MAGNETIC-RESONANCE-IMAGING OF THE MUSCULOSKELETAL SYSTEM .8. THE SPINE, SECTION-1

Magnetic resonance has assumed a preeminent role in the imaging evalua tion of the spine. Owing to its multiplanar capability and superior so ft tissue contrast, magnetic resonance imaging is the procedure of cho ice for a host of spinal disorders including degenerative disc disease , tumor evaluation, trauma, and spinal deformities. It represents the most accurate means of distinguishing between recurrent disc herniatio n and epidural fibrosis, and it excels at the assessment of many posto perative abnormalities such as infection, adjacent segment disc degene ration, and arachnoiditis. Magnetic resonance imaging is also helpful in the evaluation of numerous diagnostic challenges that are less well resolved by other means. This includes the distinction between disc h erniation and epidural hematoma, synovial cyst from nonspecific fibrou s thickening of a facet capsule, and the evaluation of numerous other soft tissue abnormalities. Computed tomography, computed tomography my elography, and scintigraphy continue to be useful for numerous specifi c disorders and in those patients with metal hardware or contraindicat ions to magnetic resonance scanning. Overall, however, magnetic resona nce is the imaging procedure preferred for many spinal disorders. This article is the first installment of a 3-part series discussing the ro le of magnetic resonance imaging of spinal disorders. Section 1 will d escribe the varying imaging modalities available and their relative ad vantages and disadvantages. A consideration of magnetic resonance imag ing techniques will follow followed by a discussion of the imaging man ifestations of early degenerative disc disease. Section 2 mill be devo ted to an in depth discussion of specific pathologic processes encount ered in patients with degenerative disc disease. Section 3 will end th e series with a consideration of postoperative imaging followed by a d iscussion of spinal deformities, trauma, and neoplasms.