MR myelography is studying the spinal canal and subarachnoid space by high-resolution MRI with a technique in which a sequence with strong T2 weighting is used to provide high contrast between the "dark" spinal cord and its nerves and the surrounding "bright" cerebrospinal fluid. MR myelography as part of an entire MR examination has virtually replaced X-ray myelography. Used sequences are T2 weighted fast spin echo pulse sequences or a refocused gradient echo pulse sequence with strong T2 weighting.

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Cervical spine MRI is a suitable tool in the assessment of all cervical spine (vertebrae C1 - C7) segments (computed tomography (CT) images may be unsatisfactory close to the thoracic spine due to shoulder artifacts). The cervical spine is particularly susceptible to degenerative problems caused by the complex anatomy and its large range of motion.
Advantages of magnetic resonance imaging MRI are the high soft tissue contrast (particularly important in diagnostics of the spinal cord), the ability to display the entire spine in sagittal views and the capacity of 3D visualization. Magnetic resonance myelography is a useful supplement to conventional MRI examinations in the investigation of cervical stenosis. Myelographic sequences result in MR images with high contrast that are similar in appearance to conventional myelograms. Additionally, open MRI studies provide the possibility of weight-bearing MRI scan to evaluate structural positional and kinetic changes of the cervical spine.
Indications of cervical spine MRI scans include the assessment of soft disc herniations, suspicion of disc hernia recurrence after operation, cervical spondylosis, osteophytes, joint arthrosis, spinal canal lesions (tumors, multiple sclerosis, etc.), bone diseases (infection, inflammation, tumoral infiltration) and paravertebral spaces.
State-of-the-art phased array spine coils and high performance MRI machines provide high image quality and short scan time. Imaging protocols for the cervical spine includes sagittal T1 weighted and T2 weighted sequences with 3-4 mm slice thickness and axial slices; usually contiguous from C2 through T1. Additionally, T2 fat suppressed and T1 post contrast images are often useful in spine imaging.

See also Lumbar Spine MRI.

MRI of the lumbar spine, with its multiplanar 3 dimensional imaging capability, is currently the preferred modality for establishing a diagnosis. MRI scans and magnetic resonance myelography have many advantages compared with computed tomography and/or X-ray myelography in evaluating the lumbar spine. MR imaging scans large areas of the spine without ionizing radiation, is noninvasive, not affected by bone artifacts, provides vascular imaging capability, and makes use of safer contrast agents (gadolinium chelate).
Due to the high level of tissue contrast resolution, nerves and discs are clearly visible. MRI is excellent for detecting degenerative disease in the spine. Lumbar spine MRI accurately shows disc disease (prolapsed disc or slipped disc), the level at which disc disease occurs, and if a disc is compressing spinal nerves. Lumbar spine MRI depicts soft tissues, including the cauda equina, spinal cord, ligaments, epidural fat, subarachnoid space, and intervertebral discs. Loss of epidural fat on T1 weighted images, loss of cerebrospinal fluid signal around the dural sac on T2 weighted images and degenerative disc disease are common features of lumbar stenosis.

Common indications for MRI of the lumbar spine:
Lumbar spine imaging requires a special spine coil. often used whole spine array coils have the advantage that patients do not need other positioning if also upper parts of the spine should be scanned. Sagittal T1 and T2 weighted FSE sequences are the standard views. With multi angle oblique techniques individually oriented transverse images of each intervertebral disc at different angles can be obtained.

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Magnetic resonance imaging (MRI) of the spine is a noninvasive procedure to evaluate different types of tissue, including the spinal cord, vertebral disks and spaces between the vertebrae through which the nerves travel, as well as distinguish healthy tissue from diseased tissue.
The cervical, thoracic and lumbar spine MRI should be scanned in individual sections. The scan protocol parameter like e.g. the field of view (FOV), slice thickness and matrix are usually different for cervical, thoracic and lumbar spine MRI, but the method is similar. The standard views in the basic spinal MRI scan to create detailed slices (cross sections) are sagittal T1 weighted and T2 weighted images over the whole body part, and transverse (e.g. multi angle oblique) over the region of interest with different pulse sequences according to the result of the sagittal slices. Additional views or different types of pulse sequences like fat suppression, fluid attenuation inversion recovery (FLAIR) or diffusion weighted imaging are created dependent on the indication.

Indications:

Contrast enhanced MRI techniques delineate infections vs. malignancies, show a syrinx cavity and support to differentiate the postoperative conditions. After surgery for disk disease, significant fibrosis can occur in the spine. This scarring can mimic residual disk herniation. Magnetic resonance myelography evaluates spinal stenosis and various intervertebral discs can be imaged with multi angle oblique techniques. Cine series can be used to show true range of motion studies of parts of the spine. Advanced open MRI devices are developed to perform positional scans in the position of pain or symptom (e.g. Upright™ MRI formerly Stand-Up MRI).

The MRI device is located within a specially shielded room (Faraday cage) to avoid outside interference, caused by the use of radio waves very close in frequency to those of ordinary FM radio stations.
The MRI procedure can easily be performed through clothing and bones, but attention must be paid to ferromagnetic items, because they will be attracted from the magnetic field. A hospital gown is appropriate, or the patient should wear clothing without metal fasteners and remove any metallic objects like hairpins, jewelry, eyeglasses, clocks, hearing aids, any removable dental work, lighters, coins etc., not only for MRI safety reasons. Metal in or around the scanned area can also cause errors in the reconstructed images (artifacts). Because the strong magnetic field can displace, or disrupt metallic objects, people with an implanted active device like a cardiac pacemaker cannot be scanned under normal circumstances and should not enter the MRI area.
The MRI machine can look like a short tunnel or has an open MRI design and the magnet does not completely surround the patient. Usually the patient lies on a comfortable motorized table, which slides into the scanner, depending on the MRI device, patients may be also able to sit up. If a contrast agent is to be administered, intravenous access will be placed. A technologist will operate the MRI machine and observe the patient during the examination from an adjacent room. Several sets of images are usually required, each taking some minutes. A typical MRI scan includes three to nine imaging sequences and may take up to one hour. Improved MRI devices with powerful magnets, newer software, and advanced sequences may complete the process in less time and better image quality.
Before and after the most MRI procedures no special preparation, diet, reduced activity, and extra medication is necessary. The magnetic field and radio waves are not felt and no pain is to expect.
Movement can blur MRI images and cause certain artifacts. A possible problem is the claustrophobia that some patients experience from being inside a tunnel-like scanner. If someone is very anxious or has difficulty to lie still, a sedative agent may be given. Earplugs and/or headphones are usually given to the patient to reduce the loud acoustic noise, which the machine produces during normal operation. A technologist observes the patient during the test. Some MRI scanners are equipped with televisions and music to help the examination time pass.
MRI is not a cheap examination, however cost effective by eliminating the need for invasive radiographic procedures, biopsies, and exploratory surgery. MRI scans can also save money while minimizing patient risk and discomfort. For example, MRI can reduce the need for X-ray angiography and myelography, and can eliminate unnecessary diagnostic procedures that miss occult disease.

See also Magnetic Resonance Imaging MRI, Medical Imaging, Cervical Spine MRI, Claustrophobia, MRI Risks and Pregnancy.
For Ultrasound Imaging (USI) see Ultrasound Imaging Procedures at Medical-Ultrasound-Imaging.com.

See also the related poll result: 'MRI will have replaced 50% of x-ray exams by'