MRI Magnetic Resonance Imaging Reports and Terminology as it applies to Spinal Disorders

MRI (Magnetic Resonance Imaging): A special imaging technique used to image internal structures of the body, particularly the soft tissues. An MRI image is often superior to a normal X-ray image.

How it works: MRI uses the influence of a large magnet to polarize hydrogen atoms in the tissues and then monitors the summation of the spinning energies within living cells. Images are very clear and are particularly good for soft tissue, brain and spinal cord, joints and abdomen. These scans may be used for detecting some cancers or for following their progress.

Understanding Magnetic Resonance Imaging Terminology can be difficult because one Reading Radiologist may use terminology to describe a condition that is totally different from another Radiologist’s reading. And just like language dialects there are variances by geographic location and the school where they received their education. However, any radiologist should be able to read another report and fully understand the condition. However this is not always the case as the whole process is open to interpretation and experience.

Terms Used to Describe Spinal Pathology on MRI Reports

Desiccation – loss of disk water

Disk bulge – circumferential enlargement of the disk contour in a symmetric fashion

Protrusion – a bulging disk that is eccentric to one side but < 3 mm beyond vertebral margin

Herniation – disk protrusion that extends more than 3 mm beyond the vertebral margin

Extruded disk – extension of nucleus pulposus through the anulus into the epidural space

Free fragment – epidural fragment of disk no longer attached to the parent disk

Osteophytes – protrusions of bone and cartilage (aka “Bone Spurs”); a pathological bony outgrowth

Widely Patent - affording free passage : being open and unobstructed, thus a “Wide” open unobstructed finding

Spinal Stenosis – is a medical condition in which the spinal canal narrows and compresses the spinal cord and nerves

Bony Edema – Edema is another word for swelling and is indicative of injury to an area. Edema is commonly seen around an area that has sustained an injury. Therefore, the structure may appear normal, but the edema may show where the injury is located. Edema may be seen within a bone (a “bone bruise”) or within the soft-tissues

Myelopathy – any disease or disorder of the spinal cord or bone marrow

Foramin (Foramina – plural) – vertebral foramen is the foramen formed by the anterior segment (the body), and the posterior part, the vertebral arch. A small opening, perforation, or orifice

Discitis – Inflammation of an intervertebral disk or disk space which may lead to disk erosion. Until recently, discitis has been defined as a non bacterial inflammation and has been attributed to aseptic processes (e.g., chemical reaction to an injected substance). However, recent studies provide evidence that infection may be the initial cause, but perhaps not the promoter, of most cases of discitis. Discitis has been diagnosed in patients following discography, myelography, lumbar puncture, paravertebral injection, and obstetrical epidural anaesthesia. Discitis following chemonucleolysis (especially with chymopapain) is attributed to chemical reaction by some and to introduction of microorganisms by others

Degenerative Disc Disease – <radiology> Plain film: narrowing of disc space; osteophytes; bone sclerosis, disc calcification, vacuum disc phenomenon (nitrogen at sites of negative pressure) MRI: endplate changes (Modic and deRoos), Type I (4%): decreased signal on T1; increased signal on T2; vascularised fibrous tissue, Type II (16%): increased T1; isointense T2; local fatty replacement of marrow, Type III: decreased T1; decreased T2; advanced sclerosis sequelae: disc bulging, disc herniation, disc sequestration, spinal stenosis (I’ve written and entire post on what constitutes DDD and there is no real agreement in the Medical Community on an exact definition).

Vertabrae Photo

I’m hoping this image will help you to visualize what is going on in your Spinal MRI. Knowing the Spinal anatomy will take you a long ways towards understanding your MRI Reports.

Please visit this link for a brief Overview of Spinal Anatomy.