Unenhanced T1- and T2-weighted spin-echo, short inversion time inversion recovery (STIR), and
gadolinium-DTPA (
Gd-DTPA)-enhanced spin-echo and STIR imaging techniques were used in 20 patients as part of a multicenter study to assess the safety and efficacy of
Gd-DTPA in spinal imaging. Five patients had normal MR scans. Of those with lesions, both
Gd-DTPA-enhanced T1-weighted spin-echo and unenhanced STIR scans improved detection and evaluation of spinal
tumors over conventional spin-echo methods, particularly T2-weighted spin echo, by providing higher tissue contrast in shorter imaging times. The
Gd-DTPA-enhanced T1-weighted spin-echo scans were most helpful in evaluating intradural
tumors, whereas STIR sequences were most effective for extradural
tumors and bone
metastases. In most cases,
Gd-DTPA-enhanced T1-weighted spin-echo scans best delineated
tumor margins, and the enhancement was helpful in suggesting a cellular or active nature of the lesions. In some cases, the enhancement resulted in a more homogeneous and thus less abnormal-appearing marrow in vertebrae involved by
tumor; therefore, a precontrast T1-weighted spin-echo scan is necessary in all patients who are to be studied with
Gd-DTPA. A combined approach that uses T1-weighted spin-echo,
Gd-DTPA-enhanced T1-weighted spin-echo, and STIR images currently appears optimal for MR imaging of
spinal neoplasms. T2-weighted spin-echo images add information only in occasional cases.