Fiani Brian, Griepp Daniel W, Lee Jason, Davati Cyrus, Moawad Christina M, Kondilis Athanasios
Neurosurgery, Desert Regional Medical Center, Palm Springs, USA.
Neurosurgery, College of Osteopathic Medicine, New York Institute of Technology, Old Westbury, USA.
Cureus. 2020 Dec 14;12(12):e12070. doi: 10.7759/cureus.12070.
Weight-bearing magnetic resonance imaging (MRI) is a unique modality in diagnostic imaging that allows for the assessment of spinal pathology in ways considered previously inaccessible or insufficient with the conventional MRI technique. Due to limitations in positioning within the MRI machine itself, difficulties would be posed in determining the underlying cause of a patient's pain or neurological symptoms, as the traditional supine position utilized can, in many cases, alleviate the severity of presented symptoms. Weight-bearing MRI addresses this concern by allowing a clinician to position a patient (to a certain degree) into flexion, extension, rotation, or side-bending with an axial load that can mimic physiologic conditions in order to replicate the conditions the patient experiences in order to give clinicians a clearer understanding of the anatomical relationship of the spine and surrounding tissues that may lead to a particular presentation of symptoms. These findings can then guide treatment approaches that are better tailored to a patient's needs in order to initiate treatment earlier and shorten the duration of treatment necessary for patient benefit. The goal of this review is to describe and differentiate weight-bearing MRI from conventional MRI as well as examine the advantages and disadvantages of either imaging modality. This will include assessing cost-effectiveness and improvements in clinical outcomes. Further, the advancements of weight-bearing MRI will be discussed, including potentially unique clinical applications in development.
负重磁共振成像（MRI）是诊断成像中的一种独特方式，它能够以传统MRI技术以前被认为无法实现或不够充分的方式评估脊柱病变。由于MRI机器本身在定位方面存在局限性，确定患者疼痛或神经症状的潜在原因会面临困难，因为在许多情况下，所采用的传统仰卧位能够减轻所呈现症状的严重程度。负重MRI通过允许临床医生在轴向负荷下将患者（在一定程度上）置于屈曲、伸展、旋转或侧弯姿势来解决这一问题，这种轴向负荷可以模拟生理状况，以便复制患者所经历的情况，从而使临床医生更清楚地了解可能导致特定症状表现的脊柱与周围组织的解剖关系。这些发现随后可以指导更符合患者需求的治疗方法，以便更早地开始治疗并缩短为使患者受益所需的治疗时间。本综述的目的是描述负重MRI并将其与传统MRI区分开来，同时研究这两种成像方式的优缺点。这将包括评估成本效益和临床结果的改善情况。此外，还将讨论负重MRI的进展，包括正在开发中的潜在独特临床应用。
