MRI Scanning Technique of Cervical Spine

Initially the localizer images are taken in all three planes i.e. axial, coronal and sagittal.

Then, myelogram is planned in sagittal and coronal plane. The epicenter of FOV is set at the posterior border of C4 vertebra in sagittal localizer and in coronal localizer, the scan line passes through the middle of the cervical vertebra which may be angled according to the rotation of the spine. In axial localizer, the mid point of the vertical scan line is set at the middle of the vertebra dividing into right and left equal halves and the mid point of the horizontal scan line is also set parallel to the posterior border of the vertebra. Cover from the superior level of cerebellum upto upper thoracic vertebra for reference.

T2 Sagittal sequence is planned in myelogram. The middle scan line is passed through the center of the spinal cord in coronal myelogram and the epicenter of FOV is set at the posterior border of cervical fourth vertebra. Cover from superior level of cerebellum upto the upper thoracic vertebra as far as possible. The scan lines are made parallel through the vertebra in coronal localizer and in axial localizer the scan lines are perpendicular to the posterior border of the vertebra. Cover at least from the right cervical nerve root foramina to the left foramina.

T1 Sagittal sequence is planned by copying the scan lines of the T2 Sagittal sequence.

T2 STIR Sagittal sequence is also planned by copying the scan lines of the T2 Sagittal sequence.

T2 Axial is now planned in mid T2 sagittal image. At least 3 scan lines are planned at each intervertebral disc covering the end plates at C2-C3 upto C7-T1. The mid point of the scan line is placed at middle of the intervertebral disc. Make sure that the scan line pass through the disc space covering the superior and inferior vertebral end plates at each level. The epicenter of FOV is placed at the middle of the axial localizer and in coronal localizer, the mid point of the scan lines are also kept at the middle of the disc space covering the end plates and may need to be angled according to the rotation of the spine.

T1 Axial sequence is planned by copying the scan lines of T2 Axial sequence.

T2 Coronal sequence is helpful to better delineate the cervical pathology. The scan lines are made parallel through spinal cord parallel to the posterior border of the cervical vertebra. Cover from the anterior end border of the vertebra to the ends of spinous processes. In axial localizer, the scan lines are parallel to the posterior border of the vertebra and perpendicular to the imaginary vertical vertebral plane.

The routine sequence in MRI Scanning of Cervical Spine are:

T2 Sagittal

T1 Sagittal

T2 Sagittal STIR

T2 Axial

T1 Axial

T2 Coronal (optional)