Radiologic Guide to MRI Interpretation

Peter D'Amour, MD

MRI Evaluation of Chiari/FMS

1. C-spine and lower posterior fossa
2. T1 sagittal
3. T2 FSE sagittal
4. Oblique Axial GRASS parallel to foramen magnum and each cervical disc
5. Phase contrast CINE flow study.

Guide to Interpretation

1. Be suspicious - "Normal" MRI does not exclude diagnosis of FM/CFS
2. Tonsillar position - Report mm's below foramen magnum - Configuration
3. Diminished CSF volume inferior and lateral to cerebellum
4. Small cerebellar folia
5. Measure AP dimension of cervical spinal canal
6. Cord contour changes
7. Decreased CSF flow basilar cisterns
8. Increased velocity of tonsillar and brainstem movement on CINE MRI flow study