11/5/2019 lumbar (lumbosacral) spine MRI planning and protocols | indications for MRI lumbar spine scan

HOME PATHOLOGY CHARACTERISE IMAGE PLANNING TECHNIQUE ANATOMY

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BRAIN

MRA BRAIN

MRV BRAIN
Indications for lumbosacral spine MRI
> Localized back pain and radiculopathy,with 6-week course of conservative car
and inadequate
PAEDIATRIC BRAIN
> response to treatment.
> Infectious or inflammatory processes (eg.spinal cord Abscess or spina
ORBITS osteomyelitis)
> Multiple sclerosis ,other demyelinating diseases or myelopathies
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EXTERNA Learn More

PARANASAL SINUSES
> Possible spinal cord injury and post-traumatic neurologic deficit
SELLA(PIT.FOSSA) > Cauda equina syndrome, (e.g., sudden bowel/bladder disturbance).
> Evaluation or monitoring of congenital malformations of the spinal cord
> Evaluation or monitoring of inflammation of the CNS or meninges
EPILEPSY PROTOCOL > Evaluation or monitoring of tumour of the CNS or meninges
> Investigation of any cause of spinal disease in pregnancy
TMJS
> Evaluation or monitoring of spinal cord compression
> Evaluation or monitoring of demyelinating disease
> Non-traumatic vascular injuries of the spine
TRIGEMINAL > Reduced power on physical examination
> Monitoring of previous spinal surgery
> Evaluation or monitoring of trauma
FACE
> Spinal cord tumour
> Spine TB
SOFT TISSUE NECK
Please check our new video tutorial for protocols and
planning
MR SIALOGRAPHY

CERVICAL SPINE

MRA NECK

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11/5/2019 lumbar (lumbosacral) spine MRI planning and protocols | indications for MRI lumbar spine scan

BRACHIAL PLEXUS Lumbar spine MRI scan, protocols, positioning and planning

MRA SUBCLAVIANS

CHEST

STERNUM

CLAVICLE

THORACIC SPINE  

CARDIAC MRI
Contraindications
>  Any electrically, magnetically or mechanically activated implant (e.g. cardiac
CARDIAC STRESS PERFUSION pacemaker, insulin pump biostimulator, neurostimulator, cochlear implant, and
>  hearing aids)
>  Intracranial aneurysm clips (unless made of titanium)
MRI KIDNEYS >  Pregnancy (risk vs benefit ratio to be assessed)
>  Ferromagnetic surgical clips or staples
>  Metallic foreign body in the eye
MRI RENALS
Metal shrapnel or bullet

ADRENALS Patient preparation

>  A satisfactory written consent form must be taken from the patient before
LIVER entering the scanner room
>  Ask the patient to remove all metal object including keys, coins, wallet, any
cards with magnetic strips, jewellery, hearing aid and hairpins
MRCP >  Ask the patient to undress and change into a hospital gown
>  Contrast injection risk and benefits must be explained to the patient before
PANCREAS >  the scan
>  Gadolinium should only be given to the patient if GFR is > 30
>  If possible provide a chaperone for claustrophobic patients (e.g. relative or
SECRETIN STIMULATED MRCP >  staff )
>  Offer earplugs or headphones, possibly with music for extra comfort
SMALL
>  Explain the procedure to the patient
Instruct the patient to keep still
BOWEL(ENTEROCLYSIS)
Note the weight of the patient
MRA & MRV
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BREAST IMPLANTS
Positioning
RECTAL CA PELVIS >  Head first supine
>  Position the paient in the spine coil and immobilise with cushions
>  Give cushions under the legs for extra comfort
PELVIS URINARY BLADDER
>  Centre the laser beam localiser over the mid abdomen (4 inches above the iliac
crest)
FEMALE URETHRA

PROSTATE PELVIS

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11/5/2019 lumbar (lumbosacral) spine MRI planning and protocols | indications for MRI lumbar spine scan

SOFT TSSUE PENIS

MRI TESTIS

GYNE PELVIS

PLACENTA MRI

RECTOVAGINAL FISTULA

FISTULA PELVIS Suggested protocols , parameters and planning

DEFECATING PROCTOGRAM
localiser
A three plane localiser must be taken in the beginning to localise and plan th
HIPS sequences. Localisers are usually less than 25sec. T1 weighted low resolution scans.

ARTHROGRAPHY HIPS

PSOAS

LUMBAR SPINE

SI JOINTS

LUMBOSACRAL PLEXUS

KUB
T2 tse sagittal
MR UROGRAPHY Plan the sagittal slices on the coronal plane; angle the position block parallel t
spinal cord.   Check the positioning block in the other two planes. An appropriat
THIGHS
angle must be given in the axial plane on a tilted patient(Parallel to the line alon
the center of the vertebral body and the spinous process). Check the position bloc
in the sagittal plan; FOV must be big enough to cover the whole lumbar and sacra
KNEE spine from T11 down to coccyx(normally 350mm).Slices must be sufficient to cove
the spine from the lateral border of RT transverse process up to the lateral borde
of LT transverse process. A saturation band must be placed over the abdomen (i
LOWER LEG
front of the aorta) in the sagittal plane. This is to avoid the peristalsis and
breathing artefacts over the spinal area. Phase direction should be head to feet t
ANKLE avoid further motion artefacts form abdomen.

FOOT

MRA LEGS

SHOULDER

SCAPULA

ARTHROGRAPHY SHOULDER

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11/5/2019 lumbar (lumbosacral) spine MRI planning and protocols | indications for MRI lumbar spine scan

Parameters
HUMERUS
TR TE SLICE FLIP PHASE MATRIX FOV GAP NEX(AVRAGE)

ELBOW 3000- 100- 4MM 130- H>F 320X320 350- 10% 2

4000 120 150 350
FOREARM
T1 tse sagittal
WRIST Plan the sagittal slices on the coronal plane; angle the position block parallel t
spinal cord.   Check the positioning block in the other two planes. An appropriat
angle must be given in the axial plane on a tilted patient(Parallel to the line alon
HAND the center of the vertebral body and the spinous process). Check the position bloc
in the sagittal plan; FOV must be big enough to cover the whole lumbar and sacra
spine from T11 down to coccyx(normally 350mm).Slices must be sufficient to cove
MRA UPPER ARM
the spine from the lateral border of RT transverse process up to the lateral borde
of LT transverse process. A saturation band must be placed over the abdomen (i
MRA HAND front of the aorta) in the sagittal plane. This is to avoid the peristalsis and
breathing artefacts over the spinal area. Phase direction should be head to feet t
avoid further motion artefacts form abdomen.
SPINAL CORD PROTOCOL

MULTIPLE SCLEROSIS

PROTOCOL

MRA WHOLE BODY

Parameters
TR TE SLICE FLIP PHASE MATRIX FOV GAP NEX(AVRAGE)

400- 15- 4 MM 90 H>F 320X320 350- 10% 2

600 25 350

T2 TSE STIR sagittal

Plan the sagittal slices on the coronal plane; angle the position block parallel t
spinal cord.   Check the positioning block in the other two planes. An appropriat
angle must be given in the axial plane on a tilted patient(Parallel to the line alon
the center of the vertebral body and the spinous process). Check the position bloc
in the sagittal plan; FOV must be big enough to cover the whole lumbar and sacra
spine from T11 down to coccyx(normally 350mm).Slices must be sufficient to cove
the spine from the lateral border of RT transverse process up to the lateral borde
of LT transverse process. A saturation band must be placed over the abdomen (i
front of the aorta) in the sagittal plane. This is to avoid the peristalsis and
berathing artefacts over the spinal area. Phase direction should be head to feet t
avoid further motion artefacts form abdomen.

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11/5/2019 lumbar (lumbosacral) spine MRI planning and protocols | indications for MRI lumbar spine scan

Parameters
TR TE FLIP NEX SLICE MATRIX FOV PHASE GAP TI

4000- 110 130 2 4MM 320X320 350- H>F 10% 130

5000 350

T2 TSE Axial multi block and multi angle

Plan the axial slices on the sagittal plane; angle the first position block parallel t
L5- S1 intervertebral disc, second position block parallel to L4- L5 intervertebra
disc, third position block parallel to L3- L4 intervertebral disc and  fourth  positio
block parallel to L2- L3 intervertebral disc(only four blocks are needed in a norma
spine). Additional blocks must be taken if there is a disc prolapsed in any othe
levels. An appropriate angle must be given in the coronal plane on a tilted o
scoliotic spine (Parallel to the intervertebral disc space). Slices must be sufficien
to cover the intervertebral discs(normally 5 slices for each disc space). A
saturation band must be placed over the abdomen (in front of the aorta) in the
sagittal plane. This is to avoid the peristalsis and breathing artefacts over th
spinal area.

Parameters
TR TE SLICE FLIP PHASE MATRIX FOV GAP NEX(AVRAGE)

3000- 100- 4 MM 130- A>P 256X256 250- 10% 2

4000 120 150 290

T1 TSE Axial multi block and multi angle

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11/5/2019 lumbar (lumbosacral) spine MRI planning and protocols | indications for MRI lumbar spine scan

Plan the axial slices on the sagittal plane; angle the first position block parallel t
L5- S1 intervertebral disc, second position block parallel to L4- L5 intervertebra
disc, third position block parallel to L3- L4 intervertebral disc and  fourth  positio
block parallel to L2- L3 intervertebral disc(only four blocks are needed in a norma
spine). Additional blocks must be taken In the presence of prolapsed disc in an
other levels. An appropriate angle must be given in the coronal plane on a tilted o
scoliotic spine (Parallel to the intervertebral disc space). Slices must be sufficien
to cover the intervertebral discs(normally 5 slices for each disc space). A
saturation band must be placed over the abdomen (in front of the aorta) in the
sagittal plane. This is to avoid the peristalsis and breathing artefacts over th
spinal area.

Parameters
TR TE SLICE FLIP PHASE MATRIX FOV GAP NEX(AVRAGE)

400- 15- 4 MM 90 A>P 256X256 250- 10% 2

600 25 290

Indications for contrast enhancement spine scans

> Evaluation or monitoring of tumour of the CNS or meninges
> Monitoring of previous spinal surgery
> MS, hemipeligia/paresthesia,Infection
> Suspected spine lesions (e.g. bone Mets)
> Spinal cord tumour
> Syringomyelia

Use T1 TSE Fat saturated axial and sagittal after the administration of IV
gadolinium DTPA injection(copy the planning outlined above). The recommended
dose of gadolinium DTPA injection is 0.1 mmol/kg, i.e. 0.2 mL/kg in adults,
children and infants.

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11/5/2019 lumbar (lumbosacral) spine MRI planning and protocols | indications for MRI lumbar spine scan

CLICK THE SEQUENCES BELOW TO CHECK THE SCANS

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