Basics of MRI Part I
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1 Basics of MRI Part I Mathew J. Dixon, D.O. Chairman Department of Radiology Memorial Health University Medical Center Savannah, GA
2 Objectives Brief History Concept of MRI Creation of a Magnetic Field Concepts of T1 and T2 Contrast Clinically Useful Information Image identification Safety Common Artifacts
3 History First scan performed July 3, 1977 on first scanner that was named Indomitable There were appx.. 20,000 clinical MR units in the U.S. in 2000
4 How does MRI work? About 2/3 of the body is composed of water There are differences in the composition of water in various tissues and organs Pathological processes frequently have a water composition that is different from normal tissues
5 How does MRI work? Water is composed of hydrogen and oxygen Hydrogen nuclei are capable of acting like a microscopic compass When placed in a magnetic field, the hydrogen nuclei will align with the field like a compass When submitted to radiowaves,, the nuclei will change their alignment/energy state This allows differences in tissues to be measured since the nuclei will re-align at different rates when in different tissues
6 HUH!
7 Let s s Review
8 Place water containing tissues in scanner images/mri-scanner.jpg
9 Figure 1. Electrons flowing along a wire Pooley, R. A. Radiographics 2005;25: Copyright Radiological Society of North America, 2005
10 Figure 3. Main magnetic field Pooley, R. A. Radiographics 2005;25: Copyright Radiological Society of North America, 2005
11 Figure 2. Hydrogen proton Pooley, R. A. Radiographics 2005;25: Copyright Radiological Society of North America, 2005
12 Figure 4. Alignment of protons with the B0 field Pooley, R. A. Radiographics 2005;25: Copyright Radiological Society of North America, 2005
13 Figure 6. Precession Pooley, R. A. Radiographics 2005;25: Copyright Radiological Society of North America, 2005
14 Figure 7. Larmor equation Pooley, R. A. Radiographics 2005;25: Copyright Radiological Society of North America, 2005
15 Figure 8. Absorption of RF energy Pooley, R. A. Radiographics 2005;25: Copyright Radiological Society of North America, 2005
16 Figure 9. Longitudinal (T1) relaxation Pooley, R. A. Radiographics 2005;25: Copyright Radiological Society of North America, 2005
17 Figure 10. Definition of T1 Pooley, R. A. Radiographics 2005;25: Copyright Radiological Society of North America, 2005
18 Figure 11. T1-weighted contrast Pooley, R. A. Radiographics 2005;25: Copyright Radiological Society of North America, 2005
19 Figure 12. Transverse (T2*) relaxation Pooley, R. A. Radiographics 2005;25: Copyright Radiological Society of North America, 2005
20 T2* and T2 Dephasing
21 Figure 14. Definition of T2 Pooley, R. A. Radiographics 2005;25: Copyright Radiological Society of North America, 2005
22 Figure 15. T2-weighted contrast Pooley, R. A. Radiographics 2005;25: Copyright Radiological Society of North America, 2005
23 T1 and T2 Relaxation Processes Occur Simultaneously
24 Figure 13. Measurement of the MR signal Pooley, R. A. Radiographics 2005;25: Copyright Radiological Society of North America, 2005
25 Still Confused?
26 Good News!
27 You only need to understand about 10% of everything we just covered to interpret MRI
28 Hey, this MRI stuff is just like making decisions at The White House!
29 Image Identification
30 Figure 11. T1-weighted contrast Pooley, R. A. Radiographics 2005;25: Copyright Radiological Society of North America, 2005
31 Figure 15. T2-weighted contrast Pooley, R. A. Radiographics 2005;25: Copyright Radiological Society of North America, 2005
32 Image Identification STIR
33 Image Identification FLAIR
34 Image Identification
35 Image Identification
36 Image Identification Qayyum, A. et al. Radiology 2005;237: Copyright Radiological Society of North America, 2005
37 Image Identification Qayyum, A. et al. Radiology 2005;237: Copyright Radiological Society of North America, 2005
38 Common Artifacts Motion-Respiration, Flow, Cardiac, Patient Susceptibility Chemical Shift Aliasing (Wraparound)
39 Figure 7a. Motion-related artifacts (Respiratory) Zhuo, J. et al. Radiographics 2006;26: Copyright Radiological Society of North America, 2006
40 Figure 7b. Motion-related artifacts (Pulsation) Zhuo, J. et al. Radiographics 2006;26: Copyright Radiological Society of North America, 2006
41 Figure 14. Sagittal MR image shows a magnetic susceptibility artifact that resulted from the presence of metallic dental fillings Copyright Radiological Society of North America, 2006 Zhuo, J. et al. Radiographics 2006;26:
42 Safety General Safety During Pregnancy Orbital Foreign Bodies Foreign Bodies Elsewhere Aneurysm Clips Orthopedic Implants Pacers Stents Heart Valves Spine Stimulators
43
44 Question #1 Electric current flowing through a wire will produce: A. Hydrogen protons B. The gyromagnetic ratio C. A magnetic field D. T1 contrast
45 Question #1 Electric current flowing through a wire will produce: A. Hydrogen protons B. The Exist in the body with or without current The gyromagnetic ratio Is unaltered by current It is fixed for different nuclei 42.6 MHz/T for hydrogen protons C. A magnetic field D. T1 contrast Correct Answer Further proton manipulation will be necessary to create T1 contrast
46 Explanation #1 Electrons flowing in a wire will create a magnetic field perpendicular to the current. Pooley, R. A. Radiographics 2005;25:
47 Question #2 Under normal circumstances and with respect to their magnetization, how are protons oriented in the body? A. Randomly B. Along the Z-axis Z (longitudinal) C. Along the X-axis X (transverse) D. Along the Y-axis Y (transverse)
48 Question #2 Under normal circumstances and with respect to their magnetization, how are protons oriented in the body? A. Randomly Correct answer B. Along the Z-axis Z (longitudinal) Protons may align along this axis, but this will not be universal and should be temporary until an external magnetic field is applied C. Along the X-axis X (transverse) Protons may align along this axis, but this typically occurs after an external magnetic field and a 90 degree RF pulse are applied D. Along the Y-axis Y (transverse) Protons may align along this axis, but this typically occurs after an external magnetic field and a 90 degree RF pulse are applied
49 Explanation #2 Protons are distributed randomly in the body until their nuclei are manipulated with external forces. Pooley, R. A. Radiographics 2005;25:
50 Question #3 Which of the following image(s) is/are T1-weighted? A. B. C. D.
51 Question #3 Which of the following image(s) is/are T1-weighted? A. B. C. D.
52 Explanation #3 Which of the following image(s) is/are T1-weighted? A. B. C. D. On T1 white matter and fat are bright and CSF and fluid are much darker, which is seen on image A. and D. The CSF in B. is dark because this is a FLAIR sequence, which is heavily T2 weighted B. and C. are incorrect because the white matter is very dark on both Kaplan et al. Musculoskeletal MRI 2001; 1:4.
53 Question #4 Which imaging artifact is frequently utilized in adrenal imaging? A. Aliasing B. Pulsation C. Gibbs D. Chemical Shift
54 Question #4 Which imaging artifact is frequently utilized in adrenal imaging? A. Aliasing is incorrect because it refers to imaging wrap and has no place in adrenal imaging B. Pulsation is incorrect since this is an artifact created by repetitive movement such as arterial flow and is also not useful in adrenal imaging unless attempting to detect vascularity within a lesion C. Gibbs is incorrect since Gibbs artifact is a group of bright or dark lines seen adjacent and parallel to regions of abrupt signal change D. Chemical Shift is correct
55 Explanation #4 D. Chemical shift is correct because it is caused by the difference of chemical shift between fat and water This artifact manifests itself as a misregistration between fat and water pixels in an image This artifact allows identification of microscopic fat in lesions, which is very useful in identifying lipid rich adrenal adenomas
56 Figure 18a. (a) In-phase MR image acquired with an echo time of 2.2 msec Zhuo, J. et al. Radiographics 2006;26: Copyright Radiological Society of North America, 2006
57 Question #5 Which of the following image(s) is/are T2-weighted? A. B. C. D.
58 Question #5 Which of the following image(s) is/are T2-weighted? A. B. C. D.
59 Explanation #5 Which of the following image(s) is/are T2-weighted? A. B. C. D. On T1 white matter and fat are bright and CSF and fluid are much darker, which fits images A. and D. The white matter in B. and C. is very dark, indicating that they are T2 weighted. CSF in B is dark because this is a FLAIR sequence, which suppresses CSF signal, but this is still T2 weighted. Kaplan et al. Musculoskeletal MRI 2001; 1:4.
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