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.

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

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.

Contrast enhanced MRI is a commonly used procedure in magnetic resonance imaging. The need to more accurately characterize different types of lesions and to detect all malignant lesions is the main reason for the use of intravenous contrast agents.
Some methods are available to improve the contrast of different tissues. The focus of dynamic contrast enhanced MRI (DCE-MRI) is on contrast kinetics with demands for spatial resolution dependent on the application. DCE-MR imaging is used for diagnosis of cancer (see also liver imaging, abdominal imaging, breast MRI, dynamic scanning) as well as for diagnosis of cardiac infarction (see perfusion imaging, cardiac MRI). Quantitative DCE-MRI requires special data acquisition techniques and analysis software.
Contrast enhanced magnetic resonance angiography (CE-MRA) allows the visualization of vessels and the temporal resolution provides a separation of arteries and veins. These methods share the need for acquisition methods with high temporal and spatial resolution.
Double contrast administration (combined contrast enhanced (CCE) MRI) uses two contrast agents with complementary mechanisms e.g., superparamagnetic iron oxide to darken the background liver and gadolinium to brighten the vessels. A variety of different categories of contrast agents are currently available for clinical use.
Reasons for the use of contrast agents in MRI scans are:
Common Indications:
Brain MRI : Preoperative/pretreatment evaluation and postoperative evaluation of brain tumor therapy, CNS infections, noninfectious inflammatory disease and meningeal disease.
Spine MRI : Infection/inflammatory disease, primary tumors, drop metastases, initial evaluation of syrinx, postoperative evaluation of the lumbar spine: disk vs. scar.
Breast MRI : Detection of breast cancer in case of dense breasts, implants, malignant lymph nodes, or scarring after treatment for breast cancer, diagnosis of a suspicious breast lesion in order to avoid biopsy.

For Ultrasound Imaging (USI) see Contrast Enhanced Ultrasound at Medical-Ultrasound-Imaging.com. See also Blood Pool Agents, Myocardial Late Enhancement, Cardiovascular Imaging, Contrast Enhanced MR Venography, Contrast Resolution, Dynamic Scanning, Lung Imaging, Hepatobiliary Contrast Agents, Contrast Medium and MRI Guided Biopsy.

Pacemaker lead wires, ECG, and plethysmographic cables can also as surface-coil connections act as antennae. Usually the materials of such wires are not ferromagnetic.

Gradient and radio frequency fields may induce current into these wires and thus cause fibrillations and burns. This presents a risk to the patient and must be eliminated before the examination. The risk of heating during the MRI scan is dependent on the length and the material of these wires as well as the used field strength. If these wires are outside the RF field there is no risk of heating to expect.

(MRI) Magnetic resonance imaging is a noninvasive medical imaging technique that uses the interaction between radio frequency pulses, a strong magnetic field and body tissue to obtain images of slices/planes from inside the body. These magnets generate fields from approx. 2000 times up to 30000 times stronger than that of the Earth. The use of nuclear magnetic resonance principles produces extremely detailed pictures of the body tissue without the need for x-ray exposure and gives diagnostic information of various organs.
Measured are mobile hydrogen nuclei (protons are the hydrogen atoms of water, the 'H' in H20), the majority of elements in the body. Only a small part of them contribute to the measured signal, caused by their different alignment in the magnetic field. Protons are capable of absorbing energy if exposed to short radio wave pulses (electromagnetic energy) at their resonance frequency. After the absorption of this energy, the nuclei release this energy so that they return to their initial state of equilibrium.
This transmission of energy by the nuclei as they return to their initial state is what is observed as the MRI signal. The subtle differing characteristic of that signal from different tissues combined with complex mathematical formulas analyzed on modern computers is what enables MRI imaging to distinguish between various organs. Any imaging plane, or slice, can be projected, and then stored or printed.
The measured signal intensity depends jointly on the spin density and the relaxation times (T1 time and T2 time), with their relative importance depending on the particular imaging technique and choice of interpulse times. Any motion such as blood flow, respiration, etc. also affects the image brightness.
Magnetic resonance imaging is particularly sensitive in assessing anatomical structures, organs and soft tissues for the detection and diagnosis of a broad range of pathological conditions. MRI pictures can provide contrast between benign and pathological tissues and may be used to stage cancers as well as to evaluate the response to treatment of malignancies. The need for biopsy or exploratory surgery can be eliminated in some cases, and can result in earlier diagnosis of many diseases.

See also MRI History and Functional Magnetic Resonance Imaging (fMRI).