Looking at the Interior of Human Body and Understanding its Physiology and Function:

Role of Magnetic Resonance Imaging (MRI)

Looking at the Interior of Human Body and Understanding its Physiology and Function:

Role of Magnetic Resonance Imaging (MRI)

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Medical Imaging Techniques

X-Ray ImagingContrast: Density, Atomic Number

X-raysource

Object

DetectorDecember 22nd, 1895

Wilhelm Roentgen

“Builder survives nailgun accident”

X ray tube

X-Ray - Digital

Comparison of CT with the Anatomy

Computerized Tomography

Pyogenic liver abscess Focal fatty degeneration of liver

Computerized Tomography

Calcaneus fracture following CT Guided surgery

Before After

MoleculeMolecule

AtomAtom

Atomic Nucleus

Atomic Nucleus

our magnetic spy !our magnetic spy !

Courtesy: Prof. Richard R Ernst

ALL INDIA INSTITUTE OF MEDICAL SCIENCESDEPARTMENT OF NMR

• High-resolution morphological

picture(anatomical structures)

• Superior soft tissue contrast

• Multi-planar imaging capability

• MR images from protons present

water and fat of human tissues

• Noninvasive – NO ionizing radiation

Magnetic Resonance Imaging

ALL INDIA INSTITUTE OF MEDICAL SCIENCESDEPARTMENT OF NMR

T1 - weighted Sagittal View

T1 - weighted Coronal View

T1 - weighted Axial View

ALL INDIA INSTITUTE OF MEDICAL SCIENCESDEPARTMENT OF NMR

Effect of T2 relaxation on Contrast in MRI

Municipal water

Mineral water

ALL INDIA INSTITUTE OF MEDICAL SCIENCESDEPARTMENT OF NMR

T1 - weighted - Axial T2 - weighted - Axial Proton Density - Axial

Tissues PD T1W T2W Fat Light Gray White Gray WM Gray Light Gray Dark Gray GM Light Gray Gray Gary CSF Gray Black White

Sella Sagittal

ALL INDIA INSTITUTE OF MEDICAL SCIENCESDEPARTMENT OF NMR

High-Resolution - Image Details

Diagnostic MR

15

Anaplastic astrocytoma Glioblastoma Mixed Glioma

ALL INDIA INSTITUTE OF MEDICAL SCIENCESDEPARTMENT OF NMR

Metastatic brain Low grade astroglia Low grade astrocytoma

MRI in the Diagnosis of Breast & Prostate Cancer

Breast -T1 - weighted

Breast - T2 - weighted ProstateT2 – weighted - Tumor

ProstateT2 – weighted – Normal

Time

Signal-Time Curves (contrast enhancement)

Functional Studies

3D dynamic CE MRI of Breast

ALL INDIA INSTITUTE OF MEDICAL SCIENCESDEPARTMENT OF NMR

Diffusion – weighted MRI

Volunteer Patient

DT

I- Diffu

sion

T

ractog

raph

y

DWIT2CTSensitivity of DWI for hyperacute stroke demonstrated in57-year old patient. Unremarkable CT and T2 MRI. DWIdemonstrates hyperintense signal in left postcentral gyrus.

ALL INDIA INSTITUTE OF MEDICAL SCIENCESDEPARTMENT OF NMR

ALL INDIA INSTITUTE OF MEDICAL SCIENCESDEPARTMENT OF NMR

Whole spine MRICervical Spine Cord compression

MR Angiography

22

ALL INDIA INSTITUTE OF MEDICAL SCIENCESDEPARTMENT OF NMR

MRI of head and cervical MRA - aortic arch to circle of Willis

MR Angiography - MRA

Monitoring Brain

Functions

24

ALL INDIA INSTITUTE OF MEDICAL SCIENCESDEPARTMENT OF NMR

Hindustan Times

31-03-2006Hindustan Times

31-03-2006

Hindustan Times

29-03-2006Hindustan Times

29-03-2006

ALL INDIA INSTITUTE OF MEDICAL SCIENCESDEPARTMENT OF NMR

Times of India

January 22nd and

24th, 2007

MRI studies brain anatomy.Functional MRI (fMRI)

studies brain function.

MRI vs. fMRI

Cerebral lateralization of function happen in a few abilities

ALL INDIA INSTITUTE OF MEDICAL SCIENCESDEPARTMENT OF NMR

Motor cortex activation Both hands

Visual cortex activation

ALL INDIA INSTITUTE OF MEDICAL SCIENCESDEPARTMENT OF NMR

fMRI during Sadand Happy moods

Activationin Amygdlaand Hippo-

campus

Liar versus Non-liar

THE TRUTH BE TOLD? [left] When the author was asked whether he had ever feigned illness to escape an obligation, his prefrontal cortex showed no unusual activity.

LIAR, LIAR? [right] When the author was asked whether he had ever padded an expense report, his prefrontal cortex became highly active [areas highlighted with hot colors].

Courtesy: Prof. Richard R Ernst

0.98 x 10-3 mm2/s

1.60 x 10-3 mm2/s

1.05 x 10-3 mm2/s

1.07 x 10-3 mm2/s

1.20 x 10-3 mm2/s

1.26 x 10-3 mm2/s

Responder Poor responder

Pre therapy

II NACT

III NACT

Diffusion MRI in Breast Cancer

ALL INDIA INSTITUTE OF MEDICAL SCIENCESDEPARTMENT OF NMR

Intra O

perative M

RI-1

Magnet positioned and preoprative images obtained

An intraoperative image performed revealing residual tumor

Magnet lowered tumor resection performed

CE images show location of the tumor

ALL INDIA INSTITUTE OF MEDICAL SCIENCESDEPARTMENT OF NMR

Intra O

perative M

RI-2

MRI demonstrates complete resection of tumor

Navigational method enables the surgeon to precisely locate the residual tumor

Surgery continues using the guidance of intraoperative navigation

MRI Scanner

Whole body MRI/A

Bilateral carotid coil

Bilateral carotid coil

Peripheral Angio coil

Matrix coil technology

Head coil

Breast array coil for biopsy

ALL INDIA INSTITUTE OF MEDICAL SCIENCESDEPARTMENT OF NMR

MRI Whole body

MRI Spine

Can’t we NOT believe this? Science or Faith???