A guide to identification and selection of axial planes in magnetic resonance imaging of the brain

For brain magnetic resonance (MR) examination, three-dimensional imaging is commonly performed. Radiologists need to know the appropriate imaging angle for viewing. We present six imaging angles for the axial images. Each angle is determined by the reference line. The landmarks on the midsagittal MR image to determine the angle of the reference lines are as follows: the supraorbito-meatal line (the center of the mammillary body and the fastigium of the fourth ventricle), the orbito-meatal (OM) line (the center of the mammillary body and the most posterior point of the cerebellar tentorium), the Talairach anterior commissure (AC)-posterior commissure (PC) line (the superior edge of the AC and the inferior edge of the PC), the Schaltenbrand AC-PC line (the center of the AC and the center of the PC), the subcallosal line (the inferior border of the genu and the inferior border of the splenium of the corpus callosum), Reid's baseline (the center of the pituitary gland and the most posterior point of the cerebellar tentorium) and the brainstem vertical line (the line perpendicular to the posterior border of the brainstem). The AC-PC line is most commonly used in MR examination. The OM line is most commonly used in computed tomography examination. The supraorbito-meatal line is recommended for avoiding irradiation to the orbit. In cases of multiple sclerosis, the subcallosal line is recommended in the guidelines. For lesions in the orbital cavity, paranasal cavity or skull base, Reid's baseline is useful. For cases of brainstem lesions, the brainstem vertical line is useful.