Magnetic Resonance Imaging Diagnostics of Vascular Myelopathies: from Basic Sequences to Promising Imaging Protocols

Magnetic resonance imaging (MRI) is the method of choice in diagnostics and differential diagnosis of spinal cord arterial infarction and venous insufficiency. However, imaging of vascular myelopathy is complicated by the lack of clear diagnostic criteria. Basic MRI sequences have low sensitivity at disease onset, and described MR patterns do not sufficiently increase imaging specificity for spinal cord ischemia, so imaging protocols are to be elaborated. Diffusion-weighted imaging is a key additional sequence that allows establishing the ischemic nature of myelopathy. Inclusion of spinal MR angiography in comprehensive MR examination allows visualization of aorta abnormalities, its large branches or spinal arteriovenous fistulas, so that they can be treated early. We presented an optimal MRI protocol for patients with suspected ischemic spinal stroke. Promising high-tech MR sequences for visualization of vascular myelopathies were reviewed.