Comprehensive and high-level analysis performed in one MRI examination of the whole spine encompassing the cervical, dorsal, or thoracic spine, lumbar, and sacral spine. As opposed to MRI Whole Spine Screening, which employs fast imaging sequences for an overview of the spine, the MRI Whole Spine Sequence deploys detailed imaging sequences for each section of the spine, enabling the spine's vertebrae, intervertebral discs, spinal cord, nerve roots, spinal canal, foramina, ligaments, and soft tissue around the spine to be more precisely assessed. This examination is often indicated if disease or abnormalities affect more than one area of the spine or if symptoms are not from one level of the spine.

Procedure for MRI Whole Spine

Before the Scan

• In-depth medical history review to take into account symptoms and imaging needs.
• Patients have to take all metal items, such as jewellery, watches, belts, hairpins, etc., out.
• Devices like pacemakers or cochlear implants, and surgical hardware are tested to see if they can withstand the MRI.
• Sedation may be used for patients who experience extreme discomfort, anxiety, and claustrophobia.
• Planning for an injection of contrast dye may occur if it is believed that a tumour, infection, inflammation, or vascular abnormalities are present.

During the Scan

• Patient is in a supine position, comfortable on an MRI table.
• The MRI coil system is used to position the entire spine.
• High-res images of the neck, back, waist, and buttock areas are taken separately.
• They are obtained in axial and sagittal planes to be evaluated carefully.
• The entire amount of the scan typically requires about 45-90 minutes, depending on the protocol and the use of contrast.
• Gadolinium is injected intravenously into the patient during the study if a contrast is needed.

After the Scan

• Patients are able to go back to normal activities after the scan, almost always, if sedation was not given.
• Sufficient hydration recommended with contrast (ambulatory).
• The images get sent to a radiologist to be examined, and a detailed report is written by the radiologist for the referring doctor.

MRI Sequences Used in Whole Spine

Sagittal T1-Weighted Images

Describe in detail the picture of the vertebrae, bone marrow, intervertebral disc, and surrounding fat planes.

Sagittal T2-Weighted Images

Assist in the diagnosis of disc degeneration, abnormalities of the spinal cord, fluid collections, edema, and inflammatory changes.

STIR Sequences

Sequences to better detect edema, infection, tumors, inflammation, and bone marrow abnormalities, with fat suppression.

Axial T2-Weighted Images

Provide a comprehensive decoding of the spinal canal, nerve roots, foramina, and surrounding structures.

Post-Contrast T1-Weighted Images

Improved examination of tumors, infections, inflammatory lesions, and abnormalities after surgery.

Common Conditions Detected with MRI Whole Spine

Metastatic Disease

Discovery of metastasis to the vertebra, spinal cord, disc, or adjacent area.

Primary Spinal Tumors

Intra-medullary, intra-dural, and extra-dural tumors.

Multiple Sclerosis and Demyelinating Disorders

Periplaque and lesional changes in various parts of the spinal cord.

Spinal Infections

Discitis, vertebral osteomyelitis, epidural abscess, and inflammatory changes.

Degenerative Spine Disease

Evaluation of multiple-level nerve compression, facet disease, ligament thickening, and/or disc herniation and/or spinal stenosis.

Inflammatory Disorders

Assessment for ankylosing spondylitis and other spinal diseases of an inflammatory nature.

Congenital Abnormalities

Diagnosis of diseases like syringomyelia, tethered cord, or developmental spinal diseases.

Post-Traumatic Changes

Evaluation of fracture, ligamental, spinal instability, and spinal cord trauma.

Advantages of MRI Whole Spine

• An assessment of the complete spine is performed in one examination.
• Excellent resolution and excellent image contrast of soft tissues.
• Identification of small lesions that cannot be seen on screening tests.
• Helpful for determining where surgery should be performed and how severe a patient's disease is.
• No radiation exposure.
• May be used in conjunction with contrast imaging for better diagnosis.

Limitations of MRI Whole Spine

• Longer scanning time than with regional MRI studies.
• A vast amount of time in a stable position can cause discomfort for the patient.
• More expensive than a focused spine MRI.
• Patient movements, or metallic implants, can affect the image quality.

When is an MRI Whole Spine recommended?

• A suspected spinal metastasis or staging of cancer.
• Neurologic complaints of more than one body area are not well understood.
• Complex Spine Trauma (CST) greater than one level.
• Preoperative evaluation of a more substantial spinal disease.
• Inflammatory and infectious processes of the spine are present in the body.

Patient Preparation Tips

• Wear loose-fitting, comfortable clothes that are free from any metal elements.
• Make the radiology team aware of any implants, pacemakers, stents, or surgeries.
• If contrast-enhanced MRI is recommended, refer to the instructions to the fast.
• Do not move around while being scanned so that the image is not distorted by the slightest movement.
• If feeling anxious or ‘closed in', engage in relaxation techniques.

Conclusion

MRI Whole Spine is a detailed, more comprehensive imaging evaluation of the cervical, dorsal, lumbar, and sacral spine in one study. It can be particularly useful in the diagnosis of multifocal disease, evaluation of abnormalities of the spine, evaluation of systemic diseases, and planning complex spinal surgery. The scan requires more time than MRI screening and may be used in conjunction with screening MRI, but the increased spatial resolution and diagnostic accuracy make the scan a valuable tool for the diagnosis and management of certain other complex spinal and neurological disorders.