Frequency of unexpected multifocal metastasis in patients with acute spinal cord compression - Evaluation by low-field MR imaging in cancer patients

Purpose: The aim of the study was to estimate, in an acute care service, the frequency of multiple-level lesion involvement in patients with clinically suspected spinal cord compression or spinal blockage. Material and Methods: Over a period of 17 months, 240 patients with symptoms of acute spinal cord compression underwent acute MR examination of the spine in a 0.1 T MR unit. The cervical spine was only added to the examination if there was clinical suspicion of cord compression above Th1. Results: In 65 (27%) of the 240 patients, involvement of at least one level was found. Of these patients, 32 (49%) showed involvement of more than one level. This high rate was surprising, since only 14 (44%) of the 32 multiple lesions had been clinically suspected. There was no correlation to age or original type of cancer. Conclusion: MR accurately demonstrates the anatomy of the spine and spinal cord, showing the level and complexity of spinal lesions. Multiple lesions may be underestimated when the combination of myelography/radiculography and CT is used.