"Inflammatory Spine / Centocor Spine (Ankylosing Spondylitis) MRI Protocol"
(coverage cerebellum to entire sacrum)
- T1 – 3 Plane Loc (Upper and Lower full spine loc)
- Sag FSE T1 – upper and lower
- Sag FSE-IR – upper and lower
- Cor Obl FSE-IR (sacrum)
- Cor Obl T1 (sacrum)
- Axial T2 fat sat respective to the lesion
Post Contrast
- T1 Fat Sat (plane according to the lesion)
- T1 Sag assessment of chronic spinal lesions, such as erosions and syndesmophytes
- STIR sag technique is able to visualize acute spinal lesions by depiction of bone marrow oedema caused by inflammation and hypervascularization
- T1 post gad with fat saturation after application of gadolinium- allows for assessment of acute spinal lesions by depicting enhancement of Gd-DTPA as a sign of hypervascularization due to spinal inflammation
- Oedematous lesions can be optimized by removing the surrounding high signal of fat, either by suppression [Short Tau Inversion Recovery sequences (STIR)] or by saturation (application of an additional pulse to saturate the protons of fat), which can be applied to T2W or T1W sequences post-gadolinium.
Inflammatory posterior element lesions on STIR MRI sequences in axial-SpA. (A) Posterior element/costovertebral T12 (arrow) lesion. (B) Superior facet lesion of T6 (arrowhead) and grade 1 endplate lesion (arrow) inferior endplate T3.
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