MRI Unable to Detect Certain Thoracic Lesions?

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MRI Unable to Detect Certain Thoracic Lesions?

Magnetic resonance imaging (MRI) is an accepted sensitive diagnostic tool for imaging spinal disorders. However, evidence suggests that in patients reporting axial mechanical pain or radicular symptoms without neurologic deficit, MRI assessment may result in false-positive readings.

In a study designed to determine responses of asymptomatic individuals to thoracic discography (as a potential alternative to MRI in the evaluation of disc pathology), 10 adult volunteers (aged 23-45) underwent MRI of the thoracic spine followed by four-level discography. At the same time, 10 adults experiencing chronic thoracic pain comprised a control group that was similarly studied.
Significant differences were observed between MRI and discography findings. Twenty-one of the 48 discs appeared normal on MRI; 10 were judged as normal on discography; and 10 discs read as normal on MRI showed annular pathology on discography.
Conclusions: Thoracic discography may demonstrate disc pathology not seen on magnetic resonance imaging. The authors suggest that MRI is useful as a screening examination for patients with mechanical-type pain indicative of thoracic pathology, but that it "cannot be relied upon conclusively to identify certain annular lesions and other potentially painful foci."
Wood KB, Schellhas KP, Garvey TA, et al. Thoracic discography in healthy individuals. Spine, August 1, 1999:24(15), pp1548-1555.