1. Looking at the Interior of Human
Body and Understanding its
Physiology and Function:
Role of Magnetic Resonance
Imaging (MRI)
utkARSh veRMA
KVJNU

2. Medical Imaging Techniques

3. X-Ray Imaging
Contrast: Density, Atomic Number
X-ray
source
December 22nd, 1895
Wilhelm Roentgen
Detector
Object
“Builder survives
nailgun accident”

4. X-Ray - Digital
X ray tube

5. Computerized Tomography
Comparison of CT with the Anatomy

6. Computerized Tomography
Pyogenic liver abscess
Focal fatty degeneration of liver

7. Calcaneus fracture following CT Guided surgery
Before
After

8. Atom
Molecu
Atomic
le
Nucleus
our magnetic spy !
Courtesy: Prof. Richard R Ernst

10. ALL INDIA INSTITUTE OF MEDICAL SCIENCES
DEPARTMENT OF NMR
Magnetic Resonance Imaging
•
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

11. ALL INDIA INSTITUTE OF MEDICAL SCIENCES
DEPARTMENT OF NMR
T1 - weighted
Axial View
T1 - weighted
Coronal View
T1 - weighted
Sagittal View

12. ALL INDIA INSTITUTE OF MEDICAL SCIENCES
DEPARTMENT OF NMR
Effect of T2 relaxation on Contrast in MRI
Mineral water
Municipal water

13. ALL INDIA INSTITUTE OF MEDICAL SCIENCES
DEPARTMENT OF NMR
T1 - weighted - Axial
Tissues
Fat
WM
GM
CSF
T2 - weighted - Axial
PD
Light Gray
Gray
Light Gray
Gray
T1W
White
Light Gray
Gray
Black
Proton Density - Axial
T2W
Gray
Dark Gray
Gary
White

14. ALL INDIA INSTITUTE OF MEDICAL SCIENCES
DEPARTMENT OF NMR
High-Resolution - Image Details
Sella Sagittal

15. Diagnostic MR
15

16. ALL INDIA INSTITUTE OF MEDICAL SCIENCES
DEPARTMENT OF NMR
Anaplastic astrocytoma
Metastatic brain
Glioblastoma
Low grade astroglia
Mixed Glioma
Low grade astrocytoma

17. MRI in the Diagnosis of Breast & Prostate Cancer
Breast -T1 - weighted
Breast - T2 - weighted
Prostate
T2 – weighted – Normal
Prostate
T2 – weighted - Tumor

18. Functional
Studies
3D dynamic CE
MRI of Breast
Time
Signal-Time Curves (contrast enhancement)

19. ALL INDIA INSTITUTE OF MEDICAL SCIENCES
DEPARTMENT OF NMR
DTI- Diffusion
Tractography
Diffusion – weighted MRI
Volunteer
Patient

20. ALL INDIA INSTITUTE OF MEDICAL SCIENCES
DEPARTMENT OF NMR
CT
T2
DWI
Sensitivity of DWI for hyperacute stroke demonstrated in
57-year old patient. Unremarkable CT and T2 MRI. DWI
demonstrates hyperintense signal in left postcentral gyrus.

21. ALL INDIA INSTITUTE OF MEDICAL SCIENCES
DEPARTMENT OF NMR
Whole spine MRI
Cervical Spine Cord
compression

22. MR Angiography
22

23. ALL INDIA INSTITUTE OF MEDICAL SCIENCES
DEPARTMENT OF NMR
MR Angiography - MRA
MRI of head and cervical
MRA - aortic arch to circle of Willis

24. Monitoring Brain
Functions
24

25. ALL INDIA INSTITUTE OF MEDICAL SCIENCES
DEPARTMENT OF NMR

26. ALL INDIA INSTITUTE OF MEDICAL SCIENCES
DEPARTMENT OF NMR

27. MRI vs. fMRI
MRI studies brain anatomy.
Functional MRI (fMRI)
studies brain function.

28. Cerebral lateralization of function happen in a few abilities

29. ALL INDIA INSTITUTE OF MEDICAL SCIENCES
DEPARTMENT OF NMR
Motor cortex activation
Both hands
Visual cortex activation

30. ALL INDIA INSTITUTE OF MEDICAL SCIENCES
DEPARTMENT OF NMR
fMRI during Sad
and Happy moods
Activation
in Amygdla
and Hippocampus

31. 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].

32. Courtesy: Prof. Richard R Ernst

33. Diffusion MRI in Breast Cancer
Responder
Poor responder
Pre therapy
1.07 x 10-3 mm2/s
0.98 x 10-3 mm2/s
II NACT
1.26 x 10-3 mm2/s
1.05 x 10-3 mm2/s
III NACT
1.60 x 10-3 mm2/s
1.20 x 10-3 mm2/s

34. ALL INDIA INSTITUTE OF MEDICAL SCIENCES
DEPARTMENT OF NMR
An
intraoperative
image
performed
revealing
residual
tumor
CE
images
show
location
of the
tumor
Magnet
lowered
tumor
resection
performed
Intra Operative MRI-1
Magnet
positioned
and
preoprative
images
obtained

35. ALL INDIA INSTITUTE OF MEDICAL SCIENCES
DEPARTMENT OF NMR
MRI
demonstrates
complete
resection of
tumor
Intra Operative MRI-2
Navigational
method
enables the
surgeon to
precisely
locate the
residual
tumor
Surgery
continues
using the guidance
of
intraoperative
navigation

36. Matrix coil technology
Peripheral
Angio coil
Head coil
MRI Scanner
Bilateral carotid coil
Bilateral carotid coil
Breast array coil for biopsy
Whole body MRI/A

37. ALL INDIA INSTITUTE OF MEDICAL SCIENCES
DEPARTMENT OF NMR
Can’t we NOT believe this? Science or Faith???
MRI Whole body
MRI Spine