnetic field 1.1.2 Excitation 1.1.3 Relaxation 1.1.4 The effects of inhomogeneities 1.2 Various image contrasts 1.2.1 T1-weighted image 1.2.2 T2-weighted image 1.2.3 Further preconditions for a T1- and T2-weighted image 1.2.4 Proton density (PD) 1.3 Fundamental scanning sequences 1.3.1 Preliminary remark on 2- and 3-dimensional acquisition methods 1.3.2 Gradient echo sequence 1.3.3 Spin echo sequence 1.3.4 Inversion-recovery (IR) sequence 1.4 Ultrafast imaging 1.4.1 Turbospin echo 1.4.2 Turbo gradient spin echo 1.4.3 Echo planar imaging 1.5 Artefacts on MR images 1.5.1 Metal-induced artefacts 1.5.2 Motion artefacts 1.5.3 Aliasing 1.5.4 Truncation artefacts 1.5.5 Susceptibility artefacts 1.5.6 Chemical-shift artefacts 1.6 Future perspectives 1.6.1 Summary 2 MRI AND SPINAL SURGERY - INDICATIONS BASED ON THE SPECTRUM OF SURGICAL THERAPEUTIC OPTIONS R. Schultheiss 2.1 General comments on pre-operative diagnostics and planning strategy 2.2 Surgical management of spinal diseases with reference to MRI 2.2.1 Cervical intervertebral disc prolapse 2.2.2 Lumbar intervertebral disc prolapse / degenerative diseases of the lumbar spine 2.2.3 Recess stenosis and spinal canal stenosis 2.2.4 Failed back-surgery syndrome (post discectomy syndrome) 2.2.5 Spondylolisthesis 2.2.6 Spinal tumours 2.2.7 Intraspinal tumours 2.2.8 Extramedullary tumours 2.2.9 Intramedullary tumours and syringomyelia 2.2.10 Changes at the craniocervical junction 2.2.11 Inflammatory changes 2.2.12 Traumatic changes 2.3 Communication as a problem of diagnostics 2.3.1 Summary 3 MALFORMATIONS OF THE SPINAL CANAL D. Uhlenbrock and D. Brechtelsbauer 3.1 Embryogenesis and maldevelopments 3.1.1 Development of the central nervous system 3.1.2 Development of the meninges 3.1.3 Formation of the vertebral column 3.2 Pathogenesis of anomalies 3.2.1 Theories of the pathogenesis of myelomeningoceles and Arnold-Chiari type II malformation 3.2.2 Theories of the pathogenesis of closed spinal malformations 3.3 Dysraphic malformations 3.3.1 Open spinal malformations Closed spinal malformations 3.4 Non-dysraphic malformations 3.4.1 Partial and total sacral agenesis 3.4.2 Congenital tumours 3.4.3 Spinal cysts 3.4.4 Arnold-Chiari malformation 3.4.5 Syringomyelia 3.4.6 Congenital spinal stenosis 3.4.6 Summary 4 DEGENERATIVE DISORDERS OF THE SPINE D. Uhlenbrock 4.1 The ageing process of the intervertebral disc 4.1.1 Classification of intervertebral disc degeneration 4.1.2 Types of annular tears 4.2 Contrast enhancement patterns of the unoperated intervertebral disc, the intraspinal structures and the vertebral joints 4.3 Degenerative changes of the vertebral body end plates 4.4 Classification of intervertebral disc herniation 4.5 Examination technique 4.5.1 Lumbar region 4.5.2 Thoracic region 4.5.3 Cervical region 4.6 Clinical symptoms 4.7 Degenerative changes of the lumbar spine 4.7.1 Protrusion/Prolapse 4.7.2 Lateral disc herniation 4.7.3 Intradural disc herniation 4.7.4 Limbus-like herniation 4.7.5 Anterior disc herniation 4.7.6 Spondylolisthesis 4.8 Degenerative changes of the thoracic spine 4.9 Degenerative changes of the cervical spine 4.10 Acquired spinal canal stenosis 4.11 MRI findings after lumbar disc surgery 4.11.1 Postoperative course 4.11.2 MRI findings 4.11.3 Pseudomeningocele 4.11.4 Spinal fusion 4.12 MRI findings after cervical disc surgery 4.12.1 Summary 5 TUMOURS OF THE SPINE AND SPINAL CANAL D. Uhlenbrock and V. Kunze 5.1 Tumours of the spine 5.1.1 Bone tumours 5.1.2 Metastases to the vertebrae and the epidural space 5.2 Tumours of the spinal canal 5.2.1 Epidural, non-metastatic space-occupying lesions 5.2.2 Intradural tumours 5.2.3 Extradural, intradural extramedullary and intramedullary tumour manifestations 5.2.4 Summary 6 INFLAMMATORY DISORDERS THE SPINE AND SPINAL CANAL D. Uhlenbrock, H. Henkes, W. Weber, S. Felber and D. Kuehne 6.1 Inflammatory disorders of the spine 6.1.1 Infectious spondylodiscitis/spondylitis 6.1.2 Rheumatoid arthritis 6.1.3 Spondyloarthropathy 6.2 Inflammatory disorders of the spinal canal 6.2.1 Spinal leptomeningitis 6.2.2 Spinal epidural abscess 6.2.3 Spinal cord abscess 6.2.4 Acute transverse myelitis 6.2.5 Radiation myelopathy / myelitis 6.2.6 Multiple sclerosis 6.2.7 Myelopathy associated with HIV infection and AIDS 6.2.8 Guillain-Barre syndrome 6.2.9 Myelitis in systemic lupus erythematosus 6.2.10 Intraspinal / intramedullary sarcoidosis 6.2.11 Post-meningitis syringomyelia 6.2.12 Spinal arachnoiditis and arachnopathy 6.2.13 Parasitic cystic disorders 6.2.14 Summary 7 USE OF MRI IN ACUTE SPINAL TRAUMA S. E. Mirvis 7.1 MRI and soft-tissue injuries 7.2 MRI and ligament injuries 7.3 MRI and acute traumatic epidural lesions 7.3.1 Intervertebral disc herniation 7.3.2 Epidural haematoma 7.4 Degenerative spondylosis 7.5 MR angiography and injuries to the cervical arteries 7.6 MRI and osseous injuries 7.7 MRI and radicular symptoms 7.7.1 Summary 8 VASCULAR DISORDERS OF THE SPINAL CANAL A. Felber, S. Felber, H. Henkes and D. Kuehne 8.1 Vascular anatomy of the spinal cord 8.1.1 Arterial blood supply 8.1.2 Spinal cord veins 8.2 Spinal haemorrhage 8.2.1 Spinal epidural haematoma 8.2.2 Spinal subdural haematoma 8.2.3 Spinal subarachnoid haemorrhage 8.2.4 Haematomyelia 8.3 Aneurysms 8.4 Spinal vascular malformations 8.4.1 Arteriovenous malformations 8.4.2 Cavernous haemangiomas (cavernomas) 8.4.3 Capillary telangiectasia and venous malformations 8.5 Haemangioblastoma 8.6 Spinal cord ischaemia 8.6.1 Arterial spinal cord infarction 8.6.2 Venous spinal cord infarction 8.6.3 Summary 9 FUNCTIONAL ANALYSIS AND SURGERY OF THE SPINE IN AN OPEN MR SYSTEM P. Hilfiker and J. F. Debatin 9.1 Open configurated MR systems 9.2 Functional analysis of the spine 9.2.1 Examination of the spine in the seated position 9.2.2 Intervertebral disc height in relation to the time of day and examination position 9.2.3 Functional MR myelography of the lumbar spine 9.3 MR-guided spinal surgery 9.3.1 MR-guided bone biopsy 9.3.2 Minimally invasive spinal surgery 9.4 Assessment 9.4.1 Summary