Interactive Transcript
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Here are the standard pulse sequences
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that we use for spinal imaging,
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whether it be for intradural intramedullary
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lesions or for intradural extramedullary lesions.
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Here is our T1-weighed sagittal scan.
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Here, the T2-weighed sagittal scan.
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This is the STIR imaging, which as I described for you,
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causes fat suppression,
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which you see on the T2-weighted scan,
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the fat is bright, but with STIR imaging,
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the fat is dark.
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This is a post-gadolinium T1-weighted scan
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that we also use typically in the sagittal
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plane. In the axial plane,
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we're usually relying on T2-weighted axial
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scans. This is the gradient echo scan,
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which is generally reserved for the cervical
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spine and not used in thoracic
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or lumbar spine imaging.
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And this is an example of the postgad
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axial scan. In this case, we either don't have very
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good fat suppression,
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or it was done without fat suppression.
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What we'd like to do is to nail the high
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signal intensity of the fat here with a
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suppressor pulse and cause it to be dark,
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which allows the background to be even darker.
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And therefore,
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enhancing lesions are going to show up more
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readily in that dark black background.
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So these are the standard pulse sequences that
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are employed for imaging of the spine
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for intradural extramedullary.
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You'll notice that this patient has an intradural
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intramedullary lesion in the spinal cord.
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These are those additional sequences
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that we use in certain occasions.
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What you're seeing on the left are the DWI
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scans, which are used generally for cord
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infarcts and not for intradural extramedullary
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lesions. And on the right hand side,
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we have the MRA of the spine.
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MRA of the spinal cord is very difficult to perform.
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It's usually done in a dynamic mode so that
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you're looking at both the arterial phase,
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as well as the venous phase.
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And then we reconstruct it in a maximum
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intensity projection reconstruction,
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which you're seeing to the right.
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So these are, again, infrequently used,
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but in that certain occasion where you're
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looking for a vascular malformation of the
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spinal canal, you will employ the MRA dynamic technique.
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