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WEEK 2 - 3
ANATOMY & PATHOLOGY
 Select a head coil
 To immobilize patients
head make use of pads
 Earplugs for ear
protection are necessary
 Patient is supine head
first into scanner
ANTERIOR
SUPERIOR
INFERIOR
POSTERIOR
 Superior will be
the top of the
image.
 Inferior will be the
bottom of the
image.
 Anterior will be the
front of the
anatomy.
 Posterior will be at
the back of the
image.
NOSE
SUPERIOR
INFERIOR
RIGHT LEFT
 Superior will be
the top of the
image.
 Inferior will be the
bottom of the
image.
 The right side of
the image will be
the technologist
left side.
 The left side will
be the
technologist right
side.
ANTERIOR
RIGHT LEFT
POSTERIOR
 Anterior will be
the front of the
anatomy.
 Posterior will be
at the back of the
image.
 The right side of the
image will be the
technologist left
side.
 The left side will be
the technologist
EYES
• The three membranes called meninges protect the
brain.
MS AIDS
 MS or Multiple
Sclerosis lesions
 AIDS or toxoplasmosis
 Infections
 Meningitis
Pineal Mass Pituitary Adenoma
Right Vestibular
Schwannoma
Tumor
Surgical
planning and
treatment
Epilepsy/seizure
s
Trauma
Hearing loss
seizure
Epidural hematoma
Subdural hematoma
• Intracranial pressure from
tumors or edema can result in
tissue protruding through the
tentorial notch.
• Skull fractures can result in
blood accumulating in the dura
and the cranium and blood
vessels rupturing in the
subdural space
Hemangioblastom
a
Abscess Hydrocephalus
 TIA ( Transient Ischemic
Attack, stroke (old and
new) last for less than
24 hours and is milder
 Syncope
 CVA (Cerebral Vascular
Accident) last for more
than 24 hours and
causes more damage.
 AMS (Altered Mental
Status)
MCA Stroke Abnormal Circle of
Willis
Normal Circle of
Willis
cyst
Right orbital
tumor
Left Internal
auditory
mass
Chari I
malformatio
n
• Chari I
Malformation
occurs when the
cerebellum extends
into the spinal
cord. Surgery is
done to correct this
abnormality.
Cerebral spinal fluid travels through this
system for the bodies central nervous
system.
ANTERIOR POSTERIOR
INFERIOR
SUPERIOR
CORPUS
CALLOSUM
PONS
PITUITARY
GLAND
MEDULLA
OBLONGATA
CEREBELLUM
THALMUS
CEREBRUM
LATERAL
VENTRICLE
4TH
VENTRICLE
CORPUS
CALLOSUM
3RD
VENTRICLE
FALIX
CEREBRI
LATERAL
VENTRICAL
Parietal Lobe
4th
VENTRICLE
Temporal
Lobe
Corpus
Callosum
Lateral
ventricle
4th
ventricle
FRONTAL
HORN OF
LATERAL
VENTRICLE
OCCIPITAL HORN OF
LATERAL VENTRICLE
THALAMUS
CHOROID
PLEXUS
3RD VENTRICLE
FALIX
CEREBRI
FRONTAL
HORN OF
LATERAL
VENTRICLE
OCCIPITAL HORN OF
LATERAL VENTRICLE
THALAMUS
CHOROID
PLEXUS
3RD VENTRICLE
FALIX
CEREBRI
• Largest part of the brain
• Functions include thought and
action.
• Divided into four lobes
• Gray Matter involves muscle
control, and sensory perception
such as seeing and hearing,
memory, emotions, speech,
decision making, and self-control.
• White Matter is responsible for
relaying and arranging
communication between various
brain areas.
BASILAR
ARTERY
CEREBELLUM
PONS
4TH
VENTRICLE
INTERNAL
AUDITORY
CANAL
Temporal
Lobe
ANTERIOR
R L
POSTERIOR
CEREBELLUM
4TH
VENTRICLEPONS
TEMPORAL
LOBE
EYENasal
Septum
PARIETAL
LOBE
TEMPORAL
LOBE
TEMPORAL
LOBE
PARIETAL
LOBE
CEREBELLUM
LOBE
LATERAL
HORN
THALMUS
PARIETAL
LOBE
OCCIPITAL
LOBE
FRONTAL
LOBE
LONGITUDINAL
FISSURE
THALMUS PARIETAL
LOBE
FRONTAL
LOBE
OCCIPITAL
LOBE
Houses these structures:
• Thalamus regulates
sleep and alertness.
• Hypothalamus
regulates body
temperature
• Pituitary Gland is the
“master gland”
because it controls
how other glands
function by means of
its hormones.
• Epithalamus regulates
• Links the nervous
system to the
endocrine system
through the pituitary
gland.
ANTERIOR POSTERIOR
INFERIOR
SUPERIOR
CORPUS
CALLOSUM
PONS
PITUITARY
GLAND
MEDULLA
OBLONGATA
CEREBELLUM
THALMUS
PINEAL GLAND
LATERAL
VENTRICLE
4TH
VENTRICLE
INTERNAL
CAROTID
ARTERY
PONS
PITUITARY
GLAND
PITUITARY
GLAND
TEMPORAL
LOBE
LATERAL
VENTRICLE
CORPUS
CALLOSU
M
4th
VENTRICLE
Sections:
• Midbrain
• Pons
• Medulla
 10 cranial nerves
originate here
 Vital for brain
function
Midbrain
Pon
s
Medulla
Spinal
Cord
 Midbrain
 Located above the pons
 Made up of many nerve fibers
whose job is for hearing, vision,
pain relief and movement.
 Pons
 Responsible for relaying
messages and plays a key role
in sleeping.
 Medulla
 Relays information from the
brain to the spinal cord.
 Needed for breathing, regulating
heart rate or swallowing.
4th
VENTRICLE
PONS
PITUITARY
GLAND
CEREBELLUM
Temporal
Lobe
• “Little brain”
• Controls motor functions
by coordinating with the
cerebrum
• Chari malformations occur
here
ANTERIOR POSTERIOR
INFERIOR
SUPERIOR
CORPUS
CALLOSUM
PONS
PITUITARY
GLAND
MEDULLA
OBLONGATA
CEREBELLUM
THALMUS
LATERAL
VENTRICLE
4TH
VENTRICLE
• Arteries: aneurysms and
strokes are common in this
vessel as it is weak.
• Veins: have no valves and
blood can flow in any direction
even allowing blood borne
pathogens to come from the
body to the head.
• Capillaries:
• Certain abnormal conditions
disrupt the brain barrier
allowing for contrast to escape
the vessels entering the
tissues.
MRA HEAD
MRA HEAD
INTERNAL
CAROTID
ARTERY
ANTERIOR
COMMUNICATING ARTERY
MIDDLE
CEREBRAL
ARTERY
BASILAR
ARTERY
ANTERIOR CEREBRAL
ARTERY
VERTIBRAL
ARTERY
Internal Carotid
Artery
Medial Cerebral
Artery
Circle of
Willis
MRA Carotid
• Stenosis:
atherosclerosis and
vasculitis are reasons
for this exam.
• Aneurysm
Dural sinuses are large
veins located within the dura
mater and house structures
as:
• Internal jugular veins
• Superior/inferior sagittal
sinus
• Straight sinus
• Transverse sinus
• Sigmoid sinus
• Cavernous sinus
• Letter A has an
arrow pointing
toward the missing
transverse sinus.
Letter B shows the
transversus sinus
present.
• Thrombosis or
blood clot is an
indication.
Arise from the brain not the spine.
• 1st – smell, coronal best represents
• 2nd- visual sharpness
• 3rd , 4th, 6th – pupil and lip movement
• 5th – corneal reflex, facial sensation
• 7th – facial weakness
• 8th – hearing and balance
• 9th – taste and salivation
• 10th – regulates bodies unconscious
behaviors
• 11th – elevate shoulders and turn head
• 12th – tongue movement
Midbrain
Pon
s
Medulla
Diencephalo
n
• Diencephalon
Cranial nerve 2
• Midbrain
Cranial nerve 3 &
4
• Pons
Cranial nerve 5-8
• Medulla
Cranial nerve 9-12
2nd
nerve
1st nerve 3rd
nerve
7th & 8th nerve5th nerve 11th & 12th
nerve
 Select a spine coil
 To immobilize patient make use of table
straps & pads
 Earplugs/muffs for ear protection are
necessary
 Patient is supine head first into scanner
 Center lights midline and horizontal light at
the level of the hyoid bone (c-spine), 4th
vertebrae (t-spine) & 3rd lumbar vertebrae.
Cervical &
Thoracic
Landmark
Lumbar
Landmark
ANTERIOR
SUPERIOR
INFERIOR
POSTERIOR
 Superior will be
the top of the
image.
 Inferior will be the
bottom of the
image.
 Anterior will be the
front of the
anatomy.
 Posterior will be at
the back of the
image.
Vertebra
SUPERIOR
INFERIOR
RIGHT LEFT
 Superior will be
the top of the
image.
 Inferior will be the
bottom of the
image.
 The right side of
the image will be
the technologist
left side.
 The left side will
be the
technologist right
side.
ANTERIOR
RIGHT LEFT
POSTERIOR
Anterior will be the
front of the
anatomy.
Posterior will be at
the back of the
image.
The right side of
the image will be
the technologist
left side.
The left side will be
the technologist
right side.
Vertebra
Myxopapillary
Ependymom
a Tuberculosis
Cord Compression
Herniated Lumbar Disc Cervical
Melanoma
Thoracic
Hemangioma
Tumor
Surgical planning and
treatment
Trauma
MS
Disc herniation,
dehydration, stenosis
Soft Tissue
Neoplasm
Spondylodiskitis Schwannoma
Lumbar
Cervic
al
Thoraci
c
• 33 vertebrae
• Provides stability to the body
by distributing the bodies
weight with the help of the
kyphotic and lordotic curves.
FUNCTIONS:
• Protection
• Point of attachment
• Support
• Flexibility and mobility
• Red blood cell production
and mineral storage
CERVICAL
THORACIC
LUMBAR
SACRUM
/COCCY
X
• 7
vertebrae
• 12
Thoracic
• 5 Lumbar
Without:
• Pain
• Fracture
• Degenerative disease
• Radiculopathy
• Fusion Post op follow up
• Herniation
• Syrinx
• Arm, finger and shoulder
pain
With & Without:
• Osteomyelitis
• Tumor or mass
• Cancer
• Rule out mets
• MS or multiple Sclerosis
• Inflammation of disc
ANTERIOR POSTERIOR
INFERIOR
SUPERIOR
Spinal
fluid
Spinal
cord
Intervertebral
disc
C2
C3
C4
C5
C6
C7
DENS
FACET
JOIN
T
FORAMEN
DISC
SPINOUS
PROCESS
Without:
• Pain
• Vertebrolasty and/or
fracture no history of
cancer
• Degenerative disease
• Radiculopathy
• Herniation
• Trauma
With & Without:
• Osteomyelitis
• Tumor or mass, cancer
• MS
• Syrinx
• Vertebrolasty and/or fracture when
there is a history of cancer
• AVM (arteriovenous malformation)
• Rule out mets
• MS or multiple Sclerosis
• Inflammation of disc
T3
T4
T6
T5
T8
T2
T1 DISC
SPINOUS
PROCESS
COSTAL
FACET
SPINAL
CORD
DISC
SPINOUS
PROCESS
TRANSVERSE
PROCESS
L3
Without:
• Pain
• Vertebrolasty and/or
fracture no history of
cancer
• Degenerative disease
• Radiculopathy
• Fusion Post op follow up
• Herniation
• Sciatica
• Trauma
With & Without:
• Osteomyelitis
• Tumor or mass
• Rule out
• Syrinx
• Vertebrolasty and/or fracture when
there is a history of cancer
• Cancer
• Rule out mets
• MS or multiple Sclerosis
• Inflammation of disc
Without:
• Pain
• Vertebrolasty and/or
fracture no history of
cancer
• Degenerative disease
• Radiculopathy
• Fusion Post op follow up
• Herniation
• Sciatica
• Trauma
With:
• Osteomyelitis
• Tumor or mass
• Rule out
• Syrinx
• Vertebrolasty and/or fracture when
there is a history of cancer
• Cancer
• Rule out mets
• MS or multiple Sclerosis
• Inflammation of disc
40-50% of MRI make use of contrast so it is extremely
important to assess each patients potential risk.
• Provide mobility because
they connect the
vertebrae to the cranium
• Protect the head and
neck
• In MRI ligaments appear
as thin black stripes or
signal void.
• No specific pulse
sequence is best to use
PSOAS
Protected by cerebrospinal fluid
forming the spinal meninges.
3 layers:
• Dura
• Arachnoid
• Pia
3 Groups:
• Superficial
Layer
• Intermediate
Layer
• Deep Layer
Nerves
 Gray matter contains
the nerves and runs
down the complete
spinal cord
Video link: https://youtu.be/DtFO3DCvcqY
• Basically are nerves
• Cervical enlargement comes off of
C3-C7
• Lumbosacral enlargement comes off
the lower thoracic area.
• Function as the motor and sensory
unit of the muscles and skin in the
extremities.
• Spinal arteries
supply blood to
the spinal cord.
• Anterior spinal
artery
• Posterior spinal
arteries
• Spinal branches
• Screening/pain
• Headaches
• Trauma/MVA
• MS
• Not routinely
given for brachial
plexus
No Contrast Contrast :
• Tumor
• Infection
• History of cancer
• Post surgery
• Brachial plexus for
mass/tumor only
MVA is motor vehicle accident
MS is multiple Sclerosis
CONTRAST
 Multihanc
e
 Magnevist
 Omniscan
TYPES: CONTRAINDICATIONS:
DOSE
CALCULATION:
 No contrast if
patient is on
dialysis*
 GFR less than 30
.1mmol/kg of
body weight
*Dialysis patients may receive contrast if a radiologist signs his/her approval and
the patient must receive dialysis as soon as possible.
ANTERIOR
SUPERIOR
INFERIOR
POSTERIOR
 Superior will be
the top of the
image.
 Inferior will be the
bottom of the
image.
 Anterior will be the
front of the
anatomy.
 Posterior will be at
the back of the
image.
SUPERIOR
INFERIOR
RIGHT LEFT
 Superior will be
the top of the
image.
 Inferior will be the
bottom of the
image.
 The right side of
the image will be
the technologist
left side.
 The left side will
be the
technologist right
side.
ANTERIOR
RIGHT LEFT
POSTERIOR
 Anterior will be the
front of the
anatomy.
 Posterior will be at
the back of the
image.
 The right side of
the image will be
the technologist
left side.
 The left side will
be the
technologist right
side.
 Labral tear
 Tumor/mass
 Lipoma
Cancer
Trauma
Contusion
Arthritis
Vascular
malformation
Abscess
ACL Tear
Baker’s Cyst
Baker’s Cyst
T1 Weighted
Sagittal
T1 Weighted
Sagittal
Post
T1 Weighted
Coronal
• Carries the weight of your
body while standing.
• Acetabular labrum and
ligaments holds the femur
in place
• The strongest and longest
bone of the body
• Bursae reduce friction in
the areas they are located
• Commonly called SI
Joint
• Comprised of the distal
femur and proximal tibia
and fibula
• Largest joint in the body
• Tibia is a large bone that makes up the knee
and ankle
• Provides support for the body
• The fibula is the long, thin and
lateral bone of the lower leg. It runs
parallel to the tibia, or shin bone, and plays
a significant role in stabilizing the ankle and
supporting the muscles of the lower leg
Contains 7 tarsal bones
• Calcaneus
• talus
• cuboid
• navicular
• the medial, middle, and
lateral cuneiforms
• Contains 5 metatarsal bones and
14 phalanges
• Calcaneus is the largest tarsal
bone that distributes weight
throughout the foot
• Femoral=femur
• Popliteal=runs down from
the femoral over the knee
• Tibial artery=tibia
Select body coil
To immobilize patients make use of
straps and pads. Point toes toward
one another and use strap to hold
them in position
Earplugs or headphones for ear
protection are necessary
Patient is supine feet first into
scanner
Arm across chest
Center light with cross hairs going
Without:
• Pain
• Fracture/Stress
Fracture
• AVN or Avascular
Necrosis
• Arthritis
• Tears in muscles or
ligaments
With & Without:
• Osteomyelitis
• Tumor or mass
• Cancer
• Rule out mets
• Ulcer
• Abscess
• Arthrogram: labral tear,
loose bodies
Femoral
head
Femoral
neck
L5 spine
Lesser
Trochante
r
Ilium
Acetabulum
Labrum
IT
band
Gluteus
minimus
muscle
Gluteus
medius
muscle
Ischium
Femoral
artery
Obturator
Internus muscle
Femoral
head
Greater
trochanter
Acetabulum
Rectus
muscle
Bladder
Femoral
vein
Gluteus maximus
muscle
Ischiu
m
Ilium
Femoral
head
Iliopsoas
muscle
Acetabulum
Gluteus
Maximu
s
muscle
Labrum
Select body coil
To immobilize patients make use of
straps and pads. Point toes toward
one another and use strap to hold
them in position
Earplugs or headphones for ear
protection are necessary
Patient is supine feet first into
scanner
Arm across chest
Center light with cross hairs going
Without:
• Pain
• Fracture/Stress Fracture
• AVN or Avascular Necrosis
• Arthritis
• Tears in muscles or
ligaments
With & Without:
• Osteomyelitis
• Tumor or mass
• Cancer
• Rule out mets
• Ulcer
• Abscess
• Arthrogram: labral tear,
loose bodies
Sacral
nerve
Gluteus
Maximus
muscle
SI Joint
Psoas
muscle
Gluteus
Medius
muscle
Sacral
foramin
a
Sacrum
Sacrum
SI Joint
Gluteus
maximus
muscle
Ilium
Psoas
Select body coil
To immobilize patients make use of
straps and pads. Point toes
toward one another and use strap
to hold them in position
Earplugs or headphones for ear
protection are necessary
Patient is supine feet first into
scanner
Arm across chest
Center light with cross hairs going
Without:
• Pain
• Fracture/Stress Fracture
• AVN or Avascular Necrosis
• Arthritis
• Tears in muscles or
ligaments
With & Without:
• Osteomyelitis
• Tumor or mass
• Cancer
• Rule out mets
• Ulcer
• Abscess
• Arthrogram: labral tear,
loose bodies
Femur
Femur
Femur
Femoral
head
Patella
Rectus
Femoris
Abducto
r
Magnus
Gluteus
maximu
s
Select body coil
To immobilize patients
make use of straps and
pads.
Earplugs or headphones
for ear protection are
necessary
Patient is supine feet first
into scanner
Center light with cross
Without:
• Pain
• Fracture/Stress Fracture
• AVN or Avascular Necrosis
• Arthritis
• Tears in muscles or
ligaments
With & Without:
• Osteomyelitis
• Tumor or mass
• Cancer
• Rule out mets
• Ulcer
• Abscess
• Arthrogram: labral tear,
loose bodies
SUPERIOR
INFERIOR
Anterior
Cruciate
Ligamen
t
Fibula
Tibia
Femur
LEFTRIGHT
SUPERIOR
POSTERIOR
Tibia
Patella
Femur
Gastrocnemiu
s
muscle
Posterior
cruciate
ligament
INFERIOR
ANTERIOR
 Select knee or flex coil
 To immobilize patients
make use of straps
and pads.
 Earplugs or
headphones for ear
protection are
necessary
 Patient is supine feet
first into scanner
 Center light with cross
hairs going through
Without:
• Pain
• Fracture/Stress Fracture
• AVN or Avascular Necrosis
• Arthritis
• Tears in muscles or
ligaments
With & Without:
• Osteomyelitis
• Tumor or mass
• Cancer
• Rule out mets
• Ulcer
• Abscess
• Arthrogram: labral tear,
loose bodies
Intercondyla
r
fossa
Tibia
Medial
condyle
Lateral
condyle
Fibula
Lateral
meniscus
Medial
meniscus
Medial
Collateral
ligament
Patella
Intercondylar
fossa
Medial
Femoral
condyle
Popliteal
artery
Lateral
Femoral
condyle
Quadriceps
tendon
Lateral
meniscus
Patella
Tibia
Patellar
ligament
Popliteal
artery
 Select ankle/foot, knee or flex coil
 To immobilize patients make use
of straps and pads.
 Earplugs or headphones for ear
protection are necessary
 Patient is supine feet first into
scanner
 Center light with cross hairs at mid
section of tarsal bone
Without:
• Pain
• Fracture/Stress Fracture
• AVN or Avascular Necrosis
• Arthritis
• Tears in muscles or
ligaments
With & Without:
• Osteomyelitis
• Tumor or mass
• Cancer
• Rule out mets
• Ulcer
• Abscess
• Arthrogram: labral tear,
loose bodies
Tibia
Fibula
Tibia
Achilles
Tendon
Talus
Navicular
Sinus
Tarsi
Calcaneu
s
Tibia
Lateral
condyle
Talus
Medial
condyle
Ankle
joint
 Select foot/ankle or flex coil
 To immobilize patients make use
of straps and pads.
 Earplugs or headphones for ear
protection are necessary
 Patient is supine feet first into
scanner
 Center light with cross hairs going
through the mid section of
metatarsal bones.
Without:
• Pain
• Fracture/Stress Fracture
• AVN or Avascular Necrosis
• Arthritis
• Tears in muscles or
ligaments
With & Without:
• Osteomyelitis
• Tumor or mass
• Cancer
• Rule out mets
• Ulcer
• Abscess
• Arthrogram: labral tear,
loose bodies
ANTERIOR
POSTERIOR
Metatarsals
Navicular
Phalanx
Talus
Tibia
Calcaneus
INFERIOR
SUPERIOR
Cuneiforms
SUPERIOR
INFERIOR
1
LEFTRIGHT 2
3
4
5
SUPERIOR
INFERIOR
Cuneiforms
Navicula
r
Talus
Metatarsals
Phalanx
LEFTRIGHT
ANTERIOR
SUPERIOR
INFERIOR
POSTERIOR
 Superior will be
the top of the
image.
 Inferior will be the
bottom of the
image.
 Anterior will be the
front of the
anatomy.
 Posterior will be at
the back of the
image.
SUPERIOR
INFERIOR
RIGHT LEFT
 Superior will be
the top of the
image.
 Inferior will be the
bottom of the
image.
 The right side of
the image will be
the technologist
left side.
 The left side will
be the
technologist right
side.
ANTERIOR
RIGHT LEFT
POSTERIOR
 Anterior will be the
front of the
anatomy.
 Posterior will be at
the back of the
image.
 The right side of
the image will be
the technologist
left side.
 The left side will
be the
technologist right
side.
 Labral tear
 Tumor/mass
 Lipoma
Cancer
Trauma
Contusion
Surgical planning
and treatment
Vascular
malformation
Abscess
Bursitis
Ganglion Cyst of wrist
Rotator Cuff Tear
Ganglion cyst of foot
(T2 FS)
T1 Weighted
Sagittal
T1 Weighted
Coronal
postPD Weighted Axial
• Responsible for the arm being
connected to the body.
• Made up by the clavicle and
scapula.
• The clavicle and sternum for the
SC or sternoclavicular joint.
• Distal portion of the humerus
flattens to form a portion of the
elbow
• Distal portion of the bicep tendon
attaches here as well.
• Largest bone in the upper portion of
the extremities
• Ball and socket joint within the glenoid
fossa and scapula.
• Biceps tendon attaches here
• Made up by the ulna and radius
bones
• Distal portion of the bicep tendon
attaches here as well.
8 carpal bones make up this
structure.
1. Scaphoid
2. lunate
3. triquetral
4. pisiform
5. trapezium
6. trapezoid
7. capitate
8. hamate
• These control hand movement
possible in various directions.
• Ability to point, lift, hold and grab
items.
• Temporomandibular joint
• Allows movement of the jaw for
eating and speaking.
• Aorta runs down into the lumbar
region and bifurcates into the
common iliac arteries. You have
serval major arteries and veins
that supply blood to the
extremities and if they are cut off
loss of use of that extremity can
 Select a shoulder or flex
coil
 To immobilize patients head
make use of straps and
pads
 Earplugs or headphones for
ear protection are
necessary
 Patient is supine head first
into scanner
 Arm down by side
thumb/palm up, if possible
 Landmark is noted by the
yellow cross hairs; center
Select a shoulder or flex
coil
To immobilize patients
head make use of straps
and pads
Earplugs or headphones
for ear protection are
necessary
Patient is supine head first
into scanner
Arm down by side palm
Deltoid
muscle
Head of
humerus
Acromion
Glenoid
fossa
Supraspinatu
s
muscle
Glenohumeral
joint
Labrum
Subscapulari
s
muscle
Biceps tendon
Glenoid
process
Labrum
Greater
Tubercl
e
Deltoid
Muscle
Infraspinatu
s
Lung
Humeral
head
Teres minus
tendon
Supraspinatu
s
muscle
Subscapularis
tendon
Biceps
tendon
Acromion
Infraspinatus
tendon
Deltoid
muscle
Head of
humerus
Labrum
Glenoid
process
Infraspinatus
tendon
 Select a flex coil that is placed
length wise with the arm
 To immobilize patients make
use of sandbags, straps and
pads
 Earplugs or headphones for ear
protection are necessary
 Patient is supine head first into
scanner .
 Arm down by side
 Landmark is noted by the
yellow cross hairs; center point
is the humerus bone.
Head of
humerus
Condyles
Humerus
Deltoid
muscle
Deltoid
muscle
Head of
humerus
Medial
epicondyl
e
Humerus
Radial head
Lateral
epicondyl
e
 Select a flex coil that is placed
length wise with the arm
 To immobilize patients make
use of sandbags, straps and
pads
 Earplugs or headphones for ear
protection are necessary
 Patient is supine head first into
scanner arm down by side or
swimmers position for those
healthier patients
 Landmark is noted by the
yellow cross hairs; center point
is the elbow joint
Humeru
s
Lateral
epicondyle
Olecranon fossa of
humerus
Olecranon
process
Medial
epicondyl
e
Humeru
s
Ulna
Medial
epicondyle
Lateral
epicondyle
Radius
Cornoid
fossa
Common
flexor
tendon
Triceps
muscle
Biceps
muscle
Radial
Fossa
Humerus
Humerus Triceps
muscle
Brachial
muscle
Radial
Neck
Radial
Head
 Select a flex coil that is placed
length wise with the arm
 To immobilize patients make
use of sandbags, straps and
pads
 Earplugs or headphones for ear
protection are necessary
 Patient is supine head first into
scanner or swimmers position
for those healthier patients
 Arm down by side
 Landmark is noted by the
yellow cross hairs; center point
is the mid point of forearm
S
I
Ulna
Radius
Wrist bones
LEFTRIGHT
S
I
Radius
Ulna
Median nerve
LEFTRIGHT
Cephalic
vein
S
I
Distal
portion of
radius
Ulna
Neck of
radius
Wrist & hand bones
Olecranon
process
Head of radius
P
A
 Select a wrist/hand or flex
coil
 To immobilize patient make
use of straps and pads
 Earplugs or headphones for
ear protection are
necessary
 Patient is prone head first
into scanner; yellow cross
hairs should meet at the
mid point of the anatomy
 Known as “Superman”
position
SUPERIOR
INFERIOR
Ulna
Scaphoid
Hamat
e
Lunate
Radius
Trapezoid
&
Trapezium
Capitate
Triquetral
LEFTRIGHT
1st
metacarpal
5Th
metacarpal
Ligaments
Radial
artery
SUPERIOR
POSTERIOR
Radius
Flexor
tendon
Capitate
Lunate
Extensor
tendons
Metacarpal
INFERIOR
ANTERIOR
SUPERIOR
INFERIOR
Distal
Interphalangeal
jt
Metacarpal
Capitate
Middle
phalanx
Distal phalanx
Proximal
phalanx
POSTERIORANTERIOR
Proximal
Interphalangeal
jt
Metacarpophalangeal
jt
Lunate
Flexor
tendons
P
A
Collateral
ligament
5th
MC
Thumb
Flexor
tendon
LEFT
RIGHT 4th
MC
2nd
MC
3rd
MC
S
I
Coronoid
Process
of
mandible Condyloid
process
Ramus of
mandible
Mandibular
fossa
Temporal lobe
External
Auditory
meatus
PA
ANATOMY, PATHOLOGY & BASIC MRI
CARDIAC
 Select a body or breast coil
 To immobilize patients make use of
straps.
 Earplugs for ear protection are
necessary.
 Chest: Patient is supine head first
into scanner.
 Cardiac gating used
 Breast: prone head first
ANTERIOR
SUPERIOR
INFERIOR
POSTERIOR
 Superior will be
the top of the
image.
 Inferior will be the
bottom of the
image.
 Anterior will be the
front of the
anatomy.
 Posterior will be at
the back of the
image.
ANTERIOR
SUPERIOR
INFERIOR
POSTERIOR
 Superior will be
the top of the
image.
 Inferior will be the
bottom of the
image.
 Anterior will be the
front of the
anatomy.
 Posterior will be at
the back of the
image.
SUPERIOR
INFERIOR
RIGHT LEFT
 Superior will be
the top of the
image.
 Inferior will be the
bottom of the
image.
 The right side of
the image will be
the technologist
left side.
 The left side will
be the
technologist right
side.
ANTERIOR
RIGHT LEFT
POSTERIOR
 Anterior will be the
front of the
anatomy.
 Posterior will be at
the back of the
image.
 The right side of
the image will be
the technologist
left side.
 The left side will
be the
technologist right
side.
ANTERIOR
RIGHT LEFT
POSTERIOR
 Anterior will be the
front of the
anatomy.
 Posterior will be at
the back of the
image.
 The right side of
the image will be
the technologist
left side.
 The left side will
be the
technologist right
side.
 Aortic
Dissection
 Cyst in
chest/breast
 Aortic
Aneurysm
Sternum Mass Aortic Dissection Lung Cancer
Tumor
Surgical planning and
treatment
Pulmonary Embolism
• Thoracic vertebrae
• Sternum
• Ribs
ANTERIOR
POSTERIOR
INFERIOR
SUPERIOR
Sternum
body
Sternum
angle
Thoracic
vertebrae
Manubrium
Right
Atrium
Pulmonary
trunk
Left
ventricle
Aortic
ArchSuperior
vena
cava
Right
brachiocephali
c vein
Esophagu
sTrache
a
SVC
Rt
pulmonary
artery
Lt
ventricle
Lt
pulmonary
artery
Lt
subclavian
artery
Vertebral
artery
Aortic
arch
Trachea
Esophagu
s
Humerus
Right
Lung
Ascending
aorta
Pulmonary
trunk
Descending
aorta
Right
mainstem
bronchi
Azygos
vein
Superior
vena
cava
• Responsible for respiration
• Divided into lobes
• Right lung has 3 lobes
• Left lung has 2 lobes
• The hilum is referred to as
the “root of the lung”
because it allows mainstem
bronchi, blood vessels, lymph
vessels and nerves to enter
and exit the lung.
Upper RT lobe
Lower LT
lobe
Upper LT lobe
Lower RT lobe
Middle RT lobe
Ribs
Right
lung Trachea
Left lungSternum
• Mediastinum is located
between two pleural cavities
of the lungs midline behind
the manubrium thoracic
cavity.
• Thymus is located behind the
manubrium and responsible
for immunity.
• Lymph nodes normally aren’t
visible unless they are
enlarged.
Thymu
s
Trache
a
Esophagus
Inferior
vena
cava
Ribs
Heart
Descending
aorta
Upper
lobe of
liver
Sternum
Spleen
• Located in the middle
of the mediastinum
• 4 chamber organ
• A muscle organ
• RA: Right Atrium
• RV: Right Ventricle
• LA: Left Atrium
• LV: Left Ventricle
• AO: Aorta
• SVC: Superior vena
cava
ANTERIOR POSTERIOR
INFERIOR
SUPERIORAortic Arch
Liver
Right
Ventricle
Pulmonary
trunk
Spine
Left Atrium
Sternu
m
Descendin
g Aorta
Descendin
g Aorta
Ascending
Aorta
Mainstrea
m Bronchi
Superior
vena
cava
Pulmonar
y Trunk
Right
Atrium
Pulmonary
trunk
Left
ventricle
Aortic
ArchSuperior
vena
cava
Right
brachiocephali
c vein
• To remove motion the
technologist will use gating or
triggering
Types of motion:
Periodic
• “beating heart motion
• Arterial flow cause pulsatile
flow motion
• Respiratory motion
Aperiodic motion
• Moving patient
• Swallowing
• Peristalsis
Technologist
set the lines at
the diaphragm
all the way to
the apices of
the lungs to
acquire an
axial/transver
se image.
Technologist set
the lines at the
diaphragm all
the way to the
apices of the
lungs to acquire
a sagittal
image.
Technologist
set the lines at
the diaphragm
all the way to
the apices of
the lungs to
acquire a
coronal image.
Standard
Protocol
• 3 plane localizer
• DWI
• Sagittal T1
• Axial T2 FSE/TSE
• Axial T1 Pre
• Axial Flair
• Coronal T2
POST GADOLINIUM
• Axial T1 post
• Coronal T1 post
• Screening
• Trauma
No Contrast Contrast :
• Tumor
• Infection
• Cancer
CONTRAST
 Multihanc
e
 Magnevist
 Omniscan
TYPES: CONTRAINDICATIONS:
DOSE
CALCULATION:
 No contrast if
patient is on
dialysis*
 GFR less than 30
.1mmol/kg of
body weight
T1 Sag Post
Gad
T1 Ax Post Gad T1 Cor Post
Gad
Standard
Protocol
• 3 plane localizer
• Sagittal T1
• Axial T2 Fat saturation (FS)
• Axial T1
• 3D Ax T1 FS GRE pre
• POST GADOLINIUM
• Dynamic 3D Ax T1 FS GRE
post
Purpose
• Evaluation for breast implant
rupture
• Diagnostic tool in the evaluation
of known or suspected breast
cancer
• Imaging of the axillary region in
cases of axillary lymphadenopathy
with unknown primary
• Monitoring response to post-
surgical primary chemotherapy
• Pre-surgical evaluation of residual
disease following neo-adjuvant
Coronal
setup
Axial
setu
p
Sagittal
setup
Corona
l setup
CONTRAST
 Multihanc
e
 Magnevist
 Omniscan
TYPES: CONTRAINDICATIONS:
DOSE
CALCULATION:
 No contrast if
patient is on
dialysis*
 GFR less than 30
.1mmol/kg of
body weight
Rate of
injection: 2ml/s
with saline flush
No fat
saturation
Fat saturation Subtraction
Normal breast
with implant
Rupture
Standard
Protocol
• 3 plane localizer
• Axial Haste thru heart
• Axial Trufi thru heart
• Axial T1black blood
• Coronal 3D TOF pre
POST GADOLINIUM
• Coronal 3D TOF post
**customize the exam based upon
the indication, age, cardiovascular
status and anatomy.
CONTRAST
 Multihanc
e
 Magnevist
 Omniscan
TYPES: CONTRAINDICATIONS:
DOSE
CALCULATION:
 No contrast if
patient is on
dialysis*
 GFR less than 30
.1mmol/kg of
body weight
Rate of
injection: 3ml/s
with saline flush
• identify abnormalities, such as aneurysms, in the aorta, both in the
chest and abdomen, or in other arteries.
• detect atherosclerotic (plaque) disease in the carotid artery of the
neck, which may limit blood flow to the brain and cause a stroke.
• identify a small aneurysm or arteriovenous malformation (abnormal
communications between blood vessels) inside the brain or other parts
of the body.
• guide interventional radiologists and surgeons making repairs to
diseased blood vessels, such as implanting stents or evaluating a stent
after implantation.
• detect injury to one or more arteries in the neck, chest, abdomen,
pelvis or extremities in patients after trauma.
• evaluate arteries feeding a tumor prior to surgery or other procedures
such as chemoembolization or selective internal radiation therapy.
• identify dissection or splitting in the aorta in the chest or abdomen or
its major branches.
• show the extent and severity of the effects of coronary artery disease
and plan for a surgical operation, such as a coronary bypass and
stenting.
• examine pulmonary arteries in the lungs to detect pulmonary embolism
(blood clots, such as those traveling from leg veins) or pulmonary
arteriovenous malformations.
• look at congenital abnormalities in blood vessels, especially arteries in
children (e.g., malformations in the heart or other blood vessels due to
MRA Chest 3D Sagittal MRA Chest
Sagittal
“Candy Cane view”: angle through a plane that
dissects the descending and ascending aorta.
MRA Chest
Coronal
MRA Chest
Sagittal
Standard
Protocol
• 3 plane localizer
• Axial haste dark blood localizer
• Sagittal T1
• Axial T2 FSE/TSE
• Axial T1 Pre
• Axial Flair
• Coronal T2
POST GADOLINIUM
• Axial T1 post
• Coronal T1 post
CONTRAST
 Multihanc
e
 Magnevist
 Omniscan
 Ablavar
TYPES: CONTRAINDICATIONS:
DOSE
CALCULATION:
 No contrast if
patient is on
dialysis*
 GFR less than 30
.1mmol/kg of body
weight (amount can
be doubled or tripled
per cardiologist only)
Rate of injection:
3ml/s with saline
flush
Imaging planes and scan setup are to the
heart muscles and chambers not the
chest itself.
Views:
1. Short Axis/two chamber=shows both
ventricles
2. Long Axis/two chamber view
3. Three chamber
4. Four chamber/long axis view=shows the left
and right side of heart
Gating methods & triggering:
1. ECG
2. Peripheral gating by use of a pulse oximeter
placed on the finger
3. The heart beat triggers the picture to be
taken.
Gating methods:
1. The rate at which the patients
heart beats will determine the
speed of the scan.
2. Slice is determine by the heart
rate.
Safety:
1. Make sure the cables don’t loop or
touch the patient
2. ECG is preferred method of gating
Axial view
Long Axis
2
chamber
Axial T1
Long Axis
4
chamber
Four chamber view
Short Axis view
Short Axis
APEX
BASE
Three Chamber View
Spin Echo
Fast Spin Echo
Blood shows
dark
EPI
Inversion Recovery
Gradient Echo
Blood shows bright
 Select a body coil
 To immobilize patients head
make use of straps
 Earplugs or headphones for
ear protection are
necessary
 Patient is supine head first
into scanner
ANTERIOR
SUPERIOR
INFERIOR
POSTERIOR
 Superior will be
the top of the
image.
 Inferior will be the
bottom of the
image.
 Anterior will be the
front of the
anatomy.
 Posterior will be at
the back of the
image.
SUPERIOR
INFERIOR
RIGHT LEFT
 Superior will be
the top of the
image.
 Inferior will be the
bottom of the
image.
 The right side of
the image will be
the technologist
left side.
 The left side will
be the
technologist right
side.
ANTERIOR
RIGHT LEFT
POSTERIOR
 Anterior will be the
front of the
anatomy.
 Posterior will be at
the back of the
image.
 The right side of
the image will be
the technologist
left side.
 The left side will
be the
technologist right
side.
 Fibroids
 Stomach mass
 Infections
 Kidney lesion
Tumor
Abdominal Aortic
Aneurysm
Dilated Ducts
Herniation
Surgical planning
and treatment
Pancreatic mass
Trauma
Spleen
abnormalities
Kidney
Renal cancer
Splenomegaly
Polyscystic kidney
T2 Weighted
Sagittal
T1 Weighted
Coronal
T1 Weighted Axial
Bowel
Left
Psoas
Muscle
Aorta
Liver
Right
Kidney
Heart
Right
Portal
vein
Aorta
Portal
vein
Left
Lung
Left
Portal vein
Stomach
Spleen
Head of
pancreas
Body of
pancreas
Right
Lung
Liver
Right
Kidney
Right
Psoas
Muscle
Spinal
Canal
Spleen
Liver
Spleen
AortaIVC
Lumbar vertebrae
Liver Spleen
Pancreas
Gallbladde
r
Lumbar vertebrae
Bowel
IVC
Aorta Left
Kidney
ANTERIOR
POSTERIOR
Liver
Inferior
Vena
Cava
Aorta
Left
kidney
Tail of Pancreas
Bowel
Stomach
Portal vein
Spleen
LEFTRIGHT
IVC
Psoas muscle
Sup.
Mesenteric
vein
Aorta
Sup.
Mesenteric
artery
Bowel
Liver
Left
ureter
IVC
Right
kidney
Liver
Aorta Stomach
Spleen
Right
Hepatic
Vein
• Divided into the fundus, body and
neck.
• Forces bile into the duodenum.
• Divided into the head, body,
uncinate process, neck, body and
tail.
• The common bile duct and
gastroduodenal artery run through
the head.
• Has a bumpy appearance
• Located on the left side and is highly
vascular.
• Responsible for producing white blood
cells, store iron from red blood cells,
filter abnormal blood cells, initiate an
immune response when needed.
• Arterial phase gives it a varied
appearance
• Located above the kidneys
• Triangular and Y shaped
• Responsible for the production of
steroids, hormones, glucose and
minerals.
• Kidneys and ureter are inside the
abdomen.
• Waste is transported and filtered
through various aspects of the
kidney.
• To transport them to the bladder
is the ureters.
• Main function is to remove urine,
filter blood and help maintain
normal body physiology.
• Stores food
• Uses acids an enzymes to break
down food
• Small and large intestines
• Transport waste, nutrients
absorption, and digestion occur
• Magnetic
resonance
cholangiopancreat
ography
• Biliary obstruction
or malignancy
• Chronic
pancreatitis
Neck of
gallbladder
Common bile
duct
Common
hepatic duct
Fundus of
gallbladder
Body of
gallbladder
Pancreas
• Aorta
• Common iliac artery
• Renal Arteries
• Celiac trunk
• Common hepatic artery
• Superior mesenteric artery
• Inferior mesenteric artery
• Veins
MRA Abdomen MRA Renal
Aorta
Left renal
artery
Common
iliac artery
Non invasive
test to see
swelling and
irritation,
bleeding and
other small
bowel
conditions.
Crohn’s Disease
 Select a body coil
 To immobilize patients head
make use of straps
 Earplugs or headphones for
ear protection are
necessary
 Patient is supine head first
into scanner
ANTERIOR
SUPERIOR
INFERIOR
POSTERIOR
 Superior will be
the top of the
image.
 Inferior will be the
bottom of the
image.
 Anterior will be the
front of the
anatomy.
 Posterior will be at
the back of the
image.
SUPERIOR
INFERIOR
RIGHT LEFT
 Superior will be
the top of the
image.
 Inferior will be the
bottom of the
image.
 The right side of
the image will be
the technologist
left side.
 The left side will
be the
technologist right
side.
ANTERIOR
RIGHT LEFT
POSTERIOR
 Anterior will be the
front of the
anatomy.
 Posterior will be at
the back of the
image.
 The right side of
the image will be
the technologist
left side.
 The left side will
be the
technologist right
side.
 Fibroids
 Tumor/mass
 Sacral tumor
Tumor Rectal Cancer Melanoma of rectum
Herniation
Surgical planning and
treatment
Uterine cancer
Trauma
Male organ
abnormalities
Female organ
abnormalities
Ewing sarcoma
Testicular Seminoma
Polyscystic kidney
T2 Weighted
Sagittal
T1 Weighted
Coronal
post
T1 Weighted Axial
• Stores urine and the urethra
drains into it.
• Rest on the pelvic floor and is
anchored by ligaments
• Begins at S3 and connects to the
anus
• Various muscles control the
evacuation of waste material out
of the anus.
• Uterus, ovaries, uterine tubes and
vagina.
• Responsible for sex hormones
• Protects embryos and support the
growth and development of embryos.
• The uterus is the main protector of the
baby.
• Formed by the sacrum, coccyx,
ilium, ischium and pubis.
• Scrotum, testis, prostate, vas
deferens, epididymis, seminal
vesicle and penis.
• These control leg movement
making walking possible and
moving the leg laterally.
• Pelvic diaphragm muscles support
contents of the pelvis.
• Drain for the lymphatic system
and originate in regions such as
common iliac, internal iliac, sacral
and external iliac.
• Aorta runs down into the lumbar
region and bifurcates into the
common iliac arteries.
Femoral
head
Bladder
Vertebrae
ilium
Acetabulu
m
Sacrum
Psoas
Muscle
Ilium
Gluteus
Maximus
Muscle
Sacral
Foramin
a
SI Joint
Gluteus
medius
Muscle
Sacral
nerves
Ilium
Gluteus
Medius
muscle
Sacral
nerves
Gluteus
maximus
muscle
Sacrum
Vagina
Coccy
x
Bladder
Pubic
Symphysis
Uterus
Sacrum
Pubic
Symphysis
Rectum
Bladder
Uterine
stripe
Uterus
Vagina
Cervix
Femoral
head
Prostate
Acetabulu
m
Coccyx
Bladder
Rectum
Urethra
Femoral
vein
Aorta
Pubic
symphysis
Vagina
Ischial
tuberosit
y
Anus
Femoral
artery
SUPERIOR
INFERIORPubic
Symphysis
Bladder
Penis
Rectum
Prostate
Sacrum
Lumbar spine
Coccy
x
POSTERIORANTERIOR
• Aorta
• Common iliac artery
• Internal iliac artery
• External iliac artery
• Femoral artery
• Veins
Aorta
Common
iliac artery
Anterior
Tibial
artery
Femoral
artery
Coronal haste
T2
T1 Coronal
vibe
T2 Ax FS
T2 Ax
• Screening
• Trauma
No Contrast Contrast :
• Tumor/mass
• Infection
• Stenosis
• Cancer
• Lesion
CONTRAST
 Multihanc
e
 Magnevist
 Omniscan
 Prohance
TYPES: CONTRAINDICATIONS:
DOSE
CALCULATION:
 No contrast if
patient is on
dialysis*
 GFR less than 30
.1mmol/kg of
body weight
Rate of injection
is 2ml/s with
saline flush

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Anatomy Pathology MRI Review

Editor's Notes

  1. MRA Brain (COW) and MRA Carotid Neck
  2. Depending on the facility contrast may or may not be used. If contrast is used you will begin the injection and watch the contrast enter the superior sagittal sinus then press START on the scanner.
  3. 40-50% of MRI make use of contrast so it is extremely important to assess each patients potential risk.
  4. 40-50% of MRI make use of contrast so it is extremely important to assess each patients potential risk.
  5. 40-50% of MRI make use of contrast so it is extremely important to assess each patients potential risk.
  6. IVC=Inferior Vena Cava
  7. IVC=Inferior Vena Cava
  8. SVC: Superior Vena Cava
  9. *Dialysis patients may receive contrast if a radiologist signs his/her approval and the patient must receive dialysis as soon as possible.
  10. *Dialysis patients may receive contrast if a radiologist signs his/her approval and the patient must receive dialysis as soon as possible.
  11. *Dialysis patients may receive contrast if a radiologist signs his/her approval and the patient must receive dialysis as soon as possible.
  12. *Dialysis patients may receive contrast if a radiologist signs his/her approval and the patient must receive dialysis as soon as possible.
  13. IVC=Inferior Vena Cava
  14. IVC=Inferior Vena Cava
  15. *Dialysis patients may receive contrast if a radiologist signs his/her approval and the patient must receive dialysis as soon as possible.