Differences

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--- library:thoracolumbar_spine [2025/03/10 19:52] – [Typical Scan Protocol] scott
+++ library:thoracolumbar_spine [2025/04/30 01:28] (current) – [Typical Scan Protocol] scott
@@ Line 45: / Line 45: @@
 ====Typical Scan Protocol====
-The protocol below represents a full thoracolumbar exam. There is a lot of variation depending on the clinical question and clinician preference. The **minimum** recommended sequences depend on pathology, so no sequences are in bold.
+The protocol below represents a full thoracolumbar exam. There is a lot of variation depending on the clinical question and clinician preference. The **minimum** recommended sequences depend on pathology, so no sequences are in bold. **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**
 Sagittal T2 Lumbar\\
@@ Line 55: / Line 55: @@
 Axial T2 ROI\\
 Axial T1 ROI\\
-Contrast
+__Contrast__\\
 Sagittal T1 ROI\\
 Axial T1 ROI\\
+====Tips and Tricks====
+===Optional Sequences==
+There is a wide scope of pulse sequences that will find utility in the thoracolumbar spine, depending on patient size, clinical question, and pathology. Some are used frequently even though they are not included in the Typical Protocol above, others are good to know about for specific clinical scenarios.
+==Myelography==
+{{:library:3dmyeloprofile.png?600|}}  {{:library:2dhastemyeloprofile.png?600|}}
+==T2* Weighting==
+{{:library:mergespineprofile.png?600|}}
+==T2 Weighting==
+Most modern scanners will have an option for a Driven Equilibrium pulse sequence that incorporates and additional -90 degree pulse to 'flip back' the transverse magnetization along the Z axis. This has the effect of speeding up longitudinal recovery even for very long T1 tissues like CSF, meaning that it isn't necessary to have very long TR's. When performing a T2 weighted sequence with this modification, TR can be as low as 1500ms in some cases, while maintaining high signal from CSF. On a GE scanner this option is known as **Fast Recovery FSE (FR-FSE)** and can be found in most GE spine protocols. On a Siemens scanner, this is known as **Restore**, and may be a check box on the contrast tab, or may be found in Siemens spine protocols. These options can shorten scan time, especially when only a few slices are needed, as is the case with sagittal spine imaging.