MRI Flashcards

1
Q

T1 vs T2-weighted images

A
  • T2 = very bright image from CSF, grey from brain and not much from fat in skin and bone marrow
  • T1 = CSF dark, good contrasts between grey and white matter
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2
Q

What parameter does contrast depend on in MRI?

A
  • T1 and T2 relaxation times, but can also depend on other parameters such as water diffusion, blood flow or perfusion
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3
Q

What can an MRI tell us?

A
  • anatomy (lesions, abnormal structures, structural changes)
  • Function (blood flow, metabolic changes)
  • Response to treatment (lesion change, functional changes)
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4
Q

Where does the magnetism come from?

A

Spinning protons within water molecules

- magnetic field doesnt line up completely, so it precesses around the field - allows interference

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5
Q

What is the Larmor equation?

A
  • Allows us to work out the exact radiofrequency we have to put in to get the axis to be lined up with the field
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6
Q

What is the basic structure of an MR machine?

A
  • patient lies in bore of superconducting magnet
  • RF coils surrounding the patient - can transmit a radiofrequency through the patient and pick up the signals they give off from the water molecules
  • RF receiver
  • computer > MR image
  • use magnetic field gradients to be able to take a slice in the body
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7
Q

What is T2-relaxation?

A

The decay of the magnetic field in the XY axis

  • more fluid it is, the longer it takes (CSF = bright)
  • something rigid will be much quicker (cartilage = dark)
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8
Q

What is T1-relaxation?

A

The magnetisation recovers along the Z axis

- again longer for fluid to recover

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9
Q

Pulse sequence

A
  • MR image is built up from a series of signal acquisitions
  • repeated several hundred times
  • Echo time and Repetition time determine the contrast
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10
Q

Pulse sequence for T2

A
  • if you wait for a certain amount of time, you get better contrast due to the T2-relaxation
  • CSF dies away slowly, fat dies quickly, grey and white matter are in the middle
  • Get contrast due to differential signals
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11
Q

Why the differences in T2-relaxation times?

A
  • signals from cell membrane die away very quickly - associated water cannot move very much
  • within cell is IC water, and there is EC water - both mobile - signal lasts longer
  • Any necrotic damage means you lose rigidity of membrane and get more water - longer t2
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12
Q

Cerebellar infarct on T2-weighted MR

A
  • longer echo time, you will get much better contrast from the increased mobile water from the infarct - much stronger signal compared to rest of brain
  • lesions in the brain will show up better with t2
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13
Q

Pulse sequence for T1

A
  • Recovery of magnetisation along Z axis (at first its along Z - get no signal, give RF pulse, knocks into XY axis)
  • CSF has very long T1
  • more structured tissue is quicker
  • Because you put next RF pulse in before CSF returns to Z axis, it wont give much of a signal
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14
Q

Differences in T1-relaxation times

A
  • get much more contrast between grey and white matter
  • white matter has lots of myelin, so more water is bound, so quicker than grey matter
  • fat shows up bright, CSF dark
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15
Q

Contrast agents

A
  • if you chelate Galadium, you can inject it safely
  • when water gets in the vicinity, there are strong fluctuations in the magnetic field - decreased relaxation times of both T1 and T2
  • If T1 is quick, then with the agent, it will get brighter
  • in T2, image will get darker
  • difference is bigger with T1 than T2
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16
Q

MS lesions on T1 and T2

A
  • T2, CSF is brighter, increase in intensity due to demyelination so more free protons - longer t2 relaxation.
  • T1, clear grey and white matter demyelination, darker as there is more water.
17
Q

fMRI

A
  • can use fMRI to interrogate the brain while pt is performing motor or mental tasks
  • use BOLD contrast
  • DeoxyHb is much more magnetic, so when there is a change in oxygenation of blood, there is a change in MR signal
  • When they perform a task, brain becomes active, change in blood flow, changes amount of oxygenated blood in brain, changes MR signal, can detect where in the brain it is being activiated
18
Q

fMRI and T2

A
  • long T2 in parts with oxygenated Hb, but when oxygen is used, the blood becomes paramagnetic
  • distortion in magnetism
  • shorter T2 relaxation
19
Q

MRS

A
  • spectroscopy doesnt look at protons in water, it uses protons from other molecules such as cholines, creatinines, aspartate, lipids, glutamate and glutamine.
  • signal intensity is very small due to low concs so have to use much smaller areas of brain
  • protons within molecules precess at different frequencies due to electron cloud shielding
20
Q

MRS and electrons

A

In water, H atoms are bound to oxygen, electrons more around the oxygen

  • in lipids, H atoms are bound to carbon, electrons more around the H atoms
  • therefore nucleus of H is much more shielded in lipids, so you get a lower frequency
  • can use oscillations to make frequency peaks - can then use these to detect what chemicals are present in other areas
21
Q

Give 3 examples of chemicals observed by MRS

A
  • N-acetyl aspartate - found predominantly in neurons, marker for viable neurons (reduced in pathology)
  • Lactate - high in tumours and stroke
  • Alanine - marker for meningiomas
  • lipids - membrane breakdown product
22
Q

Lupus and MRS

A
  • NAA is reduced by 16% in lesions - decreases because of inflammation
23
Q

Safety issues with MRI

A
  • Machine always turned on - no metal objects allowed in room
  • no pacemakers, infusion pumps
  • cant do it in 1st trimester