Clinical Applications and Indications of Magnetic Resonance Imaging MRI

Yıl 2008, Cilt: 5 Sayı: 2, 31 - 40, 01.08.2008

Orhan Oyar

Öz

Magnetic resonance imaging MRI is an imaging technique to produce high resolution tissue contrast images of the human body. It was first demonstrated by Paul Lauterbur in 1973. MRI is a safe diagnostic procedure that uses a powerful magnet and radio waves to produce detailed images of the body's organs and structures, without the use of Xrays or other radiation. Hydrogen atom nuclei which make the human body approximately 63% have a source MR signal. MRI is widely used to imagine and diagnose pathologic conditions in all over the human body, especially central nervous system, musculoskeletal system, head and neck, abdomen and pelvis. MRI is often preferred as a fast and noninvasive diagnostic modality for examination of the vascular MR-Angiography , pancreatico-biliary MRCholangiopancreaticography , and urinary systems MR-Urography . MRI can be also helping physicians evaluate the function as well as the structure of many organs with spectroscopy, diffusion, perfusion images. In this review; clinical application and indications of MRI and the radiologic algorithms have been presented with our sample cases

Anahtar Kelimeler

Magnetic resonance imaging, brain, spine, abdomen, functional imaging

Magnetik Rezonans Görüntüleme Mrg ’Nin Klinik Uygulamaları Ve Endikasyonları

Öz

Magnetik rezonans görüntüleme MRG insan vücudunun yüksek kontrast çözünürlükte görüntülenmesine olanak sağlayan bir görüntüleme tekniğidir. İlk kez 1973 yılında Paul Lauterbur tarafından gösterilmiştir. MRG güçlü bir magnet ve radyo dalgaları ile X-ışını veya diğer radyasyonları kullanmadan vücudun organ ve yapılarını detaylı görüntülenmesini sağlayan güvenli bir tanısal uygulamadır. İnsan vücudunun yaklaşık %63’ünde yer alan hidrojen atom çekirdekleri MR sinyalinin kaynağını oluşturur. MRG, özellikle santral sinir sistemi, kas-iskelet sistemi, baş-boyun, batın ve pelvis olmak üzere insan vücudunun hemen her yerinde görüntüleme ve patolojik durumların teşhisi için yaygın olarak kullanılmaktadır. MR aynı zamanda vasküler MR-Anjiografi , pankreatiko-biliyer MR-Kolanjiopankreatikografi ve üriner MR-Ürografi sistemlerin incelenmesinde hızlı ve noninvaziv bir tanısal cihaz olarak sık sık tercih edilmektedir. MRG; spektroskopi, difüzyon, perfüzyon görüntülerle pek çok organın yapısal durumu yanında fonksiyonunun da değerlendirilmesinde hekimlere yardım edebilir. Bu derlemede, MRG’nin klinik uygulamaları, endikasyonları ve radyolojik algoritmalar, vakalarımızdan örneklerle sunulmuştur

Anahtar Kelimeler

Magnetik rezonans görüntüleme, beyin, omurilik, batın, fonksiyonel görüntüleme

Kaynakça

• Oyar O. Radyolojide Temel Fizik Kavramlar. Nobel Tıp Kitapevleri, İstanbul, 1998: 151-210. 2.Bushong
• Technologists. Physics, Biology, and Protection. Third edition, C.V. Mosby Company, St Luis, 1984: 387-412.
• Yeşildağ A, Oyar O. Manyetik rezonans görüntüleme fiziği. Oyar O, Gülsoy UK ed. Tıbbi Görüntüleme Fiziği. Tisamat Basım, Ankara, 2003: 281-372
• Oyar O, Yünten N. Hızlı görüntüleme MR teknikleri ve klinik uygulamaları. Bilgisayarlı Tomografi Bülteni 1994; 3(2): 169-173.
• Frahm J, Gyngell ML, Hanicke W. Rapid scan techniques. In: Magnetic Resonance Imaging. Stark DD, Bradley WG. eds. Second ed. Mosby year book St. Louis 1992: 165-203.
• Edelman RR, Wielopolski PA. Fast MRI. In: Edelman RR, Hessellink JR. eds. Clinical Magnetic Resonance Imaging. Second ed. W.B Saunders Company, Phileadelphia 1996: 302.
• Bammer R. Basic principles of diffusion- weighted imaging. Eur J Radiol 2003; 45(3): 169- 184.
• Bachus R. Developing trends in MR imaging and spectroscopy. Electro-medica 1989; 57: 8-19. 9.Buxton RB, Frank LR, Prasad PV. Princibles of diffusion and perfusion MRI. In: Edelman RR, Hessellink JR. eds. Clinical Magnetic Resonance Imaging. Second ed. W.B Saunders Company, Phileadelphia 1996: 233.
• Kwock L, Smith JK, Castillo M, Ewend MG, Cush S, Hensing T, Varia M, Morris D, Bouldin TW. Clinical Applications of Proton MR Spectroscopy in Oncology. Technol Cancer Res Treat 2002; 1(1): 17-28.
• Mehdizade A, Somon T, Wetzel S, et al. Diffusion weighted MR imaging on a low-field open magnet. J Neuroradiol 2003; 30(1): 25-30.
• Parrish T. Functional MR imaging. MRI Clin North Am 1999;7: 765-782.
• Shigeno K, Igawa M. MRI and proton MR spectroscopy. Nippon Rinsho 2002; 60 Suppl 11: 128-132.
• Zhu M, Dai J, Li S. Cerebral angiography and MR perfusion images in patients with ischemic cerebral vascular disease. Chin Med J (Engl) 2002; 115(11): 1687-1691.
• Wilms G, Bosmans H, Demaerel P, Marchal G. Magnetic intracranial vessels. Eur J Radiol 2001; 38(1): 10- 18.
• Oyar O, Öztürk M, Yünten N. Manyetik rezonans anjiografi (MRA). Nörolojik Bilimler Dergisi 1993; 10(3-4): 283-289.
• Boraschi P, Gigoni R, Braccini G, et al. Detection of common bile duct stones before laparoscopic cholecystectomy. Evaluation with MR cholangiography. Acta Radiol 2002; 43(6): 593-8.
• Adamek HE, Weitz M, Breer H, et al. Value of magnetic-resonance (MRCP) after unsuccessful endoscopic-retrograde cholangio-pancreatography (ERCP). Endoscopy 1997; 29(8):71-74.
• Stone JA. MR myelography of the spine and MR peripheral nevre imaging. Magn Reson Imaging Clin N Am 2003; 11(4): 543-558.
• O’Connell MJ, Ryan M, Powell T, Eustace S. The value of routine MR myelography at MRI of the lumbar spine. Acta Radiol 2003; 44(6): 665- 672.
• Garcia-Valtuille R, Garcia-Valtuille AI, Abascal F, Cerezal L, Argüello MC. Magnetic resonance urography: a pictorial overview. Br J Radiol 2006; 79(943): 614-626.
• Grattan-Smith JD, Jones RA. MR urography in children. Pediatr Radiol 2006; 36(11): 1119-1132. 23.Memarsadeghi M, Riccabona M, Heinz-Peer G. MR urography: principles, examination techniques, indications. Radiologe 2005; 45(10): 915-923.
• Nolte-Ernsting CC, Adam GB, Günther RW. MR urography: examination techniques and clinical applications. Eur Radiol 2001; 11(3): 355- 372.
• Fuchs T, Kachelriess M, Kalender WA. Technical advances in multi-slice spiral CT. Eur J Radiol 2000; 36(2): 69-73. Henkelman MR. Image artefacts. In: Stark DD, Bradley WG. eds. Magnetic Resonance Imaging. Second ed. Mosby year book, St. Louis 1992: 233-251.
• Dawson P. Gadolinium chelate mr contrast agents. Clinical Radiology 1994; 49: 439-442.
• Miller JH, McKinstry RC, Philip JV, et al. Diffusion-tensor MR imaging of normal brain maturation: a guide to structural development and myelination. AJR 2003; 180(3): 851-859.
• Bradley WG, Chen DY, Atkinson DJ, Edelman RR. Fast Spin-Echo and Echo-Planar Imaging. In: Stark DD, Bradley WG. eds. Magnetic Resonance Imaging. Third ed. Mosby, St Louis, 1999, 125- 157.
• Loewe C, Schoder M, Rand T, et al. Peripheral vascular occlusive disease: evaluation with contrast-enhanced moving-bed MR angiography versus digital subtraction angiography in 106 patients. Am J Roentgenol 2002; 179: 1013-1021. 30.Semelka RC, Martin DR, Balci NC. Magnetic resonance imaging of the liver: how I do it. J Gastroenterol Hepatol 2006; 21(4): 632-637.
• Oyar O, Elmas N. Abdominal manyetik rezonans görüntülemede oral kontrast madde kullanımı. Bilgisayarlı Tomografi Bülteni 1995; 3 (3): 57-60.
• Stroszczynski C, Gaffke G, Gnauck M, et al. Current status of MRI diagnostics with liver- specific contrast agents. Gd-EOB-DTPA and Gd- BOPTA. Radiologe 2004; 44(12):1185-1191.
• Alger JR, Harreld JH, Chen S, Mintorovitch J, Lu DS. Time-to-echo optimization for spin echo magnetic resonance imaging of liver metastasis using superparamagnetic iron oxide particles. J Magn Reson Imaging 2001; 14: 586-594.
• Ward J, Robinson PJ. Combined use of MR contrast agents for evaluating liver disease. Magn Reson Imaging Clin N Am 2001; 9: 767-802.
• Pauleit D, Textor J, Bachmann R, et al. Hepatocellular gadolinium-and imaging of the liver. Radiology 2002; 222: 73-80. 36. Tuncel E. Klinik Radyoloji. Birinci Baskı. Güneş&Nobel Kitapevi, Bursa, 1994:103-110.
• Rydberg J, Buckwalter KA, Caldemeyer KS, et.al. Multisection CT: scanning techniques and clinical applications.Radiographics. 2000; 20(6): 1787-1806.
• Laissy J, Coutin F, Pavier J, et al. Multislice helical CT: principles, applications. J Radiol 2001; 82(5): 541-545.