MRI of Chest and Shoulder Joint
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Questions and Answers

What is the primary purpose of positioning the patient's shoulder as close as possible to the magnet isocenter?

  • To enhance contrast between tissues
  • To facilitate the use of the multi-channel shoulder coil
  • To improve image resolution
  • To minimize motion artifacts (correct)

    • What specific anatomical structure is targeted during the coronal localizer sequence?

  • Surgical neck of the humerus
  • Supraspinatus tendon (correct)
  • Glenoid fossa
  • Subscapularis muscle

    • Which of the following is NOT a typical indication for a shoulder MRI?

  • Evaluation of frozen shoulder syndrome
  • Diagnosis and evaluation of impingement syndrome
  • Diagnosis of rotator cuff injury
  • Assessment of spinal stenosis (correct)

    • In the axial localizer sequence, the slice acquisition is performed from:

    <p>Lateral to medial (A)</p> Signup and view all the answers

    What is the purpose of the 'Scout slice placement' step in the MRI procedure?

    <p>To identify the optimal planes for acquiring images (D)</p> Signup and view all the answers

    What anatomical structure marks the inferior boundary of the chest?

    <p>Diaphragm (B)</p> Signup and view all the answers

    Which of the following is a common indication for an MRI of the chest?

    <p>Neurogenic lesions like malignant nerve sheath tumors (B)</p> Signup and view all the answers

    In which position should a patient be placed for an MRI of the chest?

    <p>Supine, head first (C)</p> Signup and view all the answers

    What is the primary purpose of using axial slices in MRI?

    <p>To evaluate the morphology of the great vessels and heart (C)</p> Signup and view all the answers

    Which combination of structures is included in the upper boundary of the chest?

    <p>First ribs, first thoracic vertebra, upper margin of the manubrium (D)</p> Signup and view all the answers

    What is another name for the shoulder joint due to its anatomical structure?

    <p>Glenohumeral joint (A)</p> Signup and view all the answers

    What is a characteristic of the shoulder joint due to its structural design?

    <p>Wide range of movement at the cost of instability (B)</p> Signup and view all the answers

    What type of coil is set up for an MRI procedure of the chest?

    <p>Torso-array coil (C)</p> Signup and view all the answers

    Study Notes

    MRI of Chest and Shoulder Joint

    • MRI of chest and shoulder joint is presented by Dr. Hayder Jasim Taher, PhD of Medical Imaging.

    Outline of Presentation

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

    Anatomical Overview (Chest)

    • The chest (thorax) is the region between the neck and abdomen, bounded by the bony thoracic cage.
    • The upper boundary, the thoracic inlet, is formed by the first thoracic vertebra, first ribs, and the upper margin of the manubrium.
    • The chest extends downwards to the thoracic outlet, marked by the diaphragm (between the inferior margin of the sternum and the upper lumbar vertebra).

    Common Indications (Chest)

    • Mediastinal mass (e.g., lymphoma, congenital cyst)
    • Neurogenic lesions (e.g., thoracic meningoceles, malignant nerve sheath tumors)
    • Differentiation between lymph nodes and vascular anomalies
    • Assessment of vascular anomalies of the chest (e.g., thoracic aortic aneurysms) (using MRA)

    MRI Procedure (Chest)

    • Patient Position: Supine (head first), with feet-first orientation if claustrophobic.
    • Coil setup: Torso-array coil.
    • Scout slice placement (Axial):
      • Alignment: True axial
      • Coverage: From superior (thoracic inlet) to inferior (diaphragmatic crura), lateral (chest wall) to medial (spine), posterior (thoracic spinous processes) to anterior (sternum)
      • Information obtained: Showing contents of mediastinum, great vessels, and the heart.
    • Scout slice placement (Coronal):
      • Alignment: True coronal
      • Coverage: Same as axial slice
      • Information obtained: Best plane for costophrenic angles and lung apices.

    MRI Sequences (Chest)

    • T1WI (FSE): Axial and coronal sections to provide detailed anatomical illustration of structures (heart, main vessels, mediastinum).
    • T2WI (FSE): Axial and coronal sections to highlight tissue water content (inflammation, edema, abnormal tissue).
    • Fat suppression sequences: To distinguish between fat-containing and non-fat tissues.
    • DWI sequence: Assess tissue cellularity and identify chest lesions.
    • Dyn-study + contrast (GAD-based): Evaluate tissue perfusion (vascular lesions, tumors).
    • MRA: Visualize blood vessels for evaluation of vascular abnormalities (arteries and veins).

    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 large humeral head compared to the glenoid fossa leads to a wide range of movement but also instability.
    • The glenoid fossa is deepened to reduce the disproportion of joint surfaces.

    Indications for Shoulder MRI

    • Diagnosis and evaluation of impingement syndrome and instability
    • Frozen shoulder syndrome evaluation
    • Rotator cuff injury
    • Pectoralis tear

    MRI Procedure (Shoulder)

    • Patient Position: Supine (head first), offset left/right, bringing shoulder to magnet isocenter.
    • Coil Setup: Multi-channel shoulder coil.
    • Strap security: Ensure proper immobilization of the patient.
    • Scout slice placement (Axial):
      • Alignment: Usually true axial (adjust angulation if humeral head position is abnormal).
      • Coverage: From acromioclavicular joint to surgical neck of humerus.
      • Acquisition: Superior to inferior
    • Scout slice placement (Sagittal):
      • Alignment: Parallel to glenoid fossa.
      • Coverage: Entire deltoid muscle through the glenoid fossa.
      • Acquisition: Lateral to medial
    • Scout slice placement (Coronal):
      • Alignment: Perpendicular to glenoid fossa, parallel to supraspinatus muscle.
      • Coverage: Subscapularis muscle through supraspinatus tendon.
      • Acquisition: Anterior to posterior

    MRI Sequences (Shoulder)

    • Different sequences (e.g., T1WI, T2WI, T2* GRE) with specific TR, TE, FA, ETL, and slice thickness are used to evaluate various aspects of the shoulder.

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    Related Documents

    MRI of Chest and Shoulder Joint PDF

    Description

    Explore the intricacies of MRI techniques for the chest and shoulder joint, presented by Dr. Hayder Jasim Taher. This presentation covers patient preparation, safety precautions, and the use of contrast media. Delve into anatomical details and common indications for imaging in the thoracic region.

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