RadteraMRI Total Spine (Cervical/Thoracic/Lumbar) With and Without Contrast
MR+ ContrastSpine
Indications
- Metastatic disease survey / cord compression
- Multiple myeloma
- Suspected drop metastases / leptomeningeal disease
- Multifocal demyelination (NMO/MS)
- Infection survey
- Polytrauma
Patient prep
- MRI safety screening
- IV access for contrast
- Spine array coil; may require coil repositioning/large coverage
Contrast
Agentgadolinium-based
RouteIV
Dose0.1 mmol/kg
TimingPost-contrast T1 of all three regions when indicated (tumor/infection/leptomeningeal)
Technique
- Sagittal survey of entire spine in 2-3 stations (cervicothoracic, thoracolumbar) stitched together
- Sagittal T1, T2, STIR throughout for marrow/cord survey
- Axials targeted to areas of abnormality
- Post-contrast sagittal/axial T1 for enhancing lesions and leptomeningeal disease
Series / Sequences
| # | Series / Sequence | Plane | Weighting / Recon | Thickness | Notes |
|---|---|---|---|---|---|
| 1 | Sag T1 (whole spine) | sagittal | T1 | 3-4 mm | 2-3 stations |
| 2 | Sag T2 (whole spine) | sagittal | T2 | 3-4 mm | |
| 3 | Sag STIR (whole spine) | sagittal | STIR | 3-4 mm | Marrow/cord edema, mets |
| 4 | Ax T2 targeted | axial | T2 | 3-4 mm | Through lesions/compression |
| 5 | Sag T1 post | sagittal | T1 +C | 3-4 mm | Tumor/leptomeningeal |
| 6 | Ax T1 post targeted | axial | T1 +C | 3-4 mm |
Key points
- Used to survey the full neuraxis; ensure no gaps between stations.
- STIR is the workhorse for marrow metastatic survey.
- Add contrast and post-contrast FLAIR/T1 for leptomeningeal/drop metastases (e.g., medulloblastoma, ependymoma).
- Flag any cord compression urgently.
References
• ACR–ASNR–SABI–SSR Practice Parameter for the Performance of Magnetic Resonance Imaging (MRI) of the Adult Spine (Revised 2023) link
• Radiopaedia: Cervical spine protocol (MRI) Thoracic spine protocol (MRI) https://radiopaedia.org/articles/thoracic-spine-protocol-mri; Lumbar spine protocol (MRI) https://radiopaedia.org/articles/lumbar-spine-protocol-mri link
• ACR Appropriateness Criteria® on Metastatic Bone Disease (JACR 2010) link
• Radiopaedia: Cervical spine protocol (MRI) Thoracic spine protocol (MRI) https://radiopaedia.org/articles/thoracic-spine-protocol-mri; Lumbar spine protocol (MRI) https://radiopaedia.org/articles/lumbar-spine-protocol-mri link
• ACR Appropriateness Criteria® on Metastatic Bone Disease (JACR 2010) link
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.