Contrast in MRI

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Contrast in MRI

• PD, T1, and T2

2
Proton Density
3
T1-weighted
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T2-Weighted
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PD, T1, T2
http//www.med.harvard.edu/AANLIB/ (Whole Brain
Atlas)
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Clinical History

• Chronic Subdural Hematoma / Subdural Hygroma
• These images are from an 76 year old man, who
  suffered a severe fall 6 months before seeking
  medical attention. He complained of memory loss,
  and had been depressed since the death of his
  wife. He had a history of alcoholism, with
  several hospital admissions for gastrointestinal
  bleeding. Note the large fluid collection
  displacing the brain. It is white on T2-weighted
  images, and, of course, non-perfused on SPECT.
  The lateral and third ventricles are a bit large,
  partly due to the effects of age and partly to
  the effects of alcohol abuse. The mammillary
  bodies are small in this case compared to the
  normal, a finding commonly seen in alcoholics.

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Anatomical Features T1 T2 PD (Proton Density)
White Matter Bright Dark Bright
Grey Matter Dark Bright Very Bright
CSF Very Dark Very Bright Grey
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T1 vs. T2
http//darkwing.uoregon.edu/schirill/t1t2.jpg
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C-Spine T1, T2
http//www.southeastiowaopenmri.com/Clinical_Photo
s.htm
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T1, T2, T2, T2 Gradient Echo

Image Findings Marked decrease in signal is seen
in the liver on the T2- and T2-weighted images,
with a lesser amount of decreased signal on the
T1-weighted images. Discussion Hemochromatosis
is a disorder of iron metabolism resulting in
excessive iron deposits in the liver, pancreas
and skin. It is associated with diabetes, which
this patient has recently developed. www.mritutor.
org/ mriteach/9655.JPG
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PD, T1, T2

The T1-weighted image shows a large spur along
the inferior edge of the acromial-clavicular
joint causing impingement of the superspinatus
muscle. The proton-density and especially the
T2-weighted image show abnormal increased signal
in the rotator cuff tendon. An effusion is also
seen in the joint space as well as in the
subdeltoid bursae. Discussion Tears of the
rotator cuff are frequently associated with
intermediate signal on T1-weighted images and
increased signal on T2-weighted images. They may
be associated with fluid in the
subdeltoid-subacromion bursae, retraction of the
superspinatous tendon, and atrophy of the muscle.
Magic angle artifact may appear similar to a tear
on T1-weighted and proton density images. The
magic angle artifact will decrease or disappear
on T2-weighted images, unlike tears. Reference
http//www.mritutor.org/mriteach/6729.html
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Guess?!?!
Fatal Stroke The patient was a 71 year old woman
with a history of ischemic cardiomyopathy and
renal insufficiency who developed the sudden
onset of left hemiplegia, hemineglect,
hemianaesthesia, mutism and bilateral ptosis. She
was treated for elevated intracranial pressure,
but deteriorated and developed an enlarged right
pupil and a decreased level of arousal. She
expired 5 days after admission.
http//www.med.harvard.edu/AANLIB/cases/case37/mr
3/012.html
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CT, T2, PD, T1
Fatal Stroke The patient was a 71 year old woman
with a history of ischemic cardiomyopathy and
renal insufficiency who developed the sudden
onset of left hemiplegia, hemineglect,
hemianaesthesia, mutism and bilateral ptosis. She
was treated for elevated intracranial pressure,
but deteriorated and developed an enlarged right
pupil and a decreased level of arousal. She
expired 5 days after admission.
http//www.med.harvard.edu/AANLIB/cases/case37/mr
3/012.html
14
PD, T1, T2, CT
Fatal Stroke The patient was a 71 year old woman
with a history of ischemic cardiomyopathy and
renal insufficiency who developed the sudden
onset of left hemiplegia, hemineglect,
hemianaesthesia, mutism and bilateral ptosis. She
was treated for elevated intracranial pressure,
but deteriorated and developed an enlarged right
pupil and a decreased level of arousal. She
expired 5 days after admission.
http//www.med.harvard.edu/AANLIB/cases/case37/mr
3/012.html