Scanning Thorax / Breast

Question 1

What are some indications for a chest MRI ?

Answer 1

1) Mediastinal mass
2) Neurogenic lesions
3) Thoracic Aortic Dissection or aneurysm
4) Differentiation between vascular and lymph node irregularities

Question 2

What position should patients be in for a chest MRI and what coils do we use?

Answer 2

Large surface coil

Supine head 1st with their lungs near the lungs on the bed.

Question 3

What is your first MRI image in a chest protocol?

Answer 3

Localizers :)

Axial, coronal, and sagittal

Question 4

At what level should you be at for a chest MRI?

Answer 4

at the level of the mediastinum

Question 5

What are some indications for doing an Aorta MRI?

Answer 5

vascular occlusion, claudication, stenosis, aneurysm, dissection, Arteriovenous malformation.

Question 6

When scanning an aorta, should you use a large or small field of view ? (FOV)

Answer 6

large

Question 7

Will we use contrast scanning an aorta?

Answer 7

yes

Question 8

When scanning a sagital aorta, use the axial image and go oblique over the axial view of aorta.

Answer 8

True

Question 9

What are some indications for doing a heart MRI?

Answer 9

malignancy, benign mass, thrombus, mets from lung or other parts, infarction, pericarditis, or coronary diease.

Question 10

Name a few cardiac malignancies

Answer 10

Angiosarcoma, sarcoma, malignant paraganglioma, rhabdomyosarcoma (pediatric)

Question 11

Name a few benign cardiac masses

Answer 11

Fibroma, myxoma, lipoma, rhabdomyoma (pediatric)

Question 12

What are the four views we have to get when imaging the heart?

Answer 12

2 chamber
4 chamber
short axis
LVOT (left ventricular outflow tract)
RVOT (right ventricular outflow tract)

Question 13

Which view of the heart is best for evaluating abnormal wall motion?

2 chamber
4 chamber
short axis
LVOT (left ventricular outflow tract)
RVOT (right ventricular outflow tract)

Answer 13

2 Chamber view

Question 14

Where should we align our box when getting a 2-chamber view?

Answer 14

Through the apex of the heart to the midpoint of the mitral valve

(use an axial localizer or 4ch view)

Question 15

Which view would best show the calculation of ventricular volumes/mass, and ejection fraction?

2 chamber
4 chamber
short axis
LVOT (left ventricular outflow tract)
RVOT (right ventricular outflow tract)

Answer 15

short axis

Question 16

When are the chambers of the heart fully relaxed and largest??

Systole or diastole?

Answer 16

end of diastole

Question 17

To get the short axis view, you need to choose a 2 chamber view at the end of diastole and position the slice across the mitral valve annulus.

True or False

Answer 17

True

Question 18

When getting a 4chamber view, you must use which of the following views?

2 chamber
4 chamber
short axis
LVOT (left ventricular outflow tract)
RVOT (right ventricular outflow tract)

Answer 18

Short axis

You align it to pass through the midpoint of the left ventricle and apex of the heart

Question 19

The left ventricular outflow tract is often called the “three chamber view”

True or False

Answer 19

True

Question 20

Use the short axis image at the base of the left ventricle when trying to get the LVOT view.

True

Answer 20

True

Question 21

When imaging the RVOT (right ventricular outflow tract), you use a true axial localizer. Where would we align it to?

Answer 21

through the pulmonary trunk at the bifurication of the right and left pulmonary arteries.

You want to put your slice throught the main pulmonary artery.

Question 22

What are some indications for doing a breast MR?

Answer 22

Known breast cancer
Ruptured implants
Screening for high risk patients or disease in the contralateral breast prior to surgery

Question 23

Breast density is an issue in MRI.

True or False

Answer 23

FALSE!

Question 24

If you are doing a breast MRI on a male, what is the best position to put them in

Prone or Supine?

Answer 24

prone

Question 25

Why is prone the best position for an breast MRI?

Answer 25

It helps deflect any respiratory motion.

Question 26

At what point in a women’s cycle should you do a breast MRI?

Answer 26

mid cycle, around week two (days 7-14)

Question 27

We do not need contrast on breast MRI

True or False

Answer 27

False.

we shall start an IV in the antecubital vein. Timing of contrast is essential.

Question 28

Before positioning the patient in the scanner for a breast MRI, what is the first thing we should do?

Answer 28

put markers on the nipples and any scars or biopsy sites

Question 29

Which view is most important for evaluating fatty structures in the breast ?

Answer 29

3-dimensional vibrant (T1 FSPGR)

It is a NON-fat sat which makes sense bc if were looking for fatty tissues we do not want to drain the fat tissue out.