MRI J Jagan Mohan Reddy, Prasad V
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fm1 Step by Step MRI fm2
fm3 Step by Step MRI
J Jagan Mohan Reddy MD DMRD (Professor and Head) Department of Radiology and Imageology Nizam's Institute of Medical Sciences (A University established under the State Act) Hyderabad Andhra Pradesh 500082 V Prasad BSc CRA PGDRIT (MRI Technologist) Department of Radiology and Imageology Nizam's Institute of Medical Sciences (A University established under the State Act) Hyderabad Andhra Pradesh 500082
fm4 Published by
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Jaypee Brothers Medical Publishers (P) Ltd
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Step by Step MRI
© 2005, J Jagan Mohan Reddy, V Prasad
All rights reserved. No part of this publication and photo CD ROM should be reproduced, stored in a retrieval system, or transmitted in any form or by any means: electronic, mechanical, photocopying, recording, or otherwise, without the prior written permission of the authors and the publisher.
This book has been published in good faith that the material provided by authors is original. Every effort is made to ensure accuracy of material, but the publisher, printer and authors will not be held responsible for any inadvertent error(s). In case of any dispute, all legal matters to be settled under Delhi jurisdiction only.
First Edition: 2005
9788180614170
Typeset at JPBMP typesetting unit
Printed at Gopsons Papers Ltd, A-14, Sector 60, Noida 201 301, India
fm5 Dedicated to
Padmasri Prof Kakarla Subbarao
Director and Vice Chancellor, NIMS, Hyderabad
fm6 Foreword
It is with great pride and gratification that I pen these few words as a “Foreword” to this master piece. Dedication, devotion, determination and a little detachment from the family activities are essential to produce such a creative work.
As I know the authors quite intimately for almost two decades, their impeccable loyalty and commitment to their chosen speciality are exemplary.
Since the first application of MRI in clinical practice in early 1980, phenominal developments have taken place. It has emerged as the best non-radiation imaging method of investigation. I know, quite a number of technologists, even Radiologists and other MRI specialists cannot really follow the basics, protocols, but operate and interpret the images.
This book really serves to present greater comprehension and to put in the authors own words “a clear-cut understanding of the principles underlying MRI for fruitful and effective use”.
I am sure this book serves as a Bible to all those who are involved in imaging sciences and I do hope that the authors keep upgrading the latest developments in their next editions. May the scientific world derive benefit by going through this volume.
I do appreciate the sincerity, loyalty and generosity of the authors for dedicating this invaluable piece to me.
Prof Kakarla Subbarao
Director
fm7 Preface
From the initial observation that dense material attenuates X-rays, the complex field of medical imaging has developed. With the knowledge of relative densities of various tissues, radiologists and other physicians have used radiography to diagnose disease in every body part and organ system. Nearly two decades old clinical Magnetic Resonance Imaging offers diagnostic power far beyond that of radiographic density or any other principle of imaging. MRI utilizes several different principles alone or in combination to address a medical question. A clear-cut understanding of the principles underlying MRI is essential for its fruitful and effective use. The success of MRI in practice mainly lies in its clarity and logicality. It is becoming increasingly difficult to keep pace with the developments in MRI. MRI requires a multitude of operating parameter decisions and improper choices can result in impaired image quality leading to wrong diagnosis.
There are several books on MRI but they are all from foreign authors. Some Indian authors also published books on Radiology and Imageology, in which MRI is one chapter or a part of it. Realizing the important role of MRI in the field of Imageology without the effects of radiation, we have made an attempt in this book exclusively on MRI to give a comprehensive presentation of the various principles and techniques of MRI.
While preparing this book we have taken into account our experiences with the protocols which change from institution to institution, consultant fm8to consultant, company to company and equipment to equipment, version to version and technologists to technologists, while however the basic fundamentals remain the same.
Chapter-1 is about Introduction
Chapter-2 deals with Basic Principles
Chapter-3 illustrates Components of MRI system
Chapter-4 relates to Contraindications and Patient Safety
Chapter-5 belongs to Pulse Sequences
Chapter-6 explains Tissue Characteristics
Chapter-7 handles Artifacts
The topics of Technical Factors Influencing the Image Quality, MRI Contrast Agents, Recent Advances in Pulse Sequences and Practical Imaging are dealt with in chapters 8, 9, 10 and 11
Suggestions, expert advice and constructive criticism are invited to enable us to handle them in our future editions.
J Jagan Mohan Reddy
V Prasad
fm9 Acknowledgements
For an employee whose services are needed round the clock that too in a premier institute like Nizam's Institute of Medical Sciences, which caters to patients from three southern states, writing a book is an uphill task and literally impossible. But our long cherished desire has become a reality with the kind encouragement, co-operation and guidance of our beloved Director, Prof K Subbarao. Our profound thanks go to our Director who always said ‘OK’ to all our ventures.
Any book particularly scientific in nature requires the assistance and co-operation from all the colleagues in the Department. Our sincere and heartfelt thanks are to the faculty, Residents and colleagues Mr Ch VVSN Murthy, Mr D Sanjeevaiah, who extended their unstinted support in preparing material for this book.
We express our sincere thanks to Mrs Sri Vani, Typist and Mr G Mohd Siraj Ahmed, PG Diploma in Radiography and Imaging Technology. We acknowledge, with thanks, the contribution of Mr K Damodar Naidu, Radiographer who wrote the Chapter on “Pulse sequences” and that of Mr Ibrahim Jamal Mohammed, a Radiographer based in United Kingdom.
We thank our family members and children who spared us with the requisite time to prepare this book.
Last but not least, our grateful thanks are to M/s SIEMENS, M/s Philips and M/s GE Wipro, whose MRI machines are the basis for this booklet.
Our special and sincere thanks are to M/s Jaypee Brothers Medical Publishers (P) Ltd., New Delhi, who have gracefully accepted to publish this booklet.