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50 Cards in this Set
- Front
- Back
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What is the most common standard protocol for lumbar spine
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Sagital T1 flair
Sagital T2 TSE STIR Sagital Axial T2 TSE |
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What is the best imaging modality for fracture
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T1 or Stir
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What is the best imaging modality to see herniation of a disc
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T2W
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What is a disc herniation
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Focal extension of disc material beyond endplate margins at previously operated intervertebral disc level
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What is a protrusion
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Protrusion is herniated disc with broad base at parent disc
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Describe the characteristics of a protrusion
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Greatest diameter of protrusion in any plane < distance between edges of base in same plane
< 25% of disc circumference |
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What is a disc extrusion
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Extrusion is herniated disc with narrow or no base at parent disc
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What are the characteristics of an extrusion
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Greatest diameter of extrusion in any plane > distance between edges of base in same plane
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What can all disc bulges, and herniations (protrusions and extrusion) always involve
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annular tears
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Do disc bulge have annular tears
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it is possible but it is usually just the annular tissue bulging
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What is it called when greater than 50% of the disc is bulging
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a circumferential bulge
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Do disc herniations always have annular tears
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yes
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Where is the most common location of an herniation
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postero-lateral secondary to the posterior longitudinal ligament being medial
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Is there severe pain in a herniation without nerve compression
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yes sometimes but not always
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How are T1 and T2 of the lumbar spine the same
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the veterbral bodies are brighter than the disc
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How are T1 and T2 different
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the nuclueus polposa is brighter on T2 and the vetebral bodies on T1 are brighter than T2 (bc of fat)
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What is the size for spinal stenosis of lumbar spine (measure on sagital)
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12mm relative stenosis
10 mm absolute |
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How do you determine if there is neuroforaminal narrowing in the sagittal film
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Obliterated perineural fat in neural foramen on sagittal images
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Where is the most common locations for neuroforaminal narrowing
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lumbar: L3-4 and L4-5 most common
Cervical: C5-6 and C6-7 most common |
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What are 4 causes of neuroforaminal narrowing
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Disc height loss
Endplate sclerosis and spurs Spondylolisthesis (antero or retero) Facet arthropathy |
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nerve is not bright on T1
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d
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Thoracic vertabra get larger going superior to inferior
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yes
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What is the measurements for cervical canal stenosis
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normal AP diameter is approximately 17mm.
relative stenosis 10 - 13mm. absolute stensosis <10mm. |
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What is the measurements for cervical canal stenosis
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normal AP diameter is approximately 17mm.
relative stenosis 10 - 13mm. absolute stensosis <10mm. |
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What is uncovering of the disc space
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this is when there is a listhesis and a portion of the disc is not covered which is a unique term and different from a bulge.
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What is the normal width of the ligamentum flavum
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less than 6mm
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What is a strutt and graft
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this is metal object or bone that is inserted into a vetebral body and used as a crutch for support.
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What is a corpectomy
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removal of part of the vetebral body
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What is used to replace the portion of the vetebral body removed by corpectectomy
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strutt and graft.
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What does CSF pulsation artifact look like
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this is only seen on T2W images and appears as a dark signal where spinal csf is located and can be long areas of dark signal.
not seen on T1 |
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When is T2 Stir Sequences of the spine ordered
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trauma setting and is used to evaluated ligamentous injury and soft tissue injury, and to better evaluate the bone marrow (elimanates fat)
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What does a Stir sequence eliminate
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fat, brings out edema
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How can you tell if a spine sequence is post contrast
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look at the posterior portion of the vetebral body it will be bright
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What is the best sequence for tumor
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T1 then stir
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How can u tell if a sequence is fat sat
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it will say FS on the sequence list
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Do the nerve roots come out of the neuroforamen superior or inferior to the disc
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superior
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What is the best way to find S1 on MRI
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scroll all the way to the side and then you will see S1 at the bottom
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What does L5 look like on axial
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napolean hat
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What is the direction that the nerve roots come out of the cervical spine
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anterior/inferior and therefore it is useful to have oblique imaging in the cervical spine
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What are the signal characteristics of osteo
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T1 dark
T2 brigh stir brighter |
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What are the signal characteristics for Modic 1
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dark T1 and bright T2
edematous |
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What are the signal characteristics for modic 2
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bright T1 and T2
fatty |
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What are the signal characteristics for modic 3
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dark T1 and dark T2
fibrous |
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Is contrast done for the neck
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yes
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What is the source imaging for a contrast neck image
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The coronal ( this is done bc of timing)
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How is contrast imaging of the neck done
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There are is a precontrast coronal image done and then there are 2-3 repititions done as the contrast is injected at 30 sec intervals. There is done subtraction done from the precontrast coronal to get the arteries alone in the best arterial phase
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What are the 2 types of images done during neck MR
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TOF and contrast
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What is disc dessication
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this is the loss of the bright signal normaly seen in the nucleus pulposa on T2
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If there is loss of the usual T2-hyperintensity of the MRI is there disease
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yes, dessication
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What does a fracture look like on T1 and T2
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T1WI
Rounded or diffuse low signal intensity marrow replacement Very low signal intensity fracture line may or may not be visible T2WI Rounded or diffuse high signal intensity marrow replacement May be same signal intensity as fatty marrow Very low signal intensity fracture line Increase conspicuity of lesion by using fat-saturation sequences |
