Dit MRI tentamen van periode 7/8 van MBRT leerjaar 2, is een uitwerking van de opdracht die ingeleverd moet worden voor het vak MRI. Het cijfer dat behaald is met dit verslag is een 9.8. Het is een uitwerking van de casus van de hersenen. Maar ook voor andere casussen geeft dit een goede indicatie ...
Inhoudsopgave
1 Analyse aanvraag................................................................................................................. 4
1.1 Onderzoek voorbereiden als MBB’er...............................................................................4
2 Veiligheid en uitleg aan patiënt............................................................................................5
2.1 Screening........................................................................................................................ 5
2.2 Kleding............................................................................................................................ 6
2.3 Geluid............................................................................................................................. 6
2.4 Uitleg positionering......................................................................................................... 6
2.5 Alarmbel......................................................................................................................... 7
2.6 Spiegel............................................................................................................................ 7
2.7 Afspraken over communicatie tijdens onderzoek............................................................7
3 Spoelen en andere materialen.............................................................................................. 7
3.1 Soort spoel en samenstelling.......................................................................................... 7
4 Positionering van de patiënt in de spoel en de spoel in de magneet.....................................8
4.1 Positionering van de patiënt...........................................................................................8
4.2 Communicatie................................................................................................................. 9
5 Voorbereiding scanprotocol................................................................................................ 10
5.1 Wegingen en richtingen................................................................................................ 10
5.2 Scantijd totaal en per serie........................................................................................... 11
5.3 Meerwaarde van de serie voor de vraagstelling / diagnose..........................................11
5.3.1 Survey.................................................................................................................... 11
5.3.2 T2W TSE................................................................................................................. 11
5.3.3 T1 3D MPRAGE........................................................................................................ 11
5.3.4 3D FLAIR................................................................................................................. 12
5.3.5 SWIp 3mm.............................................................................................................. 12
6 Anatomie van lichaamsdeel................................................................................................ 13
6.1 Anatomie en omliggend weefsel...................................................................................13
6.1.1 Cerebrum................................................................................................................ 13
6.1.2 Cerebellum............................................................................................................. 14
6.1.3 Hersenstam............................................................................................................ 15
6.1.4 Ventrikelsysteem.................................................................................................... 15
6.3 Hoe het wordt afgebeeld op MRI...................................................................................15
6.4 Te verwachten pathologische afwijkingen op basis van de aanvraag...........................15
7 Positionering van plakken................................................................................................... 17
1
, X/X/2021
7.1 Richting......................................................................................................................... 17
7.2 Angulatie....................................................................................................................... 17
7.2.1 Transversale / axiale plak plannen..........................................................................18
7.2.2 Coronale plak plannen............................................................................................ 18
7.2.3 Sagittale plak plannen............................................................................................ 19
7.3 FOV............................................................................................................................... 19
7.4 Onder-, boven- en zijgrenzen........................................................................................ 19
7.4.1 Transversale / axiale plak.......................................................................................19
7.4.2 Coronale plak.......................................................................................................... 20
7.4.3 Sagittale plak.......................................................................................................... 20
7.5 Range........................................................................................................................... 20
7.6 Oversampling................................................................................................................ 20
7.7 Saturatiebanden........................................................................................................... 21
7.8 Plakdikte....................................................................................................................... 21
7.9 Gap............................................................................................................................... 21
8 Techniek per serie............................................................................................................... 22
8.1 Serie 1: T2W TSE........................................................................................................... 22
8.1.1 Sequentieschema................................................................................................... 22
8.1.2 TR........................................................................................................................... 23
8.1.3 TE........................................................................................................................... 23
8.2 Serie 2: T1 3D MPRAGE................................................................................................. 23
8.2.1 Sequentieschema................................................................................................... 23
8.2.2 Fliphoek.................................................................................................................. 24
8.2.3 Voxelgrootte........................................................................................................... 24
8.3 Serie 3: 3D FLAIR.......................................................................................................... 24
8.3.1 Sequentieschema................................................................................................... 24
8.3.2 TI............................................................................................................................ 25
8.3.3 TR........................................................................................................................... 25
8.3.4 SPIR........................................................................................................................ 25
8.4 Serie 4: SWIp 3mm....................................................................................................... 25
8.4.1 Scan modus en techniek......................................................................................... 25
8.4.2 Voxelgrootte........................................................................................................... 25
8.4.3 Fliphoek.................................................................................................................. 26
9 Bespreking afbeeldingen per serie......................................................................................26
9.1 Serie 1: T2W TSE........................................................................................................... 26
2
, X/X/2021
9.1.1 Anatomie en herkennen van weging.......................................................................26
9.1.2 Artefact: Aliasing/invouwing/fold-over artefact.......................................................27
9.1.3 Artefact: Bewegingsartefact...................................................................................27
9.2 Serie 2: T1 3D MPRAGE................................................................................................. 28
9.2.1 Anatomie en herkennen van weging.......................................................................28
9.2.2 Artefact: Susceptibiliteitsartefact............................................................................30
9.2.3 Artefact: Aliasing/invouwing/fold-over artefact.......................................................30
9.3 Serie 3: 3D FLAIR.......................................................................................................... 31
9.3.1 Anatomie en herkennen van weging.......................................................................31
9.3.2 Artefact: Gibbs/truncation/ringing artefact.............................................................32
9.4 Serie 4: SWIp 3mm....................................................................................................... 33
9.4.1 Anatomie en herkennen van weging.......................................................................33
9.4.2 Artefact: Susceptibiliteitsartefact............................................................................33
11 Bespreken bevindingen van het gehele onderzoek – relateren series aan de vraagstelling
............................................................................................................................................... 34
12 Eventuele aanvullende series / richtingen / techniek bij vraagstelling..............................35
12.1 Andere serie................................................................................................................ 35
12.2 Andere richting........................................................................................................... 35
12.3 Andere techniek.......................................................................................................... 35
Bijlage 1 AMC vragenlijst voor MRI onderzoek bij testpersonen (AMC, 2016).........................36
Bibliografie............................................................................................................................. 37
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