2. OUTLINE
Date & Place
Patient Information
Procedure Purpose & Type
MRI Scanner System
MRI Protocol & Sequences
Finding & Images
About the disease(finding).
3. Date & Place
Date: 10-10-2010
Place: King Khalid University Hospital,
Riyadh, Saudi Arabia.
4. Patient Information
Patient History:
21 yrs old female with scleroderma of the LT side of
the face.
Weight: 61 kg
5. Procedure Purpose &
Type
Purpose of MRI:
For soft tissue & bone assessment in face & upper
neck.
Procedure:
MRI specify area (others)
MRI of the face & upper neck
Multi-planar, multi-sequence
Head first into the bore.
6. MRI Scanner System
Siemens Company
Superconducting closed
MRI system
3 Tesla strength
RF Coils:
Head neck coil (phased-array coils)
Closed MRI
scanner
Head coil
7. MRI Protocol &
Sequences
Tumor protocol (suggested by the radiologist)
Step Sequence TE & TR Other parameters
1 Localizer (axial, coronal and sagital) - FOV: 250 mm
NEX: 1
S. Thickness: 10 mm
2
cor-localizer-T2-haste TE: 93 ms
,TR: 1500 ms
BW: 20 cm
FOV: 200 mm
NEX: 1
S. Thickness: 4 mm
-3
cor-T2-tse-FS TE: 114 ms,
TR: 3682 ms
BW: 15 cm
echo train:17
FOV: 220 mm
NEX: 3
S. Thickness: 3.5 mm
4
sag-T1-mpr-ns TE: 2.44 ms,
TR: 1430 ms
BW: 20 cm
FOV: 250 mm
NEX: 1
S. Thickness: 1.04 mm
5
AX-T2-tse FS TE: 114 ms,
TR: 3682 ms
BW: 15 cm
echo train:17
FOV: 210 mm
NEX: 3
S. Thickness: 4 mm
8. Cont.
step Sequence TE & TR Other parameters
6
AX-T1-se TE: 9.4 ms,
TR: 400 ms
BW: 20 cm
FOV: 210 mm
NEX: 1
S. Thickness: 4 mm
7
COR-T1-se TE: 9.4 ms,
TR: 400 ms
BW: 20 cm
FOV: 210 mm
NEX: 1
S. Thickness: 3.5 mm
8
CM(Gadolinium), manual
injection,12 ml.
- -
9
AX-T1-se-FS+C TE: 10 ms,
TR: 413 ms
BW: 15 cm
FOV: 210 mm
NEX: 1
S. Thickness: 4 mm
10
COR-T1-se -FS +c TE: 10 ms,
TR: 472 ms
BW: 15 cm
FOV: 210 mm
NEX: 1
S. Thickness: 3.5 mm
11
SAG-T1-mpr-fs+c TE: 3.67 ms,
TR: 1610 ms
BW: 15 cm
FOV: 250 mm
NEX: 1
S. Thickness: 1.04 mm
9. Findings & Images
Loss of the
subcutaneous fat on
the LT side over the
mandible.
10. Findings & Images
Abnormal soft
tissue mass lesion
seen overlying the LT
masseter muscle
Appears high signal
intensity in T2WI
11. Findings & Images
Post contrast images
show:
Mild enhancement of
the soft tissue mass
14. Findings & Images
Post contrast images
show:
Abnormal
enhancement of
the superficial part
of the LT parotid
gland
15. Findings & Images
Bilateral cervical
lymph node noted
the largest one on the
LT side measuring
approx 2.5 x 1 cm
16. Findings & Images
No clear evidence of abnormal signal
intensity within the visualized bone
specially on the LT side.
17. Conclusion
K/C of scleroderma with possible
infiltration of the masseter muscle.
Similar area of signal alteration seen
within the superficial part of the parotid
gland
Possibility of neoplastic lesion cannot be
rule out.
No abnormal signal intensity or
enhancement within the underlying bone.
18. Scleroderma
Scleroderma is a disease that can cause
thickening, hardening, or
tightening of the skin,
BV’s and internal organs.
F>M
Types
Localized: usually only affects the skin on the
hands and face.
Systemic: more serious and affects connective
tissue in many body parts, including internal
organs.
19. Scleroderma
Cause:
Considered as an auto-immune disease.
Symptoms: like,
Hardening and thickening of the
affected skin
Loss of hair over affected area
Change in skin color
Ulcers or sores on fingers
Telangiectasia
Muscle weakness
Dryness of eyes/mouth
Digestive, Kidney, Heart and
lung problems
Hardening and
color change
20. Scleroderma
Treatment:
No cure for scleroderma.
Medication treat symptoms + prevent
complications.
Lifestyle changes help in coping with the
disease e.g.(exercise, skin creams, no
smoking, no exposure to cold or stress).
Diagnosis:
Medical history, physical exam, lab tests, and
radiologic imaging
