Table Of Contentb
other books in the
RAD TECH SERIES
Rad Tech's Guide to Equipment Operation and Maintenance
Euclid Seeram
Rad Tech's Guide to Radiation Protection
Euclid Seeram
Rad Tech's Guide to MRI: Basic Physics, Instrumentation,
and Quality Control
William Faulkner
Rad Tech's Guide to Mammography: Physics,
Instrumentation, and Quality Control
Donald Jacobson
Rad Tech's Guide to CT: Imaging Procedures, Patient Care,
and Safety
Deborah Lynn Durham
Rad Tech's Guide to
M 1: lma ing
(J
re,
Carolyn Kaut Roth,
RT(R), (MR), (en, (M), (CVJ
Director Technologist Continuing Education
and MRI Programs
University of Pennsylvania Medical Center
Philadelphia, Pennsylvania
Series Editor
Euclid Seeram, RTR, sse, MSc, FCAMRT
Medical Imaging Advanced Studies
British Columbia Institute of Technology
Burnaby, British Columbia, Canada
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Library of Congress Cataloging-in-Publication Data
Kaut Roth, Carolyn.
Rad tech's guide to MRI : imaging procedures, patient care, and safety I by
Carolyn Kaut Roth.
p.; em.
ISBN 978-0-632-04507-5
I. Magnetic resonance imaging-Outlines, syllabi, etc. 2. Radiologic technolo-
gists- Outlines, syllabi, etc. I. Title: Guide to MRI. II. Title.
[DNLM: I. Magnetic Resonance Imaging-methods-Outlines. 2. Technology,
Radiologic-methods-Outlines. WN 18.2 K2I ra200I]
RC78.7.N83 K386 2001
6I 6.07'548-dcZI
2001025055
TABLE OF CONTENTS
Patient Care and Safety for Magnetic Resonance
Imaging. I
Introduction to Patient Care and Safety for MRI, 3
Screening Patients and Personnel, 3
Ancillary Equipment and Implants, 8
Assessing and Monitoring. 19
Contrast Agents for M Rl, 21
Life-Threatening Situations, 24
Safety Precautions for Placement of Electrical Conductors, 24
Environmental Considerations: Temperature and Humidity, 25
Gauss Line and Magnetic Field Strength, 25
Emergency Procedures, 27
Quench,27
Evacuation, 29
Biologic Considerations, 29
Radio Frequency Fields, 29
Static Field Strength, 32
FDA Guidelines for Static Magnetic Fields, 35
Gradient Magnetic Fields (Time-Varying Magnetic Fields), 35
Future Safety Considerations, 38
2 Introduction to Clinical MRI Procedures, 41
Introduction to Clinical MRI, 41
Patient Preparation for Clinical MRI, 42
Special Considerations for Pediatric Patients, 43
Choosing the Right Protocol, 43
Parameters for Image Contrast in MRI, 44
Pulse Sequences, 47
Parameters for Signal-to-Noise and Resolution, 51
Creating Artifact-Free Images, 53
Types of FDA-Approved Contrast Agents, 55
3 Imaging Procedures: Head and Neck Imaging. 57
Introduction to Head and Neck MRI, 57
Standard Protocols for Imaging of the Brain, 58
Anatomy and Physiology of the Brain, 60
Patient Set-Up and Positioning for Brain Imaging. 64
Indications for Contrast Agents for Brain Imaging. 65
Indications for High-Resolution Brain Imaging. 67
v
vi TABLE OF CONTENTS
4 Spine Imaging Procedures, 71
Introduction to Spine Magnetic Resonance Imaging, 71
Standard Protocols for Imaging the Spine, 72
Additional Spine Sequences for High Resolution, 74
Anatomy and Physiology of the Spine, 74
Patient Set-Up and Positioning for Spine Imaging, 76
Indications for Contrast Agents for Spine Imaging, 79
Cervical Spine Imaging, 80
Thoracic Spine Imaging, 80
Lumbar Spine Imaging, 82
5 Musculoskeletal Imaging Procedures, 85
Introduction to Musculoskeletal Magnetic Resonance Imaging, 86
Standard Protocols for Imaging the Musculoskeletal System, 86
Patient Set-Up and Positioning for Musculoskeletal Imaging, 90
Indications for Contrast for Musculoskeletal Imaging, 92
Standard Dose and Administration for Gadolinium, 92
Magnetic Resonance Imaging of the Temporomandibular Joint, 93
Magnetic Resonance Imaging of the Upper Extremities, 94
Magnetic Resonance Imaging of the Lower Extremities, 101
6 Thorax Imaging Procedures, Ill
Introduction to Thorax Magnetic Resonance Imaging, Ill
Standard Protocols for Imaging the Thorax, 112
Patient Set-Up and Positioning for Thorax Imaging, 116
Indications for Contrast Agents for Thorax Imaging, 121
Magnetic Resonance Imaging of the Breast, 123
7 Abdomen Imaging Procedures, 131
Introduction to Abdomen Magnetic Resonance Imaging, 131
Standard Protocols for Imaging the Abdomen, 132
Anatomy and Physiology of the Abdomen, 136
Patient Set-Up and Positioning for Abdomen Imaging, 138
Indications for Contrast Agents for Abdomen Imaging, 140
8 Pelvis Imaging Procedures, 143
Introduction to Pelvis Magnetic Resonance Imaging, 143
Standard Protocols for Imaging the Pelvis, 144
Patient Set-Up and Positioning for Pelvis Imaging, 144
Indications for Contrast Agents for Pelvis Imaging, 146
Standard Dose and Administration for Gadolinium, 147
Standard Protocols for Female Pelvis MRI, 147
Standard Protocols for Male Pelvis MRI, 152
9 Vascular Imaging Procedures, 155
Introduction to Vascular Magnetic Resonance Imaging, 156
Flow Imaging: An Overview, 156
Magnetic Resonance Angiography: An Overview, 158
Body Magnetic Resonance Angiography Challenges, 163
Anatomy and Physiology of the Vascular System, 166
SERIES EDITOR'S FOREWORD
Blackwell Science's Rad Tech Series in radiologic technolo
gy is intended to provide a clear and comprehensive coverage
of a wide range of topics and prepare students to write their
entry-to-practice registration examination. Additionally, this
series can be used by working technologists to review essen
tial and practical concepts and principles and to use them as
tools to enhance their daily skills during the examination of
patients in the radiology department.
The Rad Tech Series features short books covering the fun
damental core curriculum topics for radiologic technologists at
both the diploma and the specialty levels, as well as act as
knowledge sources for continuing education as defined by the
American Registry for Radiologic Technologists (ARRT).
The entry-to-practice series includes books on radiologic
physics, equipment operation, patient care, radiographic tech
nique, radiologic procedures, radiation protection, image pro
duction and evaluation, and quality control. This specialty
series features books on computed tomography physics and
instrumentation, patient care and safety, and imaging proce
dures; mammography; and quality management in imaging
sciences.
In Rad Tech's Guide to MRI: Imaging Procedures, Patient Care,
and Safety, Carolyn Kaut Roth, a renowned educator and direc
tor technologist of MR programs of the University of
Pennsylvania Medical Center, presents clear and concise cov
erage of patient care and safety issues of magnetic resonance
imaging (MRI), as well as MR imaging procedures. Topics
include patient care and safety, imaging procedures that
describe MRI of the head and neck, spine, chest, muscu
loskeletal system abdomen, pelvis, and vascular system.
Carolyn Kaut Roth has done an excellent job in explaining
significant concepts that are mandatory for the successful per-
vii
VIII SERIES EDITOR'S FOREWORD
formance of quality MRI in clinical practice. Students, technol
ogists, and educators alike will find this book a worthwhile
addition to their libraries.
Enjoy the pages that follow; remember, your patients will
benefit from your wisdom.
Euclid Seeram, RTR, BSc, MSc, FCAMRT
Series Editor
British Columbia, Canada
PREFACE
The purpose of Rad Tech's Guide to MRI: Imaging Procedures,
Patient Care, and Safety is to provide an easy reference for the
study of magnetic resonance imaging (MRI) for the technolo
gist who is preparing for the advanced level examination in
MRI. This guide can also be used as a quick overview of MRI
for the practicing technologist and physician. The outline for
mat provides easy reference for each section of the text. The
subtopics and bulleted text facilitate quick reference without
"over reading" the material.
MRI safety and imaging procedures with anatomy have
been discussed in this guide, and the basic principles and
image contrast to pulse sequences and k-space are discussed
in a partner guide in the Rad Tech series. The more complicat
ed topics have hopefully been expressed in an understandable
format that will encourage the reader to explore these topics,
rather than run in the opposite direction. Purists may perceive
our attempt at creating a "user-friendly" text as an oversim
plification. However, we believe it important to disseminate
difficult information to a variety of educational levels.
Carolyn Kaut Roth
ix
