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MRI
J Jagan Mohan Reddy, Prasad V
ONE:
Introduction
TWO:
Basic Principles
THE BASICS
Electromagnetic Radiation (Fig. 2.1)
MR Active Nuclei
Hydrogen Atom
Vectors
Magnetic Moments
PRINCIPLE
What is MR?
Magnetic Resonance
PRECESSION FREQUENCY
THREE:
Components of MRI System
INTRODUCTION
The Components of the MRI System (Fig. 3.3)
Documentation
Camera
Magnet
Coil
SHIELDING
RF Shielding
Shimming
Active Shimming
Passive Shimming
Gradients
Gating
Cardiac Triggering
Respiratory Gating
Respiratory Triggering
Peripheral Gating (Pegating)
Breath Holding and Abdominal Compression
MR COMPATIBLE CONTRAST MEDIA INJECTOR (MED RAD)
Quality Control (QC)
Quality Assurance (QA)
Quality Assurance in MRI
FOUR:
Contraindications and Patient Safety
MR EXAMINATION PROCEDURE
Identity
Patient Screening
Screening Prior to Scanning
Patient Positioning
Precautions to be Undertaken
EFFECTS OF RF POWER
HAZARDS
QUENCHING
Magnet Quench Hazards
APPENDIX
Metallic Implants and Other Objects Tested for Deflection Forces: A Compilation of the Literature
FIVE:
MRI—Pulse Sequences
INTRODUCTION
PULSE SEQUENCES
Types
Spin Echo (SE) Pulse Sequences (Fig. 5.1)
Conventional Spin Echo (CSE) Pulse Sequence
Fast Spin Echo (FSE) Pulse Sequence
Inversion Recovery (IR) Pulse Sequences
STIR (Short Inversion Recovery) Pulse Sequence
FLAIR (Fluid Attenuated Inversion Recovery)
Gradient Echo (GE) Pulse Sequences
Steady State
Coherent (in phase) Gradient Echo Pulse Sequences
Incoherent (Spoiled) Gradient Echo Pulse Sequences
Steady State Free Precession (SSFP)
Parameters
Ultrafast Sequences
Echoplanar Imaging (EPI)
PERFUSION WEIGHTED IMAGING (PWI)
DIFFUSION WEIGHTED IMAGING (DWI)
FUNCTIONAL MRI (FMRI)
MAGNETIZATION TRANSFER (MT) CONTRAST
MAGNETIC RESONANCE ANGIOGRAPHY (MRA)
Time of Flight MRA (TOF-MRA)
Phase Contrast MRA (PC-MRA)
ACRONYMS USED BY MANUFACTURERS (Table 5.2)
SIX:
Tissue Characteristics
ROLE OF MRI IN DISEASES
Production of Image
Advantages of Magnetic Resonance Imaging
Disadvantages
MRI Image
Proton (Spin) Density, T1W and T2W
INTENSITIES OF NORMAL ANATOMICAL STRUCTURES
Pathological Changes and Effect of Relaxation Time
T1 Shortened
T2 Shortened
T1 Prolonged
T2 Prolonged
Appearance of Blood on MR Images Utilizing Various Imaging Techniques
Bright
Dark
Hyperacute Clots and Oxyhemoglobin
Acute Clots and Deoxyhemoglobin
Subacute Clots and Methemoglobin
Chronic Clots and Iron Storage
CLINICAL APPLICATIONS
MRI of Brain and Spine
Brain Tumors
Hemorrhage–Ischemic Stroke
Trauma
Degenerative Diseases
Spine
MRI of the Thorax
Mediastinum and Hili
Breast, Chest Wall and Pleura
Cardiovascular and Flow Studies
Myocardium
Flow Studies
Abdominal MRI
Liver
Kidneys
Adrenals
Pancreas
MRI of the Pelvis
Urinary Bladder
Prostatic Hypertrophy
The Female Pelvis
Extremities and Musculoskeletal MRI
SEVEN:
Artifacts
IMPROPER COIL SELECTION
Array Processing Artifact
EIGHT:
Technical Factors Influencing the Image Quality
INTRODUCTION
FACTORS AFFECTING THE SNR
Field of View (FOV)
Spatial Resolution
Slice Thickness
SNR ~ SLICE THICKNESS
Spacing
Matrix Size
Scan Time ∼ Matrix Size Prescan
Prescan
Number of Excitations or Number of Signal Averages (NEX/NSA)
Image Acquisition Time (Examination Time)
Image (Data) Acquisition Time
Frequency
Phase
Phase FOV
Auto Shim
Contrast
Phase Correction
Auto Center Frequency
Signal-to-Noise Ratio (SNR)
Contrast-to-Noise Ratio (CNR)
Bandwidth (BW)
Two-Dimensional Fourier Transform (2DFT)
Image Reconstruction
GRADIENTS
SLICE-SELECT
NINE:
MRI Contrast Agents
CONTRAST AGENTS
IDEAL CONTRAST
HISTORY
Mechanism of Action
Positive Relaxation Agents
Negative Relaxation Agent
Magnetization Transfer (MT)
Fat Suppression
Perfusion Imaging
Administration of Contrast Agent
Adverse Reactions
Hepatobiliary Agents
Oral Contrast Agents
Conclusion
TEN:
Recent Advances in Pulse Sequences
SPIN ECHO IMAGING
Gradients
T1 and T2
CONTRAST
INVERSION RECOVERY (IR)
Short Inversion Time Inversion Recovery (STIR)
FLAIR
Gradient Recalled Echo (GRE) Technique
Advantages of Fast GRE Techniques
Disadvantages of Fast GRE
FLOW IMAGING
RAPID SCAN TECHNIQUES
Radiofrequency Refocussed Technique
FAST SPIN ECHO
ECHOPLANAR IMAGING
ECHOPLANAR DIFFUSION IMAGING
ECHOPLANAR PERFUSION IMAGING
MAGNETIZATION TRANSFER CONTRAST (MTC)
MAGNETIC RESONANCE OF ANGIOGRAPHY (MRA)
TIME OF FLIGHT
PHASE CONTRAST
MR SPECTROSCOPY
CONCLUSIONS
ELEVEN:
Practical Imaging
IMAGE PRESENTATION
SCOUT SLICE PLACEMENT AND ANGLES
IMAGE REVIEW
Identifying Image Labels
ANATOMICAL REFERENCE POINTS
HEAD AND NECK
SPINE
CHEST AND ABDOMEN
UPPER EXTREMITY
LOWER EXTREMITY
BRAIN
BRAIN
Indication
TEMPORAL LOBES
PROTOCOL: TEMPORAL LOBES
Indication
INTERNAL AUDITORY MEATUS
PROTOCOL: POSTERIOR FOSSA AND INTERNAL AUDITORY MEATUS
Indication
PITUITARY
PROTOCOL: PITUITARY
Indication
ORBITS
PROTOCOL: ORBITS
Indication:
TEMPOROMANDIBULAR JOINT
PROTOCOL: TEMPOROMANDIBULAR JOINT
Indication
DIFFUSION
PROTOCOL: DIFFUSION
Indication
PERFUSION
PROTOCOL: PERFUSION
Indication
SPECTROSCOPY
PROTOCOL: SPECTROSCOPY
Indication
FUNCTIONAL
PROTOCOL: FUNCTIONAL
Indication:
MRA-HEAD
PROTOCOL: MRA-HEAD
Indication
MRV
Protocol: MRV-Head
Indication
STERIOTACTIC BIOPSY PROCEDURE
PROTOCOL: STEREOTACTIC BIOPSY
Indication
DEEP BRAIN STIMULATION(DBS)
PROTOCOL: D.B.S (DEEP BRAIN STIMULATION)
Indication:
CSF FLOW
PROTOCOL: CSF-FLOW
Indication
PROTOCOL: CSF-RHINORRHOEA/OTORRHOEA
PROTOCOL: CSF-RHINORRHOEA/OTORRHOEA
Indication
MRA-NECK
PROTOCOL: MRA-NECK
Indication:
CERVICAL SPINE
PROTOCOL: CERVICAL SPINE
Indication
THORACIC SPINE
PROTOCOL: THORACIC SPINE
Indication
LUMBAR SPINE
PROTOCOL: LUMBAR SPINE
Indication
WHOLE SPINE IMAGING
PROTOCOL: WHOLE SPINE IMAGING
Indication
CHEST
PROTOCOL: CHEST
Indication
HEART AND GREAT VESSELS
PROTOCOL: HEART AND GREAT VESSELS
Indication
BREAST
PROTOCOL: BREAST
Indication:
BRACHIAL PLEXUS
PROTOCOL: BRACHIAL PLEXUS
Indication
ABDOMINAL ANGIO
PROTOCOL: ABDOMEN- VASCULAR IMAGING
Indication
MRCP
PROTOCOL: MRCP
Indication
MRU
PROTOCOL: MRU
Indication
PELVIS
PROTOCOL: PELVIS
Indication
ENDORECTAL
PROTOCOL: ENDORECTAL
Indication
SHOULDER
PROTOCOL: SHOULDER
Indication
HUMERUS
PROTOCOL: HUMERUS
Indication
ELBOW
PROTOCOL: ELBOW
Indication
FOREARM
PROTOCOL: FOREARM
Indication
WRIST AND HAND
PROTOCOL: WRIST AND HAND
Indication
HIPS
PROTOCOL: HIPS
Indication
THIGH
PROTOCOL: THIGH
Indication
KNEE JOINT
PROTOCOL: KNEE
Indication
TIBIA AND FIBULA
PROTOCOL: TIBIA AND FIBULA
Indication
ANKLE
PROTOCOL: ANKLE
Indication
VASCULAR IMAGING
PROTOCOL: LEG-VASCULAR IMAGING
Indication
ROUTINE IMAGING
VASCULAR IMAGING
SPECIALIZED IMAGING
Routine Imaging
Neck and Spine Imaging
Cardiac Imaging
Abdominal Imaging
Musculoskeletal Imaging
VASCULAR IMAGING
SPECIALIZED IMAGING
Diffusion Imaging
Perfusion Imaging
Functional Imaging
Spectroscopic Imaging
CSF Flow
Steriotactic Biopsy
Abbreviations
INDEX
TOC
Index
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