Are T1 weighted images helpful in MRI of cervical radiculopathy?

MRI in patients with cervical myelopathy or radiculopathy usually includes T-1 weighted (T1W) and T-2 weighted (T2W) images. We prospectively examined a hypothesis that T2W alone is sufficient to diagnose the cause of cervical myelopathy and radiculopathy and that the T1W sagittal images do not provide additional useful information. 30 patients presenting with a history of cervical radiculopathy with or without myelopathy were prospectively assessed by MRI. Those with a history suggestive of intrinsic primary cord disease or who had previously had surgery were excluded. Two neuroradiologists, blinded to the clinical information, separately viewed the sagittal and axial T2W images alone, and at a later time, the full set of T1W and T2W images. Image quality, location and severity of disease and confidence of diagnosis at each level were scored on 4- or 5-point scales. The T-1 sequences did not demonstrate any significant lesions not already seen on the T2W images alone. The T1W sequence may safely be omitted in patients with radiculopathy.