Contrast in MRI PD, T1, and T2

Proton Density

T1-weighted

T2-Weighted

PD, T1, T2 http://www.med.harvard.edu/AANLIB/ (Whole Brain Atlas)

Clinical History Chronic Subdural Hematoma / Subdural Hygroma These images are from an 76 year old man, who suffered a severe fall 6 months before seeking medical attention. He complained of memory loss, and had been depressed since the death of his wife. He had a history of alcoholism, with several hospital admissions for gastrointestinal bleeding. Note the large fluid collection displacing the brain. It is white on T2-weighted images, and, of course, non-perfused on SPECT. The lateral and third ventricles are a bit large, partly due to the effects of age and partly to the effects of alcohol abuse. The mammillary bodies are small in this case compared to the normal, a finding commonly seen in alcoholics.

Anatomical Features T1 T2 PD (Proton Density) White Matter Bright Dark Grey Matter Very Bright CSF Very Dark Grey

T1 vs. T2 http://darkwing.uoregon.edu/~schirill/t1t2.jpg

C-Spine: T1, T2 http://www.southeastiowaopenmri.com/Clinical_Photos.htm

T1, T2, T2, T2* Gradient Echo Image Findings Marked decrease in signal is seen in the liver on the T2- and T2*-weighted images, with a lesser amount of decreased signal on the T1-weighted images. Discussion Hemochromatosis is a disorder of iron metabolism resulting in excessive iron deposits in the liver, pancreas and skin. It is associated with diabetes, which this patient has recently developed. www.mritutor.org/ mriteach/9655.JPG

PD, T1, T2 The T1-weighted image shows a large spur along the inferior edge of the acromial-clavicular joint causing impingement of the superspinatus muscle. The proton-density and especially the T2-weighted image show abnormal increased signal in the rotator cuff tendon. An effusion is also seen in the joint space as well as in the subdeltoid bursae. Discussion Tears of the rotator cuff are frequently associated with intermediate signal on T1-weighted images and increased signal on T2-weighted images. They may be associated with fluid in the subdeltoid-subacromion bursae, retraction of the superspinatous tendon, and atrophy of the muscle. Magic angle artifact may appear similar to a tear on T1-weighted and proton density images. The magic angle artifact will decrease or disappear on T2-weighted images, unlike tears. Reference http://www.mritutor.org/mriteach/6729.html

Guess?!?! Fatal Stroke The patient was a 71 year old woman with a history of ischemic cardiomyopathy and renal insufficiency who developed the sudden onset of left hemiplegia, hemineglect, hemianaesthesia, mutism and bilateral ptosis. She was treated for elevated intracranial pressure, but deteriorated and developed an enlarged right pupil and a decreased level of arousal. She expired 5 days after admission. http://www.med.harvard.edu/AANLIB/cases/case37/mr3/012.html

CT, T2, PD, T1 Fatal Stroke The patient was a 71 year old woman with a history of ischemic cardiomyopathy and renal insufficiency who developed the sudden onset of left hemiplegia, hemineglect, hemianaesthesia, mutism and bilateral ptosis. She was treated for elevated intracranial pressure, but deteriorated and developed an enlarged right pupil and a decreased level of arousal. She expired 5 days after admission. http://www.med.harvard.edu/AANLIB/cases/case37/mr3/012.html

PD, T1, T2, CT Fatal Stroke The patient was a 71 year old woman with a history of ischemic cardiomyopathy and renal insufficiency who developed the sudden onset of left hemiplegia, hemineglect, hemianaesthesia, mutism and bilateral ptosis. She was treated for elevated intracranial pressure, but deteriorated and developed an enlarged right pupil and a decreased level of arousal. She expired 5 days after admission. http://www.med.harvard.edu/AANLIB/cases/case37/mr3/012.html