mri joints
TRANSCRIPT
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