Principles of MRI of the Brain and Spine

Author: Stephen Moore / Editor: John P Sloan, Peter Lynas / Reviewer: Marianne Lyons / Code: A5, T1 / Published: 23/02/2022

Magnetic resonance imaging (MRI) is rarely used in most emergency departments. However, the properties of such images can provide emergency physicians with critical information to support the optimal clinical care of many neurological disorders. Clinicians must appreciate the risks associated with this technology to ensure that outcomes are not adversely affected.

Before commencing this session you should:

• Have a basic understanding of neuroanatomy

After completing this session you will be able to:

• Express a basic understanding of the physics of MRI scanning and how this can be applied to the interpretation of images
• Explain the role and value of contrast media in MRI scanning
• Compare and contrast the applicability of MRI scanning with other imaging systems
• Identify key anatomical and pathological features on an MRI brain or spine scan
• Demonstrate an understanding of the indications for MRI scanning of the brain and spine within the emergency medicine setting
• Apply clinical risk principles to the use of MRI in emergency medicine practice

References:

1. Mansfield P, Maudsley AA. Medical imaging by NMR. Br J Radiol. 1977 Mar;50(591):188-94.
2. Broderick J, Connolly S, Feldmann E et al. Guidelines for the Management of Spontaneous Intracerebral Hemorrhage in Adults: 2007 Update: A Guideline From the American Heart Association/American Stroke Association Stroke Council, High Blood Pressure Research Council, and the Quality of Care and Outcomes in Research Interdisciplinary Working Group: The American Academy of Neurology affirms the value of this guideline as an educational tool for neurologists. Circulation 2007;116:e391-e413.
3. Weller, A., Barber, J.L. & Olsen, .E. Gadolinium and nephrogenic systemic fibrosis: an update. Pediatr Nephrol 29, 19271937 (2014).
4. The Royal College of Radiologists. Making the best use of clinical radiology services: referral guidelines. 2007; London: The Royal College of Radiologists. [Requires login]
5. Hoa D. Principles of diffusion imaging. 2009. In e-MRI: MRI Physics Interactive Tutorial.
6. Chalela JA, Kidwell CS, Nentwich LM et al. Magnetic resonance imaging and computed tomography in emergency assessment of patients with suspected acute stroke: a prospective comparison. Lancet 2007;369:293-298.
7. Runge VM, Wells JW, Williams NM et al. Detectability of early brain meningitis with magnetic resonance imaging. Invest Radiol 1995;30:484-495. Requires login
8. Incesu L, Khosla A. Bacterial Meningitis Imaging. Medscape, 2009. Updated: Mar 23, 2019.
9. Medicines and Healthcare Products Regulatory Agency. Device Bulletin: Safety Guidelines for Magnetic Resonance Imaging Equipment in Clinical Use 2007; DB2007 (03):40-47.