mri radiation spine spine mri online radiology courses

MRI RADIATION SPINE: WHEN THE CLINICIANS WON’T TELL YOU

 MRI Radiation Spine


What happens to vertebral body signal post radiation and how to spot a post radiation spine and tumour recurrence easily.

What Happens:

The effect of radiation on the spine is cell death of both tumour and normal marrow. And over time the dead cells are replaced with fat.

What Does it look like:

When we image the spine post radiation, because the marrow has become fatty replaced, its fairly uniformly bright on T1 sequences. We see two things on MRI.

 

radiology-education-asia-radedasia

Diffuse increase in T1 fatty signal in the area that has been irradiated.

mri radiation spine spine mri online radiology courses

Because the radiation beam has defined, sharp margins it produces straight lines at the bottom and top of the radiation field. Between the lines the marrow has been radiated and there is fatty replacement, above and below the lines where there hasn't been radiation, there is normal marrow. As a rule, nature doesn't like straight lines, so when you see a sharp straight demarcation in signal, with fatty marrow on one side and normal marrow signal on the other, you should be suspicious that the patient has had radiation.

When you have replacement of radiated marrow with tumour it becomes easy to see. The radiated marrow is bright T1 fatty signal, however the new tumour infiltration is low T1 signal so it stands out.

Our CPD & Learning Partners

Learn more about this condition & how best to report it in more detail in our SPINE & SIJ Imaging Mini Fellowships.

Click on the image below for more information.

X-ray demonstrating Dagger sign. In Ankylosing spondylitis, the dagger sign refers to a solid central line of bone along in AP spine view.
Ankylosing Spondylitis
X-ray showing meniscal calcification in CPPD knee.
KNEE
error: Content is protected !!

Join our Newsletter

Stay tuned on new
Mini-Fellowships launches and learnings

Mini-Fellowships

Better Than Conferences

Join our WhatsApp Community

We help radiologists learn
by doing and report with confidence

This site is intended for Medical Professions only. Use of this site is governed by our Terms of Service and Privacy Statement which can be found by clicking on the links. Please accept before proceeding to the website.