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HANDBOOK OF MRI TECHNIQUE FIFTH EDITION Distinguished educator Catherine Westbrook delivers a comprehensive and intuitive resource for radiologic technologists in this newly revised Fifth Edition of the Handbook of MRI Technique. With a heavy emphasis on protocol optimisation and patient care, the book guides the uninitiated through scanning techniques and assists more experienced technologists with image quality improvement. The new edition includes up-to-date scanning techniques and an additional chapter on paediatric imaging. The latest regulations on MRI safety are referenced and there are expanded sections on slice prescription criteria. The book also includes the contributions of several clinical experts, walking readers through key theoretical concepts, discussing practical tips on cardiac gating, equipment use, patient care, MRI safety, and contrast media. Step-by-step instruction is provided on scanning each anatomical area, complete with patient positioning and image quality optimisation techniques. The book includes: A thorough introduction to the concepts of parameters and trade-offs, as well as pulse sequences, flow phenomena, and artefacts Comprehensive explorations of cardiac gating and respiratory compensation techniques, patient care and safety, contrast agents, and slice prescription criteria Practical discussions of a wide variety of examination areas, including the head and neck, spine, chest, abdomen, pelvis, the upper and lower limbs, and paediatric imaging A companion website with self-assessment questions and image flashcards Perfect for radiography students and newly qualified practitioners, as well as practitioners preparing for MRI-based certification and examination, the Handbook of MRI Technique will also prove to be an invaluable addition to the libraries of students in biomedical engineering technology and radiology residents.

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HANDBOOK OF MRI TECHNIQUE FIFTH EDITION Distinguished educator Catherine Westbrook delivers a comprehensive and intuitive resource for radiologic technologists in this newly revised Fifth Edition of the Handbook of MRI Technique. With a heavy emphasis on protocol optimisation and patient care, the book guides the uninitiated through scanning techniques and assists more experienced technologists with image quality improvement. The new edition includes up-to-date scanning techniques and an additional chapter on paediatric imaging. The latest regulations on MRI safety are referenced and there are expanded sections on slice prescription criteria. The book also includes the contributions of several clinical experts, walking readers through key theoretical concepts, discussing practical tips on cardiac gating, equipment use, patient care, MRI safety, and contrast media. Step-by-step instruction is provided on scanning each anatomical area, complete with patient positioning and image quality optimisation techniques. The book includes: A thorough introduction to the concepts of parameters and trade-offs, as well as pulse sequences, flow phenomena, and artefacts Comprehensive explorations of cardiac gating and respiratory compensation techniques, patient care and safety, contrast agents, and slice prescription criteria Practical discussions of a wide variety of examination areas, including the head and neck, spine, chest, abdomen, pelvis, the upper and lower limbs, and paediatric imaging A companion website with self-assessment questions and image flashcards Perfect for radiography students and newly qualified practitioners, as well as practitioners preparing for MRI-based certification and examination, the Handbook of MRI Technique will also prove to be an invaluable addition to the libraries of students in biomedical engineering technology and radiology residents.

Author Biography

Catherine Westbrook is a former Senior Lecturer in Magnetic Resonance Imaging (MRI), Faculty of Medical Science, Anglia Ruskin University, Cambridge, UK, and is a founder and co-director of the MRI Education Company.

Table of Contents

Contributors ix Preface xi Acknowledgements xiii About the Companion Website xv Chapter 1 How to Use This Book 1 Introduction 1 Common indications 2 Basic anatomy 2 Equipment 2 Patient positioning 5 Slice prescription 6 Suggested protocol 6 Protocol optimization 6 Patient considerations 6 Contrast usage 6 Summary 7 Terms and abbreviations used in Part 2 7 Conclusion 17 Part 1 Theoretical and Practical Concepts 19 Chapter 2 Protocol Parameters and Trade-offs 21 Introduction 21 Signal-to-noise ratio (SNR) 24 Contrast-to-noise ratio (CNR) 24 Spatial resolution 25 Scan time 26 Decision strategies 27 Conclusion 28 Chapter 3 Pulse Sequences 29 Introduction 29 Conventional spin echo (CSE) 29 Fast spin echo or turbo spin echo (FSE/TSE) 32 Inversion recovery (IR/FSE/TSE-IR) 34 Rewound gradient echo 35 Balanced GRE 35 Spoiled GRE 36 Reverse echo GRE 37 Echo planar imaging (EPI) 38 Conclusion 42 Chapter 4 Flow Phenomena and Artefacts 44 Flow phenomena 44 Introduction 44 Time of flight (TOF) 45 Entry slice phenomenon 46 Intra-voxel dephasing 46 Flow artefact remedies 46 Artefacts 48 Introduction 48 Phase mismapping 48 Aliasing 48 Chemical shift 49 Out-of-phase signal cancellation 49 Truncation 49 Magnetic susceptibility 49 Magic angle 50 Conclusion 51 Chapter 5 Gating and Respiratory Compensation Techniques 53 Introduction 53 Cardiac gating (ECG/EKG gating) 53 Peripheral gating (Pe gating) 58 Ciné imaging 59 Imaging planes 60 Respiratory Compensation (RC) 60 Conclusion 61 Chapter 6 Patient Care and Safety 62 Introduction 62 Patient screening 62 Safety zones 63 Safety concerns during the examination 64 Patient counselling 65 Patient immobilization 67 Patient after-care 67 Conclusion 67 Chapter 7 Contrast Agents 68 Introduction 68 Gd-based positive contrast agents 68 Negative contrast agents 70 Patient considerations 70 Conclusion 70 Part 2 Examination Areas 71 Chapter 8 Head and Neck 73 Brain 73 Temporal lobes 86 Internal auditory meatus and posterior fossa 92 Pituitary fossa 97 Orbits 102 Paranasal sinuses 109 Pharynx 113 Larynx 119 Thyroid and parathyroid glands 124 Salivary glands 129 Temporomandibular joints 133 Vascular imaging 137 Head and neck imaging – key points 141 Chapter 9 Spine 142 Cervical spine 142 Thoracic spine 151 Lumbar spine 156 Whole spine imaging 162 Spine imaging – key points 166 Chapter 10 Chest 167 Lungs and mediastinum 167 Heart and great vessels 175 Thymus 186 Breast 189 Axilla 199 Brachial plexus 202 Chest imaging – key points 206 Chapter 11 Abdomen 207 Liver and biliary system 207 Kidneys and adrenal glands 215 Pancreas 222 Bowel 227 Vascular imaging 232 Abdominal imaging – key points 235 Chapter 12 Pelvis 236 Prostate 236 Rectum and testes 244 Uterus and cervix 247 Pelvic imaging – key points 251 Chapter 13 Upper Limb 252 Shoulder 252 Humerus 262 Elbow 268 Forearm 276 Wrist and hand 281 Upper limb imaging – key points 288 Chapter 14 Lower Limb 289 Hips 289 Femur 298 Knee 303 Tibia and fibula 311 Ankle 316 Foot 323 Vascular imaging 328 Lower limb imaging – key points 334 Chapter 15 Paediatric Imaging 335 Introduction 335 Creating the right environment 335 Sedation and anaesthesia 337 The MRI examination 345 Conclusion 375 Paediatric imaging – key points 375 Index 376

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