RadteraMRI Thoracic Spine Without Contrast
MRNo contrastSpine
Indications
- Thoracic back pain
- Myelopathy / cord compression
- Suspected metastasis or compression fracture
- Disc herniation
- Suspected demyelination / transverse myelitis (add contrast)
Patient prep
- MRI safety screening
- Supine in spine array coil
- Vitamin E/skin marker may be used to localize level of clinical concern
Contrast
None / non-contrast
Technique
- Supine, head/feet-first, posterior spine array
- Count levels from C2 or sacrum; place a skin marker at point of pain if focal
- Sagittal coverage cervicothoracic junction through conus/upper lumbar
- Axials through levels of interest; add contrast for tumor/infection/myelitis
Series / Sequences
| # | Series / Sequence | Plane | Weighting / Recon | Thickness | Notes |
|---|---|---|---|---|---|
| 1 | Sag T1 | sagittal | T1 | 3-4 mm | Marrow replacement, fractures |
| 2 | Sag T2 | sagittal | T2 | 3-4 mm | Cord, discs, CSF |
| 3 | Sag STIR | sagittal | STIR | 3-4 mm | Marrow/cord edema, mets, acute fracture |
| 4 | Ax T2 | axial | T2 | 4 mm | Through levels of interest |
| 5 | Ax T1 (optional) | axial | T1 | 4 mm |
Key points
- Use a skin marker—level counting in the thoracic spine is error-prone.
- STIR highly sensitive for metastatic marrow disease and acute compression fracture.
- Add contrast for cord lesion, tumor, infection (discitis/osteomyelitis), or myelitis.
- Assess for cord compression and cord signal abnormality.
References
• ACR-ASNR-ASSR Practice Parameter for MRI of the Adult Spine
• Radiopaedia: Thoracic spine MRI protocol
• ACR Appropriateness Criteria: Myelopathy
• Radiopaedia: Thoracic spine MRI protocol
• ACR Appropriateness Criteria: Myelopathy
Source: Researched — verify against your institution
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Reference template — verify and adapt to your scanner, vendor and institution before clinical use. Not a substitute for clinical judgment.