SOAP Preparation

MS

• Autoimmune neurological disorder

• Inflammation, damage, and disruption to myelin

• Symptoms include fatigue, impaired mobility, vision problems, cognitive changes

T1

TR - 400-700

TE - 10-20

ETL - 3-8

T2

TR - 3000-6000

TE - 80-110

ETL - 18-30

PD

TR - 2000-5000

TE - 10-30

MS plaques - T1

Hypointense areas, only visible with severe damage in advanced disease

MS plaques - T2

High signal due to demyelination and inflammation

T2 coronal

Good for seeing the temporal lobes, hippocampus, pituitary gland, hypothalamus and optic chiasm

SPACE

• Uses non-selective pulse trains with changing flip angles, leading to very high turbo factors and increased sampling efficiency

• More resistant to artefacts than standard TSE

MS plaque locations

Periventricular, subcortical, juxtacortical, infratentorial, and spinal cord

Dissemination in time

• Relapse of symptoms

• New lesions

• Evidence of inflammation from lumbar puncture

Dissemination in space

• Symptoms from different parts of the body

• lesions in different spaces

McDonald 2024 update

• Central vein sign

• Optic nerve lesion

• Diagnosis with lesions in four or five locations

T1 whole pelvis

Demonstrates pelvic and retroperitoneal lymph nodes

Transitional zone

Comprised of glandular and stromal tissue, heterogenous signal intensity

Prostate ca lesions

Rounded or ill-defined hypointense areas

Seminal vesicles

Included in case of invasion, which is indicated by low T2 signal, restricted diffusion, loss of angle, or visible tumour extension

Peripheral zone

Homogenous high signal surrounded by low signal capsule, 70-80% of prostate ca originates here, mostly glandular tissue

PIRADS staging

Based on how encapsulated the lesion is, how homogenous it is, and whether it extends beyond the prostate

TI - STIR

150

TI - FLAIR

2000-2500

Centre of k-space

Responsible for contrast information

WARP

Uses view angle tilting to replay the slice selection gradient during readout, which shears the image in the slice and readout directions

Higher bandwidth

• Less chemical shift, shorter TR/TE, less artefacts

• Lower SNR, larger minimum FOV

CHESS

Uses an RF pulse to suppress the resonant frequency of fat

B1 + rms

• Measures the RF field’s strength over time

• Helps determine the energy absorbed by the tissues of the body

Dotarem

• Macrocyclic ionic

• 0.2mL/kg

Gadovist

• Macrocyclic non-ionic

• 0.1mL/kg

Primovist

• Linear ionic

• 0.1mL/kg

Multihance

• Linear ionic

• 0.2mL/kg

Magnevist

• Linear ionic

• No longer approved

Omniscan

• Linear non-ionic

• No longer approved