MRI Contrast and Plain, protocols, patient care, indications ,contraindications , Mastoids, Pituitary and salivary glands ,IAC,MRI Thorax, chest, patient positioning, patient preparation.

1. MRI Contrast And Plain
By: AALIA ABDULLAH
ASSISTANT PROFESSOR RADIOLOGY AND IMAGING
MEWAR UNIVERSITY RAJASTHAN

2. Mastoids
• Magnetic Resonance Imaging (MRI) of the mastoids is a medical imaging
technique used to visualize the mastoid bones, which are located behind the
ears. It is typically performed to evaluate various conditions affecting the
mastoids

3. • Indications:
• Suspected Mastoiditis: To assess and diagnose inflammation or
infection of the mastoid air cells (mastoiditis).
• Chronic Ear Infections: To evaluate chronic ear infections that may
have spread to the mastoid bone.
• Tumors and Lesions: To detect and characterize tumors, cysts, or
lesions in the mastoid region.
• Post-Surgical Evaluation: After ear surgery, MRI can be used to assess
the surgical site and any complications.
• Complications of Otitis Media: To investigate complications related to
middle ear infections, such as cholesteatoma, abscesses, or bone
erosion.

4. Contraindications:
• Metallic Implants:
• Claustrophobia:
• Pregnancy:
• Renal Impairment
• Allergy to Contrast Agents
• Certain Medical Conditions

5. • MRI of the Mastoids Without Contrast:
• Patient Positioning: The patient lies on the MRI table, typically in a
supine position (on their back).
• Imaging Sequences: Common sequences include T1-weighted and T2-
weighted images in various planes (sagittal, axial, and coronal) to
assess the mastoid bones and surrounding structures.
• Slice Orientation: The MRI technologist may use different slice
orientations to capture images in multiple planes, depending on the
clinical indication.

6. • MRI of the Mastoids With Contrast:
• Patient Preparation: Ensure there are no contraindications to contrast
use. An intravenous (IV) line is inserted to administer the contrast
agent.
• Pre-Contrast Images: Obtain pre-contrast images, similar to the
protocol without contrast.
• Contrast Enhancement: A gadolinium-based contrast agent is injected
intravenously. Post-contrast images are acquired to enhance the
visibility of certain structures or abnormalities. Common sequences
include T1-weighted images post-contrast.

7. Patient Care:
• Patient Education
• Safety Precautions
• Comfort
• Monitoring
• Contrast Agent
• Post-Scan Care

8. Pituitary And Salivary Glands
• MRI of the Pituitary Gland:
• Indications:
• Pituitary Tumors: To detect and evaluate pituitary tumors, both benign and
malignant.
• Hormonal Disorders: To investigate hormonal imbalances and disorders related to
the pituitary gland.
• Headaches: When severe or recurrent headaches are suspected to have a pituitary
origin.
• Visual Disturbances: To assess visual disturbances caused by pituitary tumors
compressing the optic nerves (chiasmatic compression).
• Pituitary Function Assessment: In cases where pituitary function needs to be
evaluated.

10. Salivary Glands:

11. • MRI of the Salivary Glands:
• Indications:
• Salivary Gland Tumors: To detect and evaluate tumors or masses in the
salivary glands.
• Sialadenitis: To assess inflammation or infections of the salivary glands.
• Salivary Duct Stones: For diagnosing and locating salivary duct stones or
obstructions.
• Salivary Gland Function Assessment: In cases where salivary gland function
needs to be evaluated.
Contraindications, patient preparation &patient care is same as other

13. Internal Auditory Canal (IAC)
• internal Auditory Canal (IAC) bony canal that transmits nerves
and blood vessels from the base of the brain to the inner ear.
• is a specialized imaging technique
used to visualize the structures
within the ear and surrounding
areas.

15. • Indications:
• Hearing Loss: To investigate the cause of sensorineural hearing loss or
conductive hearing loss.
• Vertigo and Balance Issues: When patients experience recurrent
vertigo or balance problems.
• Tinnitus: To evaluate the cause of persistent tinnitus (ringing in the
ears).
• Facial Nerve Disorders: To assess facial nerve disorders, such as Bell's
palsy or facial nerve tumors.
• Trauma
• Congenital Abnormalities: For evaluation of congenital abnormalities
or malformations of the IAC.

16. • MRI of the Internal Auditory Canal (IAC) Without
Contrast:
• Patient Positioning:
• Head first supine
• Position the head in the head coil and immobilise with
cushions
• Give cushions under the legs for extra comfort
• Centre the laser beam localiser over the glabella
• Head and Neck Alignment: Properly align the patient's
head and neck so that they are in a neutral position.
Ensure that the patient's head is not tilted or turned to
one side.

17. • LOCALISER
• A three-plane localizer must be taken at the beginning to
localize and plan the sequences. Localizers are usually less
than 25 seconds and are T1-weighted low-resolution scans.

18. • MRI of the Internal Auditory Canal (IAC) With Contrast:
• Patient Preparation: Ensure there are no contraindications to contrast
use. An intravenous (IV) line is inserted to administer the contrast
agent.
• Pre-Contrast Images: Obtain pre-contrast images, similar to the
protocol without contrast.
• Contrast Enhancement: A gadolinium-based contrast agent is injected
intravenously. Post-contrast images are acquired to enhance the
visibility of certain structures or abnormalities. Common sequences
include T1-weighted images post-contrast.

19. Thorax:
• MRI THORAX:COILS USED
• Torso Coil: The most commonly used coil for thorax MRI is the
torso coil or body coil. It provides good coverage of the entire
thorax and surrounding structures.
• Multi-Channel Coils: In some cases, multi-channel phased-
array coils may be used to improve image quality and signal-
to-noise ratio. These coils can be placed on the chest to focus
on specific regions of interest.
• Breast Coils: For breast imaging within the thorax or when
higher resolution is needed for the breasts, dedicated breast
coils may be used in addition to the torso coil.
• Cardiac Coils: In cardiac MRI studies within the thorax,
specialized cardiac coils may be employed to optimize image
quality of the heart and great vessels.

21. Indications:
• Assess abnormal growths, including cancer of the lungs or other tissues where MRI
offers a
• superior alternative to other imaging techniques eg. mediastinal node
• For assessment of chest wall tumours, such as sarcoma, osteochondroma,
haemangioma, and metastatic tumours of the bone,
• To display lymph nodes and blood vessels, including vascular and lymphatic
malformations of the chest
• For assessment of disorders of the bone marrow, such as anaemia and avascular
necrosis of the bone
• For assessment of chest wall or diaphragmatic extension of intra thoracic masses
• For assessment of chest and chest wall infections
• Suspected superior sulcus tumour by chest x ray
• Lung cancer staging
• Trauma

22. • PATIENT PREPARATION FOR CHEST MRI SCAN
• A satisfactory written consent form must be taken from
the patient before entering the scanner room
• Ask the patient to remove all metal objects including
keys, coins, wallet, cards with magnetic strips, jewellery,
hearing aid and hairpins
• Ask the patient to undress and change into a hospital
gown
• Instruct the patient to hold their breath for the breath
hold scans and breathe gently for the gated scans (it is
advisable to coach the patient two to three times before
starting the scan)

23. • If possible provide a chaperone for claustrophobic
patients (e.g. relative or staff )
• Offer earplugs or headphones, possibly with music for
extra comfort
• Explain the procedure to the patient
• Instruct the patient to keep still
• Note down the hight and weight of the patient

24. • PATIENT POSITIONING
• Position the patient in supine position with head pointing
towards the magnet (head first supine)
• Position the patient in the spine,head and neck coil and
place the neck and body coil over the neck and chest
covering from the tip of the nose down to the lower
intercostal border
• Securely tighten the body coil using straps to prevent
respiratory artefacts
• Give cushions under the head and legs for extra comfort
• Centre the laser beam localiser over mid chest (i.e. over
the nipples)

25. • Breath-Hold Instructions: Provide clear instructions to
the patient regarding breath-holding during the scan.
Controlled breathing helps reduce motion artifacts.
• Slice Thickness :This parameters can vary depending on
the clinical indication but are typically in the range of 3-5
mm.