There are really 3 types of thing to image when we are talking about C-spine injury
- Bone
- Soft tissue (including discs)
- Neural tissue (cord & nerve roots)
The modality of choice depends on the structure of interest:
- Bone: CT >>> MRI
- Soft tissue: MRI >> CT
- Neural tissue: MRI >>>>>>CT (there’s basically no comparison)
Various features favour one over the other:
| Feature | CT | MRI |
| Availability | Widely available | Limited availability |
| Gold standard for: | Bony injury | Soft tissue & neural injury |
| Radiation | Some (potentially vulnerable thyroid tissue) | None |
| Device compatibility | Beam hardening artefact | May be totally incompatible |