Magnetic resonance imaging procedure of the cervical spine with injection of magnetic contrast agent

This is an automatically translated article.

The article is expertly consulted by Master, Doctor Hoang Van Lan Duc - Doctor of Radiology - Department of Diagnostic Imaging and Nuclear Medicine - Vinmec Times City International General Hospital.
Magnetic resonance imaging of the cervical spine with magnetic contrast injection is a highly accurate and safe imaging method, which is being widely applied today to diagnose diseases in the cervical spine such as: cancer, trauma, sensory disorders,...

1. Characteristics of cervical vertebrae

There are 7 cervical vertebrae (from C1 to C7). Between the 2 vertebrae starting at C2 and below there are intervertebral discs. The structure of the intervertebral disc includes the nucleus pulposus, the cartilage plate, and the fibrous ring, about 3mm in height. Around the vertebrae there are ligaments and tendons attached to the muscles.
The discs of the cervical spine are responsible for connecting the vertebrae. Cartilaginous plate attaches to the same plate of the vertebral body, has the effect of protecting bones and discs. The nucleus pulposus moves when the spine moves, helping to absorb shock when a force is applied to the vertebrae.

2. What is an MRI of the cervical spine with magnetic contrast injection?

Magnetic resonance imaging is an imaging method that does not use X-rays, which is very good in diagnosing spinal diseases in general and the cervical spine in particular. Injuries in the vertebral body, spinal cord, discs, ligaments, nerves and soft tissue around the spine,... can all be diagnosed accurately through magnetic resonance imaging without the use of drugs. magnetic contrast. As for the case where it is necessary to evaluate the tumor, inflammation, ... in the cervical spine, it is necessary to combine magnetic resonance imaging of the cervical spine with intravenous contrast injection to reveal the lesion clearly and help Diagnosis is easier and more accurate.

3. When should and shouldn't magnetic resonance imaging of the cervical spine with magnetic contrast injection?

Indications to perform the technique:
Cases with symptoms of neck pain, shoulder pain persisting for a long time, not responding or responding poorly to treatment; People with sensory disorders such as numbness, tingling, paresthesia, ... in the shoulder or neck, hands, ...; People with severe arm pain, unresponsive to long-term treatments; It is necessary to detect and evaluate congenital malformations of the spinal cord; Need to detect disc diseases such as bulging, degenerative or herniated discs; Diagnosis or monitoring of multiple sclerosis, spinal nerve diseases; Assess for suspected fracture or old vertebral fractures; Assess the condition of the cervical spine before performing surgery; Postoperative evaluation of cervical spine and detection of post-operative abnormalities; Check for cervical spine injuries; Diagnosis of spinal tuberculosis; Check or monitor cancer or tumor in the cervical spine (spine, spinal cord cancer). Absolute contraindications for performing the technique:
Patients carry electronic devices in their body such as automatic subcutaneous injection devices, pacemakers, anti-vibration machines or cochlear implants,... ; Persons with metal surgical clips in the intracranial, vascular or orbital for less than 6 months; Severely ill people need to have resuscitation equipment next to them. Patients have contraindications to contrast injection from Relative contraindications to the technique: Patients are afraid of solitude or fear of the dark; Patients with metal surgical clamps in the intracranial, vascular or orbital for more than 6 months.

Relative contraindications to performing the technique:
Patients are afraid of being alone or afraid of the dark; Patients with metal surgical clamps in the intracranial, vascular or orbital for more than 6 months.

4. Technical implementation process

4.1 Preparation of Implementation Personnel: Specialist doctors, radiological technicians and assistant nurses; Drugs: magnetic contrast agents; Facilities: Resonance machine 1 Tesla or more and film, film printer and image storage system; Common medical supplies: Including 10ml syringe, gloves, cotton, gauze, sterile adhesive tape, 18G intravenous needle, medicine box and necessary tools for emergency treatment for drug accidents for patients. optical ; Patient: The doctor explains in detail about the procedure to best coordinate according to the doctor's instructions; checked for contraindications; perform a change of clothes of the magnetic resonance imaging room, remove contraindicated items. 4.2 Performing the MRI Patient position: Lie supine on the table; selection - position the receiver coil; medical staff move the table into the magnetic field of the magnetic resonance machine and locate the imaging area; Location capture; Take pulse sequences before drug injection: T1W vertical, T2W vertical and T2W transverse to the required position. Stir can be shot vertically if needed; Perform intravenous contrast injection for patients, the usual dose is 0.1mmol/kg body weight; Take T1W pulse sequences after contrast injection in 3 directions; At the end of the magnetic resonance imaging of the cervical spine with magnetic contrast injection, the medical staff removed the signal receiver coil and invited the patient out to wait for the results; The technician performs image processing, film printing and transferring necessary images and data to the doctor; The doctor performs image analysis and perfusion parameters, making a diagnosis.

4.3 Evaluation of results The images obtained from the MRI scan of the cervical spine allow the doctor to clearly observe the anatomical structures of the cervical spine; The doctor can assess the nature and extent of contrast enhancement of the lesions, if any; The doctor reads the lesions and gives professional advice to the patient. 4.4 Some complications and ways of handling After magnetic resonance imaging, patients may face a number of problems such as:
Fear, agitation: The doctor needs to comfort and encourage the patient; Excessive anxiety and fear: The patient can be sedated under the supervision of an anesthesiologist; Contrast-related complications: Including conditions such as urticaria, anaphylaxis, hypotension, bronchospasm, laryngeal edema,... The patient was treated according to the protocol. standard. Magnetic resonance imaging of the cervical spine with injection of magnetic contrast is a high technique, helping doctors to assess in detail and clearly the pathologies in the cervical spine. In particular, this method does not contain ionizing radiation, so it is very safe for the photographer.
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Master. Doctor Hoang Van Lan Duc was formally trained and graduated with a Master's degree from Hanoi Medical University. The doctor has more than 10 years of experience in the field of imaging, especially in diagnosing with emergency internal, surgical, abdominal, thoracic, musculoskeletal, neurological and thyroid, breast, ...
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