Handbook of MRI Technique (5^th Ed.)

HANDBOOK OF MRI TECHNIQUE

FIFTH EDITION

Distinguished educator Catherine Westbrook delivers a comprehensive and intuitive resource for radiologic technologists in this newly revised Fifth Edition of the Handbook of MRI Technique. With a heavy emphasis on protocol optimisation and patient care, the book guides the uninitiated through scanning techniques and assists more experienced technologists with image quality improvement.

The new edition includes up-to-date scanning techniques and an additional chapter on paediatric imaging. The latest regulations on MRI safety are referenced and there are expanded sections on slice prescription criteria. The book also includes the contributions of several clinical experts, walking readers through key theoretical concepts, discussing practical tips on cardiac gating, equipment use, patient care, MRI safety, and contrast media. Step-by-step instruction is provided on scanning each anatomical area, complete with patient positioning and image quality optimisation techniques.

The book includes:

• A thorough introduction to the concepts of parameters and trade-offs, as well as pulse sequences, flow phenomena, and artefacts
• Comprehensive explorations of cardiac gating and respiratory compensation techniques, patient care and safety, contrast agents, and slice prescription criteria
• Practical discussions of a wide variety of examination areas, including the head and neck, spine, chest, abdomen, pelvis, the upper and lower limbs, and paediatric imaging
• A companion website with self-assessment questions and image flashcards

Perfect for radiography students and newly qualified practitioners, as well as practitioners preparing for MRI-based certification and examination, the Handbook of MRI Technique will also prove to be an invaluable addition to the libraries of students in biomedical engineering technology and radiology residents.

Contributors ix

Preface xi

Acknowledgements xiii

About the Companion Website xv

Chapter 1 How to Use This Book 1

Introduction 1

Common indications 2

Basic anatomy 2

Equipment 2

Patient positioning 5

Slice prescription 6

Suggested protocol 6

Protocol optimization 6

Patient considerations 6

Contrast usage 6

Summary 7

Terms and abbreviations used in Part 2 7

Conclusion 17

Part 1 Theoretical and Practical Concepts 19

Chapter 2 Protocol Parameters and Trade-offs 21

Introduction 21

Signal-to-noise ratio (SNR) 24

Contrast-to-noise ratio (CNR) 24

Spatial resolution 25

Scan time 26

Decision strategies 27

Conclusion 28

Chapter 3 Pulse Sequences 29

Introduction 29

Conventional spin echo (CSE) 29

Fast spin echo or turbo spin echo (FSE/TSE) 32

Inversion recovery (IR/FSE/TSE-IR) 34

Rewound gradient echo 35

Balanced GRE 35

Spoiled GRE 36

Reverse echo GRE 37

Echo planar imaging (EPI) 38

Conclusion 42

Chapter 4 Flow Phenomena and Artefacts 44

Flow phenomena 44

Introduction 44

Time of flight (TOF) 45

Entry slice phenomenon 46

Intra-voxel dephasing 46

Flow artefact remedies 46

Artefacts 48

Introduction 48

Phase mismapping 48

Aliasing 48

Chemical shift 49

Out-of-phase signal cancellation 49

Truncation 49

Magnetic susceptibility 49

Magic angle 50

Conclusion 51

Chapter 5 Gating and Respiratory Compensation Techniques 53

Introduction 53

Cardiac gating (ECG/EKG gating) 53

Peripheral gating (Pe gating) 58

Ciné imaging 59

Imaging planes 60

Respiratory Compensation (RC) 60

Conclusion 61

Chapter 6 Patient Care and Safety 62

Introduction 62

Patient screening 62

Safety zones 63

Safety concerns during the examination 64

Patient counselling 65

Patient immobilization 67

Patient after-care 67

Conclusion 67

Chapter 7 Contrast Agents 68

Introduction 68

Gd-based positive contrast agents 68

Negative contrast agents 70

Patient considerations 70

Conclusion 70

Part 2 Examination Areas 71

Chapter 8 Head and Neck 73

Brain 73

Temporal lobes 86

Internal auditory meatus and posterior fossa 92

Pituitary fossa 97

Orbits 102

Paranasal sinuses 109

Pharynx 113

Larynx 119

Thyroid and parathyroid glands 124

Salivary glands 129

Temporomandibular joints 133

Vascular imaging 137

Head and neck imaging – key points 141

Chapter 9 Spine 142

Cervical spine 142

Thoracic spine 151

Lumbar spine 156

Whole spine imaging 162

Spine imaging – key points 166

Chapter 10 Chest 167

Lungs and mediastinum 167

Heart and great vessels 175

Thymus 186

Breast 189

Axilla 199

Brachial plexus 202

Chest imaging – key points 206

Chapter 11 Abdomen 207

Liver and biliary system 207

Kidneys and adrenal glands 215

Pancreas 222

Bowel 227

Vascular imaging 232

Abdominal imaging – key points 235

Chapter 12 Pelvis 236

Prostate 236

Rectum and testes 244

Uterus and cervix 247

Pelvic imaging – key points 251

Chapter 13 Upper Limb 252

Shoulder 252

Humerus 262

Elbow 268

Forearm 276

Wrist and hand 281

Upper limb imaging – key points 288

Chapter 14 Lower Limb 289

Hips 289

Femur 298

Knee 303

Tibia and fibula 311

Ankle 316

Foot 323

Vascular imaging 328

Lower limb imaging – key points 334

Chapter 15 Paediatric Imaging 335

Introduction 335

Creating the right environment 335

Sedation and anaesthesia 337

The MRI examination 345

Conclusion 375

Paediatric imaging – key points 375

Index 376

Catherine Westbrook is a former Senior Lecturer in Magnetic Resonance Imaging (MRI), Faculty of Medical Science, Anglia Ruskin University, Cambridge, UK, and is a founder and co-director of the MRI Education Company.