Magnetic resonance imaging of the lumbar spine: can we reach a consensus and have norms? A plea to colleagues in radiology India.

Study design: An analytical study.

Purpose: To analyze the inadequacies of magnetic resonance imaging (MRI) films provided by diagnostic centers, leading to questionable and inconclusive diagnoses.

Overview of literature: No literature is currently available on this subject.

Methods: Lumbosacral MRI films of patients who visited the outpatient department between January 2023 and March 31, 2024, were evaluated to check for technical inadequacies.

Results: A total of 1,150 lumbar MRI sets from 100 MRI centers were examined. Thirty-five percent did not include T1 axial images, and 8% did not include T1 sagittal images. Thirty-eight percent did not specify the sagittal image sequencing (right-to-left or left-to-right). Eighty-five percent of the sagittal images were profiled from right to left, and 15% were profiled from left to right. Macnab's recommendation was not followed in 970 sets. The axial sectioning of the scout films was nonparallel to the examined segment in 350 sets. The sacroiliac joint was not screened in 40% of the sets. The number of plates provided ranged from two to six films.

Conclusions: Based on the results obtained, we strongly recommend that radiologists form structured guidelines to be followed by MRI centers to ensure uniformity, address inadequacies, and minimize the chance of errors in diagnosis and subsequent treatment.