MRI Cervical Spine Metastatic Disease

Many cancers will become metastatic and bones are a common place for the cancer to metastasize to.  Not all cancers due this, but many including lung and breast will find their way to the bone.  The most common sites for metastasis is the pelvis or spine.  When a cancer goes to the spine there is a possibility that it can cause a cord compression which is considered an emergency.  MRI's allow quick diagnosis of this.  There are not many emergency MRI's, but cord compressions top the list.  If a patient has a cord compression it can completely block the nerves and cause a patient to loss control of their body in many ways including bowel and bladder incontinence, inability to walk and loss of use of extremities.  These patients will usually present with uncontrolled or intractable pain in the spine.  http://www.merck.com/mmhe/sec06/ch093/ch093c.html is an educational website on cord compressions of all different types.  Usual imaging of cord compression with MRI include T1, T2 fatsats and sometimes STIR sagitals and T1 and T2 fatsat axials.  Post contrast imaging is also usually performed with repeating the T1 images.  The following are images of a slight cord compression laterally with bony metastatic disease.

 T1 SAGITAL

 T1 STIR SAGITAL

 T1 AXIAL

 T1 SAGITAL POST CONTRAST

T1 AXIAL POST CONTRAST

MRI Trachea Tumor

Tumors of the trachea sometimes hard to diagnose as many patients don't realize they have some pathological reason for their problems so they do not immediately go to the doctor.  Sometimes tumors of the trachea prevent people from swallowing or breathing easily as the tumor may be blocking this function.  Most tumors of the trachea are malignant, but fortunately these tumors occur very infrequently.  Smoking is a risk factor for these tumors.  Here is a website with valuable information on these types of tumors:  http://emedicine.medscape.com/article/425904-overview

MRI can be used for diagnosis of these tumors.  Ultimately a biopsy would need to be performed, but with excellent soft tissue imaging this is sometimes the first step in diagnosis.  A basic protocol of T1 and T2 imaging with post contrast T1 imaging is pretty much all one needs to image this area.  Usual neck imaging contains axial and coronal imaging, but since this structure is midline, sagital imaging should also be performed.  Attached are some images of this:

 T1 SAG

 T1 COR

 T1 AXIAL

 T1 SAG POST CONTRAST

T1 AXIAL POST CONTRAST