Grey Matter ~ Interpreting MRIs

Those of us in the medical profession have A GAZZILION pneumonics and silly little ways to remember all the bones, muscles, pathologies, etc, etc …  somehow they are always a little, well, PG-13 (at best). SOOOOO, now that the title of this post has grabbed your attention, we will not be discussing bondage or the recent book/film “sensation” –> instead how about a little MRI interpretation?

Very simply, MRI (magnetic resonance imaging) uses large, powerful magnets to align a magnetic field interacting with atomic nuclei in the body which is then interpreted by a computer to help clinicians visualize the slices of the body. They  can often look similar to a CT scan, but remember that MRIs often show soft tissue anatomy a bit clearer while CTs are more ideal for looking at bones.

There are two common ways to “weight” MRIs

T-1 uses a short time between the pulse and signal capture. T-1 gives you the clearest picture of anatomy, with structures like fat & white matter showing up bright white (INTENSE).

T-2 uses a longer time period to take the picture, so parts of the body such as water/fluid that are slow to interact with the pulse are clearer. This makes them GREAT to visualize inflammation.

mri

So check out this coronal slice of the brain on my cup here —^

Ventricles in T-1 are going to be DARK, while in T-2 they are WHITE (fluid)

Another give away, is the subcutaneous fat in the T-1 lining the skull.

It is important to know how an MRI is weighted when looking at imaging for your patients, of course we leave the diagnostic interpretation up to the professionals, however when looking for sources of inflammation and pain remember not to confuse what is bright white based on weighting.

So, quiz yourself. How are these MRIs weighted? Hover over ’em for the answers:

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