Early diagnosis of spinal-epidural metastasis by magnetic resonance imaging.

Sixteen patients with various types of cancer who developed pain along the axial spine were prospectively studied by magnetic resonance imaging (MRI). The studies were performed with a Fonar Beta-3000 (Fonar Co., Melville, NY) permanent magnet operating at 0.3 Tesla (T). Detailed neurologic examinations were followed by bone x-rays, bone scans, and MRI. In 12 patients there were focal neurologic findings. Bone x-rays and bone scans were diagnostic for metastatic disease in 10 cases; MRIs were consistent with metastatic spinal-epidural disease in all 16 patients. Magnetic resonance imaging revealed bone involvement in three patients whose x-rays and bone scans were both negative indicating a higher degree of sensitivity. In six patients thecal compression was obvious on MRI; in three of these previous myelograms had been interpreted as negative. These early results suggest that MRI can serve as a useful tool for diagnosing early spinal-epidural metastases.