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Department of Radiology University of California San Diego John R. Hesselink, M.D. MR Imaging of the Brain.

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Presentation on theme: "Department of Radiology University of California San Diego John R. Hesselink, M.D. MR Imaging of the Brain."— Presentation transcript:

1 Department of Radiology University of California San Diego John R. Hesselink, M.D. MR Imaging of the Brain

2 MR System Components Computer Gradient Amplifier Receiver Transmitter Digitizer RF Coil Gradient RF Coil Gradient Magnet

3 MR Imaging  Proton density  T1 relaxation time  T2 relaxation time  Flow effects Source of Signal and Contrast

4 Spin-echo Pulse Sequence Single Echo T1-weighted RF Signal TR TE 1 st echo 2 nd echo

5 Spin-echo Pulse Sequence Dual Echo T2-weighted 1 st echo 2 nd echo RF Signal TR TE

6 T2-Weighted Images

7 Proton Density Weighted Images

8 Normal FLAIR Images TR = 6000 msec, TI = 2000 msec, TE = 102 msec

9 T1-Weighted Images

10 MR Signal of Brain Lesions

11 Solid Brain Lesion PDW T2W T1W

12 Cystic Lesion T2W T1W FLAIR 236

13 Subacute Hemorrhage PDW T1W T2W

14 Acute Hemorrhage T2WFLAIR T1W GRE

15 History: 9 y/o boy with prior head trauma 466

16 Hemorrhage Sequence Gradient-echo

17 PDW Fat or Lipoma T2W T1W

18 MR Signal Intensities T2WIPD/FLAIRT1WI Solid massBright Dark CystBrightDark Subacute bloodBright Acute & chronic blood Dark Gray FatDarkBright

19 Acute Stroke Sequence Diffusion Weighted Imaging

20 MR Angiography

21 Dx: Anaplastic astrocytoma > GBM MR Spectroscopy

22 Brain Screening Protocol  Sagittal T1-weighted images  Axial T2-weighted images  Axial FLAIR images  Diffusion-weighted images  Gradient-echo images  Axial T1-weighted images  Gadolinium: Axial & Coronal T1

23 History: 46 y.o. man with headaches & increasing confusion 2 1 T2W PDW

24 {Page 2} 5 3 4 T1W T1W / Gd T1W

25 Dx: Meningioma & right MCA infarct Increasing confusion {Page 3} 76

26 Student Cases "May the FORCE be with you!"

27 History: 69 y/o man with nausea & memory deficits for several weeks 413 Case 1

28 Dx: Glioblastoma {Page 2}

29 History: 5 y/o girl with seizures 361 Case 2

30 {Page 2}

31 Dx: Amoebic abscesses {Page 3}

32 History: 62 y.o. man with mumbling speech 26 2 1 Case 3

33 {Page 2} 3 4

34 Mumbling speech {Page 3} 5 6

35 Dx: Enhancing subacute infarct {Page 4} 8 7

36 2 1 History: 48 y.o. male with a sensorineural hearing loss Case 4

37 Dx: Acoustic neuroma {Page 2} 5 4 3

38 History: 48 y.o. man with headaches & confusion 32 1 2 Case 5

39 {Page 2} 4 3

40 {Page 3} 7 6 5

41 Dx: Brain metastases - Lung carcinoma {Page 4} 10 98

42 History: 36 y.o. man with seizures 2 1 Case 6

43 History: Seizures {Page 2} 5 4 3

44 Dx: AVM & basilar tip aneurysm {Page 3} 8 7 6

45 History: 62 y/o woman with headaches Case 7

46 Dx: Arachnoid cyst {Page 2}

47 History: 27 y.o. man with increasing confusion & lethargy 5 2 1 Case 8

48 Confusion and lethargy {Page 2} 3 4

49 Dx: Herpes simplex encephalitis {Page 3} 6 5

50 History: 72 y.o. woman with headaches 49 3 2 1 Case 9

51 Dx: Parasagittal meningioma {Page 2} 54 6

52 History: 55 y/o female with motor weakness, double vision, & emotional lability 272 Case 10

53 {Page 2}

54 Dx: Chronic multiple sclerosis; Incidental sebaceous cyst left posterior scalp {Page 3}

55 History: 42 y/o female with chronic headaches 549 Case 11

56 {Page 2}

57 Dx: TB meningitis - HIV + {Page 3}

58 History: 75 y.o. male with dysmetria in upper extremities 1 2 Case 12

59 {Page 2} 3 5 4

60 Dx: Lipoma {Page 3} 8 6 7

61 History: Young male with increasing somnolence and irritability 11/20 - 2 1 3

62 Dx: Planum Meningioma in a dog 4 {Page 2} 6 5

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