Greetings from Bologna ,Italy, As a chiropractor I have many occasions to view MRI’s and while many are clearly marked in the transverse view as to which level each image belongs, and others have numbered referral lines in the lateral view, some exams have no such guides and it eludes me how an accurate report is generated. Clearly I am missing something, can I get some help?
For axial views, you need to start with identifiable structures, In the lumbar spine, that would be the sacrum. You then move the slice up until you identify the L5-S1 disc. For the cervical spine, start with the vertebral body of C2 as it is shaped like no other vertebral body. Continue moving up (or down in the case of the cervical spine) and count the disc spaces as you go. You do have to know if these slices are “stacks” or discal cuts to be able to identify the disc spaces.
Stacks run the slices up parallel to each other so there will be oblique views of L5-S1. In discal cuts, the technician will cut parallel to each disc space and about 5 slices will be devoted to each level. These discal cuts will typically bypass the pars interarticularis unfortunately.
For the sagittal cuts, the aorta will be on the left and vena cava will be on the right. The aorta has thicker walls and is more rounded while the vena cava will be more oval shaped. Also, sagittal images normally start from the left and run to the right but that is not always the case.