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MRI > Week 9: Neck and Back > Flashcards

Week 9: Neck and Back Flashcards

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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
The sagittal T1 protocol of an MRI soft tissue neck views sagittal midline structures, like what?
1. Nasopharynx 2. Oropharynx
26
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?
1. Pharynx 2. Thyroid. 3. Parathyroid. 4. Salivary glands. 5. Abnormal masses.
27
The axial T2 protocol of an MRI soft tissue neck gives cross-sectional views to evaluate any _________ signals.
Abnormal
28
What does the axial IR protocol of an MRI soft tissue neck evaluate for?
Abnormal fluid patterns, like edema and infection
29
The coronal T1, pre-and post-contrast protocols of an MRI soft tissue neck obtains contrast-enhanced, frontal views of what 3 anatomical structures?
1. Thyroid. 2. Epiglottis. 3. Abnormal masses.
30
What sequence options are utilized during an MRI soft tissue neck?
1. Flow compensation. 2. Inferior saturation band.
31
What sequence options are utilized during any MRIs of the spine or sacrum?
1. Flow compensation. 2. Saturation band, location depending on phase direction.
32
What are the 8 protocols of an MRI cervical spine?
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.
33
What do the sagittal T2 protocols of spinal MRIs check for?
Anterior/posterior disc herniations
34
What are five pathologies that can be evaluated on the sagittal IR protocol of an MRI cervical spine?
1. Spinal cord abnormalities. 2. Syrinx 3. Pars defect. 4. Vertebral fractures. 5. Muscle tears.
35
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?
1. Facet arthritis. 2. Abnormal masses.
36
The axial T2, low protocol of an MRI cervical spine visualizes what vertebrae?
T1 - C4
37
The axial T2 protocols of spinal MRIs include cross-sectional views of the __________ and _________________.
Spinal cord and vertebral discs
38
The axial T2 protocols of spinal MRIs evaluate what two types of herniations?
1. Central herniations. 2. Paracentral herniations.
39
The axial T2, up protocol of an MRI cervical spine visualizes what vertebrae?
C4 - Clivus
40
The axial merge protocol of an MRI cervical spine uses a ________ to visualize differences between ____________ and the _________ ____
Gradient; herniations in the vertebral body
41
The coronal PD protocol of an MRI cervical spine is an additional view used for patients with __________ or _________________ in their neck.
Rheumatoid arthritis or limited rotation
42
How many vertebrae are found in the cervical spine?
7
43
C1 is also known as what?
Atlas
44
Axis is an alternative name given to what vertebrae?
C2
45
What does the thecal sac encompass?
The spinal cord and cerebrospinal fluid
46
What two functions should a patient stay aware of during an MRI cervical spine?
1. Swallowing 2. Coughing.
47
What are five clinical concerns for an MRI cervical spine?
1. Cervical herniated nucleus pulposus (CHNP) 2. Syrinx 3. Jefferson fracture. 4. Hangman fracture. 5. Clay shovelers fracture.
48
What is a herniated nucleus pulposus?
When a vertebral disc bulges through a tear in the annulus
49
What symptoms can a CHNP cause?
Neck pain and shoulder/arm radicular symptoms
50
A fluid filled cavity or cyst located at the spinal cord is known as what?
Syrinx
51
Where are Jefferson fractures?
C1 lateral masses
52
Jefferson fractures are typically caused by what?
Diving headfirst into shallow water
53
What is the name of bilateral pedicle and lamina C2 fractures?
Hangman fracture
54
What typically causes a hangman’s fracture in modern day?
High velocity hyperextension during an MVA
55
Clay shovelers fracture is a ______ spinous process fracture, typically caused by sudden __________.
C7; muscle contractions
56
What landmark is used for MRIs of the thoracic spine?
The level of T4
57
What receiver coil is used during an MRI thoracic spine?
CTL spine coil
58
What are the eight protocols of an MRI thoracic spine?
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
What does the sagittal IR protocol of an MRI thoracic spine check for?
Compression fractures, common in elderly females
60
The axial T2, low protocol of an MRI thoracic spine what vertebrae?
Mid L1 - mid T7
61
The axial T2 mid protocol of an MRI thoracic spine includes what vertebra?
Mid T7 - mid T3
62
The axial T2 up protocol of an MRI thoracic spine include what vertebrae?
Mid T3 - C6
63
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?
False; the C section is used during the axial T2 up protocol
64
What is the coronal T2 protocol of an MRI T- and L-spine used for?
To measure the severity of scoliosis, common in pediatric and geriatric patients.
65
What is the conus medullaris?
The distal, bulb-like portion of the spinal cord
66
The conus medullaris tapers into a collection of neural roots, known as ______________.
Cauda equina
67
At what level does the conus medullaris turn into the cauda equina?
T12 - L1
68
What are six clinical concerns for an MRI thoracic spine?
1. Scoliosis. 2. Thoracic herniated nucleus pulposus 3. Kyphoplasty 4. Compression fracture confirmation. 5. Pott disease 6. Scheuermann disease
69
What is a kyphoplasty?
A surgical procedure that injects cement to fill space within a compression fracture.
70
Pot disease is a rare condition where __________ is found in musculoskeletal structures, commonly the thoracic spine.
Tuberculosis
71
THIS rare condition presents as juvenile kyphosis of the t-spine and/or lordosis of the l-spine.
Scheuermann Disease
72
When positioning for an MRI lumbar spine, the patient must be supine, but may enter the bore either ______ or _______ first.
Head or feet first
73
What landmark should be used when positioning for MRIs of the lumbar or sacral spine?
2 inches above the iliac crest
74
The CTL receiver coil is commonly used for MRIs of the lumbar spine. What other receiver coil could be used?
HNS (head, neck, and spine) coil
75
In regards to hearing protection for patients undergoing an MRI lumbar or sacral spine, earplugs or headphones are permitted. True or false?
True
76
What are the eight protocols for an MRI lumbar spine?
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
What two pathologies can be found on the sagittal IR protocol of an MRI lumbar spine?
1. Compression fractures. 2. Pars interarticularis.
78
What vertebrae is included in the axial T2 low protocol of an MRI lumbar spine?
S1 - L4
79
What vertebrae is included in the axial T2 up protocol of an MRI lumbar spine?
L4 - T12
80
What vertebrae are included in the axial T2 L5-S1 protocol of an MRI lumbar spine?
S2 - L5
81
What are seven clinical concerns for an MRI lumbar spine?
1. Pars interarticularis injury 2. Lumbar herniated nucleus pulposus 3. Lumbar stenosis. 4. Lumbar facet cysts. 5. Scoliosis. 6. Spondylolisthesis 7. Spondylosis.
82
A pars interarticularis injury is a fracture of the pars isthmus due to __________ _____________ of the low back.
Excessive hyperextension
83
A pars interarticularis injury is common in badminton and tennis players. True or false?
False; swimmers and baseball players
84
An abnormal narrowing of the lumbar spinal canal, which causes radicular symptoms, is known as what?
Lumbar stenosis
85
Where are lumbar facet cysts found and what can they cause?
The neural foramen; impingement of a nerve root
86
What is spondylolithesis?
The forward displacement of L5, due to facet fracture or dislocation
87
What is spondylosis?
Osteoarthritis within facet joints
88
What receiver coil should be used during a Sacral MRI?
8 channel cardiac phase coil
89
How should the patient be supported during a sacral MRI?
Relaxed with feet supported to point straight up
90
What are the four protocols of a sacral MRI?
1. Axial PD body. 2. Coronal IR body. 3. Coronal – Oblique IR. 4. Coronal - Oblique PD.
91
The axial PD body protocol of a sacral MRI obtains what?
Cross-sectional views of the entire pelvis
92
The coronal IR body protocol of a sacral MRI checks for what two pathologies?
1. Edema within cortical bone 2. Muscle tears.
93
The coronal-oblique IR protocol of a sacral MRI obtains an angulated view to check for what 3 pathologies?
1. Edema 2. Insufficiency fractures. 3. Sacroilitis.
94
What three pathologies does the coronal-oblique PD protocol of a sacral MRI evaluate?
1. Osteoarthritis. 2. Rheumatoid arthritis. 3. Sacral fracture confirmation.
95
What is the name of the angulated view of the sacrum in-plane and involves a 15° tilt on a sagittal image?
Shovel shot
96
What are four clinical concerns for a sacral MRI?
1. Insufficiency fracture. 2. Sacroiliitis. 3. Osteoarthritis of the sacroiliac joints. 4. Coccyx fracture.
97
What is an insufficiency fracture?
A fracture caused by stress on weak bones, common in patients with osteoporosis
98
THIS includes inflammation of the sacrum, which causes low back pain. This disease is common in patients with rheumatoid arthritis.
Sacroiliitis

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