What anatomic structures should be routinely assessed on an MR study of the lumbar spine

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See Figure 11-3.

Figure 11-1. Normal cervical spine anatomy. The sagittal T1 -weighted image (A) provides excellent anatomic delineation of the vertebral bodies (curved black arrows), intervertebral discs (straight black arrows), and spinal cord (white arrows). On the sagittal cardiac gated T2-weighted image (B), a myelographic effect is created by the increased signal intensity in the cerebrospinal fluid (CSF). There is an excellent interface between the posterior margin of the discovertebral joints (curved black arrows) and the cerebrospinal fluid, as well as excellent delineation of the spinal cord (black arrowheads). The axial T1 -weighted image (C) provides excellent delineation of the spinal cord (white arrowheads), ventral (short white arrow) and dorsal (long white arrow) nerve roots, and the intervertebral canals (curved white arrow). On the oblique T1 -weighted image (D), the fat in the intervertebral canals outlines the neural (curved arrow) and vascular structures. On the axial gradient echo image (E), the high signal intensity of the CSF produces excellent contrast for the delineation of the spinal cord (black arrow) and the posterior margin of the discovertebral joint (white arrow). (From Herzog RJ. State of the art imaging of spinal disorders. Phys Med Rehabil State Art Rev 1990;4:230, with permission.)

Figure 11-1. Normal cervical spine anatomy. The sagittal T1 -weighted image (A) provides excellent anatomic delineation of the vertebral bodies (curved black arrows), intervertebral discs (straight black arrows), and spinal cord (white arrows). On the sagittal cardiac gated T2-weighted image (B), a myelographic effect is created by the increased signal intensity in the cerebrospinal fluid (CSF). There is an excellent interface between the posterior margin of the discovertebral joints (curved black arrows) and the cerebrospinal fluid, as well as excellent delineation of the spinal cord (black arrowheads). The axial T1 -weighted image (C) provides excellent delineation of the spinal cord (white arrowheads), ventral (short white arrow) and dorsal (long white arrow) nerve roots, and the intervertebral canals (curved white arrow). On the oblique T1 -weighted image (D), the fat in the intervertebral canals outlines the neural (curved arrow) and vascular structures. On the axial gradient echo image (E), the high signal intensity of the CSF produces excellent contrast for the delineation of the spinal cord (black arrow) and the posterior margin of the discovertebral joint (white arrow). (From Herzog RJ. State of the art imaging of spinal disorders. Phys Med Rehabil State Art Rev 1990;4:230, with permission.)

Figure 11 -2. Normal thoracic spine anatomy. The sagittal T1 -weighted image (A) provides excellent anatomic delineation of the vertebral bodies, intervertebral discs (curved black arrow), and spinal cord (white arrowheads). On the sagittal cardiac-gated T2-weighted image (B), the myelographic effect results in an excellent cerebrospinal fluid (CSF)-extradural interface along with delineation of the thoracic spinal cord (blackarrowS). (From Herzog RJ. State of the art imaging of spinal disorders. Phys Med Rehabil State Art Rev 1990;4:231, with permission).

Figure 11 -2. Normal thoracic spine anatomy. The sagittal T1 -weighted image (A) provides excellent anatomic delineation of the vertebral bodies, intervertebral discs (curved black arrow), and spinal cord (white arrowheads). On the sagittal cardiac-gated T2-weighted image (B), the myelographic effect results in an excellent cerebrospinal fluid (CSF)-extradural interface along with delineation of the thoracic spinal cord (blackarrowS). (From Herzog RJ. State of the art imaging of spinal disorders. Phys Med Rehabil State Art Rev 1990;4:231, with permission).

Figure 11 -3. Normal lumbar spine anatomy. The sagittal T1 -weighted image (A) provides excellent delineation of the vertebral bodies, intervertebral discs, thecal sac, lower thoracic cord, and conus medullaris (curved white arrow). The high signal intensity of the vertebral bodies is secondary to the fat in the cancellous marrow. The interface between the posterior outer annular fibers (straight white arrow) and the CSF is not well defined. On the sagittal proton-density weighted image (B), increased signal intensity in the disc is identified, along with increased signal intensity of the CSF. This results in improved delineation of the posterior annular-posterior longitudinal ligament complex (arrow). On the sagittal T2-weighted image (C), increased signal intensity in the disc is identified, along with a linear horizontal area of decreased signal intensity in the center of the disc representing the intranuclear cleft (arrows). Increased signal intensity in the CSF creates a myelographic effect and provides an excellent CSF-extradural interface. The sagittal T1 -weighted image continued

Figure 11 -3. Normal lumbar spine anatomy. The sagittal T1 -weighted image (A) provides excellent delineation of the vertebral bodies, intervertebral discs, thecal sac, lower thoracic cord, and conus medullaris (curved white arrow). The high signal intensity of the vertebral bodies is secondary to the fat in the cancellous marrow. The interface between the posterior outer annular fibers (straight white arrow) and the CSF is not well defined. On the sagittal proton-density weighted image (B), increased signal intensity in the disc is identified, along with increased signal intensity of the CSF. This results in improved delineation of the posterior annular-posterior longitudinal ligament complex (arrow). On the sagittal T2-weighted image (C), increased signal intensity in the disc is identified, along with a linear horizontal area of decreased signal intensity in the center of the disc representing the intranuclear cleft (arrows). Increased signal intensity in the CSF creates a myelographic effect and provides an excellent CSF-extradural interface. The sagittal T1 -weighted image continued

Figure 11-3, cont'd. (D) through the intervertebral canals provides excellent delineation of the dorsal root ganglia (straight white arrows) positioned subjacent to the vertebral pedicles. The posterolateral margin of the discs (curved white arrows) is well delineated. The axial Tl-weighted image (E) provides excellent delineation of the individual nerve roots (long white arrow) in the thecal sac. The presence of fat in the epidural space and intervertebral canals provides an excellent soft tissue interface to evaluate nerve roots (short black arrows), ligaments, and osseous elements. (From Herzog RJ. State of the art imaging of spinal disorders. Phys Med Rehabil State Art Rev 1990;4:232-3, with permission.)

Figure 11-3, cont'd. (D) through the intervertebral canals provides excellent delineation of the dorsal root ganglia (straight white arrows) positioned subjacent to the vertebral pedicles. The posterolateral margin of the discs (curved white arrows) is well delineated. The axial Tl-weighted image (E) provides excellent delineation of the individual nerve roots (long white arrow) in the thecal sac. The presence of fat in the epidural space and intervertebral canals provides an excellent soft tissue interface to evaluate nerve roots (short black arrows), ligaments, and osseous elements. (From Herzog RJ. State of the art imaging of spinal disorders. Phys Med Rehabil State Art Rev 1990;4:232-3, with permission.)

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