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mri > Week 9: Neck and Back > Flashcards

Week 9: Neck and Back Flashcards

1
Q

What is the patient position during MRIs of the neck and thoracic spine?

A

Supine, headfirst

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2
Q

What is the patient’s body position during MRIs of the neck and back?

A

With the body’s midsagittal line perpendicular to the alignment light

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3
Q

What landmark is used for positioning for MRIs of the neck?

A

At the level of C4, at the carotid bifurcation

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4
Q

What 2 receiver coils could be used during MRIs of the neck?

A
  1. CTL neck coil
  2. NV coil
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5
Q

When would an NV coil be used over a CTL neck coil?

A

When an MRA COW and an MRA carotids are ordered together, as this coil can be used for both exams.

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6
Q

What kind of support is used for the patient during MRIs of the neck and thoracic spine?

A

Cushions to support the sides of the head and lumbar

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7
Q

What kind of hearing protection are patients given for MRIs of the neck and thoracic spine?

A

Earplugs

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8
Q

What is sequence options are utilized during an MRA carotids?

A
  1. Flow Compensation.
  2. Superior saturation band.
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9
Q

What are the two protocols of an MRA carotids?

A
  1. Axial 2-D TOF SPGR
  2. Axial 3-D TOF SPGR
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10
Q

How are slices plotted during the axial 2-D ToF SPGR protocol of an MRA carotid?

A

Slices are plotted inferior to superior; Starting at the aortic arch and ending just passed the Foramen Magnum

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11
Q

If we recall week eight and the ideal use for 2-D and 3-D imaging, why does the MRA carotid study include both 2-D and 3-D axial TOF SPGE protocols?

A

Because it covers a long area (from the aorta all the way up to the brain) AND is also highly vascular and detailed.

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12
Q

During the axial 3-D time of flight, spoiled gradient echo protocol of an MRA carotids, the technologist plots a 3-D slab to cover what?

A

Both the left and right bifurcations of the internal/external carotid arteries

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13
Q

What are the three arterial branches that originate from the aortic arch?

A
  1. Brachiocephalic.
  2. Left common carotid.
  3. Left subclavian.
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14
Q

The common carotid arteries bifurcate into what and at what level?

A

The internal and external carotids; at the level of C4

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15
Q

To where does the internal carotid artery supply oxygenated blood?

A

To the brain

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16
Q

To where does the external carotid artery supply oxygenated blood?

A

To the superficial structures of the face and head

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17
Q

To where, and via what, do the right and left vertebral arteries supply oxygenated blood?

A

To the posterior vertebral region and the COW region; via the basilar artery

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18
Q

What are four clinical concerns for an MRA carotid?

A
  1. Aneurysms.
  2. Transient ischemic attack.
  3. Stenotic disease.
  4. Dissection.
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19
Q

Describe an aneurysm.

A

The formation of a bulb-like protrusion in an artery due to weak arterial walls

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20
Q

TIAs are extensive, time consuming attacks. True or false?

A

False; TIAs are brief, stroke-like attacks that resolve quickly

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21
Q

When would a transient ischemic attack occur and what would it include?

A

Occurs when blood flow in the carotids or COW is briefly obstructed; includes unilateral body weakness, vision issues, and slurred speech

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22
Q

The narrowing of space within an artery or vein that limits the flow of blood is known as what?

A

Stenotic Disease

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23
Q

Dissection is when ________ walls split internally, causing blood blockages.

A

Arterial

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24
Q

What are the 7 protocols of an MRI soft tissue neck?

A
  1. Sagittal T1.
  2. Axial T2
  3. Axial IR.
  4. Axial T1, pre-contrast.
  5. Coral T1, pre-contrast.
  6. Axial T1, post contrast.
  7. Coronal T1, post contrast.
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25
Q

The sagittal T1 protocol of an MRI soft tissue neck views sagittal midline structures, like what?

A
  1. Nasopharynx
  2. Oropharynx
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26
Q

The axial T1, pre-and post-contrast protocols of an MRI soft tissue neck obtains contrast-enhanced, cross-sectional views of what five anatomical structures?

A
  1. Pharynx
  2. Thyroid.
  3. Parathyroid.
  4. Salivary glands.
  5. Abnormal masses.
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27
Q

The axial T2 protocol of an MRI soft tissue neck gives cross-sectional views to evaluate any _________ signals.

A

Abnormal

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28
Q

What does the axial IR protocol of an MRI soft tissue neck evaluate for?

A

Abnormal fluid patterns, like edema and infection

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29
Q

The coronal T1, pre-and post-contrast protocols of an MRI soft tissue neck obtains contrast-enhanced, frontal views of what 3 anatomical structures?

A
  1. Thyroid.
  2. Epiglottis.
  3. Abnormal masses.
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30
Q

What sequence options are utilized during an MRI soft tissue neck?

A
  1. Flow compensation.
  2. Inferior saturation band.
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31
Q

What sequence options are utilized during any MRIs of the spine or sacrum?

A
  1. Flow compensation.
  2. Saturation band, location depending on phase direction.
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32
Q

What are the 8 protocols of an MRI cervical spine?

A
  1. Sagittal T2.
  2. Sagittal T1, pre-contrast.
  3. Sagittal T1, post contrast.
  4. Sagittal IR.
  5. Axial T2 low.
  6. Axial T2 up
  7. Axial merge.
  8. Coronal PD.
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33
Q

What do the sagittal T2 protocols of spinal MRIs check for?

A

Anterior/posterior disc herniations

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34
Q

What are five pathologies that can be evaluated on the sagittal IR protocol of an MRI cervical spine?

A
  1. Spinal cord abnormalities.
  2. Syrinx
  3. Pars defect.
  4. Vertebral fractures.
  5. Muscle tears.
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35
Q

The wash-in/wash-out effect of gadolinium during the sagittal T1, pre- and post-contrast protocols of spinal MRIs help to evaluate what 2 pathologies?

A
  1. Facet arthritis.
  2. Abnormal masses.
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36
Q

The axial T2, low protocol of an MRI cervical spine visualizes what vertebrae?

A

T1 - C4

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37
Q

The axial T2 protocols of spinal MRIs include cross-sectional views of the __________ and _________________.

A

Spinal cord and vertebral discs

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38
Q

The axial T2 protocols of spinal MRIs evaluate what two types of herniations?

A
  1. Central herniations.
  2. Paracentral herniations.
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39
Q

The axial T2, up protocol of an MRI cervical spine visualizes what vertebrae?

A

C4 - Clivus

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40
Q

The axial merge protocol of an MRI cervical spine uses a ________ to visualize differences between ____________ and the _________ ____

A

Gradient; herniations in the vertebral body

41
Q

The coronal PD protocol of an MRI cervical spine is an additional view used for patients with __________ or _________________ in their neck.

A

Rheumatoid arthritis or limited rotation

42
Q

How many vertebrae are found in the cervical spine?

A

7

43
Q

C1 is also known as what?

A

Atlas

44
Q

Axis is an alternative name given to what vertebrae?

A

C2

45
Q

What does the thecal sac encompass?

A

The spinal cord and cerebrospinal fluid

46
Q

What two functions should a patient stay aware of during an MRI cervical spine?

A
  1. Swallowing
  2. Coughing.
47
Q

What are five clinical concerns for an MRI cervical spine?

A
  1. Cervical herniated nucleus pulposus (CHNP)
  2. Syrinx
  3. Jefferson fracture.
  4. Hangman fracture.
  5. Clay shovelers fracture.
48
Q

What is a herniated nucleus pulposus?

A

When a vertebral disc bulges through a tear in the annulus

49
Q

What symptoms can a CHNP cause?

A

Neck pain and shoulder/arm radicular symptoms

50
Q

A fluid filled cavity or cyst located at the spinal cord is known as what?

A

Syrinx

51
Q

Where are Jefferson fractures?

A

C1 lateral masses

52
Q

Jefferson fractures are typically caused by what?

A

Diving headfirst into shallow water

53
Q

What is the name of bilateral pedicle and lamina C2 fractures?

A

Hangman fracture

54
Q

What typically causes a hangman’s fracture in modern day?

A

High velocity hyperextension during an MVA

55
Q

Clay shovelers fracture is a ______ spinous process fracture, typically caused by sudden __________.

A

C7; muscle contractions

56
Q

What landmark is used for MRIs of the thoracic spine?

A

The level of T4

57
Q

What receiver coil is used during an MRI thoracic spine?

A

CTL spine coil

58
Q

What are the eight protocols of an MRI thoracic spine?

A
  1. Sagittal T2.
  2. Sagittal T1, pre-contrast.
  3. Sagittal T1, post contrast.
  4. Sagittal IR.
  5. Axial T2 low
  6. Axial T2 mid
  7. Axial T2 up
  8. Coronal T2
59
Q

What does the sagittal IR protocol of an MRI thoracic spine check for?

A

Compression fractures, common in elderly females

60
Q

The axial T2, low protocol of an MRI thoracic spine what vertebrae?

A

Mid L1 - mid T7

61
Q

The axial T2 mid protocol of an MRI thoracic spine includes what vertebra?

A

Mid T7 - mid T3

62
Q

The axial T2 up protocol of an MRI thoracic spine include what vertebrae?

A

Mid T3 - C6

63
Q

As discussed, thoracic spine MRIs use the CTL receiver coil. Every protocol for the thoracic spine uses the T section of this coil. True or false?

A

False; the C section is used during the axial T2 up protocol

64
Q

What is the coronal T2 protocol of an MRI T- and L-spine used for?

A

To measure the severity of scoliosis, common in pediatric and geriatric patients.

65
Q

What is the conus medullaris?

A

The distal, bulb-like portion of the spinal cord

66
Q

The conus medullaris tapers into a collection of neural roots, known as ______________.

A

Cauda equina

67
Q

At what level does the conus medullaris turn into the cauda equina?

A

T12 - L1

68
Q

What are six clinical concerns for an MRI thoracic spine?

A
  1. Scoliosis.
  2. Thoracic herniated nucleus pulposus
  3. Kyphoplasty
  4. Compression fracture confirmation.
  5. Pott disease
  6. Scheuermann disease
69
Q

What is a kyphoplasty?

A

A surgical procedure that injects cement to fill space within a compression fracture.

70
Q

Pot disease is a rare condition where __________ is found in musculoskeletal structures, commonly the thoracic spine.

A

Tuberculosis

71
Q

THIS rare condition presents as juvenile kyphosis of the t-spine and/or lordosis of the l-spine.

A

Scheuermann Disease

72
Q

When positioning for an MRI lumbar spine, the patient must be supine, but may enter the bore either ______ or _______ first.

A

Head or feet first

73
Q

What landmark should be used when positioning for MRIs of the lumbar or sacral spine?

A

2 inches above the iliac crest

74
Q

The CTL receiver coil is commonly used for MRIs of the lumbar spine. What other receiver coil could be used?

A

HNS (head, neck, and spine) coil

75
Q

In regards to hearing protection for patients undergoing an MRI lumbar or sacral spine, earplugs or headphones are permitted. True or false?

A

True

76
Q

What are the eight protocols for an MRI lumbar spine?

A
  1. Sagittal T2.
  2. Sagittal T1, pre-contrast.
  3. Sagittal T1, post contrast.
  4. Sagittal IR.
  5. Axial T2 low.
  6. Axial T2 up.
  7. Axial T2, L5-S1.
  8. Coronal T2
77
Q

What two pathologies can be found on the sagittal IR protocol of an MRI lumbar spine?

A
  1. Compression fractures.
  2. Pars interarticularis.
78
Q

What vertebrae is included in the axial T2 low protocol of an MRI lumbar spine?

A

S1 - L4

79
Q

What vertebrae is included in the axial T2 up protocol of an MRI lumbar spine?

A

L4 - T12

80
Q

What vertebrae are included in the axial T2 L5-S1 protocol of an MRI lumbar spine?

A

S2 - L5

81
Q

What are seven clinical concerns for an MRI lumbar spine?

A
  1. Pars interarticularis injury
  2. Lumbar herniated nucleus pulposus
  3. Lumbar stenosis.
  4. Lumbar facet cysts.
  5. Scoliosis.
  6. Spondylolisthesis
  7. Spondylosis.
82
Q

A pars interarticularis injury is a fracture of the pars isthmus due to __________ _____________ of the low back.

A

Excessive hyperextension

83
Q

A pars interarticularis injury is common in badminton and tennis players. True or false?

A

False; swimmers and baseball players

84
Q

An abnormal narrowing of the lumbar spinal canal, which causes radicular symptoms, is known as what?

A

Lumbar stenosis

85
Q

Where are lumbar facet cysts found and what can they cause?

A

The neural foramen; impingement of a nerve root

86
Q

What is spondylolithesis?

A

The forward displacement of L5, due to facet fracture or dislocation

87
Q

What is spondylosis?

A

Osteoarthritis within facet joints

88
Q

What receiver coil should be used during a Sacral MRI?

A

8 channel cardiac phase coil

89
Q

How should the patient be supported during a sacral MRI?

A

Relaxed with feet supported to point straight up

90
Q

What are the four protocols of a sacral MRI?

A
  1. Axial PD body.
  2. Coronal IR body.
  3. Coronal – Oblique IR.
  4. Coronal - Oblique PD.
91
Q

The axial PD body protocol of a sacral MRI obtains what?

A

Cross-sectional views of the entire pelvis

92
Q

The coronal IR body protocol of a sacral MRI checks for what two pathologies?

A
  1. Edema within cortical bone
  2. Muscle tears.
93
Q

The coronal-oblique IR protocol of a sacral MRI obtains an angulated view to check for what 3 pathologies?

A
  1. Edema
  2. Insufficiency fractures.
  3. Sacroilitis.
94
Q

What three pathologies does the coronal-oblique PD protocol of a sacral MRI evaluate?

A
  1. Osteoarthritis.
  2. Rheumatoid arthritis.
  3. Sacral fracture confirmation.
95
Q

What is the name of the angulated view of the sacrum in-plane and involves a 15° tilt on a sagittal image?

A

Shovel shot

96
Q

What are four clinical concerns for a sacral MRI?

A
  1. Insufficiency fracture.
  2. Sacroiliitis.
  3. Osteoarthritis of the sacroiliac joints.
  4. Coccyx fracture.
97
Q

What is an insufficiency fracture?

A

A fracture caused by stress on weak bones, common in patients with osteoporosis

98
Q

THIS includes inflammation of the sacrum, which causes low back pain. This disease is common in patients with rheumatoid arthritis.

A

Sacroiliitis

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