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Review. Radiographic Film Report Radiographic Procedure : Ultrasound of gallbladder Clinical Information: Recurrent upper abdominal pain Radiographic findings: Real-time (sector scanner) examination of the gallbladder showed a
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Radiographic Film Report Radiographic Procedure: Ultrasound of gallbladder Clinical Information: Recurrent upper abdominal pain Radiographic findings: Real-time (sector scanner) examination of the gallbladder showed a uniformly thickened gallbladder wall. There was a single large echo productive structure in contact with the dependent wall of the gallbladder. Conclusion: There is ultrasound evidence of cholelithiasis and chronic cholecystitis.
The image shows a longitudinal representation of the kidney with a large renal cyst. You can see the cyst as an area which has no internal echoes. In fact, there are three criteria to determine if a mass lesion is cystic: 1) There are no internal echoes. 2) The far wall (away from the transducer) is just as clearly displayed as the near wall. 3) There is a zone of increased echo recording deep to the mass.
RADIOGRAPHIC FILM REPORT Radiographic Procedure:GU – Ultrasound Study Clinical Information: Abdominal pain with nausea for six (6) hours. Radiographic findings: Multiple trans-axial and longitudinal sections of the left kidney were made with a “real” time sector scanner. The kidney was enlarged with an eight (8) centimeter mass involving the lower pole of the kidney. Although the mass was predominately sonolucent, there were some scattered internal echoes. CONCLUSION: There was a large left lower pole renal mass. Although the mass is likely to be predominately cystic, it did not meet the criteria for a simple renal cyst (because of internal echoes). The possibility of some solid components of the renal mass cannot be excluded.
MRI GOALS • Image creation • Representative anatomy • Indications • Strengths and weakness
Tissue Signal Time in Y plane=T2 signal Time to recover Z plane=T1 signal
MR Signal • MR signal is tissue specific. • Determined by the tissue responce to RF/magnetic field • Examples : • Water, fat, muscle, bone,organs all respond differently. • Having specific T1 and T2 values. • Image depends on separating tissue by the T1 or the T2 values in question
T1, T2, TR, & TE T1 and T2: Tissue specific parameters that dictate the strength of the MR signal. TR and TE:Are scanner times that are chosen to exploit the different T1 and T2 parameters to createimages.
TR=Repetition time TE=Echo delay time
WHY? Long TR Short TE T1 weighted T2 weighted Balanced/proton density
Whew! More physics Na! www.youhavenolife.com
MAGNETIC RESONANCE IMAGING Image Methods • T1 – Fat/soft tissue • T2 – Water/ soft tissue • Proton Density - balanced • Diffusion – New/old CVA • Angiography – Flow/contrast
MR Contrast Gadolineum Chelate as contrast agent • Based on paramagnetic effects of gadolineum • Not iodinated • Physiology similar to iodine handling • Blood pool and tissue enhancement
