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Sequences and techniques in spinal MR imaging.

Ph Demaerel1, S Sunaert, G Wilms

  • 1Department of Radiology, University Hospital K.U. Leuven, Belgium.

JBR-BTR : Organe De La Societe Royale Belge De Radiologie (SRBR) = Orgaan Van De Koninklijke Belgische Vereniging Voor Radiologie (KBVR)
|October 7, 2003
PubMed
Summary
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Optimal spinal MRI protocols vary by region. Lumbar spine imaging for sciatica commonly uses sagittal T2/T1 FSE/SE and axial T2 FSE. Cervical spine imaging requires different sequences due to limited cerebrospinal fluid (CSF).

Area of Science:

  • Radiology
  • Medical Imaging
  • Neurology

Background:

  • Optimal magnetic resonance imaging (MRI) protocols for spinal examinations are not definitively established.
  • Standard protocols exist for lumbar spine imaging in sciatica, but cervical spine imaging presents unique challenges due to limited cerebrospinal fluid (CSF).

Purpose of the Study:

  • To outline recommended MRI sequences for lumbar and cervical spine imaging.
  • To discuss the utility of specific sequences like STIR and 2D GE for bone marrow and disc/bone differentiation.
  • To address the ongoing debate regarding FLAIR sequence use for spinal cord lesions.

Main Methods:

  • Review of commonly accepted MRI sequences for spinal imaging.
  • Discussion of sequence selection based on anatomical region (lumbar vs. cervical) and clinical indication.

Related Experiment Videos

  • Evaluation of specific sequences including Fast Spin Echo (FSE), Spin Echo (SE), Gradient Echo (GE), STIR, and FLAIR.

    • Main Results:

    • Sagittal T2 FSE, sagittal T1 SE, and axial T2 FSE are standard for lumbar spine pain.
    • Cervical spine imaging often includes sagittal T2 FSE, sagittal T1 SE, and axial 2D GE.
    • STIR sequences aid bone marrow assessment in both regions.
    • 2D GE provides good image quality for differentiating disc and bony protrusions.

    Conclusions:

    • Established protocols exist for lumbar spine MRI, but cervical spine protocols require careful sequence selection.
    • STIR and 2D GE sequences offer valuable information for specific spinal pathologies.
    • The role of FLAIR in imaging spinal cord lesions requires further investigation.