Cervical spondylosis: Three-dimensional gradient-echo MR with magnetization transfer

PURPOSE: To compare a three-dimensional Fourier transform (3DFT) gradient-echo pulse sequence with magnetization transfer at a short echo time against standard 3DFT gradient-echo technique in the evaluation of cervical spondylosis, specifically addressing the effects of motion and susceptibility artifacts on the dimensions of the neural foramina and contrast at the cerebrospinal fluid (CSF)-spinal cord interface. METHODS: Ten patients with clinically suspected cervical spondylosis were examined with axial MR imaging using both our standard 3DFT gradient-echo sequence and a 3DFT gradient-echo sequence with a short echo time plus magnetization transfer. Two neuroradiologists measured the transverse dimensions of 22 diseased neural foramina and graded the contrast at the CSF-spinal cord interface. RESULTS: Sixteen of 22 affected neural foramina were larger in the transverse dimension when the magnetization transfer technique was used than when the standard 3DFT gradient-echo sequence was used. In 9 of 10 patients superior contrast was seen at the CSF-spinal cord interface on images obtained with the magnetization transfer technique. CONCLUSIONS: In the cervical spine, 3DFT gradient-echo imaging with magnetization transfer improves contrast and sharpness of the CSF-spinal cord interface at short echo times. This results in less exaggeration of the neural foraminal stenosis as compared with that seen with standard 3DFT gradient-echo techniques owing to the diminished effects of motion and susceptibility artifacts.