mrimaster

MRI Whole Spine : Protocol and Planning

Indications for Whole Spine MRI

Contraindications

Patient preparation for MRI Whole Spine

Positioning for MRI Whole Spine

MRI whole spine positioning photo

Recommended MRI Whole Spine Protocols and Planning

localiser thoraco lumbar spine

A three-plane T2/T1 localizer must be taken at the beginning to localize and plan the sequences. Localizers are typically less than 25 seconds and consist of T1/T2 weighted low-resolution scans.

MRI lumbar spine localiser

T2 tse sagittal thoraco-lumbar spine

Plan the sagittal slices on the coronal plane and angle the positioning block parallel to the thoracolumbar spine. Check the positioning block in the other two planes. An appropriate angle must be given in the axial plane, parallel to the line along the center of the vertebral body and the spinous process. Check the positioning block in the sagittal plane; the field of view (FOV) must be large enough to cover the thoracolumbar spine from T8 down to the coccyx (normally 350-400mm). The slices should be sufficient to cover the spine from the lateral border of the right (RT) transverse process up to the lateral border of the left (LT) transverse process. Place a saturation band over the abdomen in the sagittal plane, as shown in the diagram. This is done to avoid breathing artifacts over the spinal area. The phase direction should be head to feet to minimize further motion artifacts from the chest.

Parameters

TR

3000-5000

TE

100-120

SLICE

4MM

FLIP

130-150

PHASE

H>F

MATRIX

512X512

FOV

350-400

GAP

10%

NEX(AVRAGE)

2

T1 tse sagittal thoraco-lumbar spine

Plan the sagittal slices on the coronal plane and angle the positioning block parallel to the thoracolumbar spine. Check the positioning block in the other two planes. An appropriate angle must be given in the axial plane, parallel to the line along the center of the vertebral body and the spinous process. Check the positioning block in the sagittal plane; the field of view (FOV) must be large enough to cover the thoracolumbar spine from T8 down to the coccyx (normally 350-400mm). The slices should be sufficient to cover the spine from the lateral border of the right (RT) transverse process up to the lateral border of the left (LT) transverse process. Place a saturation band over the abdomen in the sagittal plane, as shown in the diagram. This is done to avoid breathing artifacts over the spinal area. The phase direction should be head to feet to minimize further motion artifacts from the chest.

Parameters

TR

400-600

TE

15-25

SLICE

4 MM

FLIP

90

PHASE

H>F

MATRIX

512X512

FOV

350-400

GAP

10%

NEX(AVRAGE)

2

T2 TSE STIR sagittal thoraco-lumbar spine

Plan the sagittal slices on the coronal plane and angle the positioning block parallel to the thoracolumbar spine. Check the positioning block in the other two planes. An appropriate angle must be given in the axial plane, parallel to the line along the center of the vertebral body and the spinous process. Check the positioning block in the sagittal plane; the field of view (FOV) must be large enough to cover the thoracolumbar spine from T8 down to the coccyx (normally 350-400mm). The slices should be sufficient to cover the spine from the lateral border of the right (RT) transverse process up to the lateral border of the left (LT) transverse process. Place a saturation band over the abdomen in the sagittal plane, as shown in the diagram. This is done to avoid breathing artifacts over the spinal area. The phase direction should be head to feet to minimize further motion artifacts from the chest.

Parameters

TR

4000-5000

TE

110

FLIP

130

NEX

2

SLICE

4MM

MATRIX

512X384

FOV

350-400

PHASE

H>F

GAP

10%

TI

130

 

T2-TSE axial with multiple blocks and angle

Plan the axial slices on the sagittal plane, angling the first position block parallel to the L5-S1 intervertebral disc, the second position block parallel to the L4-L5 intervertebral disc, and the third position block parallel to the L3-L4 intervertebral disc (only three blocks are needed in a normal spine). Additional blocks should be taken in the presence of a prolapsed disc or cord compression at any other level. Provide an appropriate angle in the coronal plane, horizontally across the intervertebral disc space. The number of slices should be sufficient to cover the intervertebral discs (normally 5 slices for each disc space). Place a saturation band over the abdomen (in front of the aorta) on the sagittal plane to avoid peristalsis and breathing artifacts over the spinal area.

Note: If the pathology is localized to a specific part of the thoracic or lumbar spine, only perform axial scans over the affected area (e.g., for bulging discs, cord compressions, or spinal cord tumors).

Whole spine MRI planning and protocol of lumbar spine axial multi slice multi angle planning

Parameters

TR

3000-4000

TE

100-120

SLICE

3 MM

FLIP

130-150

PHASE

A>P

MATRIX

320X256

FOV

180-200

GAP

10%

NEX(AVRAGE)

2

 

T1 TSE axial with multiple blocks and angle

Plan the axial slices on the sagittal plane, angling the first position block parallel to the L5-S1 intervertebral disc, the second position block parallel to the L4-L5 intervertebral disc, and the third position block parallel to the L3-L4 intervertebral disc (only three blocks are needed in a normal spine). Additional blocks should be taken in the presence of a prolapsed disc or cord compression at any other level. Provide an appropriate angle in the coronal plane, horizontally across the intervertebral disc space. The number of slices should be sufficient to cover the intervertebral discs (normally 5 slices for each disc space). Place a saturation band over the abdomen (in front of the aorta) on the sagittal plane to avoid peristalsis and breathing artifacts over the spinal area.

Whole spine MRI planning and protocol of lumbar spine axial multi slice multi angle planning

Parameters

TR

400-600

TE

15-25

SLICE

3 MM

FLIP

90

PHASE

A>P

MATRIX

320X304

FOV

180-200

GAP

10%

NEX(AVRAGE)

2

Now that the lumbar spine scans are finished, move the table around 350-400mm towards the feet. This can be done either by using the manual table move box or by aligning the cervicothoracic localizer over the thoracolumbar spine localizer. If none of these options are available on your scanner, you can reposition the patient over the sternoclavicular junction..

localiser cervico-thoracic spine

A three-plane T2/T1 localizer must be taken at the beginning to localize and plan the sequences. Localizers are typically less than 25 seconds and consist of T1/T2 weighted low-resolution scans.

T2 TSE sagittal cervico-thoracic spine

Plan the sagittal slices on the coronal plane and angle the positioning block parallel to the cervicothoracic spine. Check the positioning block in the other two planes. An appropriate angle must be given in the axial plane, parallel to the line along the center of the vertebral body and the spinous process. Check the positioning block in the sagittal plane; the field of view (FOV) must be large enough to cover the cervicothoracic spine from 1 inch above C1 down to T10 (normally 350-400 mm). The slices should be sufficient to cover the spine from the lateral border of the right (RT) transverse process up to the lateral border of the left (LT) transverse process. Place a saturation band over the chest in the sagittal plane, as shown in the diagram. This is done to avoid breathing artifacts over the spinal area. The phase direction should be head to feet to minimize further motion artifacts from the chest

Whole spine MRI planning and protocol of cervico thoracic spine sagittal

Parameters

TR

3000-4000

TE

100-120

SLICE

4MM

FLIP

130-150

PHASE

H>F

MATRIX

512X512

FOV

350-400

GAP

10%

NEX(AVRAGE)

2

It is important to have some overlap in the planning blocks to avoid missing any anatomy. For example, if the upper sagittal sequences cover the spinal cord from the pons down to T10, then the lower sagittal sequences must cover the spinal cord from T8 down to the coccyx..
block overlap in whole spine imaging

T1 TSE sagittal cervico-thoracic spine

Plan the sagittal slices on the coronal plane and angle the positioning block parallel to the cervicothoracic spine. Check the positioning block in the other two planes. An appropriate angle must be given in the axial plane, parallel to the line along the center of the vertebral body and the spinous process. Check the positioning block in the sagittal plane; the field of view (FOV) must be large enough to cover the cervicothoracic spine from 1 inch above C1 down to T10 (normally 350-400 mm). The slices should be sufficient to cover the spine from the lateral border of the right (RT) transverse process up to the lateral border of the left (LT) transverse process. Place a saturation band over the chest in the sagittal plane, as shown in the diagram. This is done to avoid breathing artifacts over the spinal area. The phase direction should be head to feet to minimize further motion artifacts from the chest

Whole spine MRI planning and protocol of cervico thoracic spine sagittal

Parameters

TR

400-600

TE

15-25

SLICE

4 MM

FLIP

90

PHASE

H>F

MATRIX

512X512

FOV

350-400

GAP

10%

NEX(AVRAGE)

2

T2 STIR sagittal cervico-thoracic spine

Plan the sagittal slices on the coronal plane and angle the positioning block parallel to the cervicothoracic spine. Check the positioning block in the other two planes. An appropriate angle must be given in the axial plane, parallel to the line along the center of the vertebral body and the spinous process. Check the positioning block in the sagittal plane; the field of view (FOV) must be large enough to cover the cervicothoracic spine from 1 inch above C1 down to T10 (normally 350-400 mm). The slices should be sufficient to cover the spine from the lateral border of the right (RT) transverse process up to the lateral border of the left (LT) transverse process. Place a saturation band over the chest in the sagittal plane, as shown in the diagram. This is done to avoid breathing artifacts over the spinal area. The phase direction should be head to feet to minimize further motion artifacts from the chest

Whole spine MRI planning and protocol of cervico thoracic spine sagittal

Parameters

TR

4000-5000

TE

110

FLIP

130

NEX

2

SLICE

4MM

MATRIX

512X384

FOV

350-400

PHASE

H>F

GAP

10%

TI

130

T2 TSE Axial block 3mm

Plan the axial slices on the sagittal plane and angle the positioning block perpendicular to the spinal cord. An appropriate angle must be given in the coronal plane, horizontally across the intervertebral disc space. The slices should be sufficient to cover the entire C spine from C1 to T1. A saturation band must be placed over the neck (in front of the esophagus) in the sagittal plane. This is done to avoid swallowing and vascular pulsation artifacts in the spinal area.

Note: If the pathology is localized to a specific part of the thoracic spine, perform axial imaging over the affected area (e.g., bulging disc, cord compressions, or spinal cord tumors)

Parameters

TR

3000-4000

TE

100-120

SLICE

3 MM

FLIP

130-150

PHASE

A>P

MATRIX

320X256

FOV

160-200

GAP

10%

NEX(AVRAGE)

2

T1 TSE Axial block 3mm

Plan the axial slices on the sagittal plane and angle the positioning block perpendicular to the spinal cord. An appropriate angle must be given in the coronal plane, horizontally across the intervertebral disc space. The slices should be sufficient to cover the entire C spine from C1 to T1. A saturation band must be placed over the neck (in front of the esophagus) in the sagittal plane. This is done to avoid swallowing and vascular pulsation artifacts in the spinal area.

Parameters

TR

400-600

TE

15-25

SLICE

3 MM

FLIP

90

PHASE

A>P

MATRIX

320X256

FOV

160-200

GAP

10%

NEX(AVRAGE)

2

Indications for contrast enhancement spine scans

Use T1 TSE Use T1 TSE Fat-saturated axial and sagittal sequences after the administration of intravenous gadolinium DTPA injection (following the planning outlined above). The document below provides access to the recommended dosage of gadolinium DTPA injection, as advised by the manufacturer.

Optional Scans

Planning axial blocks in cases of pathologies such as metastatic cord compression, spinal TB, or discitis

T2 TSE Axial block 3mm pathology

Plan the axial slices on the sagittal plane and angle the positioning block perpendicular to the spine. An appropriate angle must be given in the coronal plane, horizontally across the intervertebral disc space. The slices should be sufficient to cover the entire pathology. A saturation band must be placed in front of the spine in the sagittal plane. This is done to avoid swallowing and vascular pulsation artifacts in the spinal area.

TR

3000-4000

TE

100-120

SLICE

3 MM

FLIP

130-150

PHASE

A>P

MATRIX

320X256

FOV

160-200

GAP

10%

NEX(AVRAGE)

2

CLICK THE SEQUENCES BELOW TO CHECK THE SCANS