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