Diagnostic imaging Spine by Ross, Moore

By Ross, Moore

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EPub, 2015 Mohankumar R et al: Pitfalls and pearls in MRI of the knee. AJR Am J Roentgenol. 203(3):516-30, 2014 Motamedi D et al: Pitfalls in shoulder MRI: part 1--normal anatomy and anatomic variants. AJR Am J Roentgenol. 203(3):501-7, 2014 Motamedi D et al: Pitfalls in shoulder MRI: part 2--biceps tendon, bursae and cysts, incidental and postsurgical findings, and artifacts. AJR Am J Roentgenol. 203(3):508-15, 2014 Dagia C et al: 3T MRI in paediatrics: challenges and clinical applications. Eur J Radiol.

4. 5. 6. Menezes AH: Nosographic identification and management of pediatric craniovertebral junction anomalies: evolution of concepts and modalities of treatment. Adv Tech Stand Neurosurg. 40:3-18, 2014 Natung T et al: Symmetrical chorioretinal colobomata with craniovertebral junction anomalies in CHARGE syndrome - a case report with review of literature. J Clin Imaging Sci. 4:5, 2014 Shetty SR et al: Neurenteric cyst at the craniovertebral junction: A report of two cases. Asian J Neurosurg. 8(4):188-91, 2013 Menezes AH: Craniocervical fusions in children.

0T spine imaging – Marrow signal relatively hypointense compared to appearance on SE T1WI, simulates pathological marrow infiltration Imaging Recommendations • Protocol advice ○ Minimize artifacts using appropriate parameters, flow compensation, saturation bands, adequate sedation, or comfort measures, etc. 0T) • Results in lower normal marrow signal intensity than seen on spin-echo T1WI sequences CLINICAL ISSUES Presentation • Most common signs/symptoms ○ Artifact location often unrelated to clinical findings ○ Exception is susceptibility artifact in cases of hemorrhage, metallic foreign body, or medical devices Natural History & Prognosis • Not applicable Treatment • Not applicable DIAGNOSTIC CHECKLIST Consider • Artifacts often have characteristic appearance, recognizable if imager is aware of and considers artifact Reporting Tips • Always consider MR artifacts when confronted with bizarre imaging findings ○ If MR artifact cannot be excluded, consider true pathology ○ Clinical context always crucial to avoid failure to consider important pathologic differential considerations Syringomyelia • True dilation of central spinal cord canal, without (hydromyelia) or with (syringomyelia) underlying cord injury and myelomalacia, eccentric cavitation • Does not usually extend all the way to conus; may be sacculated • Simulated by truncation artifact or phase ghosting CSF Drop Metastases • Will usually be detectable in at least 2 planes • Mimicked (or obscured) by CSF pulsation artifact • Swap phase and frequency if needed to confirm as not an artifact SELECTED REFERENCES 1.

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