Fundamentals of Fundamentals of Image InterpretationImage Interpretation

Joseph Castillo B.Sc, M.Sc (MRI)Joseph Castillo B.Sc, M.Sc (MRI)

Five levelsFive levels

Normal anatomy as seen on MRNormal anatomy as seen on MR Abnormal anatomyAbnormal anatomy Accurate and complete patient Accurate and complete patient

history – In our unit this is not an history – In our unit this is not an option.option.

Pathology – Read MRI reportsPathology – Read MRI reports Accurate clinical interpretationAccurate clinical interpretation

Clinical ImagingClinical Imaging

Three basic orthogonal planes used Three basic orthogonal planes used in MRI – axial, sagittal and coronalin MRI – axial, sagittal and coronal

Unlike CT, radiographers have the Unlike CT, radiographers have the ability to image biological functions ability to image biological functions not just electron density.not just electron density.

We manipulate parameters to get We manipulate parameters to get T1W, T2W and PDW. The appearance T1W, T2W and PDW. The appearance of the organ is changed.of the organ is changed.

Spine ImagingSpine Imaging

featurefeature T1WT1W PDWPDW T2WT2W

Spinal Spinal CordCord

intermediatintermediatee

intermediatintermediatee

IntermediatIntermediatee

CSFCSF darkdark IntermediatIntermediatee

BrightBright

vertebraevertebrae intermediatintermediatee

intermediatintermediatee

IntermediatIntermediatee

discdisc intermediatintermediatee

Light grayLight gray BrightBright

fatfat brightbright Light grayLight gray intermediatintermediatee

CortexCortex darkdark darkdark darkdark

SpineSpine

SpineSpine

Which one is T2w?Which one is T2w? A

B

?Pathology?Pathology

?Pathology?Pathology

?disk?disk

Urgent MRI?Urgent MRI?

?fracture?fracture

What is this high signal?What is this high signal?

metalmetal

MusculoskeketalMusculoskeketal

StructureStructure T1WT1W PDWPDW T2WT2WFatFat brightbright brightbright intermediateintermediate

MuscleMuscle intermediateintermediate intermediateintermediate DarkDark

Bone marrowBone marrow Intermediate/Intermediate/brightbright

intermediateintermediate IntermediateIntermediate

Cortical boneCortical bone darkdark darkdark darkdark

CartilageCartilage brightbright brightbright IntermediateIntermediate

Ligament/Ligament/tendontendon

darkdark darkdark DarkDark

Fibrous tissueFibrous tissue darkdark darkdark DarkDark

OedemaOedema darkdark brightbright BrightBright

Solid organsSolid organs variablevariable variablevariable variablevariable

Knee MRIKnee MRI

What is wrong with this What is wrong with this knee?knee?

????

MeniscusMeniscus

STIR and T1WSTIR and T1W