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 'Multi Angle Oblique' 
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Multi Angle Oblique
 
The multi angle oblique technique gives the ability to display anatomical structures in a variety of planes from the data acquired in just one MRI scan. This technique is useful, for example in lumbar spine MRI obtaining images of each intervertebral disc, individually oriented at a different angle, to better recognize herniation or to compare degenerative changes.
This technique is more difficult in the cervical spine MRI region because of the small vertebra and therefore a short distance between the multi angle oblique planes. In case of too short distance or overlapping slices the crosstalk (artifact) destroys the signal with reduced image quality.
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Spine MRIMRI Resource Directory:
 - Spine MRI -
 
Magnetic resonance imaging (MRI) of the spine is a noninvasive procedure to evaluate different types of tissue, including the spinal cord, vertebral disks and spaces between the vertebrae through which the nerves travel, as well as distinguish healthy tissue from diseased tissue.
The cervical, thoracic and lumbar spine MRI should be scanned in individual sections. The scan protocol parameter like e.g. the field of view (FOV), slice thickness and matrix are usually different for cervical, thoracic and lumbar spine MRI, but the method is similar. The standard views in the basic spinal MRI scan to create detailed slices (cross sections) are sagittal T1 weighted and T2 weighted images over the whole body part, and transverse (e.g. multi angle oblique) over the region of interest with different pulse sequences according to the result of the sagittal slices. Additional views or different types of pulse sequences like fat suppression, fluid attenuation inversion recovery (FLAIR) or diffusion weighted imaging are created dependent on the indication.
Indications:
Neurological deficit, evidence of radiculopathy, cauda equina compression
Primary tumors or drop metastases
Infection/inflammatory disease, multiple sclerosis
Postoperative evaluation of lumbar spine: disk vs. scar
Evaluation of syrinx
Localized back pain with no radiculopathy (leg pain)

Contrast enhanced MRI techniques delineate infections vs. malignancies, show a syrinx cavity and support to differentiate the postoperative conditions. After surgery for disk disease, significant fibrosis can occur in the spine. This scarring can mimic residual disk herniation. Magnetic resonance myelography evaluates spinal stenosis and various intervertebral discs can be imaged with multi angle oblique techniques. Cine series can be used to show true range of motion studies of parts of the spine. Advanced open MRI devices are developed to perform positional scans in the position of pain or symptom (e.g. Upright™ MRI formerly Stand-Up MRI).
 
Images, Movies, Sliders:
 Anatomic Imaging of the Lumbar Spine  Open this link in a new window
      

Courtesy of  Robert R. Edelman

 
Radiology-tip.comBone Densitometry,  Myelography
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• View the DATABASE results for 'Spine MRI' (11).Open this link in a new window


• View the NEWS results for 'Spine MRI' (4).Open this link in a new window.
 
Further Reading:
  Basics:
Newer Sequences for Spinal MR Imaging: Smorgasbord or Succotash of Acronyms?
   by www.ajnr.org    
Cutting Edge Imaging of THE Spine
February 2007   by www.pubmedcentral.nih.gov    
Landmark Independent Study by UCLA School of Medicine Reports Comparison of Dynamic™ Upright® MRI With Static Upright MRI in More Than 1,000 Patients (1,302):
Thursday, 15 November 2007   by www.fonar.com    
  News & More:
Discriminating imaging findings of acute osteoporotic vertebral fracture: a prospective multicenter cohort study
Thursday, 9 October 2014   by 7thspace.com    
Lumbar spine MRI limited in diagnosing ankylosing spondylitis
Friday, 7 March 2014   by www.healio.com    
MRI Of The Spine Identifies Smoldering Myeloma Patients At High Risk Of Progressing To Multiple Myeloma
Tuesday, 26 August 2014   by www.myelomabeacon.com    
Intensive training of young tennis players causes spinal damage
Wednesday, 18 July 2007   by www.eurekalert.org    
Imaging Technique for Spinal Cord Injury Shows Promise
Sunday, 22 December 2013   by www.wauwatosanow.com    
MRI Resources 
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Lumbar Spine MRI
 
MRI of the lumbar spine, with its multiplanar 3 dimensional imaging capability, is currently the preferred modality for establishing a diagnosis. MRI scans and magnetic resonance myelography have many advantages compared with computed tomography and/or X-ray myelography in evaluating the lumbar spine. MR imaging scans large areas of the spine without ionizing radiation, is noninvasive, not affected by bone artifacts, provides vascular imaging capability, and makes use of safer contrast agents (gadolinium chelate).
Due to the high level of tissue contrast resolution, nerves and discs are clearly visible. MRI is excellent for detecting degenerative disease in the spine. Lumbar spine MRI accurately shows disc disease (prolapsed disc or slipped disc), the level at which disc disease occurs, and if a disc is compressing spinal nerves. Lumbar spine MRI depicts soft tissues, including the cauda equina, spinal cord, ligaments, epidural fat, subarachnoid space, and intervertebral discs. Loss of epidural fat on T1 weighted images, loss of cerebrospinal fluid signal around the dural sac on T2 weighted images and degenerative disc disease are common features of lumbar stenosis.

Common indications for MRI of the lumbar spine:
Neurologic deficits, evidence of radiculopathy, acute spinal cord compression (e.g., sudden bowel/bladder disturbance)
Suspected systemic disorders (primary tumors, drop metastases, osteomyelitis)
Postoperative evaluation of lumbar spine: disk vs. scar
Localized back pain with no radiculopathy (leg pain)
Lumbar spine imaging requires a special spine coil. often used whole spine array coils have the advantage that patients do not need other positioning if also upper parts of the spine should be scanned. Sagittal T1 and T2 weighted FSE sequences are the standard views. With multi angle oblique techniques individually oriented transverse images of each intervertebral disc at different angles can be obtained.

See also the related poll result: 'MRI will have replaced 50% of x-ray exams by'
 
Images, Movies, Sliders:
 Anatomic Imaging of the Lumbar Spine  Open this link in a new window
      

Courtesy of  Robert R. Edelman

 
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• View the DATABASE results for 'Lumbar Spine MRI' (6).Open this link in a new window

 
Further Reading:
  Basics:
Lumbar Spine Stenosis: A Common Cause of Back and Leg Pain
   by www.aafp.org    
MRI Findings Linked to Effect of Lumbar Spine Surgery
Wednesday, 26 June 2013   by www.doctorslounge.com    
Spine imaging after lumbar disc replacement: pitfalls and current recommendations
Tuesday, 21 July 2009   by 7thspace.com    
  News & More:
Inappropriate Ordering of Lumbar Spine Magnetic Resonance Imaging: Are Providers Choosing Wisely? -
Tuesday, 2 February 2016   by www.ajmc.com    
Lumbar spine MRI limited in diagnosing ankylosing spondylitis
Friday, 7 March 2014   by www.healio.com    
How Weight-Bearing MRIs Can Improve Care & Lower Costs While Meeting Milliman Criteria
Friday, 4 October 2013   by www.beckersspine.com    
Lumbar Diskal Cyst Containing Intervertebral Disk Materials
Tuesday, 1 November 2011   by www.orthosupersite.com    
A Study of the Morphology of Lumbar Discs in Sitting and Standing Positions Using a 0.5T Open- Configuration MRI(.pdf)
2001   by cds.ismrm.org    
MRI Resources 
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Slice Overlap ArtifactInfoSheet: - Artifacts - 
Case Studies, 
Reduction Index, 
etc.MRI Resource Directory:
 - Artifacts -
 
Quick Overview
Artifact Information
NAME Slice overlap
DESCRIPTION Loss of signal
REASON Saturation
HELP Overlapping prevention

The slice overlap artifact is another name for crosstalk artifact. If slices of multislice acquisitions are overlapping, the spinning nuclei belonging to more than one slice getting multiple times saturated, which leads to signal loss in this areas.


Image Guidance
This problem occurs often in cervical or lumbar spine MRI, when scanning each disc with multi angle oblique technique. If prevention of overlapping is not possible, try to position the saturated region posterior to the spinal canal, outside the region of interest.
See also Crosstalk (Crosstalk), and Multiple Slice Imaging.
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Further Reading:
  Basics:
Artifacts in MRI
Saturday, 1 October 2011   by www.huc.min-saude.pt    
Slice-overlap Artifacts
   by www.mritutor.org    
MRI Resources 
NMR - Patient Information - Fluorescence - Mobile MRI - Intraoperative MRI - Liver Imaging
 
MAGNETOM C™InfoSheet: - Devices -
Intro, 
Types of Magnets, 
Overview, 
etc.MRI Resource Directory:
 - Devices -
 
From Siemens Medical Systems;
www.medical.siemens.com A new, powerful, compact player in MRI. For both, patients and health care professionals, the mid-field has realized a giant step to cost efficient quality care. Obese patients and people with claustrophobia appreciate the comfortable side loading. The smallest pole diameter - 137 cm (54 inches) allows for optimal patient comfort.

Device Information and Specification
CLINICAL APPLICATION Whole body
CONFIGURATION C-shaped open MRI
SURFACE COILS Multi channel imaging, CP Head//Neck Array Coil, Body/Spine Array Coil, large, Transmit Coil
SYNCHRONIZATION ECG/peripheral: Optional/yes, respiratory gating
PULSE SEQUENCES SE, FLASH, FISP, IR, FIR, STIR, TrueIR/FISP, FSE, MT, SS-FSE, MT-SE, MTC, MSE, EPI, PSIF,
IMAGING MODES Single, multislice, volume study, multi angle, multi oblique
TR Min. TR 2.81 ms
TE Min. TE 0.98 ms
DISPLAY MATRIX 512 x 512 full screen display
MEASURING MATRIX 64 x 64 to 512 x 512
FOV 0.5 - 40 cm
MAGNET TYPE Permanent
BORE DIAMETER
or W x H
41 cm vertical gap distance
MAGNET WEIGHT 16000 kg
H*W*D 233 x 206 x 160 cm
FIELD STRENGTH 0.35 T
STRENGTH 24 mT/m
5-GAUSS FRINGE FIELD 2.2 m / 2.2 m
SHIMMING Passive and active
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• View the DATABASE results for 'MAGNETOM C™' (2).Open this link in a new window

 
Further Reading:
  Basics:
Section 2: 510(k) Summary, MAGNETOM C! System Classification Name: Magnetic Resonance Diagnostic(.pdf)
   by www.accessdata.fda.gov    
MRI Resources 
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