MRI Lumbar Spine

routine projections L spine

Sagittal, Axial and Coronal Localizer

Sag T1

Sag T2

Sag STIR

Axial PD

what plane do you plan l spine sagittal slices on

coronal

angle of sagittal L spine

parallel to spinal cord
on axial it is parallel to spinous process

sat band L spine

over aorta to reduce artifact

Sagittal T2 Lumbar

Sagittal T2 Lumbar what is bright

CSF

Sagittal plane L spine best demonstrates

degree of spinal stenosis

Sagittal T1 Lumbar

Dark on Sagittal T1 Lumbar

CSF

STIR lumbar

STIR

• Short Tau Inversion Recovery

• Inversion recovery sequence with specific timing to suppress fat based on differences in the T1 of tissues.

STIR Lumbar spine for

• diagnosis of bone marrow diseases.

• spine injury by interpreting whether vertebral compression fractures are acute, chronic or old. 

• Excellent  detection of  occult fx.

• Valuable in diagnosing osteoporic fx.

dark on STIR Lumbar

Fat

Bright on Lumbar STIR

CSF

chronic fractures of vertebral bodies look

hyperintense on the STIR

 acute/ subacute fracture on L spine

Hypointense T1 signal, hyperintensity on T2 and STIR,

axial slices for L spine plotted on

Sagittal Plane

how to plot axial slices L spine

Angle the first position block parallel to the L4-L5 intervertebral disc.

Continue through additional intervertebral disc spaces

how to plot disc axials L spine

After Sagittal T2 sequence is complete, axial slices are plotted through each disc space.

Additional slices may be added to cover pathology

axial plane L spine best visualizes

both dorsal and ventral nerve roots. (blue arrows)

Axial PD L spine

Axial PD L spine

• minimize effects of T1 and T2.

• results in image weighting dependent primarily on the proton density of the image volume

Axial PD looks like

• Higher proton density = higher image signal. (Bright)

• Lower proton density = lower image signal. (Dark

Mri lumbar scoliosis how to plot

Coronal imaging is performed to visualize the spinal cord to accurately plot sagittal images.

After coronal T2 is completed, find the best midline cord slice and plot parallel with cord.

Sagittal may have to be done as upper and lower to compensate for curvature.

axials plotted off the coronal and sagittals