magnetic resonance imaging part 2 applying the science
DESCRIPTION
Magnetic Resonance Imaging Part 2 Applying the Science. Lynn Graham DCR Msc Clinical Specialist in MRI. OUTLINE ( part 2). Clinical Applications of MRI MRI Equipment Safety issues of MRI Advantages + Disadvantages of MR MRI vs Other imaging modalities ( CT/ USS) - PowerPoint PPT PresentationTRANSCRIPT
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Magnetic Resonance Imaging
Part 2Applying the Science
Lynn Graham DCR MscClinical Specialist in MRI
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OUTLINE ( part 2)Clinical Applications of MRI
MRI Equipment Safety issues of MRI Advantages + Disadvantages of MR MRI vs Other imaging modalities ( CT/ USS) Clinical Images
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What is Clinical MRI?1. Transmitter ( generate RF @
larmour frequency)
2. Receiver ( gather MR signal from patient)
3. Computer + Visual Display Unit ( decode the information, produce + display images)
Surrounded by a magnetic field – BIG HUG!!!!
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Equipment : The Magnet
X
Y
Z
Helium Bath
Superconducting coil
Active Shielding
Gradient Coils X Y and Z Planes
Bore
Housing RF
RF
RF
RF Coils
SMM
SM
Shim coils
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Clinical Magnets
• Field strengths 0.2 - 1.5 Tesla• Superconducting
electromagnets
• Cooled by helium bath
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Surface coils
•Loops of wire that detect MR signal
•Designed to fit specific body parts
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The working environment
• Strong magnetic field present at all times.
• MRI field = 1.5 Tesla = 15,000gauss• Earth = 0.5 gauss• MRI is 3000 times stronger!
+
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MRI Safety
No radiation BUT
Very strong magnetic field+
Radio frequency waves
•THE MAGNET IS ALWAYS ON!
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MR Safety -Hazards
• Static Magnetic Field• Time Varying Magnetic Fields• Radiofrequency Waves• Cryogens ( Helium Liquid + gas)• Implants + medical devices• Acoustic Noise
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Static Magnetic Field : The Projectile effect
• Metal objects will be pulled at force towards the magnet
•Force ∝ size of object
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Static Magnetic Field : Biological effects
The creation of electrical potentials in the body may result in sensations
of vertigo or nausea, but
“ exposure to static magnetic fields below 2.5T is unlikely to have any adverse effect on health”
NRBP report 1991
“ there is no indication of serious adverse health effects from whole body exposure up to 8T ”
ICNIRP (MR) 2004
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Gradient
B0B0 -
B0 +
*The creation of differing electrical potentials in the body may result in sensations of vertigo or nausea
Time Varying Magnetic Fields: Biological effects
*Twitching sensations in hands + feet Peripheral Nerve Stimulation
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Time Varying Magnetic Fields: Acoustic Noise
Source : Rapid Switching of Gradient Coils
Risk : low – manufacturers set limits - exposure is not prolonged - ear protection is always
given.
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Radio Frequency Waves
• Biological effects RF deposition results in heating effects within the
body and can interfere with body function if body temp is increased by more than 1 degree per Kg
- Specific Absorption Rate (SAR)
• Induced current burns > cables/ ECG leads > touching the bore > creation of conductive loops e.g.clasped
hands
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Cryogenic Hazards
Liquid Helium – maintains the superconducting magnet
Potential risks - asphyxiation (from displacement of oxygen) - hypothermia - Frostbite
Safety precautions – Oxygen Alarm External Vent Pipes Outward Opening Door to scanner room
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Medical Devices + Implants
Electronic devices may malfunction and have serious medical
consequences.Cardiac Pacemakers
Neurostimulators
Brain shunts
Ear Implants
Clips around blood vessals
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Strict safety procedures
• Protection of Patients + Staff• Local rules/ MDA guidelines• Designated areas/Authorised
Personnel Only• Screening procedures : patients
and staff• Equipment monitoring
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Actual incidents : burns
• RVH 2001 : 3 year old suffered third degree burns to index finger from faulty oximeter – finger subsequently amputated.
• 2 occasions : second degree burns from nicotine patches
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Actual incidents : Fatalities
• June 2001 : Texas University Hospital : 6 year old boy killed by an oxygen cylinder.
• July 2003 : Midlands, England 83 year old woman with pacemaker killed
during MRI scan
• 2000 : Australia Death of a man with pacemaker fitted
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Advantages + Disadvantages
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Disadvantages of MRI
• MR Safety issues – Projectile effect Heating effects Acoustic noise levels Biological Effects • Patient Issues – Claustrophobia Patient co-operation Time consuming procedure Unsuitable for trauma patients
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Advantages of MRI
• No Ionising radiation involved• Non-invasive technique• Excellent anatomical detail• Choice of any anatomical plane• Versatility in tissue differentiation
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The Doctors Choice
MR?
CT?
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MRI vs CTBoth are cross-sectional imaging
( slicing through the body)
CTHigh Dose X rays
Shorter, wider tunnelOnly one plane – axial
Faster – more coverage
MRI A magnet and radiofrequency
Longer narrower tunnelAll imaging planes
availableSlower to acquire image
data
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MRI vs CT (advantages)
• Anatomical soft tissue detail –Brain + CNS - Spine + Joints• Various planes available• No ionising radiation (children)• Tissue differentiation• Lesion characterisation
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MRI vs CT (disadvantages)
• Safety issues – not for all patients - serious risks • Claustrophobia• Patient co-operation is paramount• Time consuming
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MRI vs CT: which one? Generally depends on the patients disease
Cancer - CT faster for disease throughout body MR more specific for actual tumour
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MRI vs CT: which one? Brain + Central Nervous System
Stroke – CT on A+E admission provides diagnosis – MR within 48 hours indicates prognosis
Multiple Sclerosis – MR only modality that can visualise disease
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MRI vs CT: which one?
Joints – CT bony injury MR muscles, ligaments,
cartilage
Spine - CT bony injury MR ligamentus or cord injury
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Next?
Clinical images