Spinal cord imaging

Abstract

Imaging methods such as X-ray-based methods and magnetic resonance imaging (MRI) have had a substantial impact on the ability to diagnose spinal cord injury and disease. X-ray-based methods including computed tomography (CT) provide detailed information about anatomical changes in dense materials (bone, cartilage) after traumatic injury, disc degeneration, etc. MRI methods, on the other hand, provide information about soft tissue changes such as gray matter and white matter in the spinal cord, or vascular changes. Fine detail can also be obtained about changes in tissue structure at the cellular level via changes in magnetization relaxation times, magnetization transfer, and changes in water self-diffusion. Even with these capabilities, current clinical imaging methods cannot yet assess functional changes due to traumatic or nontraumatic injury or disease. Current research to develop functional magnetic resonance imaging (fMRI) in the spinal cord shows the potential for future clinical applications. However, there are technical challenges yet to be overcome, and the reliability and specificity of the methods need to be demonstrated. The process of developing fMRI and diffusion tensor imaging (DTI) methods for the spinal cord has resulted in methodological advances that contribute to improvements in all MRI methods for imaging the spinal cord. This chapter outlines the current capabilities of spinal cord imaging methods and the future potential to overcome as yet unmet needs.