MRI

NGUYEN LY
NG DUNG
LAM SANG
Bs. Le Van Phc

Ts. Bs.Pham Ngoc Hoa

Khoa Chan oan hn

anh

MRI
Hnh cong hng t (MRI/
Magnetic resonance imaging)
Hnh cong hng t hat
nhan (NMRI/ Nuclear magnetic
resonance imaging)

Lch s
MRI
1940: Felix Block+ Edward
Furcell
1971: RaymondDamadian
1972: Hounsfield- CT.
1973: Paul C Lauterbur hnh
anh
NMR au tien
(cua mau nc).
1977: Damadian thu c
hnh anh
NMR c the

Cac thanh phan

may
MRI
Nam cham
Cuon chenh (Gradient)
Bo phan phat song RF
Bo phan thu tn hieu
(Antenna)
He thong x ly, tao anh

Nam
cucham
(Permanent)

Vnh
[15-20 tan/ 0.2
T]
ien tr (Resistance) [ Nhiet/0,7T]
Sieu dan (Superconducting)
[-2690C/T trng cao]

Phan loai
may
MRI
T trng thap ( <0.5Tesla)
T
trng
trung
bnh
(0.5< 1.0 Tesla)
T trng cao (>1.0 Tesla)

May cong

Cong hng t

NGUYEN LY CONG HNG

Nguyen t Hydrogen
T trng
Song Radio
X ly tn hieu - tao hnh

Khoa Chan oan hnh anh Benh vien Ch

CAC BC KHAO SAT

TRONG MRI
2.Phat song
3.Thu d
RF
lieu

1.at benh
nhan len

4.X ly d lieu-

NGUYEN LY TAO HNH CONG

HNG T
Cuon phat-thu song

May
tnh
T trng

PROTON HYDRO

63 % trong lng c the la Hyd

Tao tn hieu manh nhat tren M

PROTON HYDRO

M=0

Mz

B0

Chuyen ong ao

B0

PHNG TRNH LAMOR

Phng trnh Lamor:

0 = x 0

-0 la tan so ao, tnh bang Hz, Mhz.

-0 la cng o t trng ngoai, tnh bang Tesla
- la ty so hoi chuyen ( Gyromagnetic ratio )

Khoa Chan oan hnh anh Benh vien Ch

HIEN TNG CONG HN

Khi phat song RF cung tan so vi
proton-ang chuyen ong ao vi
tan so - th proton tiep nhan c
nang lng song. Hien tng nay
goi la hien tng cong hng
(resonance)

Khoa Chan oan hnh anh Benh vien Ch

Song RF

Mz

T hoa theo truc doc

Mx,y

T hoa theo truc doc

Mz

Mxy

Mz
Thi gian T1

Thi gian th dan theo

Mxy
Thi gian T2

Thi gian th dan theo

Mz

Mxy
Ghi nhan tn
hieu
(Antenna)

Thu tn hieu

NGUYEN LY TAO
HNH

Moi phan t vat (Voxel ) co

thi gian T1, T2 khac nhau va
c bieu th bang cac o
xam khac nhau cua cac
phan t hnh (Pixel) tng ng

Voxel

Pixel

Nga
n

Dai
Thi gian
T1

o
sang-toi

Voxel

Pixel

Dai

Nga
n
Thi gian
T2

o
sang-toi

Mz

Mo A
Mo
B

S tng phan hnh anh

HNH T1W, T2W,

PD
Chon cac thong so TE, TR
khac nhau ta co cac hnh
khac nhau T1W, T2W, PD
-Hnh
mau
-Hnh
mau
-Hnh

T1W : Dch nao tuy

en
PD : Dch nao tuy
xam
T2W : Dch nao tuy

T2

T1

Mo B
Mo A

TR

Hnh

TE

Hnh

Hnh
T2W

Hnh
T1W

Hnh
T2W

Hnh
PD

Hnh

Hnh

KY THUAT CHUOI
XUNG
-Spin Echo
-Gradient Echo
-Inversion recovery
-Multislices
-Echo planar

Mz
180
0

TI

Chuoi xung hoi phuc ao ngc (Inversion

Xung STIR
(
XOA
M )
Khao sat
hoc mat,

Viem hoc
mat

Di
can

Benh ly bam

T1W

T2W

PD

FLAIR

GRADIEN
ECHO
Phat hien
Hemosiderin
(Cavernous
hemangioma
)

THAY OI CNG O
TN HIEU

Cng o tn hieu cao

(Hyperintensity)
Cng o tn hieu thap
(Hypointensity)
ong cng o tn hieu
(Isointensity)

T1W

U THAN NAO
(Glioma)

T2W

CHAT
PHAN
T
Co nhieu loai

TNG

Chat thuan t (Paramagnetic

CM)
[Dan
xuat
Gd-DTPA
/MagnevistR ]
-Hay dung
-C che: Ngan thi gian T1
Giong nh Iode tren
CT
Hng nghien cu va phat

T1W

T2W

T1W+Gd

T1W

T1W+Gd
Glioblastoma
Multiforme

CH NH
CHONG CH
NH

CH
NH
Ton thng he than kinh: ho
so sau, vung yen, tuy song,
benh ly chat trang
Benh ly c-xng-khp (chan
thng, u..)
Benh ly tim-mach
Benh ly cac c quan khac:
au mat co, bung, chau...
Khoa Chan oan hnh anh Benh

CHONG CH NH
D vat kim loai, dung cu
cay ghep (pacemaker, tr
thnh, clips noi so, mach
mau..)
Benh nhan b hoi chng
s nhot kn (claustrophobia)
[Cong hng t h]
Khoa Chan oan hnh anh Benh

Thuan
li
*o nhay cao phat hien ton
thng
*Chi tiet giai phau tot
*Khong dung tia xa
*Khong b Artifacts
*Khao sat nhieu mat cat
*Khao sat mach mau khong
dung thuoc tng phan
*Ky thuat khong xam pham
(non-invasive)
Khoa Chan oan hnh anh Benh

Bat
thuan li
*Cac chong ch nh,
ong voi
*Kho khao sat benh
nhan cap cu
*Gia thanh cao, khong
san co
Khoa Chan oan hnh anh Benh

SO SANH
Tia xa

CT

MRI

Co

Mat cat
ky
Thong so

Khong
Axial, Coronal
Mot (HU)

Bat
Nhieu

(T1W,T2W,PD)
Thi gian

Nhanh

Xao anh

++

Chup cap cu

De

Cham
+++
Kho

VAI NG DUNG
LAM SANG

MRI khao sat a

mat cat

Neurinom
a hai
ben
Xung
CISS3D
o ly
giai
di
1mm
Khao
sat day

Hnh T1W

PostCE/T1W

Hnh T2W

Glioma
than nao

Lao naomang nao

Hnh T1W

GRE s

Hnh T2W

Cavernous
hemangio

Hnh T1W

Hnh T2W

BENH X CNG RAI RAC (Multiple

Sclerosis)

MRA
he
ong
mach
KHONG
DUNG
nao

THUOC TNG
PHAN E TAO
HNH

Thi gian : 612 phut

MRA he tnh mach nao

Ton
thng
cuong
tuyen
yen
(Granulom
a)
AI
THAO

PRE CONTRAST

POST CM 30

POST CM
60

DYNAMIC MRI
u tuyen yen kch
thc nho

POST CM 90

Thoat v a em

Thoat v a em
Thoai hoa than song (type 1)

Thoat v a em
Thoai hoa than song (type
2,3 )

Di
can

Schwannoma

Chiari

Benh ly bam

MRI
MYELOGRAPH
Y

Thi gian : 4-7 phu

Khong dung thuoc

CHAN THNG KHP GOI

Rach sun chem (Loai VII)

KHAO
SAT HNH
THAI
CHC
NANG TIM

KHAO
SAT
HNH
THAI
CHC NANG TIM

Khoa Chan oan hnh anh Benh vien Ch

Hep ong mach

Aneurysm ong
mach

Hep eo ong
mach chu

Thuyen tac ong

D dang ong

D dang ong

Nang gan va u
mau

Dynamic CE
MRI

Pre Gd
T1W

Post Gd T1W
60s

HCC
Post Gd T1W

DYNAMIC CE MRI

Hepatic cyst &

hemangioma

T2 W

T1 W
Depart. Radiology- Choray Hospital-

CHOLANGIOCARCINOMA
XUNG HASTE
Thi gian : 7-11 giay

Khoa Chan oan hnh anh Benh vien Ch

MRI CHOLANGIOGRAPHY

MRI- CHOLANGIOGRAPHY
Thi gian: 4-16 giay. Khong dung thuoc
tao hnh
Khoa Chan oan hnh anh Benh vien Ch

U tuyen thng
than

BENH LY VUNG
CHAU

Fibromyoma
t cung

MOT SO NG DUNG
MRI NGHIEN CU VE CHC
NANG
( FUNCTIONAL MRI/ FMRI)
MRI KHAO SAT THAM THAU
&TI MAU
(DIFFUSION & PERFUSION MRI)
PHO CONG HNG T
(SPECTROSCOPY/MRS)

MRI NGHIEN CU VE CHC NANG

( FUNCTIONAL MRI/ FMRI)

fMRI)

Diffusion

Perfusion

PHO CONG HNG

T
(SPECTROSCOPY/MRS)

Choline va lactic acid

HNG PHAT TRIEN

-Khao sat chuyen hoa, the
tch, dong chay mau, cac
chat dan truyen va receptor
than kinh, ac iem mo.
-Khong dung proton Hydro:
Phot pho, Natri : anh gia tnh
trang Oxy cua c tim, u..
-anh gia tnh chat sinh hoc
cua dch, mo benh ly, te

TNG LAI
-Phat trien & cai tien nam
cham, coils, phan mem vi tnh,
chuoi xung mi.
-Chat tng phan chuyen biet
mo, benh ly.
-Cai thien va ng dung rong
rai MRI.
-Nghien cu MRI t trng

KET LUAN
MRI la ky thuat co
gia tr
ng dung rong rai
Ha hen phat trien
manh me

XIN CAM