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CLINICAL MRI. DR.RAVICHANDRA.G. Prof . Dept of Radio Diagnosis. Clinical MRI. Over the past 15 years, MRI has emerged as an important imaging technology for the following areas; Brain Spine Musculoskeletal Vascular. Clinical MRI.
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CLINICAL MRI DR.RAVICHANDRA.G. Prof . Dept of Radio Diagnosis
Clinical MRI • Over the past 15 years, MRI has emerged as an important imaging technology for the following areas; • Brain • Spine • Musculoskeletal • Vascular
Clinical MRI • The last few years have also seen MR begin to add important information for; • Mediastinum • Liver • Biliary • Pelvis
Clinical MRI “Brain Imaging” • MRI is commonly used in the brain for assessment of; - Ischemia • White Matter Disease • Primary & Metastatic Brain Tumour • Cranial Nerves
CEREBRAL ISCHEMIA AND INFARCTION • Symptomatology of stroke has three main etiologies – • Cerebral infarction • Intraparenchymal hemorrhage • Subarachnoid hemorrhage.
Clinical MRI “Brain Imaging” • Sagittal images demonstrating normal anatomy. T2- sag T1-sag
Normal axial images T2 T1
Clinical MRI “Brain Imaging” • T2 Weighted Coronal image demonstrating normal 7th & 8th Nerve anatomy
Acute Left MCA Territory Infarct T2 W FLAIR DIFUSION WEIGHTED EPI
Acute Infarct-PICA Territory T1-axial T2-axial T1-sag T2-sag Flair coronal
Clinical MRI “Vascular Imaging” • MRI is commonly used in the Vascular Tree for assessment of; • Vessel Patency • Aneurysmal Disease • Collateral Vessel Assessment • AV Malformation
Clinical MRI “Vascular Imaging” • TOF Angiogram demonstrating the Circle of Willis and peripheral branch vessels
ACUTE LEFT MCA INFARCT-REDUCED CALIBRE AND MAGNITUDE OF FLOW IN LEFT MCA
A V M T2 AXIAL PD AXIAL GRE AXIAL FLAIR COR
WHITE MATTER DISEASEVisualization of disorders of the cerebral white matter is unquestionably one of the major areas in neurological disease where MR imaging has become the standard and in many instances ,the only acceptable imaging modality.
LEUCKO MALACIA T2-axial FLAIR CORONAL
BRAIN TUMORS • MR Imaging is more sensitive for brain tumors than CT, both in terms of detection and in showing more completely the extent of the tumor. This increase in sensitivity applies to metastatic disease.
THALAMIC GLIOMA T2WI T1WI FLAIR COR CONTRAST ENHANCED T1WI
METASTASIS P L A I N C O N T R A S T
Schwannoma Clinical MRI “Brain Imaging” • T2 Weighted Axial image demonstrating CP Angle Mass Normal 7th & 8Th Nerves Normal 7th & 8Th Nerves
Acoustic Schwannoma T2-axial T1-axial Plain study Contrast enhanced T1WI
MENINGIOMA T2 AXIAL LESION
MENINGIOMA Ctd…. POST CONTRAST
PITUITORY ADENOMA(PLAIN) T1-AXIAL ADENOMA FLAIR CORONAL T1-SAG
CONTRAST STUDY WITH Gd T1-AXIAL T1-SAG T1-CORONAL
Craniopharyngioma Clinical MRI “Brain Imaging” • T1 Weighted Contrast Enhanced Sagittal image demonstrating a Craniopharyngioma
CYSTICERCOSIS T1-axial T2-axial Flair coronal Plain study Edema Contrast study T1 images Lesion enhancing with Gd
Clinical MRI “Spine Imaging” • MRI is commonly used in the spine for assessment of; • Disk Disease • Cord Disease • Vertebral Body Integrity
Clinical MRI “Spine Imaging” • T2 Weighted Sagittal image demonstrating normal cord And vertebral anatomy
Clinical MRI “Spine Imaging” • T2 Weighted Axial images demonstrating normal anatomy
Clinical MRI “Spine Imaging” • T2 Weighted Axial images demonstrating normal Cauda Equina Nerve Root anatomy
Clinical MRI “Spine Imaging” T2W - Sag Disc extrusion Disc protrusion Disc bulge
SPINAL TRAUMA • The greatest impact that MR has made in the evaluation of spinal trauma has been in the assessment of – • Osseous injury • Ligamentous & joint disruption, • Disc injury, • Cord injury, • Epidural hematoma • Vascular injury
SPINE TRAUMA T1-Sag T2-Sag FAST IR
T2-SAG T1 SAG • TRAUMATIC DISC • HERNIATION • EPI DURAL HEMATOMA • CORD EDEMA / • CONTUSION
SCIWORASPINAL CHORD INJUJY WITH OUT RADIOGRAPHIC ABNORMALITY. T2 WEIGHTED SAG
Spine - Koch’s I R T2WI T1WI
Koch’s Contd…. T2-axial T1-axial
EPIDURAL ABSCESS T1 -SAG T2-SAG T1-SAG PLAIN STUDY CONTRAST SUDY