Communicating with children during radiographic exam...

click on the image to enlarge.....

Mock MRI simulation for pediatric MRI.....

The ‘mock MRI’ procedure involves children undergoing a simulated scan with the assistance of a play therapist prior to the actual diagnostic scan. It acts as both a screening tool, to assist in identifying children who are likely to be able to comply with the MRI procedure,and also helps to prepare these children,by familiarizing them with the environment, sounds, and equipment, while teaching them skills (such as breathing,relaxation, or distraction) to cope with the actual procedure . Use of the ‘mock’ magnet has led to a marked reduction in the numbers of patients who have required anesthetic and reduced the time required for the diagnostic scan...... 

Pediatric MRI..............

Longer TR and TE times are generally required when imaging very young children.the high water content in neonatal brains, coupled with the lack of fatty myelin results in the reduction in CNR (contrast to noise ratio) and grey/white matter differentiation.restore pulses on T2W imaging can improve CSF contrast and allow shorter TR times to reduce scan time......

Radiography of Eye....

EMERGENCIES IN MR ENVIRONMENT

EMERGENCIES IN MR ENVIRONMENT

3 categories:

•          Quench
•    Magnetic field emergencies
•           Patient emergencies

QUENCHING:

- Sudden loss of absolute zero of temperature in the magnet coils

- Coils become resistive

- Rapid escape of helium from cryogen bath

- Accidental quenching

        - Manual quenching

- In case of emergency (if a person pinned to a     magnet by a large ferromagnetic object)

- can cause severe, irreparable damage to the superconducting coils

System requirements for quenching:

- Helium venting equipment

- Oxygen monitor

- Alarms when oxygen levels fall below certain level

Steps in case of a quench:

- Do not panic

- Turn on exhaust (if not automatically turned on)

- Open the door between operator room and hallway

- Enter the scan room—undock table—help patient exit

- Evacuate area and return only when oxygen levels are normal.

- IF HELIUM IS VENTING INTO THE ROOM THE SCAN ROOM MAY NOT OPEN…..

In that case:

- Try opening the door several times, but

-- If not opened in 45 seconds

- Break window to scan room to relieve

  Pressure

- Enter the scan room

- Evacuate patient

MAGNETIC FIELD EMERGENCIES:

- If somebody pinned against the magnet or in other   magnetic-field-related emergency

                    QUENCH THE MAGNET

                                      But

        It results in several days’ downtime

                                        So

Do not press QUENCH BUTTON unless true emergency

- Do not test the button, leave to qualified service personnel

PATIENT EMERGENCY:

- Conditions

        - Seizure or claustrophobia

        - Greater potential of cardiac arrest

        - Unconscious, heavily sedated or confused patient

- Monitor these patients closely as usually direct observation of the patient not possible due to partial obscuration by magnet enclosure

- Emergency personnel either remains with the patient or on stand-by alert

Procedure to be followed in case of patient emergency:

- Hit emergency stop button

- Evacuate patient to the emergency medical treatment area outside exclusion zone

- Follow emergency hospital protocol

                                                                        Ravi

                                                               BS(RT)

MRA BRAIN.....

TYPES OF CHOLEDOCHAL CYSTS

Choledochal cysts are congenital conditions involving cystic dilatation of bile ducts.

They were classified into 5 types by Todani in 1977.

                                

 
Type I Choledochal Cysts - These are the most common, representing 80-90% of the lesions. Type I cysts are dilatations of the entire common hepatic and common bile ducts or of segments of each. They can be saccular or fusiform in configuration. Type I cysts can be divided into 3 subclassifications, including type IA cysts, which are typically saccular and involve all or a major portion of the extrahepatic bile duct (common hepatic duct plus common bile duct).

                                                    

Type II Choledochal Cysts - These are relatively isolated protrusions or diverticula that project from the common bile duct wall. They may be either sessile or connected to the common bile duct by a narrow stalk.

                                                        


Type III Choledochal Cysts - Also called choledochoceles, these are found in the intraduodenal portion of the common bile duct.

                                                              


Type IV A Cysts - These are characterized by multiple dilatations of the intrahepatic and extrahepatic biliary tree. Most frequently, a large, solitary cyst of the extrahepatic duct is accompanied by multiple cysts of the intrahepatic ducts.
Type IVB choledochal cysts - These consist of multiple dilatations that involve only the extrahepatic bile duct.

                                                          


Type V Choledochal Cysts - These are defined by dilatation of the intrahepatic biliary radicles. Often, numerous cysts are present with interposed strictures that predispose the patient to intrahepatic stone formation, obstruction, and cholangitis. The cysts are typically found in both hepatic lobes. Occasionally, unilobar disease is found and most frequently involves the left lobe.

                                                                   

Ravi

MRI technologist