American Journal of Roentgenology, Vol 154, 1069-1073, Copyright © 1990 by American Roentgen Ray Society
Pseudoatrophy of the cervical portion of the spinal cord on MR images: a manifestation of the truncation artifact?
DM Yousem, PA Janick, SW Atlas, DB Hackney, SA Glasser, FW Wehrli and RI Grossman
Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia 19104.
Routine evaluation of axial MR images of the cervical spine with high-
intensity CSF (long TR/TE spin-echo or gradient-echo images) revealed
apparent narrowing of the cord's anteroposterior diameter when these images
were compared with corresponding postmyelography CT scans. This discrepancy
was believed to be due to the truncation artifact at the CSF-cord boundary.
To examine the truncation effect, we compared cord diameters in 12 patients
on postmyelography CT scans and MR images and then compared these with MR
scans of normal volunteers and of an agar- saline spine phantom. There was
an artifactual diminution of the cord diameter in the 128-step
phase-encoding axis of the 128 x 256-matrix MR scan as compared with the
diameter of the cord in the patients' postiohexol CT scans and in the 256
phase-encoded axis MR scan in the volunteer study. A similar discrepancy
was noted in the spine phantom study, in which the cord diameter in the
256-step phase-encoded MR scan, the CT scan, and direct measurement
exceeded that in the 128-step phase-encoded axis MR scan. The range of
differences between the measurements was as large as 2.3 mm (patients), 1.7
mm (volunteers), and 1.8 mm (phantom) for the three studies. In all three
studies, varying the photographic window width and level produced variation
in the apparent cord diameter of up to 1.5 mm. To eliminate this effect,
the cord diameters in the phantom and the normal control subjects were
measured at identical window levels. The truncation artifact, coupled with
standard window settings used in photography, may lead to inaccurate
display of the diameter of the cervical spinal cord.