MRI and CT of the spine

Question 1

Describe the health and safety issues of CT scans?

Answer 1

Ionising radiation

Question 2

Describe the health and safety issues of MRI scans?

Answer 2

Magnetic fields:
- Implanted medical devices
- Metallic implants
- Missile risk (metallic objects pulled into machine)
- Magnetic media

Question 3

Identify this pathology on a radiograph

Answer 3

spinal fracture

Question 4

Identify this CT pathology

Answer 4

Calcified disc extrusion
- calcified material within vertebral column suppressing spinal cord
- either new bone growth (chronic), calcified neoplasia (chronic), or calcified extruded material (acute)

Question 5

Identify this CT pathology

Answer 5

C1 vertebral arch neoplasia:
- normal ventral aspect anatomy
- Distorted, expanded dorsal (R) aspect due to osteolysis
- osteolytic processes either infection or tumour
- marked expansion, most likely tumour

Question 6

Identify this pathology

Answer 6

discospondylitis:
- white arrows = osteodestrcution either side of intervertebral disc (affects 2 bones)
- unlikely to be tumour (osteosarcomas limited 1 bone) therefore more likely to be osteomyelitis or infection of disc
- blue circles = reactive spondylosis

Question 7

Identify this MRI pathology

Answer 7

Spinal tumour:
- spinal cord being compressed by soft tissue mass
- lesion from outside the spinal cord
- associated multi-lobulated structure within abdomen - space occupying mass that invaded through intervertebral foramina

Question 8

Identify this pathology

Answer 8

spinal tumour:
- high density (after contrast) mass in spinal cord
- causes spinal cord to expand (inflammatory or neoplastic pathology)
- marked expansion suggests tumour

Question 9

Identify this pathology

Answer 9

Fibrocartilaginous embolisation:
- area of hyperintensity within centre spinal cord
- no expansion of spinal cord, more likely to be ischaemia or oedema or inflammation in spinal cord