The document discusses the spinal cord and various imaging methods used to evaluate the spine such as x-rays, CT scans, and MRI. X-rays are often the initial test used but CT scans provide more detailed bone images while MRI is the best method for visualizing soft tissues and spinal cord abnormalities. The document then covers various pathologies that can be seen in spinal imaging like trauma, fractures, congenital defects, demyelinating diseases, tumors, and how different diseases present differently in images.
The document discusses the spinal cord and various imaging methods used to evaluate the spine such as x-rays, CT scans, and MRI. X-rays are often the initial test used but CT scans provide more detailed bone images while MRI is the best method for visualizing soft tissues and spinal cord abnormalities. The document then covers various pathologies that can be seen in spinal imaging like trauma, fractures, congenital defects, demyelinating diseases, tumors, and how different diseases present differently in images.
The document discusses the spinal cord and various imaging methods used to evaluate the spine such as x-rays, CT scans, and MRI. X-rays are often the initial test used but CT scans provide more detailed bone images while MRI is the best method for visualizing soft tissues and spinal cord abnormalities. The document then covers various pathologies that can be seen in spinal imaging like trauma, fractures, congenital defects, demyelinating diseases, tumors, and how different diseases present differently in images.
The document discusses the spinal cord and various imaging methods used to evaluate the spine such as x-rays, CT scans, and MRI. X-rays are often the initial test used but CT scans provide more detailed bone images while MRI is the best method for visualizing soft tissues and spinal cord abnormalities. The document then covers various pathologies that can be seen in spinal imaging like trauma, fractures, congenital defects, demyelinating diseases, tumors, and how different diseases present differently in images.
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Spinal Cord
(CNS BLOCK, RADIOLOGY)
Objectives
Anatomy of spinal cord.
Anatomy of vertebral column. Identify, and distinguish between, common types of Radiographic Images. You should also be able to recognize some RADIOLOGICAL presentation of spinal cord diseases. Imaging Methods to Evaluate Spine X-RAYS (RADIOGRAPHS)
Often the first diagnostic imaging test
Small dose of radiation to visualize the bony parts Can detect Spinal alignment and curvature Spinal instability – with flexion and extension views Congenital (birth) defects of spinal column Fractures caused by trauma Moderate osteoporosis (loss of calcium from the bone) Infections Tumors Is this film an adequate lateral film? COMPUTERIZED TOMOGRAPHY (CT SCAN) Uses radiation
Obtain 2-D images can be processed to 3-D images
Entire spine can be imaged within a few minutes
Detailed information regarding bony structures
Limited information about spinal cord & soft tissues
Magnetic Resonance Imaging (MRI)
Gold standard of imaging for spinal cord disorders
No radiation Can identify abnormalities of bone, soft tissues and spinal cord Claustrophobic patients, uncooperative and children may need sedation or general anesthesia Contraindications include implanted devices e.g. cardiac pacemakers and electromagnetic devices Indications Advantages Disadvantages
X-Ray Trauma Inexpensive Radiation exposure
Intra-operative localization Widely available Difficulty in interpretation Quick High rate of false-positive Portable findings
CT Trauma Visualization of bony Less useful at visualizing soft
structures tissue structures Widely available Radiation exposure Quick Cost
MRI Pts with "red flags" case Visualization of soft tissue Contraindications: presence of Radiculopathy structures (e.g. relationship of ferromagnetic implants, Tumor disc to nerve) cardiac pacemakers, Myelopathy No radiation exposure intracranial clips, Claustrophobia Not widely available Cost$$$ Abnormalities Of Spinal Cord Trauma Plain Radiographs (x-rays) are usually the first series of images to be ordered by the physician.
If fractures, or other bony defects, are suspected, CT images can provide very detailed information.
When soft tissue injury is suspected, MRI is usually the imaging technology of choice. Assess four parallel lines.
common acquired chronic relapsing demyelinating disease involving the central nervous system.
Characteristically disseminated not only in
space but also in time Transverse Myelitis Inflamed cord of uncertain cause
Viral infections
Immune reactions
Idiopathic
Myelopathy progressing over hours to weeks
TM VS MS
MS lesions in spinal cord
are more likely multiple, focal and peripherally located don’t cover the entire section on axial images often < 2 vertebral body heights on sagittal images are disseminated in time and space
Transverse myelitis lesions
extend over >3 vertebral body heights on axial images often > 4 vertebral body heights on sagittal images no brain lesions Tumors Classification Intramedullary lesions its location is determined within the cord.
extramedullary lesions May be related to nerve roots and may extend into the foramen (e.g. schwannomas and neurofibromas) or they may have a broad dural attachement (e.g. meningiomas). Astrocytoma Ependymoma Thank you
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