Pictorial Essay – Benign and Malignant Bone Tumors: Radiological Diagnosis and Imaging Features

This paper shows how the simultaneous use of multipurpose loop coils in MRI allows high-resolution musculoskeletal studies with increased contrast and specificity for assessing muscles, tendons, ligaments, joints, and cartilage. Dr. Ferrer presents a number of different daily patient routine examinations, including specifically evaluation of the carpal bones, the thumb metacarpals, the metacarpals, the distal inter-phalangeal joints, the elbow and ankle. [...]

MAGNETOM Aera – Combining Throughput and Highest Quality MR Angiography in an Optimized Clinical Workflow

This paper shows how the simultaneous use of multipurpose loop coils in MRI allows high-resolution musculoskeletal studies with increased contrast and specificity for assessing muscles, tendons, ligaments, joints, and cartilage. Dr. Ferrer presents a number of different daily patient routine examinations, including specifically evaluation of the carpal bones, the thumb metacarpals, the metacarpals, the distal inter-phalangeal joints, the elbow and ankle. [...]

MAGNETOM Aera – Combining Throughput and Highest Quality MRI in an Optimized Clinical Workflow

This paper shows how the simultaneous use of multipurpose loop coils in MRI allows high-resolution musculoskeletal studies with increased contrast and specificity for assessing muscles, tendons, ligaments, joints, and cartilage. Dr. Ferrer presents a number of different daily patient routine examinations, including specifically evaluation of the carpal bones, the thumb metacarpals, the metacarpals, the distal inter-phalangeal joints, the elbow and ankle. [...]

MRI Assessment of Articular Cartilage Repair

The evolution of sophisticated surgical repair procedures for the treatment of isolated, focal traumatic or degenerative cartialge lesions has created the need for accurate, non-invasive assessment of the repair tissue. MRI depicts well subchondral bone and bone marrow, allowing examination of repair tissue and its interface with parent cartilage and complications of repair surgeries such as graft hypertrophy and delamination. [...]

T1-weighted Phase Sensitive Inversion Recovery for Imaging Multiple Sclerosis Lesions in the Cervical Spinal Cord

The evolution of sophisticated surgical repair procedures for the treatment of isolated, focal traumatic or degenerative cartialge lesions has created the need for accurate, non-invasive assessment of the repair tissue. MRI depicts well subchondral bone and bone marrow, allowing examination of repair tissue and its interface with parent cartilage and complications of repair surgeries such as graft hypertrophy and delamination. [...]

Clinical Application of Diffusion Tensor Imaging in Radiation Planning for Brain Tumors

The evolution of sophisticated surgical repair procedures for the treatment of isolated, focal traumatic or degenerative cartialge lesions has created the need for accurate, non-invasive assessment of the repair tissue. MRI depicts well subchondral bone and bone marrow, allowing examination of repair tissue and its interface with parent cartilage and complications of repair surgeries such as graft hypertrophy and delamination. [...]

Comprehensive MRI-Based Staging of Rectal Cancer. Beneficial Combination of Local High- Resolution Imaging and a Moving-Table Platform for Simultaneous Detection of Metastasis

The evolution of sophisticated surgical repair procedures for the treatment of isolated, focal traumatic or degenerative cartialge lesions has created the need for accurate, non-invasive assessment of the repair tissue. MRI depicts well subchondral bone and bone marrow, allowing examination of repair tissue and its interface with parent cartilage and complications of repair surgeries such as graft hypertrophy and delamination. [...]

MAGNETOM Aera – Combining Throughput and Highest Quality Spine Imaging in an Optimized Clinical Workflow

The term WARP summarizes methods to minimize the impact of metal implants on MR image quality. This article introduces different techniques such as high bandwidth, VAT and SEMAC. [...]

Faster Abdominal MRI Examinations by Limiting Table Movement

The article shows how to reduce total examination time of a non-contrast liver MRI/MRCP by up to 20% with no observable change in image quality. It presents a scanning protocol which prohibits table movement, particularly time-consuming shim data, throughout the course of the examination. [...]

Brain Perfusion; How & Why

Pathologic perfusion is sometimes the reason and often the consequence of brain pathologies. Evaluation of perfusion with dynamic susceptibility-weighted imaging is a well understood and established method to evaluate these changes. In this article, Binesh et al. (Cedars Sinai Medical Center, Los Angeles) show step-by-step how they apply this method and present four case reports illustrating the usefulness of perfusion imaging in clinical practice. [...]

Introduction to Advanced Techniques in MR Neuroimaging

Neurology is the largest field of application for MRI. In their article the authors give a comprehensive introduction to advanced techniques in neuroimaging. Learn more about fMRI, DTI, DWI, ASL, SWI and many other techniques that go beyond standard imaging. [...]

Simplifying the Workflow of Long Bone Imaging for Short Bore Systems

Imaging of long bones on 1.5T short bore systems can be challenging at times for technologists. This article provides tips that will make long bone imaging easier to acquire. [...]

MRI of the Shoulder: Utilizing the Glenoid Clockface Orientation

Orthopedic surgeons describe the glenoid fossa as the face of a clock, with the longitudinal axis defined by the supraglenoid tubercle at the 12:00 position and the inferior margin of the glenoid at the 6:00 position. Orienting the shoulder MRI exam relative to this clockface is ideal as it results in images which consistently correspond with the arthroscopists’ perspective and optimally profiles the major anatomic structures of the glenohumeral joint. In this article, Steven D. Needell, M.D. describes how to use the technique and shows its advantages in clinical cases. [...]

CMR Imaging of Profound Macrovascular Obstruction

Cardiac cine imaging of the myocardium, dynamic first pass myocardial perfusion imaging, and delayed myocardial enhancement imaging are presented in a patient with macrovascular obstruction. [...]

Techniques in Pediatric MRI – Tips for Imaging Children

This paper provides an overview of the challenges that pediatric patients raise in the MR setting, and some of the different techniques that may be employed to overcome these difficulties. [...]

Clinical Lung Imaging

MRI of the lung can be applied in a variety of clinical scenarios. It is a feasible alternative to CT– as it avoids unnecessary radiation in young patients and provides additional physiological information such as perfusion or respiratory dynamics. Diffusion-weighted imaging can even add biological information about cell density. In this report, Professor Biederer (University Hospital Kiel, Germany) gives a detailed review on lung imaging protocols and an insight into typical applications for lung MRI. [...]

Long Bone Imaging

In this step-by-step guide divided in two articles, James Hancock of Benson Radiology in Adelaide, Australia, shows how to image the distal and proximal lower limbs using the Tim User Interface. This demonstration takes you through an examination including positioning the patient, running the localizers, and setting up fields-of-view and slice positions. Helpful tips and screenshots make this a valuable tool. [...]

Cerebral Amyloid Angiopathy (CAA) using Susceptibility-Weighted Imaging (syngo SWI)

Susceptibility weighted imaging well demonstrates microhemorrhages within the brain. In CAA, these involve the cortex and subcortical white matter within the frontal and parietal lobes. This is in distinction to hypertensive microangiopathy, where microhemorrhages occur in deep white matter as well as infratentorially. [...]

3T MR Imaging of Peripheral Nerves Using 3D Diffusion-Weighted PSIF Technique

High-resolution magnetic resonance (MR) Neurography is a novel imaging technique, which enables multiplanar imaging of peripheral nerves, as well as diagnosis and localization of entrapment and non-entrapment peripheral neuropathies related to etiologies, such as inflammation, tumor and trauma. [...]

Assessment and Classification of Peripheral Vascular Anomalies by Time-Resolved MRA using TWIST.

Vascular malformations (VM) are complex lesions present in various anatomical locations with a variety of clinical manifestations. Time-resolved MRA combined with parallel imaging and echo sharing schemes offer a reasonable alternative to more invasive diagnostic methods such as digital subtraction angiography (DSA) in evaluation of VMs. MRI is becoming the imaging modality of choice in assessing morphological issues regarding VMs. Time-resolved MRA can play an important role in characterizing these lesions and can influence therapeutic decision-making. [...]

Susceptibility-Weighted Imaging (syngo SWI) at 3T.

This is a pictorial review of susceptibility- weighted imaging (syngo SWI) using a MAGNETOM Trio system with software version syngo MR B15 and a 32-channel head coil at The Geelong Hospital, Victoria, Australia. syngo SWI is a 3D FLASH sequence that is flow compensated in slice, read and phase directions. [...]

Definition and Clarification of TR in Modern Imaging, with Emphasis on Cardiac Applications

As MR has evolved, the definition of TR has become quite complex, particularly with gated sequences. This article begins with an introduction to TR, covering its definition in spin echo and multislice fast spin echo sequences, and subsequently discusses in depth its definition in the plethora of cardiac gated sequences employed in modern imaging. [...]

An Overview of Imaging Techniques for the Carotid Bifurcation

Because it has been proven that there is a link between the development of nephrogenic systemic fibrosis (NSF) and the application of high volumes of magnetic resonance (MR) contrast agents in patients with impaired renal function, interest in non-contrast-enhanced techniques for MR angiography has experienced a renaissance. This set of images presents 5 different techniques for imaging the carotid bifurcation, one of the most critical and commonly diseased vascular regions within the entire arterial system. Except one (D), for best comparability, all exams were acquired with the same spatial resolution of 0.9 x 0.9 x 0.9 mm3 at 3 T (Magnetom Verio, Siemens Medical Solutions). [...]

Bandwidth in MRI?

Questions about bandwidth are common during discussions regarding MR parameters and image quality. In his How-I-do-it, Joachim Graessner (Hamburg, Germany) clarifies the meaning of bandwidth in MRI, discussions interactions with other MR parameters and gives hints for daily routine work and protocol optimization. [...]

Cerebral Magnetic Resonance Spectroscopy at 1.5T and 3T

MR spectroscopy is a powerful technique that adds metabolic information to routine MRI brain examinations. Through four cases, this article provides tips for performing cerebral MRS. Examples of additional information using this technique include differentiating cerebral neoplasms from abscesses and distinguishing solitary primary cerebral neoplasms from solitary cerebral metastatic deposits. [...]

How Breast MRI Changed the Operative Management

MR diffusion-weighted imaging (DWI) is no longer just for brain applications. Whole body DWI is becoming a standard application in routine imaging. Whole body DWI has become as valuable as T2 contrast in tumor imaging and it allows characterization of tissue properties. This article provides responses to some of the more frequently asked questions including the background, application, and interpretation of whole body DWI and its calculated Apparent Diffusion Coefficient (ADC) images. [...]

Frequently Asked Questions: Diffusion Weighted Imaging (DWI)

MR diffusion-weighted imaging (DWI) is no longer just for brain applications. Whole body DWI is becoming a standard application in routine imaging. Whole body DWI has become as valuable as T2 contrast in tumor imaging and it allows characterization of tissue properties. This article provides responses to some of the more frequently asked questions including the background, application, and interpretation of whole body DWI and its calculated Apparent Diffusion Coefficient (ADC) images. [...]

Assessment and Classification of Peripheral Vascular Anomalies by Time-Resolved MRA using TWIST

Vascular malformations are complex lesions with a variety of clinical manifestations. Time-resolved MRA combined with parallel imaging and echo sharing schemes represents a reasonable alternative to more invasive DSA for the evaluation of VMs. Therefore, time-resolved MRA can play an important role in categorizing these lesions and determining their extent in order to correctly guide treatment. [...]

Cerebral amyloid angiography using SWI

Compared to conventional T2*-weighted imaging, a susceptibility-weighted imaging technique is very sensitive in the detection of small bleedings and vascular malformations. This case report shows that SWI is a sensitive tool for the precise assessment of CAA. His findings show that by using SWI, multiple small cortical and subcortical bleedings can be depicted in detail and can show the extent of the severity of CAA better than with conventional T2*-weighted MRI only. [...]

Whole-Body Oncologic Imaging with syngo TimCT

The article shows that the addition of syngo TimCT functionality makes whole-body MR oncologic evaluation a viable reality. Extended, whole-body anatomic coverage is now possible without off-isocenter artifacts or signal loss. In-plane image quality with the TimCT application is maintained in comparison to conventional MR. Non-breathhold technique did not limit diagnostic quality in the presented patients. Skull-base to upper thigh coverage was achieved in standard imaging times of 30–40 minutes. With the addition of DWI to conventional sequences, functional-anatomic information correlation is possible through the whole-body field of view. TimCT has removed the barriers to whole-body MR evaluation. [...]

Fat Suppression in the Abdomen

Due to the different chemical environment, hydrogen nuclei in water- and in fat-tissue have different values for some MRI-relevant parameters, mainly being the relaxation time and the resonance frequency (chemical shift). These differences can be used to selectively suppress/reduce the signal of fat bound protons.Thus relaxation-dependant and chemical shift-dependant methods can be used for fat suppression. [...]

Case Report: syngo TimCT – MR Angiography in Clinical Routine

Studies at the University Medical Center in Mannheim, Germany show that the continuous moving table MRA approach is a major improvement in imaging the lower extremities in a clinical setting as it combines an easy, fast and robust workflow with good clinical results and is applicable to a broad range of patients. [...]

Case Report: Fast Joint Imaging at 1.5 Tesla with a Combination of the Quadrature Knee and Body Matrix Coil in Case of Severe Knee Pain of an Obese Patient

Knee MRI is challenging in both obese patients and patients in pain, requiring in some cases special coil setups as imaging is impossible with a conventional closed knee coil. In the presented case, a flexible coil setup is demonstrated in combination with open-bore MR technology. This illustrates the benefit of such setups in the diagnosis of knee pain in obese patients. [...]

Tips for T2-weighted TSE Shoulder Imaging with Spectral Fat Saturation

Robust fat saturation can be achieved by different approaches including the application of inversion recovery sequences or advanced fat suppression pulses such as SPAIR. However, in some cases, such as the musculoskeletal imaging of the shoulder, the combination of a T2- weighted turbo spin echo (TSE) sequence with a conventional spectral fat saturation pulse is needed. When imaging obese or very tall patients, the shoulder has to be positioned off-center in many MR exams and therefore several factors will affect image quality with spectral fat saturation. This article provides tips on patient positioning and sequence set-up that will help you to achieve high quality spectral fat saturation. [...]

Magnets, Spins, and Resonances: An introduction to the Basics of Magnetic Resonance

This 193 page essay describes in easily understandable language the basic principles of MR. It starts with a short excursion through MR physics. The essay then proceeds to a discussion of spin relaxation and echoes, which leads to the section dedicated to the resultant observed signal and generation of the final image. The wide range of tissue contrasts that can be achieved, how fast images are generated, and the actual components that make up an MR system, are all then discussed in turn. [...]

Magnets, Flows and Artifacts: Basics, Techniques, and Applications of Magnetic Resonance

This 133 page essay describes in easily understandable language several important topics encompassing overall image quality and then specifically the impact of flow. It starts with a short discussion of image quality and important factors therein. Flow and motion are then discussed in depth. The essay continues with the topics of saturation and chemical shift, which are important in a discussion of image quality and flow effects. Functional imaging, fast imaging techniques, and the detection and avoidance of image artifacts, are all then discussed in turn. [...]

MR Protocols

The goals of this series of MR imaging protocols are to: Offer protocols that are state of the art for newer equipment and contrast agents to enable clinicians to use MR imaging technologies to their fullest capabilities Provide an important educational service to radiologists and radiology technologists by presenting optimized approaches for the acquisition of highly diagnostic images of the central nervous system (CNS), body, and vasculature using newer-generation MR scanners, sequences, and acquisition parameters Demonstrate how protocols should be modified to take into account the different physicochemical properties of the currently available MR contrast agents Suggested protocols specific to General Electric (GE), Siemens, and Philips MR systems are included, with these protocols developed based on the consensus of 3 panels of experts with experience on each platfor [...]