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A Patient's Guide: How To Navigate Your Spine MRI

Our spine plays a fundamental role in supporting our body.

It protects the spinal cord, facilitates movement, and connects the different parts of our musculoskeletal system. Many factors can influence the likelihood of experiencing spinal problems, including injury, genetics, congenital conditions, infection, autoimmune disorders, tumors, and lifestyle habits. Seeking medical attention for any persistent back pain or spinal issues can help initiate the healing process and reduce the risk of developing more a serious medical condition.

A spine MRI provides a non-invasive and highly accurate way for your doctors to visualize the spine’s structures and evaluate for any abnormalities.

Types of Spine MRI

Imaging of the spine splits the vertebrae into three regions: cervical, thoracic, and lumbar. Your doctor will choose the appropriate type of MRI based on your symptoms, medical history, and suspected spinal condition.

Cervical Spine MRI:

The cervical spine comprises the seven vertebrae (C1-C7) in the neck area. A cervical spine MRI is commonly used to assess conditions like herniated discs, spinal stenosis, nerve impingement, fractures, tumors, and other abnormalities that may affect the neck and upper limbs.

Thoracic Spine MRI:

The thoracic spine is the middle portion corresponding to the chest region, extending from the base of the neck to the lower back. It consists of twelve vertebrae (T1-T12). A thoracic spine MRI is primarily used to evaluate issues like spinal deformities, tumors, spinal cord compression, and other conditions that may affect the chest area.

Lumbar Spine MRI:

The lumbar spine is the lower portion of the spine, consisting of five vertebrae (L1-L5) that span the lower back. A lumbar spine MRI is commonly used to assess conditions like herniated discs, spinal stenosis, degenerative disc disease, sciatica, and other problems that may affect the lower back and legs.

In some cases, your doctor may request a whole spine MRI that includes all three studies. This evaluation is typically required when there is a suspicion of widespread spinal issues or when a condition affecting multiple areas of the spine is suspected.

Spine MRI vs Spine CT

Unlike computed tomography (CT), MRI does not use ionizing radiation. It generates images using a strong magnetic field and radio waves. CT scans involve exposure to X-rays, which carry a small risk of radiation exposure. The level of radiation exposure in a CT scan is generally higher than in a standard X-ray but still within acceptable limits.

Each modality has its strengths and limitations. A spine MRI is preferred when studying soft tissues, such as the spinal cord, muscles, ligaments, and discs, due to its superiority in differentiating between normal and abnormal soft tissue. It is also the preferred modality to look for subtle bone marrow edema. A CT of the spine is superior in its ability to visualize bone and calcium, making it particularly useful for assessing fractures, bony abnormalities, or bony alignment. It may also be used over MRI in emergent settings due to quicker exam time.

Spine MRI With or Without Contrast

Contrast agents help enhance the visibility of specific tissues and structures. Depending on the clinical question and any suspected or known medical conditions, your doctors will decide whether to use contrast in a spine MRI.

Some instances where a contrast-enhanced spine MRI may be helpful include:

  • Identifying and characterizing tumors or abnormal growths
  • Distinguishing areas of active infection or inflammation
  • Improving the detection and characterization of vascular malformations
  • Assessing the presence of postoperative complications
  • Identifying nerve abnormalities or compression (in some instances)
  • Diagnosing certain demyelinating diseases of the spinal cord, such as multiple sclerosis
  • Visualizing suspected vascular injuries or dissections involving the blood vessels

Wait Time to Receive Results of a Spine MRI

The time it takes to receive the results of a spine MRI can vary depending on several factors, including the imaging facility’s protocol, medical urgency, and the availability of reading radiologists. In most cases, the results are available within one to two weeks. However, the exact turnaround time can differ from one healthcare facility to another.

You can learn more about the factors influencing wait time in our article: How Long Does It Take To Get MRI Results.

Appropriate Type of Radiologist to Read a Spine MRI

A radiologist specializing in neuroradiology or musculoskeletal radiology is the best type of specialist to read a spine MRI. Both subspecialties within radiology involve extensive training in evaluating the nervous system (including the spine) and the musculoskeletal system, respectively. Depending on your symptoms, a neuroradiologist or musculoskeletal radiologist may be preferred over the other. Their skill and experience ensure a thorough spine assessment, which is critical for providing an accurate diagnosis and guiding appropriate treatment plans.

Neuroradiologist: A neuroradiologist is a radiologist with additional fellowship training focused explicitly on interpreting images of the brain, spinal cord, and nerves. They are well-versed in identifying and diagnosing various spinal conditions, such as disc herniation, spinal cord compression, spinal tumors, spinal stenosis, and other neurological abnormalities.

Musculoskeletal Radiologist: Musculoskeletal radiologists have undergone fellowship training in interpreting images of the body’s bones, joints, muscles, and soft tissues, including the spine. They are skilled at evaluating spinal anatomy, bone structures, and musculoskeletal disorders affecting the spine, such as fractures, degenerative changes, and inflammatory conditions.

In some cases, general radiologists with experience interpreting spine MRIs may also read these studies effectively. However, when there are specific concerns related to neurological or musculoskeletal issues, consulting a subspecialty radiologist can lead to a more comprehensive and precise evaluation. A subspecialty second opinion is a great avenue to have your spine MRI interpreted by a qualified and experienced radiologist. Appropriate specialization helps ensure the best possible diagnostic outcome.

You can learn more about whether a second opinion is right for you in our article – Should I Get a Radiologist Second Opinion.

What To Do If Your Spine MRI Findings Do Not Explain Your Symptoms

If your spine MRI results do not fully explain your symptoms, try not to be discouraged and focus on continuing to investigate other options. You can start by following up with your healthcare provider who ordered the spine MRI. Discuss why the MRI results did not provide a conclusive explanation, ask questions, and revisit your symptoms. Your doctor may reevaluate your medical history, conduct a physical examination, and consider other potential causes for your symptoms.

If your doctors remain unsure about the cause of your symptoms, they may refer you to another type of specialist. Neurologists, orthopedic spine specialists, rheumatologists, or other relevant specialists can provide specialized assessments and opinions. Your doctor may also recommend additional imaging studies or tests. These can range from CT or bone scans to specialized MRI sequences that further investigate certain areas or structures. You can also consider seeking a second opinion from a subspecialty radiologist. Another radiologist’s interpretation of the MRI might provide additional insights into your condition.

If you feel that your concerns are not being adequately addressed, or that your symptoms are being dismissed, be proactive and advocate for yourself. Try to be patient, and don’t hesitate to seek the opinion of other specialists or request further tests to get to the root of your symptoms. Your health and well-being are important, and a thorough evaluation is essential for an accurate diagnosis and appropriate treatment plan.

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