General Spine

Kenneth, l, Weiss, MD
Matthew, A, Fox, MD, Non ASSR Member
Robert, P, Baughman, MD, Non ASSR Member
Jane, L, Weiss, Non ASSR Member
Dongmei, Sun, PhD, Non ASSR Member

Excerpta

Worsening, generalized spine pain is a common clinical complaint. Ordering diagnostic imaging studies for patients with poorly localizing symptoms or systemic pathology presents the clinician with many choices and challenges: what level, what modality, and at what cost? We present such a case of progressive back pain in a patient referred to our investigational MRI lab for a rapid total spine survey. MRI results were compared to routine FDG PET-CT.

Purpose

To apply a recently developed 2-D color-encoded sub-minute automated total spine MRI screening technique with improved tissue contrast through optimized fat-water separation[1-5] in a patient with generalized spine pain.

Methods & Materials

57 year old female, five years post liver transplant for hepatitis C, was referred to the investigational image laboratory for worsening back pain. Imaging was performed on a 3.0 T GEHDx MR scanner with 8-channel spine array coil and manufacturer supplied investigational pulse sequences (GE Healthcare (GEHC), Waukesha, WI). A dual-echo automated spine survey iterative scan technique (ASSIST DE) protocol was employed, wherein the skull base to sacrum, was auto-imaged in two contiguous 21 sec, 35 cm FOV breath-hold prompted sagittal acquisitions, yielding a composite superior-inferior (SI) field-of-view (FOV) of 70 cm and anterior-posterior (AP) FOV of 35 cm. 3D fast spoiled gradient (FSPGR) dual echo (DE) 2-point Dixon sequencing was performed with auto calibrating reconstruction for Cartesian sampling (ARC)[6] and surface coil intensity correction (SCIC), [TR = 5.6 msec, TE1 = 1.4 msec, TE2 ~ 2.6 msec, flip angle = 12, BW = +/- 167 khz, SI frequency encoding = 336, AP phase encoding =284, zero interpolation (ZIP 2) and slice thickness = 3mm with 1.5 mm overlap, 40 slices providing 58.5 mm right to left coverage. Fat-water separation was performed by the host computer using Maâ