MR Pediatric Total Spine WWO - Double Jump

IMPORTANT — Pediatric total spine postcontrast images must be zero gap (0mm spacing)

Protocol Description

Version (Last Updated):

2025-05-08

Scanner Preference:

DCH7

Coil:

Neurovascular (NV) and Anterior Torso Coils

Indications:

Total spine evaluation when the differential diagnosis includes infectious, inflammatory, neoplastic, vascular, and post-surgical entities.

Field-of-View (FOV):
  • Craniocaudal coverage on sagittal images should extend continuously from mid-clivus to the S4-S5 "disc" level.
  • FOV should not exceed 450mm for any stations on any exam.
  • Should the FOV include the coccyx?
    • If indication is for sacral dimple, tethered cord, syrinx or chiari → FOV should include coccyx
    • For other indications → FOV should end end at S4-S5
  • One jump or two jumps?  Sagittal coverage should extend continuously from mid-clivus to the S4-S5 "disc" level.  
    • If this distance < 450 mm → use single jump for the whole spine
    • If this distance ≥ 450 mm → use two jumps, dividing into equal lengths with ≥10% overlap
Technical Notes:
  • Do not change parameters (including sense factors) to reduce scan time.
  • Should an axial non-contrast T1 of the filum/lumbar spine be included?  This sequence is useful for detecting filar lipomas, closed spinal dysraphisms, and hemorrhage, among others. 
    • If the indication is for tumor, infection, or demyelinating disease → non-contrast axial T1 through the filum is not needed
    • For all other indications → include non-contrast axial T1
  • Do not use ScanAlign/MobiView without sending unprocessed / unfused images
Charge As:

Total Spine WWO

Approval:

Michael Regner, MD, MS

Pulse Sequences

Plane Weighting Mode Slice (mm) Gap (mm) FAT SAT FOV (cm) MPR (mm) Notes
Upper Station - Pre-contrast
SAG T2 3D TSE 1 or less 0 or less no AXIAL 1/0
SAG T2 2D TSE dixon 3 0 Dixon: InPhase & Water only no
SAG T1 FLAIR 2D IR-TSE 3 0 no no
Lower Station - Pre-contrast
SAG T2 3D TSE 1 or less 0 or less no AXIAL 1/0
SAG T2 2D TSE dixon 3 0 Dixon: InPhase & Water only no
SAG T1 FLAIR 2D IR-TSE 3 0 no no
Lumbar only SEE NOTE
AXIAL T1 2D TSE 3 0.3 no 10 no SEE NOTES
HAND INJECT CONTRAST
SAG-upper T1 2D TSE dixon 3 0 Dixon: InPhase & Water only no
SAG-lower T1 2D TSE dixon 3 0 Dixon: InPhase & Water only no
AXIAL T1 VIBE/THRIVE 3 0 YES 15 no Use 3-4 stations to cover whole spine.

Optional Sequences

Diffusion-weighted imaging (DWI)
  • If the indication is infection or cord infarct → consider adding sagittal DWI
  • Use DWI sequences labeled IRIS, TSE XD, or TSE XD STIR