MRI Exam-Specific Parameters: Spine Module (Revised 4-15-2020)
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Modified on: Wed, 15 Apr, 2020 at 3:08 PM
In addition to the exam-specific instructions in the following tables, review the following information prior to examination selection and submission. Failure to follow the guidance below may result in failure of the submitted examination.
The CSF on the axial bright fluid sequence must be bright or will result in a failure of the submission.
Failure to meet anatomic coverage and imaging plane specifications may result in failure.
Cervical Spine |
Required Sequences | Category A: Pulse Sequence and Image Contrast | Category B: Anatomic Coverage and Imaging Planes | Category C: Spatial Resolution |
Sagittal dark fluid | CSF must be hypointense to the cord/nerve roots so that cord/nerve roots are well-defined Should not have non-anatomic heterogeneous signal intensity of the cord Must show good contrast between the cord and CSF Should not be fat suppressed. The fat must be bright, but not so intense that it masks the fat/muscle plane T1 FLAIR is acceptable for this
| Must cover foramen magnum to T1Must cover laterally through the neural foramina
| Slice thickness ≤ 3.0 mmGap ≤ 1.0 mmPixel area ≤ 1.0 mm2
|
Sagittal bright fluid | Should not have non-anatomic heterogeneous signal intensity of the cordCSF must be hyperintense to the cord/nerve roots so that cord/nerve roots are well-definedFat must be bright, but not so intense that it masks the fat/muscle planeMust show good contrast between the cord and CSF
| Must cover foramen magnum to T1Must cover laterally through the neural foramina
| Slice thickness ≤ 3.0 mmGap ≤ 1.0 mmPixel area ≤ 1.0 mm2
|
Axial bright fluid(Recommendation is to consider GRE or 3D T2) | Should not have non-anatomic heterogeneous signal intensity of the cordCSF must be hyperintense to the cord/nerve roots so that cord/nerve roots are well-definedFat must be bright, but not so intense that it masks the fat/muscle planeMust show good contrast between the cord and CSF
| Must cover contiguously from C3 to T1 (from C3 inferior endplate to T1 superior endplate)Axial or oblique axials are acceptable
| Slice thickness ≤ 3.0 mmGap ≤ 1.0 mmPixel area ≤ 1.0 mm2
|
Cervical Spine with Contrast for Intramedullary Disease |
Required Sequences | Category A: Pulse Sequence and Image Contrast | Category B: Anatomic Coverage and Imaging Planes | Category C: Spatial Resolution |
Sagittal dark fluid | Should not have non-anatomic heterogeneous signal intensity of the cord CSF must be hypointense to the cord/nerve roots so that cord/nerve roots are well-defined Should not be fat suppressed. The fat must be bright, but not so intense that it masks the fat/muscle plane Must show good contrast between the cord and CSF T1 FLAIR is acceptable for this sequence
| Must cover foramen magnum to T1Must cover laterally through the neural foramina
| Slice thickness ≤ 3.0 mmGap ≤ 1.0 mmPixel area ≤ 1.0 mm2
|
Sagittal bright fluid | Should not have non-anatomic heterogeneous signal intensity of the cordCSF must be hyperintense to the cord/nerve roots so that cord/nerve roots are well-definedFat must not be so intense that it masks the fat/muscle planeMust show good contrast between the cord and CSF
| Must cover foramen magnum to T1Must cover laterally through the neural foramina
| Slice thickness ≤ 3.0 mmGap ≤ 1.0 mmPixel area ≤ 1.0 mm2
|
Axial bright fluid | Should not have non-anatomic heterogeneous signal intensity of the cordCSF must be hyperintense to the cord/nerve roots so that cord/nerve roots are well-definedFat must not be so intense that it masks the fat/muscle planeMust show good contrast between the grey and white matter
| Must cover contiguously from C3 to T1 (from C3 inferior endplate to T1 superior endplate)Axial or oblique axials are acceptable
| Slice thickness ≤ 3.0 mmGap ≤ 1.0 mmPixel area ≤ 1.0 mm2
|
Axial dark fluid post contrast | Should not have non-anatomic heterogeneous signal intensity of the cordCSF must be hypointense to the cord/nerve roots so that cord/nerve roots are clearly-definedShould not be fat suppressed, the fat must not be so intense that it masks the fat/muscle planeMust show good contrast between the cord and CSF
| Must cover contiguously from foramen magnum to T1Axial or oblique axials are acceptable
| Slice thickness ≤ 3 mmGap ≤ 1.0 mmPixel area ≤ 1.0 mm2
|
Sagittal dark fluid post contrast | Should not have non-anatomic heterogeneous signal intensity of the cordCSF must be hypointense to the cord/nerve roots so that cord/nerve roots are clearly-definedShould not be fat suppressed, the fat must not be so intense that it masks the fat/muscle planeMust show good contrast between the cord and CSF
| Must cover foramen magnum to T1Must cover laterally through the neural foramina
| Slice thickness ≤ 3 mmGap ≤ 1.0 mmPixel area ≤ 1.0 mm2
|
Thoracic Spine |
Required Sequences | Category A: Pulse Sequence and Image Contrast | Category B: Anatomic Coverage and Imaging Planes | Category C: Spatial Resolution |
Sagittal dark fluid | Should not have non-anatomic heterogeneous signal intensity of the cordCSF must be hypointense to the cord/nerve roots so that cord/nerve roots are well-definedShould not be fat suppressed, the fat must be bright, but not so intense that it masks the fat/muscle planeMust show good contrast between the cord and CSFT1 FLAIR is acceptable for this sequence
| Must cover C7 to L1 inclusiveMust cover laterally through the neural foramina
| Slice thickness ≤ 4.0 mmGap ≤ 1.0 mmPixel area ≤ 1.6 mm2
|
Sagittal bright fluid | Should not have non-anatomic heterogeneous signal intensity of the cordCSF must be hyperintense to the cord/nerve roots so that cord/nerve roots are clearly-definedFat must not be so intense that it masks the fat/muscle planeMust show good contrast between the cord and CSF
| Must cover C7 to L1 inclusiveMust cover laterally through the neural foramina
| Slice thickness ≤ 4 mmGap ≤ 1.0 mmPixel area ≤ 1.6 mm2
|
Axial bright fluid, contiguous or angled | Should not have non-anatomic heterogeneous signal intensity of the cordCSF must be hyperintense to the cord/nerve roots so that cord/nerve roots are clearly-definedFat must not be so intense that it masks the fat/muscle planeMust show good contrast between the cord and CSF
| Axials may be angled or continuousAxials or oblique axials are acceptableAngled slices must cover at least 6 disc spacesAngled slices must include at least 3 spaces per discAngled slices must include center slice through the disc spaceContiguous slices must cover at least 6 contiguous vertebrae (inclusive)
| Slice thickness ≤ 4 mmGap ≤ 1.0 mmPixel area ≤ 1.6 mm2
|
Sagittal localizer | Must be able to number the vertebrae C2 through T6 and include landmarks on the localizer and at least one thoracic sagittal series that allows unambiguous labeling of the thoracic vertebraeLandmarks may include a skin marker and/or sternal notch
| Must include C2 through T12
|
|
Lumbar Spine |
Required Sequences | Category A: Pulse Sequence and Image Contrast | Category B: Anatomic Coverage and Imaging Planes | Category C: Spatial Resolution |
Sagittal dark fluid | Should not have non-anatomic heterogeneous signal intensity of the cordCSF must be hypointense to the cord/nerve roots so that cord/nerve roots are well-definedShould not be fat suppressed, the fat must be bright, but not so intense that it masks the fat/muscle planeMust show good contrast between the cord and CSFT1 FLAIR is acceptable for this
| Must cover T12 to S2 inclusive (in the sagittal lumbar sequences, T12 to S2 inclusive means from T12 superior endplate to S2 inferior endplate)Must cover from and through one pedicle, all the way through to the contra-lateral pedicle, inclusive
| Slice thickness ≤ 5.0 mmGap ≤ 1.5 mmPixel area ≤ 1.5 mm2
|
Sagittal bright fluid | Should not have non-anatomic heterogeneous signal intensity of the cordCSF must be hyperintense to the cord/nerve roots so that cord/nerve roots are clearly-definedFat must not be so intense that it masks the fat/muscle planeMust show good contrast between the cord and CSF
| Must cover T12 to S2 inclusive (in the sagittal lumbar sequences, T12 to S2 inclusive means from T12 superior endplate to S2 inferior endplate)Must cover from and through one pedicle, all the way through to the contra-lateral pedicle, inclusive
| Slice thickness ≤ 5.0 mmGap ≤ 1.5 mmPixel area ≤ 1.5 mm2
|
Axial dark fluid and/or bright fluid | Should not have non-anatomic heterogeneous signal intensity of the cordDark fluid sequence: CSF must be hypointense to the cord/nerve roots so that cord/nerve roots are clearly-definedBright fluid sequence: CSF must be hyperintense to the cord/nerve roots so that cord/nerve roots are clearly-definedFat must not be so intense that it masks the fat/muscle planeMust show good contrast between the cord and CSF
| Must cover the L3-4, L4-5 and L5-S1 levels including each disc and contiguous endplatesAxial or oblique axials are acceptable
| Slice thickness ≤ 4 mmGap ≤ 1.0 mmPixel area ≤ 1.5 mm2
|
Revision History for this Article |
Date | Section | Description of Revision(s) |
12-12-19 | All | Article created; FAQs incorporated; No criteria changes |
4-15-2020 | All | Clarified that the CSF on the axial bright fluid sequence must be bright or will result in a failure of the submission
|
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