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Chiropractic Research Review

Tomography vs. MRI: Out with the Old, in with the New?

Conventional wisdom claims that tomography provides a superior image of joint subluxation and bone erosion compared to other imaging techniques. With recent advances in magnetic resonance imaging technology and the widespread use of MRI scanners, it is important to determine whether existing imaging techniques (i.e., tomography) can be replaced by MRI for specific clinical conditions.

A comparison of findings from plain radiography and conventional tomography with findings in plain radiography and MRI of the upper cervical spine investigated whether plain radiography and MRI provide enough information to dispense with tomography in investigations of cervical spine involvement in rheumatoid arthritis.

Twenty-eight patients with rheumatoid arthritis and with known or suspected abnormalities of the cervical spine underwent plain radiography, including full flexion lateral radiography; anteroposterior and lateral tomography at C1-C2; and magnetic resonance imaging at the same level in neutral position and in flexion.

For each patient, two radiologists evaluated one image set consisting of plain radiography and conventional tomographic images and another image set consisting of plain radiography and magnetic resonance images

Conclusion: MRI produces sufficiently distinct images of subluxation and destruction of the odontoid for it to replace conventional tomography in investigations of upper cervical spine involvement in rheumatoid arthritis.

Oostveen JC, Roozeboom AR, et al. Functional turbo spin echo magnetic resonance imaging versus tomography for evaluating cervical spine involvement in rheumatoid arthritis. Spine
, June 1998;23(11), pp1237-44.

Chiropractic Research Review

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