Tng quan v my MRI

1./ L ch s pht trin

Felix Block v Edward Purcell pht hin ra hin tng cng hng t ht nhn
vo nm 1946 v t nhng nm 1950 n nm 1970 cng hng t c ng dng v pht trin
rng ri. Thnh qu c chng nhn bng gii Nobel Vt l vo nm 1952 cho 2 nh vt l Felix
Block v Edward Purcell. V l c s vt l quan trng cho s pht trin MRI.
n nm 1970, nn to nh y hc th gii c mt s thay i ng k vi s cng b kt qu nghin
cu ca tin s Raymond Damidian. ng pht hin ra cu trc c th ngi bao gm phn ln nc v
l cha kha cho to nh cng hng t, v rng nc pht ra mt tn hiu m c th d v ghi li
c. Sau tin s Damidian v cc cng s tip tc nghin cu mit mi trong 7 nm v thit
k, ch to ra chic my qut cng hng t u tin dng trong vic to nh y t ca c th ngi.
n nm 1980 chic my cng hng t u tin c a vo p dng. n nm 1987 k thut
Cardiac MRI c a vo s dng cho vic chn on cc bnh v tim mch. n nm 1993 th FMRI
dng chn on cc chc nng v hot ng ca no b

K thut to nh cng hng t (MRI) hin tr thnh mt phng php ph thng trong y hc chn
on hnh nh. Cc thit b MRI u tin ng dng y hc xut hin vo u nhng nm 1980. Vo nm
2002, c gn 22.000 camera MRI c s dng trn ton th gii. Trn ton th gii mi nm c hn 60
triu ca chn on bng MRI v phng php ny vn ang pht trin nhanh. MRI thng tt hn cc k

thut hnh nh khc v c ci thin ng k v chnh xc trong vic chn on nhiu cn bnh.
N thay th mt s phng php kim tra theo kiu a thit b vo c th, do gim au n, ri ro
cng nh s bt tin cho nhiu bnh nhn. Chng hn nh s dng phng php ni soi kim tra tuyn
ty hoc tuyn mt c th gy mt s bin chng nghim trng.
Li th ca MRI l tnh v hi ca n. MRI khng s dng bc x ion ho ging nh phng php chp
X quang thng quy (Nobel Vt l -1901) hoc chp CT (Nobel Y hc -1979). Tuy nhin, n c mt
nhc im l bnh nhn no phi tim kim loi t hoc mang my iu ho nhp tim khng th c
kim tra bng MRI bi MRI c trng t tnh mnh. Ngy nay, MRI c s dng kim tra gn nh
mi c quan trong c th. K thut ny c bit c gi tr trong vic chp nh chi tit no hoc dy ct
sng. K t khi MRI mang li nhng hnh nh 3 chiu, bc s c th nm c thng tin v a im
thng tn. Nhng thng tin nh vy rt c gi tr trc khi phu thut chng hn nh tiu phu no.
2./ Nguyn l to nh
phng php chp nh cng hng t ht nhn MRI (Magnetic Resonnance Imaging), ngi ta a
c th bnh nhn vo vng c t trng mt chiu rt mnh, hin nay ph bin l dng t trng sinh ra
do cun dy siu dn c dng in rt ln chy qua. Trong c th c nhng nguyn t m ht nhn c
momen t tng t nh c gn mt thanh nam chm cc nh. Di tc dng ca t trng ngoi,
momen t ca ht nhn nguyn t quay o tng t nh con quay di tc dng ca trng trng trn
mt t. Nu ht nhn ang quay o vi tn s w m c thm sng v tuyn cng tn s w tc dng,
ht nhn s quay o cc mnh v c hin tng cng hng. l cng hng t ht nhn. Khi ngng
tc dng sng v tuyn, ht nhn s t trng thi quay o cc mnh tr v trng thi quay o bnh
thng. Ht nhn c momen t quay nh vy s sinh ra sng in t pht ra khng gian xung quanh, c
th o c sng in t nu t vo y mt cun dy in.

Vic ht nhn t trng thi quay o mnh do cng hng tr v trng thi quay o bnh thng nhanh
hay chm cn ty thuc vo cc nguyn t quanh ht nhn cn tr chuyn ng quay t hay nhiu. V d,
ht nhn ca nguyn t H trong phn t nc (H2O) ca mu, t trng thi cng hng quay v trng
thi thng rt nhanh nu mu ang lu thng trong mch mu, tri li quay v rt chm nu mu chy
thm ra ngoi tht, m.
my MRI, ngi ta c th to ra cng hng ng vi mt loi ht nhn no (v d ht nhn hyr)
trong tng th tch c milimet khi ca no v theo di trng thi cng hng. Ln lt qut th tch c
cng hng ny, s c c hnh nh cng hng t ht nhn tng lp. C th theo di nh bit
c cu to bn trong ca no lc c th ang sng (bit c c chy mu trong no hay khng, chy
ch no). C th dng MRI theo di hot ng ca no, v d nh khu vc no ca no hot ng,
mu a oxy v vng mnh hay yu...

c im MRI
phn gii khng gian rt cao, cn phn gii thi gian va phi: Phn gii khng gian: 3 mm v
phn
gii
thi
gian:
3
giy
y l phng php hiu nghim v d s dng nht hin nay nghin cu v no. Ngi ta pht
trin phng php chp nh cng hng t chc nng (FMRI Function MRI) nghin cu khng ch
v
cu
to
m
cn
v
chc
nng
hot
ng
ca
no.
Tuy nhin, phng php ny kh tn km do phi dng hli lng lm lnh cun dy siu dn.
u im
nh cu trc cc m mm trong c th nh tim, phi, gan v cc c quan khc r hn v chi tit hn so
vi
nh
c
to
bng
cc
phng
php
khc.
MRI gip cho cc bc s nh gi c cc chc nng hot ng cng nh l cu trc ca nhiu c
quan
ni
tng
trong
c
th
S chi tit lm cho MRI tr thnh cng c v gi trong chn on thi k u v trong vic nh gi cc
khi
u
trong
c
th.
To nh bng MRI khng gy tc dng ph nh trong to nh bng chp X quang thng quy v chp
CT
MRI cho php d ra cc im bt thng n sau cc lp xng m cc phng php to nh khc kh
c
th
nhn
ra.
MRI c th cung cp nhanh v chun xc so vi tia X trong vic chn on cc bnh v tim mch.
Khng pht ra cc bc x gy nguy him cho con ngi.
Nhc im
Cc vt bng kim loi cy trong c th khng c pht hin c th b nh hng bi t trng mnh
Khng s dng vi cc bnh nhn mang thai 12 tun u tin. Cc bc s thng s dng cc
phng php to nh khc, v d nh siu m, vi cc ph n mang thai tr phi tht cn thit bt buc
phi s dng MRI.
3./ p dng
Cc bnh l thn kinh : ng kinh , bnh mt Myelin, bnh no bm sinh, u bu , vim nhim, .. . ca
no
v
ty
sng
.
Mch Mu : D dng , x va , teo hp mch mu no b v tn thng.
C
xng
khp
:
bnh
l
vim
c
xng
khp,
dy
chng,
c
bp.
Mt, tai mi hng : U hc mt, u ni nh, u hu hng, vim nhim, p xe ...
Tim mch : bnh l c tim, ng mch c, ng mch ch, ng mch ngoi vi
C
quan
ni
tng
:
cc
bnh
l
gan,
thn
ty,
lch
...
U buu : pht hin, nh gi mc xm ln theo iu tr.

4./ So snh MRI vi CT

Chp ct lp in ton (CT Scan) s dng tia X v h thng detector thu thp tn hiu khc nhau ca
tng im trn c th sau ti to li hnh nh theo tng lt ct.
Chp cng hng t (MRI) s dng t trng lm phn cc cc nguyn t Hydro c trong phn t nc
ca c th. Khi cc nguyn t H o cc s cho cc tn hiu in t c ghi nhn. V hm lng nc
khc nhau trn mi loi m nn tn hiu nhn c s khc nhau, to ra hnh nh khc nhau ca cc
vng
m
trong
c
th.
CT v MRI u l phng tin chn on hnh nh cao cp, thu nhn cc hnh nh bnh l nm su
trong c th chn on bnh. Hnh nh thu c c th ti to thnh hnh 3 chiu, lt ct rt mng v
chi
tit
rt
nh
gip
ch
rt
nhiu
trong
chn
on.
CT s dng tia X nn c tc hi do c th b nhim tia, gi r hn MRI.
MRI s dng t trng, hon ton khng tn hi c th nh gi mc hn.
5./ ng dng Vit Nam
Ngy 14/7/1996, ti Medic khnh thnh my MRI u tin ti Vit Nam vi s hin din ca GS. Trn
Vn
Giu,
my
MRI
hiu
Toshiba
Access
loi
m
(open).
ngy 14-07-1996 khai trng MRI..u tin ca MEDIC. My MRI u tin ny hot ng khi m
ngi bnh cn cha sn lng xt nghim bng k thut ny v qu mi, gi cao,, bc s cha bit r
ch nh khi no cn chp MRI.
i ng bc s chn on s dng cng hng t (MRI) c o to ti Singapore v M Lai, ri M
dn uy tn v nhu cu chn on vi MRI trong lnh vc no v ct sng, lm nn cho 2 chuyn khoa
ny pht trin. Nhu cu chp MRI tng ln cao, MRI th 2 ra i bnh vin Vit X v sau l bnh
vin ch Ry ri ph bin rng ra ton quc.
Ti Medic, TPHCM, nhu cu chp MRI tng nhanh, my MRI th 2 ca Medic ra i, loi siu dn
1,5T GE LX. Ri tip tc li cn thm my th 3 MRI siu dn 1,5T CVI GE Hin ti, mi ngy Medic
chp 50 bnh nhn vi nhiu k thut, nht l ct sng v no.

Hin ti trn ton quc c 23 my MRI phn b nh sau :

H Ni : 9 my
BV
BV
BV
BV
TT
TT
chn
TT
chn
BV
BV 108 (1,5T)

Bch
Vit
Qun

Mai
c
Saint-Paul
103
Amtic
H)
Thng)
(1T)

Y
on

(178

on
Vit

(107

Thi
c

Tn
X

Hu Nng : 3 my
BV
BV
BV

Trung
a
Hon

ng

khoa
M

Hu
Nng
Nng

(1,5T
(open
(open

China)
Hitachi)
Toshiba)

TPHCM : 11 my
Medic
BV
BV
BV
BV
BV
BV
BV

(3
Ch

my
Ry

2
my

(2

GE
:
Y

hc
Thng

1T

nht
115

Vn
Chn

1,5T

(1,5T
(open
hnh

Hnh
thng
175

Chnh
(open

v
v
(1,5T
(1,5T

1
1,5T

(open

open)
Siemens)
Siemens)
Philip)
Siemens)
Siemens)
Hitachi)
Philip)

ng bng Sng Cu Long : 1 my

BV a khoa Kin Giang (open Hitachi)
TNG CNG : 23 MY (C 11 MY LOI SIU DN)
Tng lai s cn nhiu my MRI ra i na, ko theo cc chuyn khoa su pht trin nh thn kinh, ct
sng, khp, v mt tin vui cho ngnh ung th l c th pht hin ra ung th sm vi cht cn t nano
c bit, mt ng r ca cng hng t tng lai cnh tranh vi k thut PET trong truy tm ung th
sm.
Sau 10 nm pht trin (1996 2006), t 1 my nay c 23 my, ngi bnh Vit Nam gi y khng cn
phi ngh l phi i Singapore chp MRI na, c ai bit chi ph chp ti Vit Nam ch l 20% so vi gi
chp nc ngoi, khng cn chi ph v my bay v khch sn, khng cn i ch xp hng lu na.
Tt c s thun li cho bnh nhn c cht lng iu tr cao v chi ph r phi cn 10 nm qua
pht trin.

(Trch bo co ca K47 TYS H BK Hhn 4: Chp cng hng t l g?

MRINguyenTriPhuong - Chp cng hng t ( MRI scan ) ph bin trn th gii cng nh Vit Nam bi
tnh u vit ca n so vi cc phng php to nh y hc khc, nhng phn ln chng ta vn cha c hiu bit
c bn v phng php chp cng hng t, tuy nhin hiu chi tit v phng php ny th l cng vic ca
cc nh vt l v chng ta ch cn hiu c bn v n tn hng nhng thnh tu ca khoa hc m n mang li
nhng li ch cho cuc sng . Vy cng hng t l g?
Chp cng hng t hay cn gi l chp MRI (Magnetic Resonnace Imaging) l phng php a c th
vo vng t trng mnh ng ha chiu chuyn ng ca cc nguyn t Hydro trong cc phn t nc ca c
th v mt ng ten thu pht sng radio tn s thp (tn s radio ny c thay i trong vng t trng n nh ca
nam chm chnh ty theo mc ch kho st ca s phn bit m, nc, v v) c s dng gi tn hiu n c
th gp cc nguyn t Hydro ca c th sau nhn li tn hiu v chiu chuyn ng ca cc nguyn t ny, tn
hiu ca ng ten c truyn v trung tm my tnh x l tn hiu s sau cc tn hiu c truyn v my tnh
iu khin v cc hnh nh cu trc c th c m phng ti y.

N)

Nguyn l ca chp cng hng t

ng lc: Th ba - 15/04/2014 13:50 - Ngi ng bi vit: admin

Nguyn l ca chp cng hng t

Bnh vin a khoa tnh k Lk va a vo s dng h thng chp cng hng t

(Magnetic Resonance Imaging: MRI).
c phim ng, thy thuc phi tip cn vi mt s khi nim i khi kh tru tng. V th, chng
ti xin trnh by khi qut mt s khi nim thng dng ca phng tin ni trn. Cc vn c th v
vai tr ca phng tin ny trong chn on cc bnh l ca nhng c quan khc nhau s c trnh
by trong lot bi khc.
Nguyn l hot ng ca MRI (Magnetic Resonance Imaging)
Chng ta u bit mi vt th u c cu to t nguyn t. Ht nhn nguyn t c cu to t cc
proton (mi proton mang in tch +1) v cc neutron (khng mang in tch). Quay quanh ht nhn l
cc electron (mang in tch m). Trong nguyn t trung ha in tch, s proton ca ht nhn bng
ng s electron ca nguyn t . Tt c cc tiu th ny u chuyn ng. Neutron v proton quay
quanh trc ca chng, electron quay quanh ht nhn v quay quanh trc ca chng. S quay ca cc
tiu th ni trn quanh trc ca chng to ra mt mmen gc quay gi l spin. Ngoi ra, cc ht
mang in tch khi chuyn ng s sinh ra t trng. V proton c in tch dng v quay nn n to
ra mt t trng, ging nh mt thanh nam chm nh, gi l mmen t (magnetic moment) (Hnh 1).
Nh cc c tnh vt l nh vy, khi t mt vt th vo trong mt t trng mnh, vt th c kh
nng hp th v bc x li cc xung in t mt tn s c th. Khi hp th, trong vt th din ra
hin tng cng hng t ht nhn (Nuclear Magnectic Resonance: NMR). Tn s cng hng ca
cc vt th m thng thng nm trong di tn ca sng v tuyn (radiofrequency: RF). Cn khi bc
x, vt th cng pht ra cc tn hiu v tuyn (Hnh 2).
C th chng ta cu to ch yu t nc (60-70%). Trong thnh phn ca phn t nc lun c nguyn
t hydro. V mt t tnh, nguyn t hydro l mt nguyn t c bit v ht nhn ca chng ch cha 1
proton. Do , n c mt mmen t ln. T iu ny dn ti mt h qu l: nu ta da vo hot ng
t ca cc nguyn t hydro ghi nhn s phn b nc khc nhau ca cc m trong c th th chng
ta c th ghi hnh v phn bit c cc m . Mt khc, trong cng mt c quan, cc tn thng
bnh l u dn n s thay i phn b nc ti v tr tn thng, dn n hot ng t ti s thay
i so vi m lnh, nn ta cng s ghi hnh c cc thng tn.
ng dng nguyn l ny, MRI s dng mt t trng mnh v mt h thng pht cc xung c tn s
v tuyn iu khin hot ng in t ca nhn nguyn t, m c th l nhn nguyn t hydro c
trong phn t nc ca c th, nhm bc x nng lng di dng cc tn hiu c tn s v tuyn. Cc
tn hiu ny s c mt h thng thu nhn v x l in ton to ra hnh nh ca i tng va
c a vo t trng .
Qu trnh chp MRI gm c 4 giai on. Nguyn l ca 4 giai on nh sau:
Giai on 1: Sp hng ht nhn
Mi proton trong mi trng vt cht u c mt mmen t to ra bi spin (xoay) ni ti ca n. Trong
iu kin bnh thng, cc proton sp xp mt cch ngu nhin nn mmen t ca chng trit tiu ln
nhau do khng c t trng d ra ghi nhn c. Khi t c th vo my chp MRI, di tc
ng t trng mnh ca my, cc mmen t ca proton s sp hng song song cng hng hoc
ngc hng ca t trng. Tng tt c mmen t ca proton lc ny c gi l vect t ha
thc (net magnetization vector). Cc vect t sp hng song song cng chiu vi hng t trng

my c s lng ln hn cc vect t sp hng ngc chiu v chng khng th trit tiu cho nhau
ht. Do vect t ho thc c hng ca vect t trng my. l trng thi cn bng. Trong
trng thi cn bng khng c mt tn hiu no c th c ghi nhn. Khi trng thi cn bng b xo
trn s c tn hiu c hnh thnh.
Ngoi s sp hng theo hng ca t trng my, cc proton cn c chuyn ng o (Precession),
tc quay quanh trc ca t trng my. Chuyn ng o l mt hin tng vt l sinh ra do s tng
tc gia t trng v ng lng quay ca proton. Chuyn ng o ging nh hin tng con quay,
n lm cho proton khng ng yn m o quanh trc ca t trng bn ngoi (Hnh 1). Tn s ca
chuyn ng o nm trong di tn s ca tn hiu RF v c xc nh bng phng trnh Lamor. Khi
pht xung RF cng tn s vi proton ang chuyn ng o th proton hp th nng lng xung to
nn hin tng cng hng t ht nhn.

Hnh 1: M t mt proton c mmen t c t trong t trng ngoi B 0 v c chuyn ng o

Giai on 2: Kch thch ht nhn
Sau giai on sp hng ht nhn, cun pht tn hiu (transmitter coil) ca my pht ra cc xung in
t ngn (o bng mili giy) gi l xung tn s v tuyn (radiofrequency pulse: xung RF). V cc xung
pht ra c tn s RF tng ng vi tn s cng hng ca proton nn mt s nng lng s c
proton hp th. S hp th nng lng ny s y vect t ho lm chng lch khi hng ca vect

t trng my. Hin tng ny gi l kch thch ht nhn (Hnh 2).

Hnh 2: M t qu trnh kch thch ht nhn (cng hng) v qu trnh dn (bc x nng lng di
dng tnh hiu RF)
C hai khi nim quan trng trong x l tn hiu l t ha dc (longitudinal magnetization), song
song vi t trng ca my v t ha ngang (transverse magnetization), vung gc vi t trng
my.
T ha dc l hin tng t ha do nh hng ca t trng my. chnh l trng thi cn bng nh
trnh by trn. Trng thi ny c duy tr cho n khi c mt xung RF tc ng lm vect t ho
lch khi hng ca vect t trng my. Khi pht xung RF, sau mt thi gian no , vect t ho li
khi phc tr v v tr dc ban u. Qu trnh khi phc (recovery) theo hng dc ca t trng my
gi l qu trnh dn theo trc dc(longitudinal relaxation) (Hnh 3). Thi gian dn theo trc
dc (longitudinal relaxation time) l thi gian cn thit hin tng t ha dc t 63% gi tr ban
u ca n. Thi gian ny cn gi l thi gian T1.
T ha ngang xy ra khi pht xung RF ln m. Xung ny thng l xung 900. Do hin tng cng
hng nn vect t ho lch khi hng ca vect t trng my v b y theo hng ngang to
nn vect t ha ngang (transverse magnetization vector). T ha ngang l trng thi khng n
nh, kch thch v nhanh chng phn r khi kt thc xung RF. T ho ngang cng l mt qu trnh dn
gi l dn theo trc ngang (transverse relaxation). Khi ngt xung RF, vect t ha ngang mt pha,
suy gim nhanh chng v dn dn tr v 0. Thi gian cn thit 63% gi tr t ho ban u b phn
r gi l thi gian dn theo trc ngang (transverse relaxation time) (Hnh 3). Thi gian ny cn gi
l thi gian T2. Thi gian T2 ngn hn nhiu so vi thi gian T1.

Hnh 3: M t qu trnh t ho dc v t ho ngang. M0 l vect t ho thc trng thi cn bng. Y l

hng ca vect t ho ngang. MZ l vect t ho khi dn theo trc dc.
Giai on 3: Ghi nhn tn hiu
Khi ngt xung RF, cc proton ht b kch thch, tr li sp hng nh c di nh hng ca t trng
my (gi l qu trnh dn theo trc dc nh trnh by trn). Trong qu trnh ny, khi mmen t
ca cc proton khi phc tr li v tr dc ban u, chng s bc x nng lng di dng cc tn hiu
tn s v tuyn. Cc tn hiu ny s c cun thu nhn tn hiu (receiver coil) ca my ghi li.
Giai on 4: To hnh nh
Cc tn hiu v tuyn bc x t vt th m sau khi c cun thu nhn tn hiu ca my ghi li s c
x l in ton to ra hnh nh. Cng bc x t mt n v khi lng m c th hin trn
phim chp theo mt thang mu t trng n en. Trong mu trng l cng tn hiu cao, mu
en l khng c tn hiu (Hnh 4).

Hnh 4: M t mi lin h gia thi gian T1, T2 vi mc t ho v cng tn hiu trn phim chp.
Trong qu trnh dn (tng li) ca t ho dc, cc m khc nhau s c mc t ho khc nhau. V th
tc tng s khc nhau, hay ni cch khc gi tr T1 khc nhau. M vi gi tr T1 ngn hn c tc
tng li s t ho dc nhanh hn. Do vy, trong sut thi gian ny n c mc t ho cao hn, to tn
hiu mnh hn v xut hin trn nh sng hn.
Trong qu trnh phn r s t ho ngang, cc m khc nhau c mc t ho khc nhau do tc
phn r khc nhau, hay T2 khc nhau. Gi tr T2 di tc m c mc nhim t cao, to ra tn hiu mnh
hn v sng hn trong nh so vi m c gi tr T2 ngn. Ti thi im bt u chu k, khng c tng
phn T2, nhng tng phn T2 tng dn trong qu trnh dn.
C th thy rng, phng thc to nh MRI c hai pha khc nhau. Mt pha i cng vi s t ho dc v
pha kia i cng vi s t ho ngang. Mt khc, nh trn trnh by, trong thi gian T1 khi mmen t
ca cc proton khi phc theo chiu dc di nh hng ca t trng my th tng tt c mmen t
ca proton lc ny c gi l vect t ha thc. ln ca vect t ho thc ph thuc vo mt

proton ca m . Gia hai m ln cn, d thi gian T1 c th bng nhau nhng nu mt proton
khc nhau th mc t ho s khc nhau. V th cng tn hiu bc x ra cng khc nhau nn s
to ra tng phn nh khc nhau. Nh ta c th nhn bit ring bit c chng qua s tng phn
trn nh. Nu hai m c gi tr T1 khc nhau, th s tng phn s cng tng ln. Nhng khi cc m
tin dn n trng thi cn bng th mt proton li tr thnh mt yu t chnh nh hng n tng
phn gia hai m.
Nh vy, u im vt tri ca phng php to nh MRI so vi cc phng php khc l ch ta c
th chn cc c tnh khc nhau ca m to ra tng phn hin th trn phim chp. C 3 c tnh
c bn ca m l ngun tng phn nh : (1) mt proton kt hp vi thi gian dn dc T1, (2) thi
gian dn dc T1, (3) thi gian dn ngang T2.
Khi nim TR, TE, T1W, T2W, PD v PDW
Nh bit trn, cng tn hiu tng dn t 0 n cc i trong thi gian T1 v gim dn t cc
i tr v 0 trong thi gian T2. Nhm to ra s tng phn tt nht v hnh nh ca cc m, ngi ta
phi chn thi im T1 v T2 thch hp thu nhn cc tn hiu bc x cung cp cho qu trnh to
nh. TR v TE chnh l cc thng s v thi gian o tn hiu c ngi vn hnh my thit lp trc
khi chp MRI.
TR (Time of Repetition) l khong thi gian t khi bt u dn dc n khi mc t ho ca m c
o to ra tng phn nh. Xc nh gi tr TR l xc nh thi im chp nh.
TE (Time of Echo event) l khong thi gian t khi bt u dn ngang n khi mc t ho ca m
c o to ra tng phn nh. Cc gi tr kt hp gia TE v TR c chn qua cc bng tu thuc
vo tng loi m.
Bng cch iu chnh cc gi tr TR v TE ca T1 v T2, ta thu c cc tng phn nh tng ng vi
mt c tnh m ring bit. nh ca T1 v T2 trong trng hp ny gi l T1 iu chnh (T1-weighted:
T1W) v T2 iu chnh (T2-weighted: T2W).
Nhm to nh T1 iu chnh, ngi ta cn chn mt gi tr TR tng ng vi thi gian m ti tng
phn T1 ln nht gia hai loi m. Nu la chn TR di hn s to ra cng tn hiu ln hn nhng
tng phn T1 t hn. Vic la chn TR thch hp vi cc gi tr T1 ca m rt c ngha trong chn
on lm sng, c bit khi phn bit gia m lnh v m bnh l. Nu gi tr TR c chn bng gi
tr T1 ca m, l nh c chp khi m tr li 63% s nhim t m ca n.
Nhm to nh T2 iu chnh, ngi ta cn chn mt gi tr TE tng ng vi thi gian m ti tng
phn T2 ln nht gia hai loi m. Tng phn T2 cc i thu c bng cch dng TE tng i di.
Tuy nhin, nu dng TE qu di th s nhim t v tn hiu RF li qu thp hnh thnh mt nh.
Mt k thut to nh hay gp na l PD. PD (Proton Density) l nh kho st mt proton. Nh
ni trn, khi s nhim t dc t gi tr cc i th tng phn theo thi gian T1 s km i. Lc ny
tng phn nh do mt proton ca m quyt nh. Do vy, nu ta chn gi tr TR tng i di
to nh tng phn mt proton th gi l nh mt proton iu chnh (Proton Densityweighted: PDW).
Kt lun: Vic hiu bit nguyn l hot ng v cc khi nim c bn ca chp cng hng t s gip
thy thuc nhn nh ng cc cu trc bnh thng hoc bnh l ca cc m. Khi c bt k phim MRI
no, trc tin phi nhn bit l phim T1 hay T2. C th thy rng nc (hay cht lng ni chung) v
c mt proton cao nn thi gian n khi phc li 63% gi tr t ho ban u s ko di hn so vi
m c t nc. V th nc (hay cht lng ni chung) c cng tn hiu yu trong thi gian T1 v th
hin bng mu ti (en) trn phim T1W. Ngc li, v c mt proton cao nn u thi gian T2, nc
(hay cht lng ni chung) c cng tn hiu cao v suy gim ko di hn nn th hin bng mu
sng (trng) trn phim T2W. Cc m b ph n, vim, nhim trng v cc nang cng c tnh cht tng
t. V vy khi c bt k phim MRI no, trc tin phi tm nhng cu trc no m ta bit chc chn l
nc nh dch no tu trong cc no tht v ng sng, nc tiu trong bng quangNu cu trc nc
y c mu ti th l nh T1W, nu mu sng th chnh l nh T2W.