MRI of Chest and Shoulder Joint

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Questions and Answers

What is the main purpose of positioning the patient with their shoulder as close as possible to the magnet isocenter?

To reduce the amount of time required for the scan.

To facilitate the use of specific coils designed for shoulder imaging.

To ensure optimal image quality by minimizing signal loss. (correct)

To minimize patient discomfort by reducing the weight on the shoulder.

Which of the following is NOT a reason why an MRI of the shoulder joint might be indicated?

Determining the severity of osteoarthritis in the shoulder joint. (correct)

Assessment of a suspected glenohumeral instability.

Evaluation of a possible torn rotator cuff.

Diagnosis of a possible fracture of the humerus.

When obtaining the axial localizer for sagittal slices, what is the recommended slice alignment and acquisition?

Parallel to the glenoid fossa, acquired from superior to inferior.

Perpendicular to the glenoid fossa, acquired from anterior to posterior.

Parallel to the glenoid fossa, acquired from lateral to medial. (correct)

Perpendicular to the glenoid fossa, acquired from superior to inferior.

What is the primary function of the glenoid fossa in the shoulder joint?

To provide stability to the shoulder joint by articulating with the humeral head. (D) Signup and view all the answers

Which of the following MRI sequences would be most helpful for visualizing the supraspinatus tendon?

T2-weighted (D) Signup and view all the answers

What is the best MRI plane for visualizing the lung apices?

Coronal (B) Signup and view all the answers

Which of the following is NOT a common indication for a chest MRI?

Evaluation of the thyroid gland (B) Signup and view all the answers

What is the purpose of performing a scout slice placement in MRI?

To identify the appropriate region of interest and plan the imaging sequence (A) Signup and view all the answers

What is the preferred patient position for a chest MRI?

Supine, head first (A) Signup and view all the answers

Which of the following is a negative relaxation agent used in MRI?

Water (D) Signup and view all the answers

What is the name of the joint formed by the articulation of the head of the humerus and the glenoid fossa of the scapula?

Glenohumeral joint (C) Signup and view all the answers

What anatomical structure forms the upper boundary of the chest?

Thoracic inlet (D) Signup and view all the answers

Which of the following is a characteristic of the shoulder joint?

Relatively unstable, with a wide range of motion (C) Signup and view all the answers

Study Notes

MRI of Chest and Shoulder Joint

The presentation is about MRI of the chest and shoulder joint
The presenter is Dr. Hayder Jasim Taher, PhD of Medical Imaging

Outline of the Presentation

Patient preparation and safety
Precautions
Contrast media
- Positive relaxation agents (T1 agents)
- Negative relaxation agents (T2 agents)
- Gadolinium

Anatomical Overview (Chest)

The chest, or thorax, is the bony cage region between the neck and abdomen
The upper boundary, the thoracic inlet, is formed by the first thoracic vertebra, the first ribs, and the upper margin of the manubrium
Inferiorly, the chest extends to the level of the thoracic outlet, marked by the diaphragm, which spans between the inferior margin of the sternum and the upper lumbar vertebra

Common Indications (Chest)

Mediastinal mass: Examples include lymphoma and congenital cysts
Neurogenic lesions: Examples include thoracic meningoceles and malignant nerve sheath tumors
Differentiation between lymph nodes and vascular anomalies
Assessment of vascular anomalies Examples include thoracic aortic aneurysms (evaluated in conjunction with MRA)

MRI Procedure (Chest)

Patient position: Supine (head first). Patients with claustrophobia may prefer a feet-first orientation
Coil: Torso-array coil used
Scout slice placement (axial slice):
- Alignment: True axial
- Coverage: Superior to inferior (thoracic inlet to diaphragmatic crura), lateral to medial (chest wall on each side), posterior to anterior (thoracic spinous processes to sternum)
- Demonstrates mediastinum contents, morphology of the great vessels and heart, and lymph node location and size
**Scout slice placement (Coronal slice):**Axial localizer for coronal slice. -Alignment: True coronal. -Coverage: As for axial plane. -Demonstrates costophrenic angles and lung apices
MRI Sequences (Chest): Various sequences like T1WI (FSE), T2WI (FSE), fat suppression, DWI sequence, dynamic study + contrast (GAD-based contrast), and MRA are used to provide detailed anatomical information from axial and coronal sections(5mm slice thickness). Used to assess tissue differences in water content, assess lesions, and characterize vascular anomalies

Anatomical Overview (Shoulder)

The shoulder joint is formed by the articulation between the head of the humerus and the glenoid cavity (fossa) of the scapula
The larger humeral head compared to the glenoid gives the joint a wide range of movement but also instability
The glenoid fossa is deepened by the glenoid labrum to reduce the instability

Indications (Shoulder)

Diagnosis and evaluation of impingement syndrome and instability
Evaluation of frozen shoulder syndrome
Rotator cuff injury
Pectoralis tear

MRI Procedure (Shoulder)

Patient position: Supine, head first; offset the patient left or right and bring the shoulder close to the magnet isocenter to minimize motion (oblique the patient, shoulder of interest down)
Coil: Multi-channel shoulder coil
Straps: Recheck straps to secure immobilization
**Scout slice placement (axial slice):**Coronal localizer. Alignment usually true axial(adjust angulation if humeral head is abnormally high) from above acromioclavicular joint through surgical neck of humerus. Slice acquisition has superior to inferior orientation.
Scout slice placement (sagittal slice): Axial localizer. Lateral to medial alignment. Parallel to the glenoid fossa.Entire deltoid muscle through glenoid fossa.
Scout slice placement (coronal slice): Axial localizer. Anterior to posterior slice acquisition. Perpendicular to glenoid fossa, parallel to supraspinatus muscle. Subscapularis muscle to supraspinatus tendon

MRI Sequences (Shoulder)

Specific sequences (TR, TE, FA, ETL) and slice thickness (e.g., T1WI (FSE), and T2WI (FSE)) are used to provide detailed information for evaluation (table included in the slides)

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Description

This presentation by Dr. Hayder Jasim Taher, PhD explores the MRI techniques specific to the chest and shoulder joint. It covers essential topics like patient preparation, contrast media, and anatomical considerations, along with common clinical indications for MRI imaging. Suitable for medical imaging professionals and students.