Professional Documents
Culture Documents
Objectives
Define MRI imaging pulse sequences and their
parameters.
Demonstrate the value of using additional MRI
imaging sequences to benefit patient diagnosis.
Demonstrate the value of multiple imaging
modality utilization to benefit patient diagnosis.
Overview
MRI Pulse Sequences
STIR, FLAIR, & DWI
http://slideplayer.com/slide/3280943/
Westbrook, Catherine, Roth, Carolyn, & Talbot, John. MRI in Practice, 3 rd Edition. Blackwell Publishing Ltd., 2005.
https://mrimaster.com/characterise%20image%20stir.html
http://slideplayer.com/slide/3280943/
http://casemed.case.edu/clerkships/neurology/Web%20Neurorad/MRI%20Basics.htm
https://www.mypacs.net/cases/63348420.html
http://konez.com/Protocol_head_contrast.htm
Bammer, Roland. Basic Principles of Diffusion Imaging. European Journal of Radiology, 45, 2003, 169-184.
DWI
https://openi.nlm.nih.gov/detailedresult.php?img=PMC2678695_ymj-50-211-g001&req=4
ADC
https://mrimaster.com/characterise%20image%20stir.html
https://bodymri.stanford.edu/brucedaniel
FLAIR
Seizure foci & damaged tissue
DWI
Lesion assessment Breast & prostate
T2 vs. STIR
ACTA Neurologica
Scandinaviac,
2014 STIR allows
for better contrast
and visualization of
MS lesions. STIR
should be within
routine protocol.
T2 Image
Nayak, NB et all. A comparison of sagittal short T1 inversion recover and T2-weighted FSE
sequences for detection of multiple sclerosis spinal cord lesions. ACTA Neurologica
Scandinavica, 2014, 129, 198-203. doi: 10.11 11/ane.12168.
STIR
TR = 2888 ms
TE = 60 ms
TI = 110 ms
Slices: 3, gap 0
http://radiopaedia.org/images/16069297
Takuya, T. et all. Hippocampal damage after prolonged febrile seizure: One case in a
consecutive prospective series. Epilepsia, 2011, 52(4), 837-840. doi: 10.1111/j.15281167.2010.02958.x
TR = 8800 ms
TE = 120 ms
TI = 2200 ms
Slices: 5, 0 gap
Benefits:
Fast scan time
Non-contrast imaging
Tan, C., Wang, J., Kundra, V. Diffusion weighted imaging in prostat cancer.
European Radiology, 2011, 21, 593-603. doi: 10.1007/s00330-010-1960-y
Spine Anatomy
http://www.uscspine.com/spine-health-education/spinal-anatomy.cfm
Spine Anatomy
http://nw-mc.com/lateral-recessforaminal-stenosis/
http://www.mayfieldclinic.com/PE-STEN.htm
http://www.healio.com/spine-surgery/lumbar/news/print/spine-surgery-today/%7B80dc5496-8b14-4770-89c4b439201fb92d%7D/study-shows-oblique-mri-may-aid-precise-lumbar-foraminal-stenosis-diagnosis
Shoulder Anatomy
http://www.kaliper.com.au/shoulder-anatomy.html
http://sportsrehabcoach.com/shoulder-rehabilitation-labral-tear-repairs/
http://www.healio.com/orthopedics/journals/ortho/2010-8-33-8/%7B24a09a5f-9cb2-46fb8048-fa1afe352fd4%7D/the-abduction-external-rotation-aber-view-for-mri-of-the-shoulder
http://www.healio.com/orthopedics/journals/ortho/2010-8-33-8/%7B24a09a5f-9cb2-46fb8048-fa1afe352fd4%7D/the-abduction-external-rotation-aber-view-for-mri-of-the-shoulder
http://www.santiforestmonastery.com/anatomy-of-the-knee-lateral-collateral-ligamentmuscles-joint-illustrated/muscle-tendon-articular-cartilage-anatomy-of-the-knee-linecushions-bone-in-your-joint-cruciate-ligament-medial-collateral-ligament-mcl-meniscalcartilage/
http://www.tsaog.com/our-specialties/joint-replacement/san-antonio-ankle-replacement/
T2 Mapping Sequence
Functional cartilage mapping
Detects cartilage breakdown by evaluating
cartilage hydration
Increased hydration = increased cartilage damage
T2 Mapping Sequence
T2 Map Cartigram
Color Scale
Blue --- Green =
Damaged cartilage
Yellow ---- Red =
Normal cartilage
T2 Mapping Sequence
Sagittal, Axial or Coronal Planes
T2 Mapping Sequence
http://www.auntminnie.com/index.aspx?sec=rca&sub=ecr_2012&pag=dis&itemId=98513
Conclusion
Take the time needed to acquire the
images your patient needs for proper
diagnosis!
It is up to you as the technologist to use
proper imaging sequences!
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