MRI cervical spine is a high-precision study by means of magnetic radiation and radio waves aimed at visualizing the structure of bone tissue and tissues adjacent to the spinal column (in particular, bone marrow) by a non-invasive method.
When to do
The list of what the MRI cervical spine shows includes all structures located in this area:
- vertebrae of the cervical spine with intervertebral discs and the spinal cord located inside the center of the spinal column;
- a huge number of nerve endings and roots extending from the vertebrae;
- blood vessels of the neck, feeding the soft tissues of the head, face, as well as all parts of the brain;
- bundles of ligaments that fix the vertebrae with the skull and the upper part of the body;
- fascia, creating a kind of framework and isolating muscles, vessels and nerves from each other;
- muscle fibers, etc.
The neck is extremely unstable and constantly undergoes enormous loads. Muscle spasm, injury to the vertebrae, chronic compression of nerves or veins of the neck can provoke serious malaise. Any violation in one of the listed structures always (but not immediately) leads to a deterioration in a person’s well-being.
The list of diseases, as shown by MRI cervical spine, includes:
- injuries in the neck — fractures and dislocations of the vertebrae, their displacement;
- congenital anomalies in the structure of the upper or thoracic spine — extra vertebrae, cervical ribs, underdevelopment of intervertebral discs, fusion of vertebrae, etc.
- herniated discs;
- stenosis of nerves and blood vessels due to curvature, incorrect structure or spinal injuries;
- atrophic and deforming processes – osteochondrosis, spondylosis, spondyloarthrosis;
- inflammatory diseases of neck structures — myelitis, arthritis, arachnoiditis;
- multiple sclerosis;
- congenital or inherited syndromes — Bekhterev, Guillain-Barre;
- congenital and acquired thyroid abnormalities;
- congenital and acquired diseases of the larynx;
- inflammatory, tumor and other changes in the lymph nodes of the neck;
- benign and malignant tumors, metastases.
To obtain the most accurate picture, an additional examination of the thoracic spine, as well as the head, is performed. In order to more intensively “highlight” the vessels and neoplasms in the photo, diagnostics with contrast is carried out.
Almost all diseases that are detected by MRI cervical spine have non-specific symptoms. Most of them manifest themselves in the form of acute or chronic neurological disorders
- acute or chronic headache, spreading to the face, neck, sometimes to the hands;
- loss of sensitivity of various parts of the body, numbness of the limbs, face;
- loss of control over the motor functions of the limbs, unilateral and bilateral paresis;
- loss of the ability to maintain balance, shaky gait, loss of orientation in space;
- sound, tactile and visual hallucinations.
These symptoms may appear suddenly or there is a gradual increase in their intensity. Regardless of the degree of manifestation and duration of their appearance, doctors call it a direct indication for the procedure of an MR scan of the neck. If the source of these problems is not identified in time, there is a possibility that they will become irreversible or cause mental abnormalities.
Also, an MRI of the neck is performed if the doctor suspects the patient has the following abnormalities:
- compression of the spinal cord due to dislocation of the vertebrae or the formation of a hernia;
- instability of vertebral joints;
- the presence of benign tumors or metastases in the bone or soft tissues of the neck;
- the presence of tumors in the thyroid gland and larynx.
If any types of tumors are suspected, an MRI is performed using contrast. The same method is indicated for the detection of vascular anomalies.
Magnetic nuclear tomography has no restrictions on the frequency of studies, so the procedure is shown as the main way to monitor conditions after chemotherapy and radiation therapy, surgical interventions. It detects errors well and determines the risk of relapse in the early postoperative periods.
The usual MRI cervical spine has many times fewer contraindications than other methods of radiation diagnostics. These include
- the first trimester of pregnancy;
- the presence of metal fixed dentures;
- the presence of a pacemaker, a non-removable hearing aid, an insulin pump;
- metal clips or stents on the vessels of the brain, heart;
- suspicion of the presence of metallic foreign bodies in the body .
The list of contraindications includes diseases and conditions in which the patient will not be able to remain motionless while taking pictures. These include fear of confined spaces and other types of phobias, mental and neurological disorders. If there are no other ways to make a diagnosis, such a patient may be put into a drug-induced sleep during the procedure.
Obesity can make it difficult or impossible to examine an adult. The load capacity of modern devices does not exceed 120 kg, therefore, if the patient’s weight is greater, other methods are chosen: CT, ultrasound or X-ray.
There are additional contraindications for undergoing MRI with contrast. This is an intolerance to drugs administered intravenously. If the samples showed an allergy to a contrast agent, you can choose a remedy with a different composition, but more often you have to do with a standard scan or do a CT scan.
The specifics of the preparation for the examination depends on how the MRI cervical spine is performed – with or without contrast. In the absence of contrast, special training is not needed. It is enough for the patient to fill out a questionnaire or answer questions to the doctor orally. With this, the doctor makes sure that there are no obvious contraindications to the procedure.
For patients with an increased level of anxiety or mild claustrophobia, the doctor will recommend taking a sedative 1-2 hours before the start of the scan. If the patient has problems with self-control, he will be prescribed medication sleep. In order for anesthesia not to provoke complications, the patient undergoes an ECG and consultation with an anesthesiologist in advance.
A more serious and complex preparation will require an MRI of the neck with contrast. Since drugs sometimes provoke nausea or vomiting, it is worth refraining from eating at least 8 hours before the procedure. Also, the doctor may ask not to take some medications for 1-3 days to avoid undesirable interaction of drugs with a contrasting substance. If the contrast is injected into the spinal canal, and not intravenously, you will have to give up taking some medications 5-7 days before the examination. The exception is cases when medications need to be taken constantly as prescribed by a doctor.
Methodology of conducting
Before starting the study, the doctor explains how to do an MRI cervical spine on the equipment installed in the clinic, what happens during the scan and what sensations the patient may have. After the conversation, the doctor asks to remove the piercing, all jewelry and accessories, removable dentures and clothes with metal elements. If necessary, the patient is given a cotton shirt with ties, in which he changes clothes before being placed in a tomograph.
To obtain clear MRI cervical spine of a person, they are fixed on a movable tomograph table using rollers and straps. The head can be placed in a special frame. At the request of the patient, he can be given sound-proofing headphones, through which the noise of the tomograph will not penetrate, but the doctor’s voice will be clearly broadcast. After that, the doctor and medical staff leave the room with a tomograph. They will monitor the process from an adjacent office.
On average, a full cycle of creating a series of images on an MRI scanner takes about 20 minutes. If a contrast study is performed, the procedure takes a little longer — about 40 minutes.
Interpretation of results
In conclusion (transcript) to the MRI of the neck, the radiologist describes all the organs and structures in the field of view
- vertebrae — their size, number, distance between them, the state of the processes and other information indicating whether the parameters correspond to the norms, as well as an accurate description of pathologies – fractures, protrusions, displacements;
- intervertebral discs — their shape, density, integrity of the shell, the presence of ruptures, displacements and other pathologies, indicating their exact localization;
- spinal canal and spinal cord – diameter, amount of cerebrospinal fluid, condition of the membranes of the brain and its substances, in the presence of pathologies, their location and nature are indicated;
- the state of nerves and blood vessels, their compliance with the norms, the presence of stenosis, thrombosis, other pathologies, indicating their localization, origin;
- condition of muscles, ligaments and fascia, their compliance with the norms.
Depending on why the examination was carried out, additional data may be entered into the transcript about how the larynx, thymus and thyroid glands look like, how much their structure has changed, whether there are neoplasms in them. In some cases, three-dimensional images of individual organs and structures of the neck are created for better visualization.
The text description (transcript) with the pictures is passed to the doctor who issued the referral for an MRI of the neck. Narrow specialists look at the detected violations, compare them with previously obtained information, and, if necessary, prescribe additional studies. Only after that they make a final diagnosis.