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library:cervical_spine [2025/05/09 01:51] – scottlibrary:cervical_spine [2025/06/18 02:53] (current) – scott
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-=====Cervical Spine MRI=====+======Cervical Spine MRI======
  
-====Scan Coverage and Planning====+=====Scan Coverage and Planning=====
  
  
-===Sagittal Plane===+====Sagittal Plane====
 On the axial and dorsal scout imaging, plan the slices parallel to the center of the spinal cord. On the sagittal scout image, center the FOV on C4/5. On the axial and dorsal scout imaging, plan the slices parallel to the center of the spinal cord. On the sagittal scout image, center the FOV on C4/5.
 For each patient, the FOV should be re-sized to include the Cerebellum to include the T3 vertebral body. On the dorsal scout image, add enough slices to cover the entire vertebral body out to the transverse processes. **Be sure to use an ODD number of slices. This will ensure that the center slice is in true midline.** For each patient, the FOV should be re-sized to include the Cerebellum to include the T3 vertebral body. On the dorsal scout image, add enough slices to cover the entire vertebral body out to the transverse processes. **Be sure to use an ODD number of slices. This will ensure that the center slice is in true midline.**
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-===Axial Plane===+====Axial Plane====
 There are two common variations for planning axial slices in the cervical spine, parallel to the intervertebral disc or perpendicular to the spinal cord. Both variations will yield diagnostic images, so be sure to **check clinician preference**.  There are two common variations for planning axial slices in the cervical spine, parallel to the intervertebral disc or perpendicular to the spinal cord. Both variations will yield diagnostic images, so be sure to **check clinician preference**. 
 In the image below, axial slices prescribed parallel to the disc are in __orange__, and slices prescribed perpendicular to the cord are in __yellow__. Center the FOV in the middle of the intervertebral disc and check dorsal images to ensure that the slices are not tilted tot he left or right. If patient positioning is suboptimal, it may be necessary to rotate the slices to match any side-to-side curve of the neck. If axial slices are being prescribed caudally toward C5/C6/C7, check axial and dorsal images to ensure wrap won't occur. In the image below, axial slices prescribed parallel to the disc are in __orange__, and slices prescribed perpendicular to the cord are in __yellow__. Center the FOV in the middle of the intervertebral disc and check dorsal images to ensure that the slices are not tilted tot he left or right. If patient positioning is suboptimal, it may be necessary to rotate the slices to match any side-to-side curve of the neck. If axial slices are being prescribed caudally toward C5/C6/C7, check axial and dorsal images to ensure wrap won't occur.
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 {{:cspineaxplan.png?500|}} {{:cspineaxplan.png?500|}}
  
-===Dorsal Plane===+====Dorsal Plane====
 The dorsal plane angulation is tailored to the clinical scenario, and may not be consistent between exams. A sample slice planning is below in __orange__. Due to the natural curve of the spine, there isn't one angle that will get all the spinal cord in one slice, to be sure to adjust the angle to best emphasize pathology noted on prior axial or sagittal images. It is good practice to extend slice coverage ventrally beyond the vertebral bodies, as the __Brachial Plexus__ nerves exit ventrocaudally  from C4/5 to T1/2. Incidental findings are also frequently located on the dorsal plane (Right image, red arrow) The dorsal plane angulation is tailored to the clinical scenario, and may not be consistent between exams. A sample slice planning is below in __orange__. Due to the natural curve of the spine, there isn't one angle that will get all the spinal cord in one slice, to be sure to adjust the angle to best emphasize pathology noted on prior axial or sagittal images. It is good practice to extend slice coverage ventrally beyond the vertebral bodies, as the __Brachial Plexus__ nerves exit ventrocaudally  from C4/5 to T1/2. Incidental findings are also frequently located on the dorsal plane (Right image, red arrow)
  
 {{:cspinedorplan.png?500|}}{{:dorincidental.png?500|}} {{:cspinedorplan.png?500|}}{{:dorincidental.png?500|}}
  
-====Typical Scan Protocol==== +=====Tips and Tricks=====
-The protocol below represents a full cervical spine exam. There is variation depending on the clinical question and clinician preference. The **minimum** recommended sequences are in bold text. **It is highly recommended to include at least 1 sequence, either T2 or STIR, in the dorsal plane and at least 1 sequence with fat saturation post contrast** For more technical details, see the Protocol Page __here__. +
- +
- +
-**Sagittal T2** \\ +
-**Sagittal or Dorsal STIR**\\ +
-Sagittal T1\\ +
-**Axial T2**\\ +
-Axial T1\\ +
-__Contrast__\\ +
-Sagittal T1 C+\\ +
-Axial T1 C+\\ +
- +
-====Tips and Tricks====+
  
 ===Selecting Phase Direction=== ===Selecting Phase Direction===