MRI of the shoulder with its excellent soft tissue discrimination, and high spatial resolution offers the best noninvasive way to study the shoulder. MRI images of the bone, muscles and tendons of the glenohumeral joint can be obtained in any oblique planes and projections. MRI gives excellent depiction of rotator cuff tears, injuries to the biceps tendon and damage to the glenoid labrum. Shoulder MRI is better than ultrasound imaging at depicting structural changes such as osteophytic spurs, ligament thickening, and acromial shape that may have predisposed to tendon degeneration.
A dedicated shoulder coil and careful patient positioning in external rotation with the shoulder as close as reasonably possible to the center of the magnet is necessary for a good image quality. If possible, the opposite shoulder should be lifted up, so that the patient lies on the imaged shoulder in order to rotate and fix this shoulder to reduce motion during breathing.
Axial, coronal oblique, and sagittal oblique proton density with fat suppression, T2 and T1 provide an assessment of the rotator cuff, biceps, deltoid, acromio-clavicular joint, the glenohumeral joint and surrounding large structures. If a labral injury is suspected, a Fat Sat gradient echo sequence is recommended. In some cases, a direct MR shoulder arthrogram with intra-articular injection of dilute gadolinium or an indirect arthrogram with imaging 20 min. after intravenous injection may be helpful.

See also Imaging of the Extremities.

(SPAIR) The MRI fat suppression technique SPAIR is characterized by a low sensitivity to RF field inhomogeneities. The used adiabatic radio frequency pulses for spectral saturation ensure a high uniformity and lower specific absorption rate (SAR).
SPAIR is suitable for offset and difficult to suppress regions such as liver, pelvis, shoulder and hips.

Magnetic resonance imaging (MRI) of the spine is a noninvasive procedure to evaluate different types of tissue, including the spinal cord, vertebral disks and spaces between the vertebrae through which the nerves travel, as well as distinguish healthy tissue from diseased tissue.
The cervical, thoracic and lumbar spine MRI should be scanned in individual sections. The scan protocol parameter like e.g. the field of view (FOV), slice thickness and matrix are usually different for cervical, thoracic and lumbar spine MRI, but the method is similar. The standard views in the basic spinal MRI scan to create detailed slices (cross sections) are sagittal T1 weighted and T2 weighted images over the whole body part, and transverse (e.g. multi angle oblique) over the region of interest with different pulse sequences according to the result of the sagittal slices. Additional views or different types of pulse sequences like fat suppression, fluid attenuation inversion recovery (FLAIR) or diffusion weighted imaging are created dependent on the indication.

Indications:

Contrast enhanced MRI techniques delineate infections vs. malignancies, show a syrinx cavity and support to differentiate the postoperative conditions. After surgery for disk disease, significant fibrosis can occur in the spine. This scarring can mimic residual disk herniation. Magnetic resonance myelography evaluates spinal stenosis and various intervertebral discs can be imaged with multi angle oblique techniques. Cine series can be used to show true range of motion studies of parts of the spine. Advanced open MRI devices are developed to perform positional scans in the position of pain or symptom (e.g. Upright™ MRI formerly Stand-Up MRI).

(THRIVE) THRIVE is an optimized fast T1 weighted 3 dimensional imaging technique combining sensitivity encoding, large volume coverage and uniform fat suppression. THRIVE improves for example dynamic liver, small bowel, breast, prostate and pancreas MRI, providing isotropic images with high resolution in short breath-hold times.