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Comprehensive Overview of MRI Techniques and Protocols for Clinical Brain Imaging

This document provides an in-depth exploration of MR imaging principles, focusing on the generation of MR images, image quality metrics, and tailored MR imaging protocols for various clinical scenarios. Key concepts include nuclear magnetic resonance, spin density, T1 and T2 relaxation, and spatial encoding. It covers basic brain imaging protocols along with specialized approaches for pediatric imaging, stroke evaluation, metastases, and tumors. Detailed guidance is provided on imaging sequences such as T1-W, T2-W, and FLAIR, including considerations for contrast enhancement and fat saturation.

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Comprehensive Overview of MRI Techniques and Protocols for Clinical Brain Imaging

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  1. Elias R. Melhem, MD MR Imaging: Basic Principles

  2. Overview • Generation of MR Image • MR Image Quality • MR Imaging Protocols for Clinical Brain Imaging

  3. Generation of MR Image • Nuclear magnetic resonance • Spin density • Spin lattice relaxation (T1) • Spin spin relaxation (T2) • Spatial encoding

  4. MR Image Quality • Spatial Resolution • Contrast Resolution • Signal-to-Noise • Artifacts

  5. MR Imaging Protocols Tailored Based on: • Clinical Question • Capabilities of the MR scanner

  6. Basic Brain Protocol • Sagittal T1-W SE • Axial T2-W FSE • Axial Fast FLAIR • Axial D-W (b-1000)

  7. Metastases and Primary Brain Tumors Basic Brain Protocol + Gd-enhanced: • Axial T1-W SE • Coronal T1-W SE • Fast FLAIR (Subarachnoid Metastases)

  8. Pediatric (Age < 2 years-old) Basic Brain Protocol + • Axial T1-W SE • Coronal Phase-Sensitive Fast IR

  9. Pediatric (Age < 2 years-old) Basic Brain Protocol + • Axial T1-W SE • Coronal Phase-Sensitive Fast IR

  10. Stroke Protocol Basic Brain Protocol + • 3D TOF MRA of the Circle-of-Willis • Gd-based perfusion imaging

  11. Cervical Carotid Artery Protocol • 2D TOF MRA • Single slab 3D TOF MRA at the bifurcation • Contrast-enhanced Coronal 3D MRA • Axial T1-W SE with Fat Saturation (Dissection)

  12. Internal Auditory Canal Protocol Basic Brain Protocol + High Resolution: • Axial 3D T2-W FSE • Axial T1-W SE • Coronal T1-W SE with and without Gd -enhancement May consider Fat Saturation for post-operative evaluation

  13. Orbital Protocol Basic Brain Protocol + High Resolution: • Coronal STIR or FLAIR with Fat Saturation • Axial T1-W SE • Coronal T1-W SE with and without Gd -enhancement

  14. Pituitary Protocol Basic Brain Protocol + High Resolution: • Sagittal T1-W SE • Coronal T1-W SE with and without Gd -enhancement May consider Fat Saturation for post-operative evaluation

  15. Epilepsy (Age < 35 year-old) Basic Brain Protocol + Oblique Coronal: • T2-W-FSE • Fast FALIR • Phase-Sensitive Fast IR

  16. Fetal Imaging • HASTE / Single Shot FSE

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