M -AGNETICR -ESONANCE I -MAGING :M -AGNETICR -ESONANCE I -MAGING


CONTENT :CONTENT PHYSICS SAFETY APPLICATIONS QUESTIONS


PHYSICS :PHYSICS


TYPES OF ATOMIC MOTION :TYPES OF ATOMIC MOTION The electron orbits the nucleus The electron spins on its own axis ***The nucleus spins on its own axis***


Slide 5:MRI USES THE HYDROGEN ATOM 1 electron orbits the nucleus The nucleus contains no neutrons but contains 1 proton THE HYDROGEN NUCLEUS HAS A NET POSITIVE CHARGE Hydrogen nucleus is a spinning, positively charged particle


Slide 6:LAW OF ELECTROMAGNETISM A charged particle in motion will create a magnetic field The postitively charged, spinning hydrogen nucleus generates a magnetic field WHY HYDROGEN? Very abundant in the human body-H20 Has a large magnetic moment


Slide 7:MAGNETIC MOMENT The tendency of an MR active nuclei to align its axis of rotation to an applied magnetic field MR ACTIVE NUCLEI odd # protons or odd # neutrons or BOTH e.g. Hydrogen1, Carbon13, Nitrogen15, Oxygen17, Fluorine19, Sodium23, Phosphorus31 STABLE ATOMS # protons = # electrons IONS # protons  # electrons


Slide 8:When a body is placed into the bore of the scanner, the strong magnetic field will cause the individual hydrogen nuclei to either: A) ALIGN ANTI-PARALLEL TO THE MAIN MAGNETIC FIELD (B0) OR B) ALIGN PARALLEL TO THE MAIN MAGNETIC FIELD (B0) B0 NMV Anti-parallel high energy Parallel low energy


NET MAGNETIZATION VECTOR :NET MAGNETIZATION VECTOR An excess of hydrogen nuclei will line up parallel to B0 and create the NMV of the patient


Slide 10:N S N S direction size The magnetic vector


THE NUCLEI WILL ALSO PRECESS… :THE NUCLEI WILL ALSO PRECESS…


PRECESSION :PRECESSION Due to the influence of B0, the hydrogen nucleus “wobbles” or precesses (like a spinning top as it comes to rest) The axis of the nucleus forms a path around B0 known as the “precessional path” Hydrogen nucleus B0 Precessional path


PRECESSION :PRECESSION The speed at which hydrogen precesses depends on the strength of B0 and is termed the “precessional frequency” The precessional frequency of hydrogen in a 1.5 Tesla magnetic field is 63.86 MHz The precessional paths of the individual hydrogen nucleus’ is random, or “out of phase”


WE NEED THEM TO BE “IN-PHASE” OR TO RESONATE… :WE NEED THEM TO BE “IN-PHASE” OR TO RESONATE…


Slide 15:RESONANCE Occurs when an object is exposed to an oscillating perturbation that has a frequency close to its own natural frequency of oscillation Ella Fitzgerald Tacoma Narrows bridge failure


RESONANCE con’t :RESONANCE con’t Frequency of the hydrogen proton in a 1.5T magnetic field can be found in the RF band of energy in the electromagnetic spectrum


RADIOFREQUENCYENERGY :RADIOFREQUENCYENERGY Follows the Law of Electromagnetism (charged particles in motion will generate a magnetic field) Magnetic field known in MR as B1 Applied as a “pulse” during MR sequences The RF pulse is applied so that B1 is 90 to B0


Slide 19:DURING RESONANCE… 1) The hydrogen atoms begin to precess “in phase” 1) 2) The hydrogen atoms align with the RF’s magnetic field (B1) and they flip!! B0 B0 B1 B1 NMV NMV flips! RF PULSE


Slide 20:AS THE NUCLEI PRECESS IN-PHASE IN THE B1 PLANE, A CHANGING MAGNETIC FIELD IS CREATED IF YOU PLACE A RECEIVER COIL (ANTENNA) IN THE PATH OF THE CHANGING MAGNETIC FIELD, A CURRENT WILL BE INDUCED THIS IS FARADAY’S LAW OF INDUCTION


Slide 21:FARADAY’S LAW OF INDUCTION A changing magnetic field will induce an electrical current in any conducting medium COILS Used to: transmit pulses of radiofrequency energy receive induced voltage - MR SIGNAL increase image quality by tuning in to one body part at a time


Slide 22:RELAXATION When the RF pulse is turned “off”, the NMV “relaxes” back to B0 (away from B1) B0 B1 NMV RF pulses are applied very quickly in succession - RF PULSE SEQUENCE 3 minute sequence (20 slices, axial brain) - 60 RF pulses may be applied


MR SIGNAL :MR SIGNAL Collected by a coil Encoded through a series of complex techniques and calculations (magic?) Stored as data Mapped onto an image matrix


Slide 24:TR - REPETITION TIME Time from the application of one RF pulse to another RF pulse TE - ECHO TIME Time from the application of the RF pulse to the peak of the signal induced in the coil


Slide 25:T1 WEIGHTING A short TR and short TE will result in a T1 weighted image Excellent for demonstrating anatomy T2 WEIGHTING A long TR and long TE will result in a T2 weighted image Excellent for demonstrating pathology MANY OTHER DIFFERENT TYPES OF IMAGES THAT COMBINE ABOVE AND INCLUDE OTHER PARAMETERS


T1 WEIGHTED IMAGE :T1 WEIGHTED IMAGE


T2 WEIGHTED IMAGE :T2 WEIGHTED IMAGE


SAFETY :SAFETY


THE MAGNET IS ON ALL THE TIME!!! :THE MAGNET IS ON ALL THE TIME!!!


OHM’S LAW OF RESISTANCE :OHM’S LAW OF RESISTANCE V = IR V = voltage I = current R = resistance R depends on the material, the length, the cross-sectional area, and the temperature of the loops of wire through which the current flows **Decreasing the temperature of the wire will decrease resistance to the flow of electricity


SUPERCONDUCTING MAGNET :SUPERCONDUCTING MAGNET No resistance to flow of electricity Coils of wire surrounded by cryogen bath (Helium) at -273 C No external source of energy required Magnetic field present ALL THE TIME!!!


Slide 32:Gauss - measure of magnetic field strength refrigerator magnet - 150-250 G 10,000 Gauss = 1T MRI - 0.2T - 1.5T  100x stronger that fridge magnet


THE STRONG MAGNETIC FIELD OF THE MAGNET CAN TURN THE FOLLOWING INTO DANGEROUS PROJECTILES: :THE STRONG MAGNETIC FIELD OF THE MAGNET CAN TURN THE FOLLOWING INTO DANGEROUS PROJECTILES: coins scissors trauma boards sandbags safety pins wheelchairs oxygen tanks I.V. poles I.D. tags keys


THE CHANGING MAGNETIC FIELDS CAN DO DAMAGE TO: :Monitoring equipment Infusion pumps Credit cards Cellular telephones Any electronic device THE CHANGING MAGNETIC FIELDS CAN DO DAMAGE TO:


THE FOLLOWING ARE (USUALLY*) OKAY: :Gold Silver Digital watches Eyeglass frames Snaps/zippers fastened to clothing Dental work THE FOLLOWING ARE (USUALLY*) OKAY:


APPLICATIONS :APPLICATIONS


ADVANTAGES :ADVANTAGES Superior soft tissue contrast resolution - excellent pathological discrimination No ionizing radiation Direct multi-planar imaging (transverse, coronal, sagittal, any oblique) Non-invasive - vascular studies can be performed without contrast


KNEE :KNEE


ANGIOGRAPHIC TECHNIQUES :ANGIOGRAPHIC TECHNIQUES Circle of Willis angiograms without any contrast


ANGIOGRAPHIC TECHNIQUES :ANGIOGRAPHIC TECHNIQUES Studies using contrast can also be performed


RENAL MRA :RENAL MRA


GADOLINIUM :GADOLINIUM USEFUL FOR DETECTION OF: Tumours pre- and post-operative Infection Inflammation Post-traumatic lesions Post-operative changes MRA’s


DISADVANTAGES OF MRI :DISADVANTAGES OF MRI Expensive Long scan times Audible noise (65-115dB) Isolation of patient (claustrophobia, monitoring of ill patients) Exclusion of patients with pacemakers and certain implants


BRAIN :BRAIN Hemorrhage (stages of) Demyelinating disorders (M.S.) Infectious processes (encephalitis, meningitis) Abscesses Neoplasms Neurofibromatosis Trauma Vascular disorders (AVM’s, infarcts, aneurysms)


BRAIN (cont’d) :BRAIN (cont’d) Metastasis Internal auditory canal pathology Pituitary pathology Hydrocephalus Child abuse Cranial nerve pathology Congenital anomalies (for anatomical review) Epilepsy (seizures in general)


AXIAL T2 BRAIN :AXIAL T2 BRAIN


SPINE :SPINE Radiculopathy Tumours Trauma/contusion Syringomyelia Metastasis Vascular disorders Cord edema M.S. plaques


SPINE (cont’d) :SPINE (cont’d) Cauda equina syndrome Tethered cord Arachnoiditis Marrow-replacing processes Degenerative disc disease Discitis Congenital anomalies


SPINE :SPINE


MUSCULOSKELTAL(shoulder, knee, ankle, wrist, elbow, TMJ) :MUSCULOSKELTAL(shoulder, knee, ankle, wrist, elbow, TMJ) Meniscal pathology Ligament/tendon injury Muscle/nerve impingement Avascular necrosis Labral tears (shoulder, hip) Chondromalacia Inflammation (osteomyelitis) Primary bone tumours Soft tissue tumours


SHOULDER :SHOULDER


ABDOMINAL/PELVIC :ABDOMINAL/PELVIC Liver pathology Kidney pathology Renal artery MRA Fetal abnormalities


ABDOMINAL IMAGING :ABDOMINAL IMAGING Breath-hold scans to overcome motion artifact problem MRCP’s - images of the biliary and pancreatic ductal systems performed non-invasively (no contrast or endoscope!) within seconds Fetal imaging very diagnostic


MRCP :MRCP


FETAL BREATH-HOLD IMAGE :FETAL BREATH-HOLD IMAGE


FETAL ENCEPHALOCELE :FETAL ENCEPHALOCELE


CARDIAC :CARDIAC Co-arctation RV dysplasia Cinematic studies Measure cardiac output, stroke volume, ejection fraction


MR Spectroscopy (MRS) :MR Spectroscopy (MRS) Information obtained is in the form of a spectrum which provides the biochemical information contained within a selected voxel of tissue Used to detect the absence or presence of a certain compound Assists in differential diagnosis when standard clinical radiological tests fail or are too invasive


Spectrum :Spectrum


MRS Current Applications :MRS Current Applications Multiple Sclerosis Leigh’s Huntington’s Parkinson’s Alzheimer’s Epilepsy other dementias metabolic disorders Stroke Asphyxiation or ischemic injury Tumours and intracranial lesions Prostate cancer Encephalopathies Leukodystrophies


Functional MRI (fMRI) :Functional MRI (fMRI) research topic Detects changes in blood flow or metabolism associated with specific motor or sensory functions or stimuli Performed by scanning specific areas of the brain/spine while: a) the subject performs a certain motor task or b) exposing the subject to certain external/internal stimuli HOT


fMRI cont’d :fMRI cont’d Subjects are scanned at rest and then during exercise or exposure to various stimuli The two conditions are subtracted to reveal areas of brain activation Areas of activation will have increased levels of blood flow and are therefore detectable


fMRI cont’d :fMRI cont’d Mapping of the brain’s motor and sensory areas Delineating primary cortical areas prior to surgery on patients with tumours (to avoid paralysis when operating on tumours in dangerous locations) Assessment of brain function following injury


MANY OTHER WORKS IN PROGRESS… :MANY OTHER WORKS IN PROGRESS…


QUESTIONS????? :QUESTIONS?????