How to read MRI results of the cervical spine

Written by john kibilko
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How to read MRI results of the cervical spine
Unlike X-rays, MRI images of the spine can reveal subtle defects or damage. (spine x-ray image by Julianna Olah from

Since the first successful nuclear magnetic resonance experiment in 1946, magnetic resonance imaging has slowly evolved from a means of scientific experimentation to an adjunct and alternative to X-rays and other ionising-radiation imaging. MRI provides better body-tissue contrast and can be adapted to accommodate many imaging techniques, including those used to diagnose spinal-cord abnormalities. A radiologist reads your MRI scan, interprets the results and provides your physician with a report. As with X-rays, making sense of MRI images can be difficult for lay people. But with the aid of the radiologist's notes, interpreting and understanding your cervical spine, or C-spine, MRI is possible.

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  1. 1

    Familiarise yourself with the lexicon and structure of the spine. In reading a radiologist's notes and discussing your MRI results with your doctor, you'll want to be as prepared as possible. For example, the spine is divided into three main sections---the cervical, thoracic and lumbar regions, from your neck to your lower back. The cervical region consists of seven sections, or vertebra, labelled as the atlas, the axis, and C-3, C-4, C-5, C-6 and C-7. Basic anatomical knowledge is a precursor to reading your C-spine MRI results.

  2. 2

    Read the doctor's notes that accompany your film or CD; these are directions to the MRI staff detailing what she's looking to diagnose. You may see such notes as "r/o disc disease." "r/o" means "rule out," meaning that your doctor wants images that rule out or confirm disc disease or damage. These orders also assist the radiologist in looking for specific conditions in your spine.

  3. 3

    Read the radiologist's notes. He should have addressed all the "r/o" directions from the doctor, confirming or ruling out specific concerns your doctor had. His notes will include such notations as, "Small disc bulge at C3/C4, a bigger one at C4/C5 (A) and a smaller one again at C5/C6." He may also address issues not outlined by your physician if he detects abnormalities.

  4. 4

    Take note of the angle of the image. There is usually an indication in a corner of the film that describes the "anatomical plane" that the image represents. This will be one of three options. The coronal or frontal plane separates the body vertically from top to bottom into front and back halves. The sagittal or lateral plane also divides the body vertically from head to toe but into left and right sides. The axial or transverse plane separates the body horizontally, providing top and bottom halves. There will also a directional note, so that you'll know that you're viewing, for instance, your spine from the right-side -- i.e., sagittal -- view.

  5. 5

    Look closely at the film in relation to the doctor's and radiologist's notes. If an irregularity was detected, the notes will assist you in spotting it. What may have been indistinguishable without the notes often becomes obvious when you know what to look for. Scan the film even if there were no abnormalities found, especially if you have previous MRI results against which you can compare the current film. It's not unusual for patients to find problems on their own films that weren't detected by doctors. This is particularly true among patients who have undergone numerous testing---often over years---and are familiar with their own bodies through previous radiological inspections.

Tips and warnings

  • You can acquire your MRI film or CD, sometimes for a fee but often for free. Ask the radiology department where your MRI was performed about obtaining copies, either on film or on CD. Many facilities offer patient sets for free as a matter of policy. You also can get professional second opinions online, via mail or modem, or in person, and these, too, are often free.
  • Know whether any dyes or other media were used during your MRI, as these compounds affect the contrast qualities of the images.

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