Spinal cord MR imaging protocol
| When Acquired Immediately Following an Enhanced Brain MRI* | When Acquired without a Preceding Enhanced Brain MRI | ||||
|---|---|---|---|---|---|
| Sequence | Recommendation | Sequence | Recommendation | ||
| 1 | 3 plane (or other scout) | Recommended | 1 | 3 plane (or other scout) | Recommended |
| 2 | Postcontrast sagittal T1 | Recommended | 2 | Precontrast sagittal T1 | Recommended |
| 3 | Postcontrast sagittal FSE PD/T2† | Recommended | 3 | Precontrast sagittal FSE PD/T2† | Recommended |
| 4 | Postcontrast axial T1 | Through suspicious lesions | 4 | Precontrast Axial FSE PD/T2‡ | Through suspicious lesions |
| 5 | Postcontrast axial FSE PD/T2‡ | Through suspicious lesions | 5 | 3D T1§ | Optional |
| 6 | Postcontrast 3D T1§ | Optional | 6 | Postcontrast-enhanced sagittal T1‖ | Recommended |
| 7 | Postcontrast-enhanced axial T1 | Through 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.