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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

 
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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:
Recommendations for MRI Assessment in Managing Axial Spondyloarthritis
Wednesday, 8 January 2020   by www.rheumatologyadvisor.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    
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    
Spine imaging after lumbar disc replacement: pitfalls and current recommendations
Tuesday, 21 July 2009   by 7thspace.com    
  News & More:
Impact of patient-reported symptom information on lumbar spine MRI Interpretation
Monday, 25 January 2021   by www.eurekalert.org    
Lumbar spine MRI reports are too difficult for patients to understand
Friday, 29 March 2019   by www.eurekalert.org    
Inappropriate Ordering of Lumbar Spine Magnetic Resonance Imaging: Are Providers Choosing Wisely? -
Tuesday, 2 February 2016   by www.ajmc.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
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.
mri safety guidance
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:
Slice-overlap Artifacts
   by www.mritutor.org    
MRI Resources 
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MAGNETOM™InfoSheet: - Devices -
Intro, 
Types of Magnets, 
Overview, 
etc.MRI Resource Directory:
 - Devices -
 
www.medical.siemens.com From Siemens Medical Systems;
70 cm + 125 cm + 1.5T and Tim - a combination never seen before in MRI ... MAGNETOM Espree™s unique open bore design can accommodate more types of patients than other 1.5T systems on the market today, in particular the growing population of obese patients. The power of 1.5T combined with Tim technology boosts signal to noise, which is necessary to adequately image obese patients.
Device Information and Specification
CLINICAL APPLICATION
Whole body
CONFIGURATION
Open bore
Body, Tim [32 x 8], Tim [76 coil elements with up to 18 RF channels])
SYNCHRONIZATION
ECG/peripheral: Optional/yes, respiratory gating
PULSE SEQUENCES
GRE, IR, FIR, STIR, TrueIR/FISP, FSE, FLAIR, MT, SS-FSE, MT-SE, MTC, MSE, EPI, 3D DESS//CISS/PSIF, GMR
IMAGING MODES
Single, multislice, volume study, multi angle, multi oblique
SINGLE/MULTI SLICE
Image Processor reconstructing up to 3226 images per second (256 x 256, 25% recFoV)
FOV
35 cm coronal//sagittal, 45 cm axial
Min 2D/3D: 0.1/0.05 mm
1024 x 1024 full screen display
MEASURING MATRIX
64 x 64 to 1024 x 1024
BORE DIAMETER
or W x H
70 cm diameter
MAGNET WEIGHT
3800 kg
H*W*D
? x ? x 125 cm
STRENGTH
33 mT/m
5-GAUSS FRINGE FIELD
2.5 m / 3.8 m
Passive, active
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• View the DATABASE results for 'MAGNETOM Espree™' (2).Open this link in a new window

 
Further Reading:
  News & More:
First 1.5 Tesla Open Bore MRI Introduced
Tuesday, 10 August 2004   by www.hospimedica.com    
Obesity May Influence Imaging Diagnosis
Wednesday, 22 December 2004   by www.hospimedica.com    
MRI Resources 
Quality Advice - Blood Flow Imaging - Examinations - Resources - NMR - Most Wanted
 
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