1. Fundamentals of Image Interpretation Joseph Castillo B.Sc, M.Sc (MRI)

2. Five levels Normal anatomy as seen on MR Normal anatomy as seen on MR Abnormal anatomy Abnormal anatomy Accurate and complete patient history – In our unit this is not an option. Accurate and complete patient history – In our unit this is not an option. Pathology – Read MRI reports Pathology – Read MRI reports Accurate clinical interpretation Accurate clinical interpretation

3. Clinical Imaging Three basic orthogonal planes used in MRI – axial, sagittal and coronal Three basic orthogonal planes used in MRI – axial, sagittal and coronal Unlike CT, radiographers have the ability to image biological functions not just electron density. Unlike CT, radiographers have the ability to image biological functions not just electron density. We manipulate parameters to get T1W, T2W and PDW. The appearance of the organ is changed. We manipulate parameters to get T1W, T2W and PDW. The appearance of the organ is changed.

4. Spine Imaging featureT1WPDWT2W Spinal Cord intermediateintermediateIntermediate CSFdarkIntermediateBright vertebraeintermediateintermediateIntermediate discintermediate Light gray Bright fatbright intermediate Cortexdarkdarkdark

5. Spine

6. Spine Which one is T2w? Which one is T2w? A B

7. ?Pathology

8. ?Pathology

9. ?disk

10. Urgent MRI?

11. ?fracture

12. What is this high signal?

13. metal

14. Musculoskeketal StructureT1WPDWT2W Fatbrightbrightintermediate MuscleintermediateintermediateDark Bone marrow Intermediate/brightintermediateIntermediate Cortical bone darkdarkdark CartilagebrightbrightIntermediate Ligament/tendondarkdarkDark Fibrous tissue darkdarkDark OedemadarkbrightBright Solid organs variablevariablevariable

15. Knee MRI

16. What is wrong with this knee?

17. ??

18. Meniscus

19. STIR and T1W