What is the role of MRI in the diagnosis of cervical disc disease?

Updated: Apr 16, 2020
  • Author: Michael B Furman, MD, MS; Chief Editor: Dean H Hommer, MD  more...
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Answer

See the list below:

  • MRI remains the imaging modality of choice to evaluate cervical HNP, due to its low morbidity. [5, 6]

  • Advantages include soft-tissue definition (eg, cervical discs, spinal cord), cerebrospinal fluid visualization, noninvasiveness, and lack of patient radiation exposure. (See the images below.)

    Axial magnetic resonance imaging (MRI) scan (C3-C4 Axial magnetic resonance imaging (MRI) scan (C3-C4) demonstrating left-sided posterolateral protrusion of the nucleus pulposus with compression of the cerebrospinal fluid.
    Sagittal magnetic resonance imaging (MRI) scan dem Sagittal magnetic resonance imaging (MRI) scan demonstrating cervical intervertebral disc protrusions at C3-C4 and C7-T1.
  • Newer MRI pulse sequences and higher field magnets provide faster and more detailed imaging.

  • Unfortunately, some sequences (eg, spin echo) depict pathology larger than actual size and obscure other abnormalities. Other disadvantages include expense, inability of claustrophobic patients to tolerate the procedure, dependence on patient cooperation to minimize artifact, high false-positive rate, and insensitivity compared with CT scanning in evaluating bony structures.

  • Furthermore, MRI appears inferior in differentiating cervical disc prolapse (ie, soft cervical disc) from spondylitic osteophytic compression (ie, hard cervical disc).

  • A literature review by Michelini et al indicated that upright MRI can be used to demonstrate spinal problems in symptomatic patients in whom conventional MRI produces negative results, with kinetic MRI allowing patients to be imaged in weight-bearing, flexed, and extended positions. [29]

  • Contraindications to MRI include patients with embedded metallic objects, such as pacemakers, surgical clips, spinal cord stimulators, or prosthetic heart valves that may be dislodged by MRI magnets.


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