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. 2019 Mar 17;7(1):e000599. doi: 10.1136/bmjdrc-2018-000599

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© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

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Differences in spinal T1 imaging with epidural fat region of interest selection and validation. (A) Sagittal T1-weighted image slices were used to determine the boundaries of the lumbar spine from mid-L1 to mid-S1. (B, C) Axial image slices were used to locate the thecal sac and the surrounding epidural fat to draw our eight-point region of interest on each slice. In patients with epidural lipomatosis, the condition is diagnosed by observing the epidural fat’s deformation of the thecal sac which is highlighted in blue on image B. This portion of the thecal sac is severely compressed. (D, E) Two different MRI techniques were used: one following the conventional clinical protocol with a slanted correction at mid-L4 (D) and one without (E). (F) Graph showing interobserver and intraobserver variability for total fat volume calculations among four different readers with two trials each.