RadteraMRI Lumbar Spine Without Contrast
MRNo contrastSpine
Indications
- Low back pain with radiculopathy / sciatica
- Disc herniation
- Spinal/foraminal stenosis
- Cauda equina syndrome
- Spondylolisthesis
- Suspected fracture
Patient prep
- MRI safety screening
- Supine, knees supported for comfort
- Spine array coil
Contrast
None / non-contrast
Technique
- Supine, posterior spine array coil
- Sagittal coverage from conus (T12-L1) through sacrum, including neural foramina laterally
- Axial T1 and T2 angled through each disc space (typically L3-S1, extend if pathology)
- Add contrast if postoperative (scar vs recurrent disc), tumor, or infection
Series / Sequences
| # | Series / Sequence | Plane | Weighting / Recon | Thickness | Notes |
|---|---|---|---|---|---|
| 1 | Sag T1 | sagittal | T1 | 3-4 mm | Marrow, foramina |
| 2 | Sag T2 | sagittal | T2 | 3-4 mm | Discs, canal, CSF |
| 3 | Sag STIR | sagittal | STIR | 3-4 mm | Marrow edema, fracture, infection |
| 4 | Ax T2 | axial | T2 | 3-4 mm | Angled through disc levels |
| 5 | Ax T1 | axial | T1 | 3-4 mm | Foraminal fat, nerve roots |
Key points
- Identify the lowest disc and count up; note transitional/lumbosacral anatomy.
- STIR adds sensitivity for edema/fracture/infection (Modic changes, discitis).
- Cauda equina syndrome is an emergency—evaluate canal at all levels.
- If prior surgery, perform with-and-without contrast to differentiate scar from recurrent disc.
References
• ACR-ASNR-ASSR Practice Parameter for MRI of the Adult Spine
• Radiopaedia: Lumbar spine MRI protocol link
• ACR Appropriateness Criteria: Low Back Pain
• Radiopaedia: Lumbar spine MRI protocol link
• ACR Appropriateness Criteria: Low Back Pain
Source: Researched — verify against your institution
Reference template — verify and adapt to your scanner, vendor and institution before clinical use. Not a substitute for clinical judgment.