Imaging of Tumors of the Spinal Canal and Cord

Magnetic resonance is the best noninvasive modality for imaging the size, shape, position, and presence or absence of compression of the spinal cord. MR is less optimal than CT for the assessment of intrinsic bone abnormalities. Myelography and CT have, as their chief advantage relative to MR, short data acquisition times. Consequently, MRI has the problem of image degradation from patient motion. The advent of gadolinium-DTPA as a paramagnetic contrast agent (following FDA approval) is expected to increase the sensitivity of MR further in defining neoplasms arising from intramedullary, intradural-extramedullary, and extradural locations. In view of the ability of multiplanar MR to demonstrate neoplasms that affect the spinal cord, the use of sedation and pain medication protocols appears justified. Moreover, to eliminate intrinsic artifacts arising from cardiac pulsation, respiration and CSF flow, MR imaging must utilize advanced techniques such as flow compensation and cardiac gating.