1. MRI Student orientation
Flinders medical centre

2. overview Why MRI? Basic physics overview Safety Departmental overview
Equipment
What students can do in our department
Goals

3. Why mri? Challenging Rewarding Engaging Interesting
Cutting edge of technology
Rapidly evolving imaging modality
Always learning and developmental opportunities, including sub-specialities
Cardiac
Breast

4. Why mri?
Work with a dynamic, supportive and flexible team environment Amazing pictures over a wide variety of applications

5. cardiac

6. breast

7. orthopaedic

8. Body

9. neuro

10. vascular

11. is it for you??
Excellent patient care and communication skills required
High level of technical knowledge and expertise
Ability to work independently
Participation in after hours, weekends, and on call roster
Education!
Structured training program including training modules
AIR level 1 accreditation
IV cannulation (in-house training)
Post graduate university qualification

12. Physics review
When an external magnetic field is applied, H atoms align either parallel or antiparallel with the magnetic field

13. Physics review
A radiofrequency wave is applied at the resonant frequency to the spinning protons
The protons jump to a higher energy level and are ‘flipped’ into the transverse plane

14. PHYSICS REVIEW

15. PHYSICS REVIEW
When the RF pulse is switched off, the spins start to relax back to their original state

16. Physics review
An antenna measures the signal coming from the excited protons

17. PHYSICS REVIEW
T1 RELAXATION

18. PHYSICS REVIEW
T2 RELAXATION

19. safety Arguably the most important consideration in MRI
Large invisible magnetic fields which ARE ALWAYS ON
All students MUST be accompanied by an MRI radiographer in the scan room at all times
Department is ‘zoned’ and access to inner zones is restricted
Past safety incidents have resulted in injury and even death

20. hazards Projectile effect
Scanner can cause ferrous objects to accelerate towards it
Hair pins can reach speeds of 40mph at 1.5T

21. hazards Burns Tattoo burn
Generally caused by use of electrically conductive material inside magnet bore
Occassionally tattoos and tattooed eye liner can heat if they contain iron oxide
Tattoo burn

22. hazards ALSO: Twisting/torsion of devices or implants
Image artifacts from device interference and metallic foreign bodies
Device malfunction

23. safety All patient implants need to be investigated for safety
All equipment entering scan room must be approved as MRI compatible and all conditions adhered to (e.g. distance from scanner)
Any persons entering scan room must complete safety questionnaire, remove all loose metal, and be accompanied by MRI radiographer

24. safety
Emergency shut down (‘quench’) of scanner due to life-threatening projectile costs between $20,000-$500,000

25. Departmental overview
2 scanners – 1.5T & 3T 3T
Holds (most) medicare licences
Billable pts
Outpatients
Inpatients from FPH/Noarlunga/Repat
Rapid knee assessment clinic
Small amount of cardiac

26. Departmental overview
Non-billable magnet
FMC inpatients inc ICCU & NNU
Outpatient non billable studies e.g. most pelvic work
Work cover pts
Pts not safe for 3T but safe on 1.5T e.g. pregnant, surgical implants etc
Cardiac list – 4 lists weekly
General anaesthetic list – 1 list weekly
Breast scanning – approx 4 patients per week

27. workflow Very busy department Usually 2 radiographers per scanner
Up to 3 month waiting list for non urgent patients
Usually 2 radiographers per scanner
one scanning
other one getting next patient ready
change into scrubs
go over safety questionnaire
chase up last minute safety queries
explain procedure
cannulate
set up dynamic/pump injector
transfer into MRI safe wheelchair or slide onto scan table if necessary

28. equipment Very expensive and must be handled with care
Antennae used for capturing image must fit as closely as possible to anatomy → multiple coils which are changed depending on anatomy
Two different scanners have quite different equipment, including coils and table/docking systems

29. Siemens aera (1.5T)

30. Siemens trio (3T)

31. What you can do
Limited opportunities for students to scan due to complicated nature of MRI
Where time, radiographers will endeavour to teach some very basic scanning skills so that students can get a feel for what MRI scanning is like
Knee
Brain
Lumbar spine

32. What you can do
MRI takes a long time to acquire images – average examination time is around 30 mins
Scanning conditions can quickly become stressful and radiographers will occassionally not have much time for teaching

33. What you can do Students can get involved by Getting patients changed
Help change bed linen and coils
Position patients and advance into scanner
Assist in patient transfers
Scanning paperwork
Accessing reference books/computer programs for anatomy and pathology information

34. Student goals By the end of your week in MRI, you should be able to:
Select/change coils for common examinations
Be able to scan either knee/brain/Lspine
Have a basic understanding of MRI physics
Understand the main safety contraindications to MRI scanning

35. references MRI suite orientation folder
MRI suite training program 2012
Fundamentals of MRI Course program. Marc Agzarian 2012.
Siemens healthcare