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MRI in Practice - MIDTERM > Midterm > Flashcards

Midterm Flashcards

1
Q

What is one extra feature of IR pulse sequence?

A

TI

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2
Q

What is the TI range for suppressing fat?

A

80 - 175 (depending on the anatomy)

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3
Q
  1. 2D VS. 3D :
A

2D is a slice

3D is a slab (MRA head because arteries are curvy and thinner)

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4
Q

What protocol is used for carotids ?

A

2D or 3D

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5
Q

Sat pulse for arteries —-

A

superior

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6
Q

What comes off subclavian arteries?

A

Vertebral arteries

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7
Q

Internal VS. External carotid arteries:

A

Internal - supplies blood to the brain; lateral (on coronal view)
External - supplies blood to the face; medial (on coronal view)

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8
Q

What comes off carotid siphon?

A

Ophthalmic artery

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9
Q

What pulse sequence is used for the venous system?

A

2D (coronal and axial)

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10
Q

Condition where in the connection between veins and arteries are dilated?

A

AVM (Arterial Venous Malformation)

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11
Q

What sequence is used for AVM?

A

Tricks (contrast enhanced)

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12
Q

Sat pulse for veins —-

A

inferior

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13
Q

What sequence allows you to see the direction of flow?

A

Phase contrast

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14
Q

What pathology is T2 flair good for?

A

MS

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15
Q

Diffusion is good for what pathologies?

A

Stroke, infection, dermoid cyst

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16
Q

What does active/acute stroke look like on diffusion?

A

Bright (old stroke will be dark; REALLY old stroke will be black because tissue is dead and replaced with CSF)

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17
Q

What sequence confirms if something is a stroke or T2* artifact?

A

ADC

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18
Q

What does acute stroke look like on ADC?

A

Dark (old stroke will be bright)

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19
Q

What pathology is GRE good for?

A

Bleed (also concussion, mv accident, TIA, cavernous malformation)

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20
Q

Multiple dark spots on a GRE is what kind of pathology?

A

Microbleed

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21
Q

What kind of bleed is on the side of the head and displaces brain tissue?

A

Subdural hemorrhage (bright on T1)

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22
Q

What is good sequence for the brain post contrast?

A

T1

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23
Q

What sequence is used post contrast for other parts of the body?

A

T1 fat sat

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24
Q

What sequence shows lesion as if double dose contrast was given?

A

MTSE (suppresses background)

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25
Q

What exam will you run for glioblastoma and astrocytoma?

A

Perfusion (for surgical and treatment prep)

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26
Q

What exam will you run for mets in lung (and primary is in brain)?

A

Routine brain w/ and w/o contrast

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27
Q

What exam will you run for facial numbness?

A

High IAC (CN V aka trigeminal nerve)

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28
Q

What exam will you run for h/o meningioma?

A

Routine brain w/ 1/2 dose contrast

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29
Q

What exam will you run for someone with abnormal blood work (prolactin)?

A

Pituitary

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30
Q

What exam will you run for optic neuritis?

A

MS (T2 flair)

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31
Q

What exam will you run for someone who has numbing and tingling on one side of their body?

A

MS

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32
Q

What exam will you run for someone who has olfactory nerve issue?

A

Coronal sinus (FSE fat sat)

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33
Q

What scan will substitute if fat sat fails?

A

STIR

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34
Q

What do you do for metal artifact post contrast?

A

Turn off the fat sat

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35
Q

How can you reduce metal artifact in terms of adjusting the protocol?

A

Increase the bandwidth

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36
Q

Best planes for IAC?

A

Axial and coronal

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37
Q

Best planes for pituitary?

A

Sagittal and coronal

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38
Q

Best planes for orbits?

A

Axial and coronal

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39
Q

What is used to calculate GFR?

A

Creatinine

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40
Q

What is the name of the pathology wherein ventricles are dilated due to excessive CSF?

A

Hydrocephalus

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41
Q

What pathology can hydrocephalus cause on the spine?

A

Syrinx

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42
Q

Syrinx is the dilation of what anatomy?

A

Central canal

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43
Q

What is a good view and sequence to diagnose syrinx?

A

Sagittal T2

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44
Q

What is chiari malformation?

A

Herniation of cerebellar tonsils into the neck (cranio-cervical junction). It also leads to syrinx.

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45
Q

When is it not safe to scan a pregnant lady?

A

During the 1st trimester

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46
Q

What instructions will you give a breast feeding lady who needs contrast?

A

Pump and dump (48hrs)

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47
Q

What is the main concern for a pregnant technologist?

A

RF

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48
Q

What is the main concern for the developing fetus exposed to RF?

A

SAR

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49
Q

What does SAR stand for?

A

Specific Absorption Rate

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50
Q

What is the SAR limit for normal mode?

A

2w/kg

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51
Q

Rise in core body temperature should not exceed ________.

A

(1 degree Celsius)

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52
Q

Which government agency regulates these policies?

A

FDA

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53
Q

What causes peripheral nerve stimulation?

A

Gradient magnetic factor

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54
Q

What causes missile trajectory?

A

Translation traction

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55
Q

What is explosive boil off of helium called?

A

Quench

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56
Q

What are the risks of a quench?

A

Frostbite, asphyxiation, ruptured eardrum

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57
Q

Why do patients need to uncross their arms during scan?

A

To avoid contact burn

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58
Q

What is happening when patients feel a slight electrocution?

A

Peripheral nerve stimulation

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59
Q

How many salivary glands do we have?

A

3 pairs (parotid, submandibular, sublingual)

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60
Q

Why do we need to include C-spine on a T-spine localizer?

A

To be able to count from C2

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61
Q

What artifact commonly shows up around the spine area?

A

Flow artifact (looks dark)

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62
Q

What sequence is used for MS in spine?

A

IR

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63
Q

What sequence is used for fracture in the spine?

A

IR

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64
Q

What procedure is done on spinal fracture?

A

Kyphoplasty

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65
Q

How can you differentiate C,T and L spine?

A

C-spine - has bifid spinous process (C3-C6) ; Vertebral prominens, single spinous process
(C7) ; has transverse/vertebral foramen (passage of vertebra arteries)

T-spine - has facets joints as attachment for the ribs ; cord ends around T12 - L2 (conus
medullaris)

L-spine - sits next to psoas muscles; contains cauda equina part of the cord

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66
Q

What artifact makes bleed on GRE look dark?

A

Susceptibility

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67
Q

What pulse sequence causes chemical shift?

A

In/out phase sequence

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68
Q

How do can you resolve aliasing?

A

Increase FOV, use NPW

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69
Q

What artifact does a flickering light bulb cause?

A

Zipper artifact

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70
Q

What causes corduroy artifact?

A

Two metals rubbing together

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71
Q

What artifact is produced if a wrong coil is used for a certain body part?

A

Annefact artifact

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72
Q

What sequence will you run for hydrocephalus?

A

Midline SPGR (thinner slices, covers the whole head)

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73
Q

What sequence will you run for MS brain?

A

Sagittal T2 flair

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74
Q

When you’re doing FLAIR you’re trying to suppress

A

Fluid - Fluid Attenuated Inversion Recovery

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75
Q

When you’re trying to suppress Fat -

A

80-175 TR

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76
Q

2D TOF -

A

Slice

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77
Q

3D TOF -

A

Slab - smaller survey use 3D

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78
Q

For Carotids you can use:

A

3D and 2D

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79
Q

Sat Pulse direction on arteries of Brain -

A

Superior

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80
Q

Carotids - Internal and external carotids

A

external goes to face, internal goes into the brain

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81
Q

Internal carotid curves =

A

carotid siphon

82
Q

external carotids -

A

medial

83
Q

internal carotids

A

lateral

84
Q

Name of artery that connects anterior and posterior circulation

A

posterior communicating artery

85
Q

off of basilar another branch -

A

anterior inferior cerebellar artery

86
Q

branches off of vertebral -

A

PICA

87
Q

Venous Brain -

A

Superior Sagittal sinus, to straight sinus, transverse sinus goes off to the side, where the connection is confluence of sinus, curving down Sigmoid sinus, down to neck with internal jugular vein, to superior vena cava

88
Q

Venous Brain -

A

Superior Sagittal sinus, to straight sinus, transverse sinus goes off to the side, where the connection is confluence of sinus, curving down Sigmoid sinus, down to neck with internal jugular vein, to superior vena cava

89
Q

what pulse sequence do you scan for venous Brain -

A

2D coronal and axial

90
Q

AVM -

A

(malformation) TRICKS (contrast enhancement) sat pulse INFERIOR

91
Q

MRA - to see direction of the flow =

A

Phase Contrast

92
Q

Pulse Sequences:

T2 FLAIR -

A

good for MS

93
Q

Pulse Sequences:

Stroke or infection =

A

Diffusion

94
Q

Diffusion is good for -

A

infection, stroke, dermoid cyst

95
Q

Acute stroke looks ______ on diffusion

A

Bright

96
Q

Old stroke looks ______ on diffusion

A

Dark or black

97
Q

ADC - acute stroke is _____

old stroke is _____

A

Dark

Bright

98
Q

Gradient Echo GRE - good for ______.

A

Bleeds

99
Q

Dark dots on GRE is ______.

A

micro bleed - subdural bleed is on the outside bleeding in (pushing in on the brain)

100
Q

Scan GRE for patients with ____________________.

A

concussion, car accident, cavernous malformation

101
Q

Once you give someone an injection for brain - good scan is __.

A

T1

102
Q

If you’re doing a scan Post gad - use ________.

A

T1 with Fat Sat

103
Q

Someone comes in with glioblastoma (cancerous tumor) - important sequence scan _________.

A

Perfusion (for surgical planning)

104
Q

Someone with a history of metastatic disease scan ________.

A

routine brain w w/o contrast

105
Q

Someone with facial numbness - scan

A

High IAC for Trigeminal nerve

106
Q

Someone with history of meningioma (benign tumor of meninges(surrounds brain)) - scan

A

routine brain and half a dose of contrast

107
Q

Someone comes in with abnormal blood work - scan

A

pituitary (prolactin levels)

108
Q

Someone comes in with optic neuritis - scan

A

MS T2 FLAIR

109
Q

Someone has numbing or tingling on one side of the body - scan

A

MS

110
Q

Someone has an Olfactory nerve issue - scan

A

Coronal Sinus —– (if you can’t get Fat Sat to work scan STIR))

111
Q

Someone has metal you’re giving them contrast for cervical spine -

A

turn off Fat Sat - or increase Bandwidth

112
Q

Best plane to see IACs on -

A

Axial and Coronal

113
Q

ituitary - best planes

A

Sagittal and Coronal

114
Q

Orbits - best planes

A

axial and coronal

115
Q

What do you use to calculate GFR -

A

Creatinine

116
Q

Looking at CSF moving in the brain - what pulse sequence =

A

phase contrast with venc

117
Q

Phase contrast to look at ___.

A

CSF

118
Q

Too much CSF in Brain:

A

hydrocephalus - could lead to syrinx (dilation of central canal)

119
Q

Good view of pulse sequence to diagnose syrinx:

A

Sagittal T2

120
Q

Chiari - could have:

A

syrinx, CSF everywhere

121
Q

If RF is on - the patient or baby concern is:

A

heating

122
Q

SAR stands for:

A

Specific absorption rate

123
Q

GE machine normal mode SAR limit -

A

2 is normal —- 4 is for research

124
Q

core temperature is

A

1 degree Celsius - regulated by FDA

125
Q

When you talk about RF - peripheral nerve stimulation is

A

gradient magnetic factor

126
Q

Magnetic force:

A

translational attraction

127
Q

Torque

A

aneurism clips

128
Q

Quench:

A

explosive - frost bite, ruptured eardrums, asphyxiation

129
Q

When you’re positioning patients you uncross hands - because of

A

contact burns

130
Q

When a patient feels like they’re being electrocuted:

A

peripheral nerve stimulation

131
Q

What artifact do you see on a spine -

A

pulsing artifact CSF - flow artifact is CSF - syrinx is in spiel cord not CSF

132
Q

f you’re looking for spinal plaque -

A

Inversion Recovery —- IR

133
Q

If you’re looking for fracture on spine - best sequence

A

IR Inversion Recovery

134
Q

Procedure on spine when they put cement in:

A

kyphoplasty

135
Q

T1 spine - dark is _________, fracture not as dark

A

kyphoplasty

136
Q

How would you now between cervical, thoracic, or lumbar spine?

A

Cervical - has transverse foramen (vertebral arteries) other two don’t have

Thoracic - facets and ribs, Spinal cord ends around conus medullaris

Lumbar - has cauda equina, psoas muscle

137
Q

On a GRE a dark hemorrhage is caused by:

A

susceptibility artifact

138
Q

Chemical shift artifact cause by:

A

In and out of phase

139
Q

Scanning pituitary (Small FOV) and nose/back of head show up:

A

wrapping or aliasing

140
Q

2 ways you can solve phase wrap:

A

swap phase and freq, or larger FOV, turn on no phase wrap

141
Q

Light bulb goes out in the room, filament:

A

zipper artifact

142
Q

Corduroy artifact caused by:

A

RF leak, or two rubbing metals

143
Q

When you chose a wrong coil for wrong area on spine:

A

Annefact - looks like bright line

144
Q

Someone has hydrocephalus - scan

A

midline SPGR (anything in the middle of the head when you want a thin slice)

145
Q

Someone has MS - scan:

A

Sagittal T2 FLAIR

146
Q

Optic neuritis scan:

A

MS Brain = Sag T2 FLAIR

147
Q

Pituitary Tumors are the only tumor that appears ____.

A

Dark

148
Q

Best views of Pituitary:

A

Coronal and Sagital

149
Q

Orbits views

A

Axial and Coronal

150
Q

Sinuses are the best way to find ________.

A

contrast

151
Q

For Stroke - scan:

A

routine brain and Diffusion and gradient echo

152
Q

Dermoid cyst is proven by scanning:

A

Diffusion DWI

153
Q

Perfusion is for detecting:

A

tumors for surgery

154
Q

Diffusion - New strokes _____ old strokes _____.

A

Bright, Dark

155
Q

Brain MRA - have to do _______.

A

3D TOF

156
Q

Anytime you’re looking for a bleed/stroke - use

A

gradient echo pulse sequence — GRE

157
Q

lateral fissure angle to for:

A

seizure brain

158
Q

cavernoma

A

(little berries blood clusters in the brain)

159
Q

Diffusion 4 - Tensor is

A

20-60

160
Q

Main reason for ADC

A

eliminate T2 Shine through

161
Q

Pituitary and IAC use

A

Half dose and Dynamic injection

162
Q

Pituitary Dx -

A

Growth Hormone or abnormal bloodwork

163
Q

*don’t do IR_____ GAD - or it will suppress the legion - do it ___ gad

A

POST – PRE

164
Q

ANYTIME you have phase wrap -

A

swap phase and frequency (it becomes a to p A-P)

165
Q

MRI Neck - Sagital Sat Pulse -

A

Anterior Inferior

166
Q

MS patient - use

A

STIR IR

167
Q

to see BLEEDS - use

A

GRE

168
Q

MRA neck sat pulse =

A

Superior

169
Q

To visualize MS plaque - use

A

STIR

170
Q

Brachial nerve passes through ________ muscle

A

scalene

171
Q

Subclavian Steal - because of severe

A

stenosis or occlusion

172
Q

stenosis - start seeing collections of __________.

A

collaterals

173
Q

2D TOF shows _______ vessels

3D is good for smaller vessels (brain)

A

straight

174
Q

MRA Above Heart _______ Sat Pulse

Below Heart ________

A

Superior

Inferior

175
Q

MRV Above Heart ______ Sat Pulse

Below Heart _______

A

Inferior

Superior

176
Q

Pathway of blood through heart:

A

Superior vena cava, Right atrium to right ventricle to lungs (pulmonary artery de-oxygenated blood), pulmonary artery, left atrium, left ventricle to aortic arch

177
Q

Phase Contrast PC - done on

A

subclavian and carotids - shows you the direction of the flow (artery vs veins)

178
Q

When we give contrastive scar tissue will _______.

A

light up

179
Q

STIR and T1 fat sat- makes fat _____.

A

Dark

180
Q

lumbar localizer to sacrum -

A

350 or 400

181
Q

In TOF sequence flowing blood - doesn’t become saturated by RF pulse because it’s _______.

A

moving

182
Q

Motion Artifact - always shows in the ___________.

A

background

183
Q

Soft tissue neck

scan after post contrast -

A

T1 fat sat —— (if there’s metal take fat sat away)

184
Q

do not use _____ post gad - it will suppress the lesion

A

STIR

185
Q

use STIR for___ - bright lesions

A

MS

186
Q

Anterior and Middle Scalene muscles =

A

brachial plexus nerve

187
Q

___ lymph nods in the neck

A

300

188
Q

best way to suppress soft tissue neck -

A

Shim

189
Q

SNR increases if you increase ___.

A

FOV

190
Q

f slice thickness increases SNR __________.

A

Increases

191
Q

If looking for dissection -

A

Black Blood (pulse ox) or Spin-Echo

192
Q

If you decrease NEX - SNR __________.

A

decreases

193
Q

If you want to see Vertebral arteries -_________ sat pulse

A

Superior

194
Q

use if you’re trying to get subclavian

A

Tricks

195
Q

Phase Contrast sequence -

A

shows direction of the flow

196
Q

vertebral are off the

A

subclavian

197
Q

internal carotids go to _____.

A

brain

198
Q

decrease bandwidth - SNR __________.

A

increases

199
Q

if you increase FOV it will not increase __________.

A

scan time

200
Q

f you increase matrix it will increase _________.

A

scan time

MRI in Practice - MIDTERM (1 decks)

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