MAGNETIC RESONANCE IMAGING [M.R.I.

]
DEFINITION:Its a technique that provides anatomic and physiologic information non invasively and without the use of ionising radiation.

 HISTORY: PAUL LAUTERBUR[1973]:Described the first M.R.I. PETER MANSFIELD:Developed the further use of signals for image reconstruction. M.R.I. developed for clinical use:1980 Lauterbur and Mansfield awarded nobel prize in physiology or medicine:2003

 WORKING PRINCIPLE:

1. Patient is first placed inside a large magnet. 2.Magnetic field causes the nuclei of many atoms in the body, particularly hydrogen, to align with the magnetic field. 3.Scanner then detects the radiofrequency pulse into the patient. 4.Causing some hydrogen nuclei to absorb energy[resonate]. 5.When radiofrequency pulse is turned off, the stored energy is released from the body and detected as a signal in a coil in the scanner. 6.The signal is used to construct the magnetic resonance imaging ,in essence a map of the distribution of hydrogen.

 MAGNETIC RESONANCE FIELD STRENGTH: 0.1 to 4 Tesla[T] 1.5T:Most common

 M.R.I. ASSEMBLY:

The magnetic resonance scanner is cylindrical device into which the patient ,lying on a specially designed table is placed. The scanner surrounds the patients body with powerful electromagnets. A cooling system removes the heat generated by electromagnets. The electromagnets creates an extremely strong external magnetic field[1 to 1.5T] that causes randomly oriented spinning nuclei of hydrogen atoms in patients body to alignThis state is now intentionally distrupted when a radiofrequency pulse is applied which knocks the hydrogen atom out of alignment.

 These distrupted nuclei rearrange themselves within milliseconds and emit distinctive radiofrequency signals, which are stored in a computer.
CONTRAST AGENTS:

Most common:Gadolinium[may be introduced I/V to improve tissue contrast.

 DISADVANTAGE OF GADOLINIUM: Gadolinium based contrast media could be a cause of debilitating disease like nephrogenic systemic fibrosis in some patients with renal dysfunction.
FACTORS THAT AFFECT MR SIGNAL: 1.Density of nucleus of hydrogen atom. 2.Relaxation time. 3.Flow phenomenon

 1.Density of nucleus of hydrogen atom: Greater the no. of hydrogen atom nuclei per unit volume of tissue, greater and stronger is the MR signal. 2.Relaxation time:2 processes by which excited nuclei relax. a] Longitudinal relaxation time. b] Transverse relaxation time.

a]LONGITUDINAL RELAXATION TIME OR SPIN LATTICE RELAXATION[T1]:

When the nuclei releases excess energyu to general environment.

b]TRANSVERSE RELAXATION OR SPIN SPIN RELAXATION[T2]:

Release of energy by excited nuclei through among themselves.

-- Short T1:Intense signal,displayed by white. --Long T1:Low intensity signal ,displayed dark. --Short T2:Low intensity, dark image. --Long T2;High intensity signal,bright image.

 FLOW PHENOMENON:

It states that moving substances give a weak MR signal.Flowing blood in vessels has low signal whereas stagnant blood as in acute blood clots have higher intesity MR signal

 USES OF M.R.I. IN DENTISTRY: 1] FOR HEAD AND NECK LESIONS: T1 weighted images are useful for defining the anatomy of lesion. T2 weighted images are useful for assessing invasion of legion into surrounding structures Extension of legion into muscles, brain or blood vessels can be precisely studied using contrast enhanced M R I 2] congenital disorders T1 weigheted sequences with coronal and axial images demonstrates abnormalities such as cleft lip and palate

 3] INFECTIONS: AIDS: Generalised cervical lymphadenopathy and cystic lesion of parotid. 4] T.M.J.: Disc and integrity of disc. 5] Tumors: BENIGN TUMORS:Hemangiomas ,lymphangiomas,neurfibromas can be studied.

MALIGNANT TUMORS:MRI can be used for

diagnosis, staging and for monitoring of malignant tumors affecting head and neck region. ADVANTAGES OF M.R.I.: _ Non invasive. _Makes high quality images of soft tissue resolution in any imaging plane. _Accurate and rapid localisation intracranial pathologies. _MRI uses non ionising radiation and hence considered non hazardous.

 DISADVANTAGES: _High cost. _Long scan times. _Various metals in the imaging field either will distort the image or may move in the strong magnetic field, injuring the patient. _MRI is contraindicated in patients with cardiac pacemakers. _Not used in patients with ferromagnetic substancec implanted in body such as intracranial aneurysmal clips;

 SAKSHI MANHAS PRE-FINAL YEAR ROLL NO. 76