Table 2:

Spinal cord MR imaging protocol

When Acquired Immediately Following an Enhanced Brain MRI*When Acquired without a Preceding Enhanced Brain MRI
13 plane (or other scout)Recommended13 plane (or other scout)Recommended
2Postcontrast sagittal T1Recommended2Precontrast sagittal T1Recommended
3Postcontrast sagittal FSE PD/T2Recommended3Precontrast sagittal FSE PD/T2Recommended
4Postcontrast axial T1Through suspicious lesions4Precontrast Axial FSE PD/T2Through suspicious lesions
5Postcontrast axial FSE PD/T2Through suspicious lesions53D T1§Optional
6Postcontrast 3D T1§Optional6Postcontrast-enhanced sagittal T1Recommended
7Postcontrast-enhanced axial T1Through suspicious lesion(s)
  • Note.—FSE indicates fast spin-echo (or turbo spin-echo); PD, proton density-weighted (long TR, short TE sequence); T2, T2-weighted (long TR, long TE sequence); T1, T1-weighted (short TR, short TE sequence).

  • * Indications are (1) main presenting symptoms are at the level of the spinal cord, and these have not resolved (2) if the brain MRI results are equivocal. No additional intravenous contrast is required if the spinal cord study immediately follows the contrast-enhanced brain MRI, as gain is very limited. The segment to be studied (cervical and/or thoracic) is based on clinical findings. Sagittal section thickness is 3-mm (no gap).

  • PD series may depict lesions less apparent on heavily T2-weighted series.

  • Increases confidence in the findings of sagittal series; may provide classic lesion characteristics.

  • § For volumetric analysis if desired.

  • Standard dose of 0.1 mmole/kg injected over 30 s; scan starting 5 min after start of injection.