A comparison of T2 and gadolinium enhanced MRI with CT myelography in cervical radiculopathy

Two MRI strategies which have been reported to be effective in assessing cervical exit foramina, were prospectively compared with CT myelography in 20 patients with cervical radiculopathy. The first strategy utilized 3D T-2* images, the second gadolinium enhanced 2D T-1 images. Gadolinium (dimeglumine gadopentetate, Schering Ltd) enhanced images did not confer any benefit in the investigation of this condition, probably due to enhancement of herniated disc material and osteophytes adjacent to the neurocentral joint. Three-dimensional (3D) T-2* white cerebrospinal fluid images had an accuracy approaching 90% for the diagnosis of foraminal encroachment, compared with a gold standard. MRI including a 3D T-2* sequence is thus an acceptable primary investigation for cervical radiculopathy, but when the findings are incompatible with clinical symptomatology, CT myelography is still indicated.