Indications for MRI examination of the cervical spine
> Persistent neck pain or radiculopathy after 6 weeks of conservative and inadequate treatment
>response to treatment.
> Cancer or tumors of the spine (cancer of the spine, spinal cord, or meninges)
> Evaluation or monitoring of congenital malformations of the spinal cord
> Myelopathies, multiple sclerosis and other demyelinating diseases
> Possible spinal cord injury and post-traumatic neurological deficit
> Postoperative evaluation with new neurological findings
> Congenital or acquired spinal anomalies in children
> Evaluation of suspected or suspected fractures.
> Severe and persistent arm pain for more than 6 weeks
> Infectious or inflammatory processes
> Evaluation or monitoring of myelopathy
> Follow-up of previous spinal surgeries
> Evaluate or monitor Syrinx
> Spinal injury or trauma
> Spinal cord tumor
> Tuberculosis espinal
contraindications
> > | Any electrically, magnetically, or mechanically activated implant (eg, cardiac pacemaker, biostimulator with insulin pump, neurostimulator, cochlear implant, and hearing aids) |
patient preparation
> > > | Satisfactory written informed consent must be obtained from the patient prior to entering the scanning room. |
Positioning for MRI of the cervical spine
> | Head first in supine position |
Proposal of protocols, parameters and planning
To locate
To locate and plan sequences, a three-level locator should be used initially. Pagers typically last less than 25 seconds. Low-resolution T1-weighted scans.
T2 are sagittal
Plan the sagittal slices in the coronal plane; Tilt the block to position parallel to the spinal cord. Check the positioning block in the other two planes. When the patient is tilted, there should be an appropriate angle in the axial plane (parallel to the line running down the middle of the vertebral body along the spinous process). Check the position block in the sagittal plane; The FOV should be large enough to cover the entire cervical spine from the pons to T4 (typically 280mm). The discs should be sufficient to cover the spine from the lateral border of the RT transverse process to the lateral border of the LT transverse process.A saturation band should be placed over the neck (in front of the esophagus) in the sagittal plane. This is to prevent swallowing of artifacts over the spinal area. The phase direction should be head to toe to avoid neck motion artifacts.
Parameter
TR 3000-4000 | HE 100-120 | DESCENT 3MM | FLIP 130-150 | PHASE H>F | HEADQUARTERS 256X256 | field of view 280-290 | GAP 10% | NEXT (AVERAGE) 2 |
T1 sagital
Plan the sagittal slices in the coronal plane; Tilt the block to position parallel to the spinal cord. Check the positioning block in the other two planes. When the patient is tilted, there should be an appropriate angle in the axial plane (parallel to the line running down the middle of the vertebral body along the spinous process). Check the position block in the sagittal plane; The FOV should be large enough to cover the entire cervical spine from the pons to T4 (typically 280mm). The discs should be sufficient to cover the spine from the lateral border of the RT transverse process to the lateral border of the LT transverse process.A saturation band should be placed over the neck (in front of the esophagus) in the sagittal plane. This is to prevent swallowing of artifacts over the spinal area. The phase direction should be head to toe to avoid neck motion artifacts.
Parameter
TR 400-600 | HE 15-25 | DESCENT 3MM | FLIP 150 | PHASE H>F | HEADQUARTERS 256X256 | field of view 280-290 | GAP 10% | NEXT (AVERAGE) 2 |
T2 TSE STIR sagittal
Plan the sagittal slices in the coronal plane; Tilt the block to position parallel to the spinal cord. Check the positioning block in the other two planes. When the patient is tilted, there should be an appropriate angle in the axial plane (parallel to the line running down the middle of the vertebral body along the spinous process). Check the position block in the sagittal plane; The FOV should be large enough to cover the entire cervical spine from the pons to T4 (typically 280mm). The discs should be sufficient to cover the spine from the lateral border of the RT transverse process to the lateral border of the LT transverse process.A saturation band should be placed over the neck (in front of the esophagus) in the sagittal plane. This is to prevent swallowing of artifacts over the spinal area. The phase direction should be head to toe to avoid neck motion artifacts.
Parameter
TR 7000-9000 | HE 110 | FLIP 130 | NEXT 2 | DESCENT 3MM | HEADQUARTERS 256X256 | field of view 280 | PHASE H>F | GAP 10% | VON 130 |
T2*(Medical) Axial
Plan axial slices in the sagittal plane; Tilt the block to position perpendicular to the spinal cord.If the disc is herniated at a different level (eg T2, T3), additional blocks should be placed..If the spine is tilted (parallel to the disc space), there should be a corresponding angle in the coronary plane. The discs should be enough to cover the entire C vertebra from C2 to T1. A saturation band should be placed over the neck (in front of the esophagus) in the sagittal plane. This is to prevent swallowing of artifacts over the spinal area.
Parameter
TR 800-1200 | HE 15-25 | FLIP 30 | NEXT 2 | DESCENT 3MM | HEADQUARTERS 256X256 | field of view 180-200 | PHASE A>P | GAP 10% | over sampling 100% |
T1 EET-Axial
Plan axial slices in the sagittal plane; Tilt the block to position perpendicular to the spinal cord.If the disc is herniated at a different level (eg T2, T3), additional blocks should be placed..If the spine is tilted (parallel to the disc space), there should be a corresponding angle in the coronary plane. The discs should be enough to cover the entire C vertebra from C2 to T1. A saturation band should be placed over the neck (in front of the esophagus) in the sagittal plane. This is to prevent swallowing of artifacts over the spinal area.
Parameter
TR 400-500 | HE 15-20 | FLIP 150 | NEXT 2 | DESCENT 3MM | HEADQUARTERS 256X256 | field of view 180-200 | PHASE A>P | GAP 10% | over sampling 100% |
Suggestions for examinations of the cervical spine with contrast
> Evaluation or monitoring of CNS or meningeal tumors
> Follow-up of previous spinal surgeries
> Suspected spinal lesions (eg bone metastases)
> Spinal cord tumor
> Siringomielia
Use EET T1Saturated fatsaxial and sagittal after IV administrationGadolinio-DTPAInjection (copy the plan described above). The recommended dose of gadoliniumDTPAinjection is 0.1 mmol/kg, i.e. h 0.2 ml/kg in adults, children and infants.
