Syringomyelia

Preliminary Diagnosis: Syringomyelia

I. What imaging technique is first-line for this diagnosis?

  • Non-contrasted intradural protocol MR of the (cervical, thoracic, and/or lumbar spine) in patients without a history of prior spine surgery.

  • In patients with prior spine surgery, the first line for diagnosis is a contrasted intradural protocol MR of the (cervical, thoracic, and/or lumbar spine.)

II. Describe the advantages and disadvantages of this technique for diagnosis of syringomyelia.

Advantages
  • Does not expose the patient to ionizing radiation.

  • Able to detail the size and extent of the syrinx.

  • Able to differentiate granulation tissue from recurrentherniated disc.

Disadvantages
  • Expensive.

  • Time-consuming.

  • Requires significant patient cooperation to minimize artifact.

III. What are the contraindications for the first-line imaging technique?

Non-MR compatible hardware.

IV. What alternative imaging techniques are available?

CT imaging

V. Describe the advantages and disadvantages of the alternative techniques for diagnosis of syringomyelia.

Advantages
  • May be performed in patients with non-MR compatible hardware.

  • May be performed much faster than MR exams.

Disadvantages
  • Exposes the patient to ionizing radiation.

VI. What are the contraindications for the alternative imaging techniques?

May be contraindicated in pregnant patients.