Basics of MR Imaging
Dynamic MRI
MRI Closed
The bed rotates from Upright to
Recumbent, stopping at any
angle in between
MRI Open Patient with Low Back Pain After Surgery
Sagittal T2 WI of the lumbar spine with the
Extremity MRI patient supine position (left) and sagittal T2 WIs
of the same patient in the erect position (right)
Note the marked narrowing of the spinal canal
in the erect film denoting marked spinal
instability.
MRI advantages
Superior soft tissue contrast
Multiplannar imaging capability
Absence of artifact from bone
Tissue characterization based on signal behavior
Surface coils
The surface coils are designed to be as close as possible to the
examined area. This ensures better resolution of the images with
adequate adjustment of the field of view
Neck surface coil Spine surface coil
Knee surface coil
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Absolute contra-indications to MRI
Cardiac pace maker
Intra-cranial aneurysmal clipping
Intraocular metallic FB
Cardiac pace maker Aneurysm clip
Relative contra-indications to MRI
Ferro- magnetic metallic objects [wheel chair, trolley,..]
Metallic internal fixation devices [nails, screws, plates,..]
Artificial valves and internal stents are no more contraindications
for MRI
How are MR images produced?
Images are created by the interaction between the external
magnet in the machine and the internal magnet in the human
body
The targeted internal magnet in the human body is the hydrogen
proton because of its widespread availability through out the
tissues (about 80% of the human body is made of water
molecules)
The MR images are obtained by applying radiofrequency (RF)
waves having the same frequency of vibration similar to the
hydrogen proton. This will make these protons to move. This
movement is utilized by the MR machine to produce the image.
So that:
Non mobile protons will give no image, they appear black
If there is no enough protons as in air which contains minimal
hydrogen, then there will be no image as well.
Non mobile hydrogen protons are present in the following sites:
Cortical bone
Mature fibrous tissue [ligaments and tendons in the body]
Calcifications
These structures will normally appear black in all MR images
Sagittal MR images for the knee joint showing the cortex of the femer and
tibia as well as the cruciate ligaments (arrows) as black lines because they
contain non mobile hydrogen protons
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Fluids as [ CSF , effusion , ascites , urine , vitreous , …. ]will
appear black in the T1 and bright in the T2 weighted
images
Axial MR brain images showing the CSF in the ventricles of low signal (black)
in the T1 weighted image (left), while the vitrous humor and CSF in the 4 th
ventricle appear of high signal (bright) in the T2 weighted image (right)
Fat [ Subcutaneous fat, bone marrow , dermoid
cyst,…]will appear bright in the T1 weighted images and
black in T2 weighted images
Sagittal MR images of the knee showing the bone marrow fat of bright
signal (white) in the T1 weighted image (left) and of dark signal in the T2
weighted image (right). The arrow points to an abnormality in the patellar
tendon which is not black in the T2 weighted image
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Minimal hydrogen [air]
Air in the paranasal sinuses as well as in the lung appears black
because it contains minimal hydrogen protons
Axial MR image showing black maxillary
sinuses containing air
The resultant MR image depends on
The presence of adequate amount of hydrogen protons that are
mobile
Motion Amount
Non mobile hydrogen Minimal hydrogen [air] →
[cortical bone] → no signal = no signal= black
black
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Minimal hydrogen [air]
Air in the sinuses Air in the lungs
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MR angiography MRA
Normal MRA of the Circle of Wilis
MR pancreatico-cholangiography MRCP
MR cholongiography showing multiple stones in
the CBD as well as in the gall bladder
MR urography MRU
MR urography showing normal appearance of both
pelvicalyceal systems, uretes and urinary bladder
MR Myelography MRM
MR myelography showing normal findings
