mri joints

Shoulder MRI Indications : Evaluation of impingement syndrome and

instability .(clinical syndrome which occurs when the tendons of the rotator cuff muscles become irritated and inflamed)

Evaluation of frozen shoulder syndrome .(soft tissue capsular lesion accompanied by painful and restricted active and passive motion at the glenohumeral joint)

Tears in shoulder capsule . Tendonitis.

Shoulder MRI Equipment : Shoulder coil . circular

surface coil Pt position : Supine , head

first ,arm by sides the shoulder placed within coil over humeral head ,the horizontal line pass through joint .

Shoulder MRI

Rotor cuff muscles : Supraspinatous Infraspinatous Subscapularis Teres minor

Shoulder MRI

Protocol : Localizer Axial T2 or PD fat sat Paracoronal T2 fat sat Paracoronal T1 Parasagittal T2

Shoulder MRI Axial : Plot on coronal

localizer 3 mm thickness 20% gap PD parameters TR :3000 TE : 35

Shoulder MRI Paracoronal : Parallel to

supraspinatus muscle on axial slice .

3 mm thickness

20% gap

Shoulder MRI Parasagittal Parallel to

glenoid cavity.

3 mm thickness

20% gap

Shoulder MRI

Axial PD Fat suppression paraCoronal PD

Knee MRI

Indications : Assesmnet of internal derangment of the

joint . Evaluation of chondromalcia patella and

patella tracking . Diagnosis of bone tumors Other knee disorder .

Knee MRI

Advantages : Fast ,non invasive ,informative ,high

accuracy ,low claustrophobic , majority of knee content is soft tissue and water .

Knee MRI

Equipment : Knee coil . Position : Supine , feet first , External rotation 15 Centre of the coil.

Knee MRI Main anatomy : femur and tibia Collateral ligament ( medial and lateral ) Cruciate ligament (ant. And post. ) *** responsible for knee stability Medial and lateral meniscus ( ant. And post. Horn )*** Prevent fraction of bones

Knee MRI Protocol : Localizer : plan sagittal and coronal on

axial localizer (off centre position) Coronal fat sat coronal PD Sagittal fat sat Sagittal PD Axial T2 ( optional )

Knee MRI Coronal sequence : Plot on sagittal and

axial parallel to condyles.

3 mm thickness No sat slab

Knee MRI Sagittal sequence : Plot on axial and

coronal parallel to condyles .

External rotation For Ant. Cruciate

ligamnet

Knee MRI

Sagittal sequence :Sagittal sequence :Plot on axial and coronal without Plot on axial and coronal without angulations to show the angulations to show the posterior cruciate ligament .posterior cruciate ligament .

Knee MRI Axial sequence : Plot on sagittal Same parameters Axial doesn’t provide

good information for the ligaments and meniscus , better in case of neoplasm ,cyst and other pathology not related to ligaments

Knee MRI

The anterior cruciate ligament is delineated best at 15-20 of external rotation .

The posterior cruciate ligament at 0-5 of internal rotation .

PD TR :3000 TE: 20-45

Knee MRI

Knee MRI

Ankle MRI

Indications : Assessment of tendonitis Achilles tendon rupture or tear Avascular necrosis Visualization of soft tissue

abnormalities. Equipment : Exremity coil .

Ankle MRI

Pt position : Supine , feet first Foot is dorsiflexed The horizontal line at level of malleoli .

Ankle MRI

Protocol : Localizer Sagittal T1 Sagittal fat sat Axial PD Axial Fat sat Coronal T2

Ankle MRI Sagittal : Plot on axial

localizer 3 mm thickness 20% gap FOV : large

enough to include toes

Sat slab superior to slices

Ankle MRI Coronal : Plot on

sagittal localizer

Ankle MRI Axial : Plot on

sagittal localizer

4 mm thickness

20% gap Superior sat

slab

Ankle MRI (additional ) Optimized imaging of the : 1- calcaneonavicular and deltoid ligaments:

coronal slice in maximum dorsiflexion ( 10-20 ) 2- anterior and posterior talofibular ligaments :

axial slice in maximum dorsiflexion ( 10-20 ) Calcaneofibular ligament : axial slice in

maximum plantar flexion (40-50) Deltoid ligament : coronal slice in maximum

plantar flexion (40-50)

MRCP MR

Cholangiopancreatography Pt . Position : Supine, feet first, arms crossed

on chest with hands on shoulders in order to prevent arm wrap-around artifact.

Equipment : Phased array body coil

MRCP

Protocol : Locator coronal Axial T2 HASTE (Half Fourier

Acquisition Single Shot Turbo Spin Echo) sequence

Thick slab Thin slab

Locator

Thick slab

Radical with all direction

Pt should suspend respiration

Thin slab paracoronal The best thick slab

taken as thin slab Use of respiratory

triggers