MRI of Thoracic & Lumbar Spine
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Questions and Answers

What is the primary function of the thoracic spine?

  • It provides articulation with the ribs. (correct)
  • It allows for lateral bending.
  • It houses the spinal cord.
  • It supports the head.

Which vertebra does the thoracic spine extend from?

  • C7 (correct)
  • L1
  • T12
  • S1

Which imaging procedure utilizes a patient's positioning supine with either head or feet first?

  • CT scan
  • MRI of the thoracic spine (correct)
  • Ultrasound
  • X-ray

Which of the following is NOT typically an indication for a thoracic spine MRI?

<p>Fracture (D)</p> Signup and view all the answers

What anatomical feature distinguishes thoracic vertebrae from cervical and lumbar vertebrae?

<p>Presence of costal facets (D)</p> Signup and view all the answers

How should the axial alignment light be positioned for an MRI thoracic spine scan?

<p>2 cm above the xiphoid (D)</p> Signup and view all the answers

When preparing a patient for a thoracic spine MRI, which comfort measure is NOT recommended?

<p>Remove all accessories for safety (C)</p> Signup and view all the answers

What is a common characteristic of thoracic vertebral bodies compared to lumbar vertebral bodies?

<p>They are medium-sized and heart-shaped. (C)</p> Signup and view all the answers

What is the preferred patient position for an MRI of the lumbar spine?

<p>Supine position (A)</p> Signup and view all the answers

Which accessory can be used to help flatten the lumbar curve during an MRI procedure?

<p>Knee bolster (B)</p> Signup and view all the answers

For a coronal localizer, where should the alignment be in relation to the spinal cord?

<p>Parallel to the long axis of the spinal cord (D)</p> Signup and view all the answers

What is the coverage area for the axial slices in a single block?

<p>Pedicle of the third lumbar to the pedicle of the first sacral segment (D)</p> Signup and view all the answers

What is the purpose of axial slices in the MRI procedure?

<p>To demonstrate space-occupying lesions within the spinal canal (C)</p> Signup and view all the answers

What should be included in the coverage for a sagittal localizer's axial slice?

<p>Entire vertebral foramen to midway through the vertebral bodies (D)</p> Signup and view all the answers

Which of the following indicates a proper alignment for a sagittal localizer for a coronal slice?

<p>Parallel to the long axis of the cauda equina (D)</p> Signup and view all the answers

What should the coverage area for the coronal slice include?

<p>Transverse processes on each side (D)</p> Signup and view all the answers

What can sagittal slices primarily demonstrate in MRI of the thoracic spine?

<p>Vertebral alignment (C)</p> Signup and view all the answers

Which statement about axial slices in thoracic spine imaging is correct?

<p>They can show space-occupying lesions. (C)</p> Signup and view all the answers

What coverage is required when obtaining a coronal slice for thoracic MRI?

<p>From pedicles of one vertebra above and below the vertebrae of interest (D)</p> Signup and view all the answers

Which of the following conditions is an indication for lumbar spine MRI?

<p>Discitis (B), Herniated disc (C)</p> Signup and view all the answers

Which feature is true concerning the anatomy of the lumbar spine?

<p>It exhibits a natural curve known as lumbar lordosis. (C)</p> Signup and view all the answers

Which of these imaging techniques is used specifically for tissue characterization of bone tumors in the sagittal plane?

<p>Chemical shift imaging (C)</p> Signup and view all the answers

What is the primary purpose of using DWI in MRI procedures?

<p>Evaluating spinal ischemia (D)</p> Signup and view all the answers

Considering the coronal slices in MRI, which of the following can they effectively demonstrate?

<p>Space-occupying lesions (C)</p> Signup and view all the answers

Flashcards

Patient Positioning

Position the patient supine on the MRI table with proper coil setup.

Orientation for Anxious Patients

Feet-first orientation can help reduce anxiety during MRI.

Scout Slice Placement

Initial imaging setup for determining optimal slice locations for the lumbar spine.

Coronal Localizer

Used for sagittal slice alignment, parallel to spinal cord for proper coverage.

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Sagittal Slices Usage

Demonstrates vertebral alignment, canal stenosis, and end conditions.

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Axial Block Series

Technique planning for axial slices with alignment to intervertebral discs.

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Sagittal Localizer for Coronal Slice

Alignment parallel to the cauda equina, allowing for specific coverage.

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Coverage Specifications

Guidelines for ensuring complete imaging of spinal levels and surrounding structures.

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Sagittal Slices

Slices used in MRI to assess vertebral alignment and other spinal issues.

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Herniated Disc

Condition where an intervertebral disc protrudes and may compress nerves.

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Axial Slices

Horizontal slices in MRI used to demonstrate conditions like canal stenosis.

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Lumbar Spine

Lower part of the spine consisting of five vertebrae, involved in lumbar lordosis.

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Disc Prolapse

Condition where the disc material pushes out, potentially compressing nerves.

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Chemical Shift Imaging

MRI technique to characterize tissue, especially for bone tumors.

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Indications for Lumbar MRI

Reasons for performing MRI of the lumbar spine, such as disc prolapse and syrinx.

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Thoracic Spine (T-spine)

The middle part of the vertebral column, consisting of 12 vertebrae (T1-T12).

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Function of Thoracic Spine

Provides stability and supports rib cage; most mobile spinal segment.

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Thoracic Vertebrae Features

Heart-shaped bodies, round canals, prominent transverse processes, long angled spinous processes.

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MRI Indications for Thoracic Spine

Conditions warranting MRI include myelopathy, herniated disc, malignancies, and multiple sclerosis.

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Patient Positioning in MRI

Patient should be supine; arms by sides or above head; feet-first for claustrophobia.

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Use of Phased Array Coil

Equipment for better imaging of the thoracic spine during the MRI scan.

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Patient Instructions During Scan

Emphasize patient's need to remain still to avoid image distortion.

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Study Notes

MRI of Thoracic & Lumbar Spine

  • The presentation is about MRI procedures for the thoracic and lumbar spine.
  • The presenter, Dr. Hayder Jasim Taher, holds a PhD in Medical Imaging.
  • The study covers patient preparation, safety precautions, contrast media (positive relaxation agents, negative relaxation agents, gadolinium), anatomical overview, indications, and procedures for both the thoracic and lumbar spine.

Thoracic Spine

  • The thoracic spine (T-spine) is the middle part of the vertebral column, extending from C7 (cervical spine's bottom) to L1 (lumbar spine's top).
  • It consists of 12 vertebrae (T1-T12).
  • The thoracic spine's unique characteristic is its articulation with ribs via costal facets, this limits some movement.
  • Thoracic spine is relatively more mobile compared to the cervical and lumbar spine.
  • Vertebral bodies are medium-sized, heart-shaped.
  • Vertebral canals are medium-sized, round.
  • Transverse processes have costal facets.
  • Spinous processes angle downwards.

Indications for Thoracic Spine MRI

  • Myelopathy
  • Herniated disc
  • Primary malignancy
  • Secondary malignancy
  • Radiculopathy
  • Syrinx
  • Benign tumor
  • Multiple sclerosis
  • Scoliosis

MRI Procedure (Thoracic Spine)

  • Patient is placed supine on the magnet table, phased array coil is positioned and connected.
  • Head or feet first positioning, depending on patient preference (claustrophobia).
  • Arm placement (sides or above head) is based on patient comfort.
  • Accessories like knee bolsters, blankets are used for comfort.
  • Axial alignment light is placed 2 cm above xiphoid (approximately T7).
  • Patient instructed not to move during the scan.
  • Coronal and sagittal localizers are utilized to obtain sagittal and axial slices.
  • Various sequences (e.g., Sagittal T2 FSE, Axial T2 FSE, Axial T1 Dual SE) are utilized for different imaging needs (thickness of 4mm-5mm).
  • Optional sequences include chemical shift imaging (T1 GRE) for bone tumor characterization and DWI for spinal ischemia evaluation.

Lumbar Spine

  • The lumbar spine (L-spine) consists of 5 vertebrae.
  • In some cases, 4 or 6 lumbar vertebrae may be present.
  • The lumbar spine's natural curve is convex anteriorly (lumbar lordosis).
  • Facet (zygapophyseal) joints permit flexion/extension and abduction movements.
  • Rotation is limited mostly to the lumbosacral joint.

Indications for Lumbar Spine MRI

  • Disc prolapse with cord/nerve root compression
  • Syrinx
  • Discitis
  • Conus evaluation (in appropriate symptomatic patients)
  • Arachnoiditis

MRI Procedure (Lumbar Spine)

  • Patient placed supine on the magnet table.

  • Phased array coil is positioned and connected.

  • Feet-first positioning might be preferred by anxious patients.

  • Patient adjusted for anatomical structure of interest to be centered over the coil.

  • Accessories like knee bolsters, blankets are used for optimal comfort.

  • Coronal and sagittal localizers are utilized to obtain sagittal and axial slices.

  • Various sequences (e.g., Sagittal T2 FSE, Axial T2 FSE, Axial T1 SE, Axial T1 FSE (post GAD)) are used with varied slice thicknesses ranging from 3mm to 5mm.

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Description

This presentation focuses on MRI procedures for the thoracic and lumbar spine, highlighting important aspects such as patient preparation, safety precautions, and the use of contrast media. Led by Dr. Hayder Jasim Taher, the study provides an anatomical overview and outlines the indications and procedures specific to these regions of the spine.

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