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ANATOMY OF MRI SPINE

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Kanhu Charan
Kanhu Charan

ANATOMY OF MRI SPINE

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RADIOLOGY FOR RADIATION ONCOLOGISTS SPINE MRI DR KANHU CHARAN PATRO MD,DNB(RADIATION ONCOLOGY),MBA,FAROI(USA),PDCR,CEPC HOD,RADIATION ONCOLOGY Mahatma Gandhi Cancer Hospital And Research Institute, Visakhapatnam drkcpatro@gmail.com M-9160470564
IDENTIFICATION OF MRI SPINE
Spine sequences • T1 • T2 • STIR • T1C • DIXON • DWI • SWI
MRI sequences Basic sequences 1. T1 2. T2 3. Inversion recovery (IR) 4. Post contrast T1 Advanced sequences 1. DWI (Functional sequence) 2. SWI 3. Multi-point Dixon 4. Dynamic Post contrast T1
Identify yourself SL NO SEQUENCE IDENTIFICATION 1 T1 CSF BLACK 2 T1-CONTRAST CSF BLACK, VESSEL WHITE 3 T2 CSF WHITE 4 STIR CSF WHITE, ABDOMINAL FAT AND BACK FAT BLACK 5 DWI GHOST LOOK, CSF BLACK 6 ADC GHOST LOOK, CSF WHITE
T1W 1. Morphology of bones and soft tissue 2. Most pathological lesions appear hypo intense against normal fatty marrow
T1C 1. Gives details about cellularity and necrosis 2. Dynamic post contrast will assess vascularity of bone metastasis 3. Response assessment
T2W 1. Adds information about morphology of bones and soft tissue. 2. Most pathological lesions appear hyper intenseagainst normal marrow
IR sequence 1. Fat suppressed T2W sequence 2. More clear 3. Differentiate from T2 by back FAT[arrow] 1. Bright on T2 2. Darker on IR 4. Most pathological lesions appear more hyper intenseagainst normal marrow Thanks to Dr C Seetharaman T2 SEQUENCE IR SEQUENCE
DWI-diffusion weighted image DWI ADC T1 STIR T1C
Susceptibility-weighted MRI spine Susceptibility-weighted MRI enables the reliable differentiation between predominantly osteoblastic and osteolytic spine metastases with a higher accuracy than standard MRI sequences
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Summary • CT and MR should be same slice thickness • Flat couch • Discuss with radiologist • Fuse properly • Delineate with radiologist • Get the result 25

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ANATOMY OF MRI SPINE

  • 1. RADIOLOGY FOR RADIATION ONCOLOGISTS SPINE MRI DR KANHU CHARAN PATRO MD,DNB(RADIATION ONCOLOGY),MBA,FAROI(USA),PDCR,CEPC HOD,RADIATION ONCOLOGY Mahatma Gandhi Cancer Hospital And Research Institute, Visakhapatnam drkcpatro@gmail.com M-9160470564
  • 3. Spine sequences • T1 • T2 • STIR • T1C • DIXON • DWI • SWI
  • 4. MRI sequences Basic sequences 1. T1 2. T2 3. Inversion recovery (IR) 4. Post contrast T1 Advanced sequences 1. DWI (Functional sequence) 2. SWI 3. Multi-point Dixon 4. Dynamic Post contrast T1
  • 5.
  • 6. Identify yourself SL NO SEQUENCE IDENTIFICATION 1 T1 CSF BLACK 2 T1-CONTRAST CSF BLACK, VESSEL WHITE 3 T2 CSF WHITE 4 STIR CSF WHITE, ABDOMINAL FAT AND BACK FAT BLACK 5 DWI GHOST LOOK, CSF BLACK 6 ADC GHOST LOOK, CSF WHITE
  • 7. T1W 1. Morphology of bones and soft tissue 2. Most pathological lesions appear hypo intense against normal fatty marrow
  • 8. T1C 1. Gives details about cellularity and necrosis 2. Dynamic post contrast will assess vascularity of bone metastasis 3. Response assessment
  • 9. T2W 1. Adds information about morphology of bones and soft tissue. 2. Most pathological lesions appear hyper intenseagainst normal marrow
  • 10. IR sequence 1. Fat suppressed T2W sequence 2. More clear 3. Differentiate from T2 by back FAT[arrow] 1. Bright on T2 2. Darker on IR 4. Most pathological lesions appear more hyper intenseagainst normal marrow Thanks to Dr C Seetharaman T2 SEQUENCE IR SEQUENCE
  • 11.
  • 13. Susceptibility-weighted MRI spine Susceptibility-weighted MRI enables the reliable differentiation between predominantly osteoblastic and osteolytic spine metastases with a higher accuracy than standard MRI sequences
  • 14.
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  • 25. Summary • CT and MR should be same slice thickness • Flat couch • Discuss with radiologist • Fuse properly • Delineate with radiologist • Get the result 25