By Jaap Valk

With the growing to be variety of MR installations, clinicians and radiologist are being faced a growing number of with visible details they don't suppose as convinced with as with the extra 'mono-form' infor­ mation of traditional radiographs, CT and US. the liberty of parameter selection ofthe MR operator permits a similar item to be depicted in quite a few methods and the distinction within the pictures to be replaced and inverted at will. For these now not skilled in examining MR photographs, this can reason confusion and uncertainty approximately their diagnostic content material. this may occasionally result in an pointless retreat to different diagnostic modalities. the aim of this booklet is to assist shut the space among MR operators and readers and clinicians. a number of situations is gifted, including the MRI issues. In approximately a lot of these instances, confirma­ tion of analysis used to be received by means of histological exam. fairly intentionally, this e-book in simple terms comprises the occasional CT experiment or angiography for comparability, to prevent the temptation of falling again on different modalities and of escaping from the customarily more challenging to interpret, yet after all extra lucrative MR photos. the entire MR photographs during this e-book have been made with a 'first-generation', unsophisticated Teslacon I, 0.6 T, superconducting magnet procedure. with a bit of luck, they're going to mirror the standard of the computer. a few humans will trust me that it really is unhappy that investments in pricey wellbeing and fitness care structures are topic to the whims of these who're generally attracted to pleasant their stockholders.

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Additional info for MRI of the Brain, Head, Neck and Spine: A teaching atlas of clinical applications

Example text

In the image one sees a band of irregular, but patterned shift of pixel signal intensities (arrow in e). Figure f. shows the effect of choosing a limited field of view (FOV). This means that the area actually imaged is smaller than the scanned area. The data in the field outside the FOV are folded in into the image (arrows in f). This does not usually pose a big problem, because the positioning of the patient, of the coils, of the offset, should be chosen in such a way that the central part of the image contains the information one was looking for.

Because of the varied symptomatology in this patient, no surgery or embolization was attempted. 2. Mesencephalon, regio pinealis 33 Case: Pinealoma? Male, 54 years, has an episode of not feeling well and headache of a different nature than usual. On neurological examination he had at that moment an upward gaze paralysis, Parinaud's syndrome, indicating a lesion involving the lamina quadrigemina. This symptom proved to be transitory. CT, however, revealed a rounded, enhancing lesion in the pineal gland region.

G one sees a perfectly normal brainstem, in fig. h, the round lesion is again seen (arrows in h). The colliculi may appear rather flat; the aqueduct, however, does not show any sign of compression. Although the extent of the lesion is well depicted and its possible cystic nature established, it is still not possible to state with absolute certainty that we are not dealing with a cystic pinealoma but with a harmless cyst of the pineal gland. Our proposal is to ask the patient to return for frequent check-ups to see whether changes take place or symptomatology reappears and to postpone radiotherapy until more evidence is obtained.

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