ANATOMY OF MRI SPINE

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 [email protected] M-9160470564

2. IDENTIFICATION OF MRI SPINE

3. Spine sequences T1 T2 STIR T1C DIXON DWI SWI

4. MRI sequences Basic sequences T1 T2 Inversion recovery (IR) Post contrast T1 Advanced sequences DWI (Functional sequence) SWI Multi-point Dixon Dynamic Post contrast T1

5. 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

6. T1W Morphology of bones and soft tissue Most pathological lesions appear hypo intense against normal fatty marrow

7. T1C Gives details about cellularity and necrosis Dynamic post contrast will assess vascularity of bone metastasis Response assessment

8. T2W Adds information about morphology of bones and soft tissue. Most pathological lesions appear hyper intense against normal marrow

9. IR sequence Fat suppressed T2W sequence More clear Differentiate from T2 by back FAT[arrow] Bright on T2 Darker on IR Most pathological lesions appear more hyper intense against normal marrow Thanks to Dr C Seetharaman T2 SEQUENCE IR SEQUENCE

10. DWI-diffusion weighted image DWI ADC T1 STIR T1C

11. 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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21. Summary CT and MR should be same slice thickness Flat couch Discuss with radiologist Fuse properly Delineate with radiologist Get the result 25