Applications of Diagnostic Imaging Magnetic Resonance Imaging Gerald R. Aben, MD FACR Department of Radiology College of Osteopathic Medicine In this presentation, I would like to discuss some of the applications of Magnetic Resonance Imaging. 11/14/2018 Department of Radiology

Magnetic Resonance Imaging No ionizing radiation Utilize magnetic fields and radio waves Contraindication: implanted devices, ferro-magnetic metals Relative contraindication: claustrophobia Differentiation of distribution of Hydrogen ions as impacted by adjoining molecules Ability to do spectral analysis (remember organic chemistry) Let’s talk next about MRI or magnetic resonance imaging. No ionizing radiation is necessary for this technology. It utilizes magnetic fields and radio waves which we will learn more about in the on-line modules. The contraindications to magnetic resonance imaging include the presence of implanted devices, ferromagnetic metals or wires. There are some relative contraindications which include a claustrophobic patient. MRI works on the principle of being able to differentiate the distribution of hydrogen ions as they are impacted in their neighborhood by adjoining molecules. We are also able to do spectral analysis very similar to what you may have seen in organic chemistry during your undergraduate career.

Magnetic Resonance Imaging Primary applications: First line evaluation of suspected neurologic abnormality First line evaluation of soft tissue mass/ neoplasm First line evaluation of joint disarrangements First line evaluation of bone neoplasm The primary application of MRI imaging include the first line evaluation for any suspected neurologic abnormality, first line evaluation for soft tissue mass or neoplasm, first line evaluation for joint derangements or tendon injuries, and the first line evaluation of bone neoplasm to evaluate the extent of bone involvement as well as involvement of the adjoining soft tissues.

Magnetic Resonance Imaging Primary applications: Head Neoplasm Infection CVA Developmental anomalies Trauma MR angiography Neck Effect of arthritis and degenerative changes MR Angiography More specifically the primary applications of MRI of the head include evaluation of neoplasm, infection, cerebrovascular accident, development anomalies and brain development, post trauma evaluation and utilization of MR angiography to evaluate the vascular supply to the brain. In the neck we can evaluate the impact and effect of arthritis and degenerative changes upon the spinal cord. We can evaluate for neoplasm, trauma to the neck as well as MR angiography for evaluating the carotid arteries and vertebral arteries during their cervical course

Magnetic Resonance Imaging Primary applications: Thorax Spine – cord, roots, bodies Heart – function, perfusion MR angiography Abdomen Liver – mass, iron content, biliary tree MR Cholangiography Kidneys MR Urography MR Colonography Retroperitoneum In the thorax MRI can be utilized for evaluation of the spine, looking at the cord the roots and vertebral bodies. The heart can be evaluated both for cardiac function as well as perfusion and MR angiography can also be utilized. In the abdominal region liver evaluation for the presence of mass or neoplasm or hemangioma can be easily performed with MRI imaging. Additionally MRI imaging can be utilized to determine the iron content of liver in the case of iron retaining diseases. The biliary tree can be quite easily evaluated including MRI cholangiography to look at the biliary branching structures. MR angiography has become a relatively useful tool in recent years for this evaluation. MRI is also useful in evaluating the kidneys including both MR urography as well as anatomic evaluation. MR colonography much like CT colonography provides a mechanism for evaluating the colon for polyps without use of optical colonography and is less invasive that optical colonography. Retroperitoneal structures are also well-defined with MRI imaging  

Magnetic Resonance Imaging Primary applications: Pelvis Prostate Neoplasm Hypertrophy CAD Uterus & Ovaries Masses Leiomyoma Spine Cord Roots Foramina Stenosis Arthritis In the pelvis MRI can be utilized for the evaluation of the prostate and is useful in evaluation for hypertrophy and neoplasm. Computer-aided detection technology can be applied which can assist in a better evaluation of potential areas of neoplasm within the prostate. MRI is useful for uterine evaluation, does a very good job evaluating for leiomyoma or fibroid, and can also evaluate masses and the ovaries. Also, spinal evaluation including the cord, roots, foramina and the presence of stenosis or arthritis can be evaluated using MRI technologies.

Magnetic Resonance Imaging Primary applications: Bones & Joints Tendons and ligaments injury Articular cartilage evaluation Muscle abnormality Trauma – fracture, contusion Mass/ Neoplasm – appearance and extent Soft tissues Mass/ Neoplasm MR angiography The primary MRI applications in bone and joint include evaluation of tendon and ligamentous injury, articular cartilage evaluation and muscle abnormality evaluation. The majority of these evaluations do not require contrast enhancement for diagnosis. In the case of trauma, MRI is very sensitive to subtle fractures including stress fractures as well as contusions. MRI is useful in evaluating bone neoplasm or masses, both the appearance and extent. MRI excels in soft tissue evaluation and evaluating mass or neoplasm. MR angiography can also be applied in many locations.