February 2019 Edition. Volume XIX

ImagManNwswk100It has required the advent of modern high-resolution Magnetic Resolution Scanning (\MRI) to finally be able to accurately and objectively document adhesive arachnoiditis as a disease entity.  MRI has emerged as an almost magical diagnostic tool.  Quality high-resolution MRI has determined that there are literally tens of thousands of adhesive arachnoiditis sufferers throughout the world today and millions more who are unaware that they harbor this pathologic entity and are presently asymptomatic.  More advanced non-invasive imaging studies in the future will be of even greater value in understanding what has transpired.

The Burton experience with the the MRI diagnosis of adhesive arachnoiditis has been that the great majority of MRI studies being performed at present are technically inadequate to demonstrate the intra-thecal spinal nerves and associated collagenous scar tissue. Only at institutions where the radiologists and neuroradiologists have madethe effort to technically tune their MRI scanners has definitive diagnosis been possible.  What then basically constitutes appropriate technique for a MRI scan to be considered “high-esolution”:

Adequate magnet strength; typically at least 1.5 Tesla Axial T2 weighted technique with fast-spin echo imaging Saggital, axial and coronal imaging Sequencing Phasing

Even when the guidelines noted above are observed an MRI scan can be inadequate.  How can this be?  Well, consider two similar Mercedes sedans.  One runs well and the other runs poorly because of poor quality tuning.

The same is true for MRIs where proper shimming, proper RF pulsing and proper technique protocols need to be achieved.


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