MR Pulse Sequence & Applications

SIEMENS Healthineers MR Pulse sequence & Application Textmasterformat, Disclaimer Unrestricted © Siemens Healthcare GmbH, 2017 Page 1 Magnetom Cognizance Author / Department HC XX HOOD05162002737284 Effective date: 01/24/2018 Resonance principle SIEMENS Healthineers Some nuclei are magnetic : Hydrogen H - 1 B Carbon C - 13 Fluorine F - 19 Phosphorus P - 31 ϖ Precession Frequency ϖ < φ * B φ = Gyromagnetic Ratio (depends on nuclei, e.g. protons: 42 MHz/T) B Magnetic Field Strength = Textmasterformat, Disclaimer Page 2 Unrestricted © Siemens Healthcare GmbH, 2017 Magnetom Cognizance Author / Department HC XX HOOD05162002737284 Effective date: 01/24/2018 SIEMENS Healthineers S N Unrestricted © Siemens Healthcare GmbH, 2017 Textmasterformat, Disclaimer Page 3 Magnetom Cognizance Author / Department HC XX HOOD05162002737284 Effective date: 01/24/2018 0.5 Vs1.5 Tesla vs7T -Resolution, Speed, Advanced SIEMENS Healthineers imaging Textmasterformat, Disclaimer Page 4 Unrestricted © Siemens Healthcare GmbH, 2017 Magnetom Cognizance Author / Department HC XX HOOD05162002737284 Effective date: 01/24/2018 Signal-to-Noise Ratio (SNR) SIEMENS Healthineers Improved spatial resolution and diagnostic information TSE 255x512 220X220 FOV 2acqs 4mm TA=5:11 Textmasterformat, Disclaimer Page 5 Unrestricted © Siemens Healthcare GmbH, 2017 Magnetom Cognizance Author / Department HC XX HOOD05162002737284 Effective date: 01/24/2018 Potential for non-invasive visualization of microscopic SIEMENS Healthineers anatomy in-vivo 1 Anterior Commissure ⋅Excellent sensitivity yields delineation of 2 Subthalamic Nucleus morphological structures 3 Red Nucleues ⋅Reproducibility in longitudinal studies (e.g. 4 Optic Chiasm brain degenerative processes) 5 Cerebral Peduncle ⋅High specificity e.g. within tumor areas 1 2 3 ⋅anatomy for interventional plan 6 Substantia Nigra 8 7 Ventral Tegmental Area 4 6 7 9 10 NRI, Gachon, South Korea 8, 9, 10 Superior Cerebella 5 Peduncle 11 Corticospinal Tracts 12 15 12 Medial Lemniscus 11 16 13 Olivary Nucleus 14 Nucleus Solitary Tr. 14 15 4th Ventricle 13 16 Cerebelum Unrestricted © Siemens Healthcare GmbH, 2017 Textmasterformat, Disclaimer Page 6 Magnetom Cognizance Author / Department HC XX HOOD05162002737284 Effective date: 01/24/2018 SIEMENS Healthineers Pulse Sequences in MR Β SE Β TSE Β IR Β GRE Β EPI Textmasterformat, Disclaimer Page 7 Author / Department HC XX HOOD05162002737284 Effective date: 01/24/2018 SIEMENS Healthineers Spin Echo Spin Echo Sequence = 90° - 180° with a repetition time TR Textmasterformat, Disclaimer Page 8 Author / Department HC XX HOOD05162002737284 Effective date: 01/24/2018 SIEMENS Healthineers 90° 180° 90° σ σ FID Echo TE = 2σ TR TR TE Textmasterformat, Disclaimer Page 9 Author / Department HC XX HOOD05162002737284 Effective date: 01/24/2018 TSE SEQUENCE SIEMENS Healthineers 90° 180° 180° 180° TE T2 1 2 3 T2* FID Textmasterformat, Disclaimer Page 10 Author / Department HC XX HOOD05162002737284 Effective date: 01/24/2018 Inversion Recovery (IR) SIEMENS Healthineers • Inversion Pulse Inital 180° RF pulse = followed by 90° - 180° pulses • Inversion time TI Time from inital 180° pulse to 90° = RF pulse Textmasterformat, Disclaimer Page 11 Author / Department HC XX HOOD05162002737284 Effective date: 01/24/2018 SIEMENS Healthineers 180° 90° 180° 180° FID Echo TI TI TE TR Textmasterformat, Disclaimer Page 12 Author / Department HC XX HOOD05162002737284 Effective date: 01/24/2018 Inversion Recovery- STIR, TIR,FLAIR SIEMENS Healthineers 180 90 180º 180€ 90º 180 RF in AV Vin Vin Slice-select gradient Phase-encoding gradient m Frequency-encoding gradient Signal out -TE2ª TI TE/2ª F TR TE TE ECI 92 3 ........................................... Textmasterformat, Disclaimer Page 13 Shoulder Fat Suppressed True Inversion Recovery FLAIR- Mesial Sclerosis Author / Department HC XX HOOD05162002737284 Effective date: 01/24/2018 SIEMENS Gradient Echo Sequences Healthineers Spin Echo Sequence Diagram Gradient Echo Sequence Diagram TR TR TE TE 90o 180o 90o RF   RF Echo Signal Echo Signal GSS GSS GPE GPE GRO GRO Lower flip angle (< 90o ) Echo by gradient pulse instead of 180o pulse Textmasterformat, Disclaimer Page 14 Author / Department HC XX HOOD05162002737284 Effective date: 01/24/2018 SIEMENS 3D sequences In MRI Healthineers 3D MEDIC- C spine, Joints 3D TSE Restore- C spine 3D FLASH- Brain, Joints, Spine 3D TOF- Cerebral/Carotid Angio 3D VIBE-Flash 3d- Abdomen 3D CISS- Brain, IAC 3D DESS- Joints 3D TruFisp- Spine,Brain 3D HASTE- MRCP SWI-Acute Hemorrhage SPACE 3D-Isotropic Imaging Textmasterformat, Disclaimer Page 15 Author / Department HC XX HOOD05162002737284 Effective date: 01/24/2018 Sequences Acronyms SIEMENS Healthineers Sequence Type SIEMENS GE PHILIPS Gradient Echo GRE GRE GRE Spoiled gradient echo FLASH SPGR T1-FFE Rephased gradient echo FISP GRASS FFE Time-reversed steady state free PSIF SSFP T2-FFE precession Balanced steady state free precession trueFISP FIESTA bFFE Phase-cycled fully balanced steady-state CISS FIESTA-C bFFE free precession Double echo steady state DESS M-FFE -- Ultrafast gradient echo TurboFLASH FGRE, FSPGR TFE 3D T1-weighted ultrafast gradient echo MP-RAGE IR prepared 3D-FGRE or 3D-FSPGR 3D TFE 3D interpolated GRE VIBE LAVA THRIVE Textmasterformat, Disclaimer Page 16 Author / Department HC XX HOOD05162002737284 Effective date: 01/24/2018 Sequences Acronyms SIEMENS Healthineers Sequence Type Siemens GE Philips Inversion Recovery IR, TurboIR IR, MPIR, FSE-IR IR-TSE Long tau IR Turbo dark fluid FLAIR FLAIR True IR TrueIR Real IR -- Sequence Type Siemens GE Philips Turbo/Fast Spin Echo TSE FSE TSE Single-shot TSE/FSE HASTE SSFSE SSTSE TSE/FSE with 90 flip angle, DEFT RESTORE FR-FSE DRIVE Textmasterformat, Disclaimer Page 17 Author / Department HC XX HOOD05162002737284 Effective date: 01/24/2018 Sequences Acronyms SIEMENS Healthineers Sequence Type SIEMENS GE PHILIPS Body Diffusion REVEAL DWIBS -- Susceptibility-Weighted Imaging SWI SWAN VenousBOLD Dynamic MRA with k-space Manipulations TWIST TRICKS Keyhole (4D-TRAK) High Resolution Bilateral Breast Imaging VIEWS VIBRANT BLISS Parametric mapping MapIT CartiGram -- 3D TSE with Variable Flip Angle SPACE CUBE VISTA Motion Correction BLADE PROPELLER MultiVane Textmasterformat, Disclaimer Page 18 Author / Department HC XX HOOD05162002737284 Effective date: 01/24/2018 SIEMENS Healthineers SWI • SWI (susceptibility-weighted imaging) enables excellent visualization of intravenous deoxygenated blood and extravascular blood products • Can be used for the assessment of several clinical conditions including aging, multiple sclerosis, stroke, trauma, vascular malformations, traumatic injuries and tumors1,2 Textmasterformat, Disclaimer Page 19 Unrestricted © Siemens Healthcare GmbH, 2017 Magnetom Cognizance Author / Department HC XX HOOD05162002737284 Effective date: 01/24/2018 SWI ( Susceptibility weighted Imaging) SIEMENS Healthineers 3D high-resolution FLASH Sequence Enhanced contrast through phase masking Flow compensation in all three directions (slice, read, phase) Parallel Imaging for shorter scan times (<3 min) T2*-weighting (TE ≡ 20 ms@ 3 T, TE ≡ 40 ms @1,5 T) Inline Technology for on-the-fly immediate results: • Combination of magnitude and phase information • Inline Minimum intensity projections (mIP) Unrestricted © Siemens Healthcare GmbH, 2017 Textmasterformat, Disclaimer Page 20 Magnetom Cognizance Author / Department HC XX HOOD05162002737284 Effective date: 01/24/2018 SIEMENS Healthineers BOLD • Complete package for BOLD (Blood Oxygenated Level Dependent) imaging and analyses • NNL package: LCD monitor, response grips, BOLD paradigms • syngo.MR Neuro3D for easy, flexible analysis and reporting of BOLD datasets Unrestricted © Siemens Healthcare GmbH, 2017 Textmasterformat, Disclaimer Page 21 Magnetom Cognizance Author / Department HC XX HOOD05162002737284 Effective date: 01/24/2018 SIEMENS Healthineers Leg control Body control, Arm control Hand control Reading Face control Sight Speech Textmasterformat, Disclaimer RTA Page 22 Author / Department HC XX HOOD05162002737284 Effective date: 01/24/2018 SIEMENS Healthineers MOTOR HAND Textmasterformat, Disclaimer Page 23 Author / Department HC XX HOOD05162002737284 Effective date: 01/24/2018 RT HAND LT HAND S 'S PM PM 9 OFF 9 OFF Textmasterformat, Disclaimer Page 24 Author / Department HC XX HOOD05162002737284 Effective date: 01/24/2018 SIEMENS Healthineers BOTH HANDS Textmasterformat, Disclaimer Page 25 Author / Department HC XX HOOD05162002737284 Effective date: 01/24/2018 SIEMENS Healthineers FOOT HAND Textmasterformat, Disclaimer Page 26 Author / Department HC XX HOOD05162002737284 Effective date: 01/24/2018 NNL Basic fMRI System for Siemens SIEMENS Healthineers nordicAktiva • Stimulus presentation software – NordicAktiva File Edit Tools Help Load paradigm Run Select Paradigm: Visual CheckerBoard Language: English • Step-by-step guidance through preparation and Paradigm name: Visual CheckerBoard Number of volumes: Number of slices pr volume: TR Time: 3000 ms. stimulus presentation Trigger pulse interval: 3000 ms. Total measurement time: 4 min, and 30sec. to nordicAktiva - Hardware test Visual: Checkerboard Paradigm description: VisualSystem AudioSystem ResponseGrips Alternating flickering checkerboard (8 Hz) and REST • Detailed instructions for the operator and the 1 REST plus 4 cycles (B AB AB AB AB): Instructions: Left channel: Please instruct patients appropriately and conduct p Buttons dicked: Patients will see a flickering checkerboard on the so Load audiofile >> Button patient Left thumb 11:19:38 Left index 11:19:37 Right index Right thumb 11:19:36 Right channel: • Library of ready-to-use standard clinical Load audiofle >> Enter text >> Load image >> paradigms (motor, perceptual, and language) Both channels: Load audiofile >> • Automatic interfacing with all hardware nordicAktiva File Edit Tools Help Finish Load paradigm Run paradigm => Save and exit components • Automatic logging of exam parameters and patient responses Duration : Time left • Interfaces with the MR scanner for Run mode Visual CheckerBoard Back Next synchronization of stimulus presentation with image acquisition. Unrestricted © Siemens Healthcare GmbH, 2017 Textmasterformat, Disclaimer Page 27 Magnetom Cognizance Author / Department HC XX HOOD05162002737284 Effective date: 01/24/2018 SIEMENS DIFFUSION TENSOR IMAGING Healthineers Textmasterformat, Disclaimer Page 28 Author / Department HC XX HOOD05162002737284 Effective date: 01/24/2018 Fractional Anisotropy & Direction SIEMENS Healthineers AP RL Sup-Inf Textmasterformat, Disclaimer Page 29 Author / Department HC XX HOOD05162002737284 Effective date: 01/24/2018 DIFFUSION TENSOR IMAGING WHITE MATTER PATHOLOGY DTI can provide visually appreciable information about white matter pathology that cannot be seen in conventional MRI, as most radiological diagnosis is based on visual inspection of images. Mori,Introduction to Diffusion Tensor Imaging, 2007 ● White matter tracts displaced by a tumor can retain their anisotropy and remain identifiable in their new location or orientation on a fiber orientation color map. Infiltrated ● Edematous or tumor-infiltrated Deviated tracts may lose anisotropy, but still retain enough orientation organization to remain identifiable on a color map. ● Or white matter tracts might be destroyed or disrupted to the point where directional and anisotropy organization is lost completely. Edematous Destroyed Jellison, AJNR, 2004 Jellison, AJNR, 2004 Textmasterformat, Disclaimer Page 30 Author / Department HC XX HOOD05162002737284 Effective date: 01/24/2018 SIEMENS Healthineers Textmasterformat, Disclaimer Page 31 Author / Department HC XX HOOD05162002737284 Effective date: 01/24/2018 SIEMENS Healthineers syngo MR Spectroscopy Textmasterformat, Disclaimer Page 32 Author / Department HC XX HOOD05162002737284 Effective date: 01/24/2018 SIEMENS Metabolites and their position in MR Spectrum - Brain Healthineers Observable Proton M etabolites ppm M etabolite Properties 0.9-1.4 Lipids Products of brain destruction 1.3 Lactate Product of anaerobic glycolysis 2.0 NAA Neuronal marker 2.2-2.4 Glutamine/GABA Neurotransmitters 3.0 Creatine Energy metabolism 3.2 Choline Cell m embrane marker 3.5 myo-inositol Glial cell marker, osmolyte hormone receptor mechanisms 1.2 Ethanol Triplet 1.48 Alanine Present in meningiomas 3.4&3.8 Glucose Increased in diabetes 3.8 M annitol Rx for increased ICP Textmasterformat, Disclaimer Page 33 Author / Department HC XX HOOD05162002737284 Effective date: 01/24/2018 LiverLab SIEMENS Healthineers Inline Calculations can be reviewed for QA First look DIXON Multi-echo DIXON VIBE Dixon: water / fat Inline signal modeling Inline Dual Ratio and Scatter Plot Inline parametric maps Inline Liver segmentation Inline Report HISTO Standard adjustments Inline Evaluation Inline Report Textmasterformat, Disclaimer Page 34 Author / Department HC XX HOOD05162002737284 Effective date: 01/24/2018 LiverLab SIEMENS Clinical examples for iron overload and fatty liver Healthineers disease Patient with relatively severe fatty liver Patient with focal iron deposition Lipid = 4.64 Lipid = 23.37 (T2cor) (T2cor) O 30 60 30 60 O R2water = 282- R2water = 31.02 (rsq: 1.00) (rsq: 1.00) NORMAL MILD MODERATE SEVERE NORMAL MILD MODERATE SEVERE 10 60 10 60 Inline Parametric Map Fat Fraction Inline Color Report Inline Parametric Map R2* Inline Color Report University Hospital of Arizona, Tucson, USA Textmasterformat, Disclaimer Page 35 Author / Department HC XX HOOD05162002737284 Effective date: 01/24/2018 syngo MapIt SIEMENS Healthineers Inline Parametric Mapping est ankle 10 10 06 23 28/03/1985, M. 21Y STUDY 1 0/10/2006 3:37:25 5 IMA 1 / 1 Sag>Tra 1 USED MPR/CSAMANIPULATED ANKLE T2-star Map T1 map for detection of T2 map for evaluation of T2* map (0.2 mm resolution) showing protoglycan content collagen structure water distribution Moving MSK MR imaging ahead by evaluation of macromolecular structures • Enabling assessment of developing disease before actual damage • Follow up of treatment in OA patients and after sports injury • Textmasterformat, Disclaimer Page 36 Author / Department HC XX HOOD05162002737284 Effective date: 01/24/2018 SIEMENS Healthineers Thank you for your attention Engineering success. Pioneering healthcare. Textmasterformat, Disclaimer Page 37 Unrestricted © Siemens Healthcare GmbH, 2017 Magnetom Cognizance Author / Department HC XX HOOD05162002737284 Effective date: 01/24/2018