Magnetic Resonance Curriculum



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Imaging

  1. Positioning

    1. Body mechanics

    2. Exam coils

    3. Positioning accessories




    1. Technical Considerations

      1. Protocols

        1. Scan menus

        2. Scan sequences

      2. Variations




    1. Image processing

      1. Display functions

      2. Archival

        1. Legal requirements for image documentation and retention




    1. Image analysis

      1. Image quality

        1. window levels and widths

        2. formats

      2. Image quality

        1. Parameters

        2. Artifacts

        3. Region of interest




    1. Patient/personnel protection

      1. Screening

        1. Metallic objects

        2. Implants/pacemakers

        3. Sickle cell disease

        4. Renal disease

        5. Asthma

        6. Pregnancy

        7. Breast feeding

        8. Dialysis

        9. Claustrophobia

      2. Equipment/accessories

        1. Coils

        2. Call button

        3. Earplugs/ headphones

        4. MR-conditional:

          1. ECG leads

          2. Oxygen/tanks

          3. IV pumps

          4. Anesthesia equipment

          5. Pulse oximeters

          6. Blood pressure cuffs

          7. Suction

          8. Monitors

      3. Medical/artifact error reduction

        1. Environment

          1. Gauss lines

          2. RF shielding/magnetic shielding

          3. Warning alarms/signs

        2. Biological Considerations

          1. RF field

            1. SAR

            2. Biological effects

            3. FDA guidelines

          2. Static and gradient fields




  1. Competency (Mandatory, Elective)* from ARRT Clinical Experience Requirements (http://arrt.org/education/mr)

    1. Head and neck




    1. Spine




    1. Thorax




    1. Abdomen and pelvis




    1. Musculoskeletal




    1. Special imaging procedures




    1. Quality control

*Refer to ARRT Competency Requirements for mandatory and elective requirements.

Computers in Imaging and Medical Informatics

Description

Content introduces knowledge in computing and information processing. It presents computer applications in the radiologic sciences related to image capture, display, storage and distribution. Additional content is designed to provide the basic concepts of patient information management. Medical records management, including privacy and regulatory issues, are examined. The role of the technologist is identified and discussed. In addition, this content imparts an understanding of the components, principles and operation of digital imaging systems found in MR, image data management, storage and data manipulation (post-processing). Factors that impact image acquisition, display, archiving and retrieval are discussed.


Rationale

This course is required to develop an understanding of computers in the imaging environment. The subjects are formatted in individual outlines and can be sequenced according to the desired level of knowledge. Topics include: computers, computer components and characteristics, digital imaging (image acquisition, data management, storage, data manipulation (post-processing), display, archiving and retrieval), patient information systems, picture archiving and communication system (PACS), Health Insurance Portability and Accountability Act (HIPAA), hospital information systems (HIS) and radiology information systems (RIS).


Prerequisites

  1. Medical terminology – a course in terminology used in the medical profession.

  2. Basic computer skills.


Objectives

Upon completing the course, the student will be able to:



  1. Apply knowledge base to use computerized systems.

  2. Identify various types of computers.

  3. Explain the way a computer operates.

  4. Identify various terms related to computer fundamentals and components.

  5. Describe how to apply various types of software.

  6. Describe the various types of hardware applications.

  7. Distinguish between analog and digital signals.

  8. Define analog-to-digital conversion and digital signal processor.

  9. Describe the major functions of the central processing unit (CPU).

  10. Differentiate among the various input and output devices.

  11. Give examples of various types of memory.

  12. Use technology to retrieve, evaluate and apply information.

  13. Describe computer care and preventive maintenance.

  14. Distinguish among the Internet, intranet and other online services.

  15. Apply The Joint Commission/HIPAA standards regarding accountability and protection of patient information.

  16. Explain RIS, HIS and PACS applications as they relate to radiology.

  17. Describe how the Internet affects distribution of health information.

  18. Define digital imaging and communications in medicine (DICOM).

  19. List the requirements of a patient consent document.

  20. Identify the challenges in protecting patient information.

  21. Distinguish between various types of patient records.

  22. Explain the contents of a medical record.

  23. Apply protocols to properly chart patient information.

  24. Explain the procedures for document administration.

  25. Discuss privacy and regulatory issues related to patient information.

  26. Assess how HIPAA is applied to patient information systems.

  27. Define medical informatics and describe examples of informatics systems found in today’s patient care setting.

  28. Identify potential abuses related to using confidential patient information.

  29. Describe methods of complying with HIPAA.


Content

  1. Computer Fundamentals

    1. Terminology

      1. Analog

      2. Digital

      3. Binary




    1. Types of computers

      1. Supercomputer/mainframe

      2. Minicomputer

      3. Microcomputer




    1. Digital fundamentals

      1. Binary coding

        1. Bits

          1. Bit depth

        2. Bytes

          1. Information content

          2. Megabytes/image

      2. Digital signal processor (DSP)

        1. A-D conversion

        2. D-A conversion




    1. Considerations

      1. Environmental conditions

        1. Temperature

        2. Humidity

      2. Computer catastrophes

      3. Ethical/legal concerns

      4. Preventive maintenance

      5. Security

        1. Passwords

        2. Limited access

        3. Firewalls




  1. Computer Components

    1. Hardware

      1. Computer

        1. Mainframe

        2. Hard drive

      2. Monitor

      3. Keyboard

      4. Mouse




    1. Software

      1. Word processing

      2. Database

      3. Spreadsheet

      4. Desktop publishing

      5. Graphics

      6. Integrated application programs

      7. Image manipulations

        1. DICOM

        2. Joint photographic experts group (JPEG)




    1. Central processing unit (CPU)

      1. Arithmetic logic unit (ALU)

      2. Control unit (CU)




    1. Input and output (I/O) devices (peripherals)

      1. Input

        1. Keyboards

        2. Non-keyboard devices

        3. Touch screen

        4. Voice activation

      2. Output

        1. Printers

        2. Video monitors

        3. Graphic displays

        4. Voice output

      3. Storage/memory

        1. Primary memory

          1. Random access memory (RAM)

          2. Read-only memory (ROM)

        2. Secondary storage

          1. Magnetic tape

          2. Magnetic disk

          3. CD-ROM

          4. DVD

          5. Off-site storage




  1. Computer Operations

    1. Programming

      1. Definition

      2. Purpose

      3. Languages

      4. Software




    1. Computer Functions (for Imaging)

      1. Image acquisition

      2. Image processing

      3. Image display

      4. Image storage




    1. Implementation

      1. Definition

      2. Purpose




  1. Radiology Applications

    1. Patient information and image manipulation

      1. Seamless patient/image information

        1. Scheduling

        2. Image/patient evaluation

        3. Billing/coding

      2. Documentation

        1. Completeness

        2. Quality control

        3. Quality assurance




    1. Patient information systems

      1. Patient information

        1. Personal information

        2. Clinical information

        3. Other

      2. HIS

      3. RIS

      4. DICOM




    1. Image information systems

      1. PACS

        1. Terminology

        2. System components and functions

        3. Image manipulation

        4. Access to report information

        5. Access from multiple locations

        6. Image retrieval

        7. PACS issues – contingency plans

        8. DICOM

      2. Image display and manipulation

        1. Viewing

        2. Post-processing

        3. Measurements

      3. Teleradiology




    1. Technologist’s responsibilities

      1. Access order (worklist)

      2. Image acquisition

      3. Post-processing – image manipulation

      4. Annotation issues

      5. Transmitting an image(s) to PACS

      6. HIPAA and patient confidentiality




  1. Digital Imaging

    1. Digital image characteristics

      1. Picture elements – pixels

      2. Pixel size

        1. Field of view (FOV)

        2. Matrix

      3. Voxel size

        1. FOV

        2. Thickness

        3. Matrix

      4. Matrix size

      5. Image quality characteristics

        1. Spatial resolution

        2. Temporal resolution

        3. Image contrast

        4. Data size




    1. Digital image acquisition

      1. MR image acquisition

        1. Protocol/parameter selection

          1. Resolution (FOV, thickness, matrix)

          2. Contrast – repetition time (TR), echo time (TE), inversion time (TI), and flip angle (FA)

          3. Other parameters

        2. System requirements

          1. Hardware requirements

          2. Software requirements

        3. Anatomical considerations

          1. Anatomy of interest

          2. Plane/baseline reference

          3. Anatomical variations

          4. Body habitus

          5. Pathology

        4. Positioning aids

        5. Special concerns

          1. Age

          2. Patient condition

          3. Positioning

      2. MR image formation

        1. K-space

        2. Analog to digital converter

        3. Fourier transformation




    1. Imaging standards

      1. Protocol selections

      2. Parameter selections

      3. Problem-solving process

      4. Role of the MR technologist




    1. Artifacts

      1. Determining the cause(s) of artifacts

      2. Optimizing acquisition parameters to reduce artifacts




  1. Quality Assurance and Post-processing

    1. Image display

      1. Window/level

      2. Brightness/contrast

      3. Reconstruction algorithms




    1. Image evaluation

      1. Image quality (SNR)

      2. Image quality (image contrast)




    1. Post-processing

      1. 3-D

      2. Maximum intensity projection (MIP)

      3. Region of interest (ROI)

        1. Measurements

        2. Signal intensity

      4. Image display

        1. Brightness

        2. Contrast




  1. Display

    1. Monitor

      1. Liquid crystal display (LCD)

      2. Cathode ray tube (CRT)




    1. Film

      1. Dynamic range

      2. Degraded thermal film

      3. Film storage




    1. Image display

      1. Image quality display

        1. Contrast

        2. Recorded detail/spatial resolution

        3. Distortion

      2. PACS

        1. Terminology

        2. System components and function

        3. PACS operation

          1. Image manipulation

          2. Access to report information

          3. Access from multiple locations

          4. Image retrieval

          5. Contingency plans

        4. DICOM




    1. Procedural factors display

      1. Image identification

        1. Patient information

        2. Date of examination

        3. Parameters and options

        4. Institutional data

      2. Documenting an ordered exam

        1. Prescription

        2. Patient chart

        3. Telephone orders

        4. Faxed orders

        5. Electronic orders – Computerized Physician Order Entry (CPOE)

        6. Contrast agent

        7. Pre-examination preparation

      3. Artifacts

        1. Image acquisition errors

        2. Corrective action

      4. Equipment

        1. Spatial resolution

        2. More contrast resolution




    1. Image evaluation

      1. Contrast

        1. Appropriate for exam

        2. Evidence of processing error

      2. Spatial resolution

      3. Distortion

      4. Artifacts




  1. Computer Advancements for Imaging

    1. The Internet

      1. History

      2. Internet vs. intranet




    1. Intranets

      1. Access to information

      2. Security of patient information




    1. Enhancer to customer service

      1. Referring physician

      2. Patient

Ethics and Law in the Imaging Sciences



Description

Content__Ethics_and_Ethical_Behavior'>Content provides a fundamental background in ethics. The historical and philosophical bases of ethics and the elements of ethical behavior are discussed. The student examines a variety of ethical issues and dilemmas found in clinical practice.


An introduction to legal terminology, concepts and principles also are presented. Topics include misconduct, malpractice, legal and professional standards. The importance of proper documentation and informed consent is emphasized.
Content

  1. Ethics and Ethical Behavior

    1. Origins of history of medical ethics




    1. Moral reasoning




    1. Personal behavior standards




    1. Competence




    1. Professional attributes




    1. Standards of practice




    1. Self-assessment and self-governance




    1. Code of professional ethics




    1. Ethical concepts

      1. Ethics principles

      2. Violation process




    1. Systematic analysis of ethical problems




    1. Ethical patient care data research/data discovery




  1. Ethical Issues in Health Care

    1. Individual and societal rights




    1. Cultural considerations




    1. Economical considerations




    1. Technology and scarce resources




    1. Access to quality health care




    1. Human experimentation and research




    1. Medical/health care research




    1. End-of-life decisions




  1. Legal Issues

    1. Parameters of legal responsibility




    1. Patient personal information

      1. Health Insurance Portability and Accountability Act (HIPAA)

      2. Confidentiality of patient information




    1. Intentional misconduct




    1. Negligence/malpractice

      1. Definitions

      2. Components of malpractice

      3. Legal doctrines

      4. Legal and professional standards

      5. Medical liability

      6. Sources of Law

      7. Civil and Criminal Liability




    1. Legal risk reduction




  1. Patient Consent

    1. Definition




    1. Types




    1. Condition for valid consent




    1. Documentation of consent


Fundamentals of Imaging Science and Health Care

Description

Content provides an overview of the foundations in radiologic science and the practitioner’s role in the health care delivery system. The principles, practices and policies of the health care organization(s) are examined and discussed in addition to the professional responsibilities of the MR technologist.


Content

  1. The Health Science Professions

    1. Radiologic technology

      1. Radiography specialties

        1. Diagnostic radiography

        2. Computed tomography

        3. Mammography

        4. Cardiac-interventional radiography

        5. Vascular-interventional radiography

        6. Bone densitometry

        7. Quality management

        8. Radiologist assistant

        9. Multiskilled

      2. Radiation therapy

      3. Nuclear medicine technology

      4. Diagnostic medical sonography

      5. Magnetic resonance imaging

      6. PACS administration

      7. Education

      8. Management




    1. Health care professions

      1. Health information technology

      2. Medical laboratory sciences

      3. Occupational therapy

      4. Pharmacy

      5. Physical therapy

      6. Respiratory therapy

      7. Social services

      8. Nursing

      9. Other




  1. The Health Care Environment

    1. Health care systems

      1. Hospitals

        1. Veterans Administration/military

        2. Not-for-profit

        3. For-profit

        4. System/network

      2. Clinics

      3. Independent facilities

      4. Mental health facilities

      5. Long-term/residential facilities

      6. Hospice




    1. Health care delivery settings

      1. Outpatient/ambulatory care

      2. Inpatient

      3. Long-term care

      4. Preventive care

      5. Home health care

      6. Telehealth/telemedicine




    1. Payment/reimbursement systems

      1. Self pay

      2. Indemnity insurance

      3. Entitlement/governmental programs

        1. Medicare

        2. Medicaid

      4. Managed care




  1. Hospital Organization

    1. Philosophy




    1. Mission

      1. Role within the community

      2. Commitment to education within the profession and community health




    1. Administrative services

      1. Governing board

      2. Hospital administration

      3. Admissions

      4. Information systems

      5. Procurement

      6. Accounting

      7. Support services

        1. Facilities management

        2. Environmental services (housekeeping)

        3. Security

      8. Personnel




    1. Medical services

      1. Personnel

        1. Medical director

        2. Medical staff

        3. House staff

          1. Medical residents

          2. Interns

          3. Medical students

      2. Nursing services

      3. Clinical services

        1. Internal medicine

        2. Surgery

        3. Mental health

        4. Geriatrics

        5. Pediatrics

      4. Clinical support services

        1. Dietary

        2. Medical laboratories

        3. Oncology

        4. Pastoral care

        5. Rehabilitation

        6. Social services

        7. Risk management

        8. Pharmacy




  1. Radiology Organization

    1. Professional personnel

      1. Radiology director/chair

      2. Radiologists

        1. Attending

        2. Fellow

        3. Resident

        4. Intern

      3. Radiation physicist

      4. Technologists

        1. Administrative director

        2. Chief/senior technologist

        3. Staff technologist

        4. Quality control/assurance officer/technologist

      5. Radiologist assistant

      6. Radiology nurses




    1. Support services

      1. Clerical staff

        1. Administrative assistant

        2. Receptionist

        3. Medical secretary

      2. Financing/accounting

      3. Patient transportation services

      4. File room/image management

      5. Information systems manager

        1. RIS

        2. PACS




    1. Patient services




    1. Educational personnel

      1. Educational/program director

      2. Clinical coordinator

      3. Didactic instructor

      4. Clinical instructor

      5. Clinical staff

      6. Students




  1. Accreditation

    1. Definition




    1. Programmatic accreditation

      1. Joint Review Committee on Education in Radiologic Technology (JRCERT)




    1. Institutional accreditation

      1. Degree granting regional (college/proprietary)

      2. Health care organization(s)

        1. The Joint Commission

        2. American Osteopathic Association

        3. American College of Radiology (ACR)

        4. Intersocietal Accreditation Commission (IAC)

        5. American Medical Association (AMA)




    1. Regional Continuing Education Evaluation Mechanism (RCEEM)

      1. American College of Radiology (ACR)

      2. American Healthcare Radiology Administrators (AHRA)

      3. American Institute of Ultrasound in Medicine (AIUM)

      4. American Society of Nuclear Cardiology (ASNC)

      5. American Society of Radiologic Technologists (ASRT)

      6. Canadian Association of Medical Radiation Technologists (CAMRT)

      7. Radiological Society of North America (RSNA)

      8. Society of Diagnostic Medical Sonography (SDMS)

      9. Section for Magnetic Resonance Technologists (SMRT)

      10. Society of Nuclear Medicine Technologist Section (SNMTS)

      11. Society for Vascular Ultrasound (SVU)




  1. Regulatory Agencies

    1. Federal




    1. Reimbursement




    1. State




  1. Professional Credentialing

    1. Definition

      1. Certification

      2. Registration

      3. Licensure




    1. Agencies

      1. National

        1. American Registry of Radiologic Technologists (ARRT)

        2. Nuclear Medicine Technology Certification Board (NMTCB)

        3. American Registry of Diagnostic Medical Sonographers (ARDMS)

        4. American Healthcare Radiology Administrators (AHRA)/Radiology Administration Certification Commission (RACC)

        5. State – licensure




  1. Professional Organizations

    1. Purpose, function, activities




    1. Local organizations




    1. State organizations




    1. National organizations

      1. American Society of Radiologic Technologists (ASRT)

      2. American Healthcare Radiology Administrators (AHRA)

      3. Association of Collegiate Educators in Radiologic Technology (ACERT)

      4. Association of Educators in Imaging and Radiologic Sciences Inc. (AEIRS)

      5. Section for Magnetic Resonance Technologists (SMRT)

      6. American Registry for Diagnostic Medical Sonographers (ARDMS)

      7. Nuclear Medicine Technology Certification Board NMTCB)

      8. Magnetic Resonance Managers Society (MRMS)

      9. American College of Healthcare Executives (ACHE)




    1. International

      1. International Society of Radiographers and Radiological Technologists (ISRRT)

      2. International Society for Magnetic Resonance in Medicine (ISMRM)




    1. Related associations and organizations

      1. American Board of Radiology (ABR)

      2. ACR

      3. RSNA

      4. AMA




  1. Professional Development and Advancement

    1. Continuing education and competency programs

      1. Definition

      2. Rationale/benefits

      3. Requirements

        1. ARRT

        2. State

        3. Institutional




    1. Continuing education opportunities

      1. Postprimary certification

      2. Collegiate/educational programs

      3. Self-learning activities

      4. Professional conferences




    1. Employment considerations

      1. Geographic mobility

      2. Economic factors

      3. Manpower issues




    1. Advancement opportunities

      1. Education

        1. Administration

        2. Faculty

          1. Didactic

          2. Clinical

      1. Administration

      2. Physics

      3. Research

      4. Industrial

      5. Medical informatics

      6. Sales/applications


General Education

General education is an integral part of MR technologist development. The content assists in developing the communication, human diversity, scientific inquiry, critical-thinking and judgment skills required to perform the responsibilities of an entry-level MR technologist. Knowledge gained from general education serves to enhance the content and application of the MR curriculum.


General education provides personal enrichment and exploration outside the confines of the technical curriculum. The general education content objectives in this curriculum purposely are labeled “global content objectives” to give program officials flexibility in determining specific college-level credit-bearing course work that will satisfy these objectives. A program must offer a minimum of 15 credit hours of general education course work. The minimum 15 credit hours must include Communications and Mathematics/Analytical Studies. For the remaining general education credits, institutions are encouraged to require courses from different categories, such as the Social/Behavioral Sciences, Natural Sciences, Computing or Humanities/Fine Arts, to insure a diversified educational experience.

Required post-secondary general education gained through college credit bearing course work must meet the global content objectives listed below:


Required Post-secondary General Education:

• Communications

• Write, read, speak and listen critically

• Develop the ability to perceive, gather, organize and present information

• Locate, evaluate and synthesize material from diverse sources and points of view
• Mathematical/Logical Reasoning

Develop skills in analysis, quantification and synthesis

• Apply problem-solving or modeling strategies
• Arts and Humanities

• Develop knowledge and understanding of the human condition

• Demonstrate respect for diverse populations

• Develop an understanding of ethics and the role they play in personal and professional lives

• Recognize and critically examine attitudes and values
• Information Systems

• Develop knowledge base for using computerized systems

• Use technology to retrieve, evaluate and apply information
• Social/Behavioral Sciences

• Adapt interactions to meet cultural/psychological needs of people

• Develop an understanding of individual and collective behavior

• Promote the development of leadership skills

• Develop capacity to exercise responsible and productive citizenship

• Function as a public-minded individual


• Natural Sciences

• Understand and apply scientific method

• Make informed judgments about science-related topics

• Develop a scientific vocabulary

MR Imaging Procedures

Description

This content provides the student with imaging techniques related to the central nervous system (CNS), neck, thorax, musculoskeletal system and abdominopelvic regions. The content covers specific clinical application, coils that are available and their use, considerations in the scan sequences, specific choices in the protocols (e.g., slice thickness, phase direction and flow compensation), and positioning criteria. Anatomical structures and the plane that best demonstrates anatomy are discussed as well as signal characteristics of normal and abnormal structures.


Rationale

This content outlines the critical criteria relevant to acquiring high-quality images of various anatomical regions. Due to different considerations for the various regions in the body, imaging protocols vary. The student studies the variations in imaging parameters for specific body regions and the resultant effect on signal characteristics and the anatomy represented. Evaluation criteria for determining the quality of images provides MR technologists with a better understanding of what constitutes a high-quality image. In a competency-based educational system, this content is completed prior to competency examinations.


Prerequisites

  1. MR physical principles. Overview of imaging parameters and terminology, safety and patient care procedures.

  2. Sectional anatomy. Human anatomy in axial, sagittal and coronal planes. Other planes are discussed when appropriate to particular anatomy. Correlating anatomy to MR images. (May take place simultaneously with Imaging Procedures.)

  3. Pulse sequences and image formation. Physical principles of magnetic resonance, relaxation characteristics, signal production, pulse sequences, signal-to-noise and parameter influences, fluid flow compensation and demonstration, and image formation.

  4. MR instrumentation. Equipment used to produce the MR signal and image, specific coil designs, quality assurance measures and equipment safety


Objectives

Upon completing the clinical education, students will be able to:




  1. State the coils available for MR and their specific application.

  2. Describe considerations in designing an imaging protocol and state the application of protocols in specific situations.

  3. Demonstrate proper patient screening.

  4. Demonstrate knowledge of scanning menus, archival procedures and display functions.

  5. Demonstrate proper windowing levels and widths.

  6. Demonstrate proper use of MR-safe monitoring devices.

  7. Demonstrate how to prepare contrast materials and use MR injectors.

  8. State positioning criteria for different areas of the body.

  9. State advantages and disadvantages of axial, sagittal, coronal and oblique images (i.e., what structures are best demonstrated).

  10. Describe common pulse sequences used to evaluate the different areas of the body.

  11. State tissue signal characteristics of anatomical structures with and without contrast.

  12. Explain the use of contrast media in evaluating pathology.

  13. Describe common artifacts that occur during imaging.

  14. Describe the differences between adult and pediatric pulse sequences in MR.

  15. Describe the differences in tissue signal characteristics between adult and pediatric examinations.

  16. Describe the criteria for imaging windows for different areas of the body.

  17. Describe the MR characteristics of blood as seen on arterial and venous magnetic resonance angiography (MRA).

  18. Identify how field strength affects the ability to visualize select pathology.

  19. Describe the MR tissue characteristics of select pathological processes.

  20. Discuss saturation pulses, which help to identify arteries and veins.

  21. Evaluate images for appropriate positioning, anatomy, pulse sequences and overall quality.

  22. Identify the common indications and common pathology for the central nervous system, soft tissue structures of the head and face, orbit, nasopharynx, oropharynx, neck, and spine, the abdomen, the musculoskeletal system, the soft tissue pelvis that includes the male and female reproductive systems, the chest, the heart, mediastinum, the brachial plexus and breast exams.

  23. Demonstrate effective communication skills with patients, their family members and staff.

  24. Demonstrate MR safety and protective practices associated with MR examinations.

  25. Cite the components of the central nervous system, including the brain and spinal cord.

  26. Identify the normal anatomic location of the components of the central nervous system, including the brain and spinal cord, on diagrams and scan images.

  27. Describe the normal MR tissue characteristics of the components of the brain and spine.

  28. Explain the principles of MR spectroscopy.

  29. Discuss the current and future development of in vivo spectroscopic diagnosis of disease processes.

  30. Discuss the hardware requirements for MR spectroscopy.

  31. Describe and discuss the various imaging planes and pulse sequence parameters that maximize the diagnostic value of an MR scan of the central nervous system including the brain and spine.

  32. Describe the normal MR tissue characteristics of the soft tissue structures of the head and face, orbit, nasopharynx, oropharynx, neck and spine.

  33. Describe the effects of blood flow characteristics on image quality, including laminar turbulent, vortex and stationary or stagnant flow.

  34. Identify common pathology of the soft tissue structures of the head and face, orbit, nasopharynx, oropharynx, neck and spine on MR images.

  35. Identify common vascular lesions on MRA images.

  36. Identify the normal anatomic location of the soft tissue structures of the head and face, orbit, nasopharynx, oropharynx, neck, spine and vasculature of the neck on scan images.

  37. Review the components of the abdomen.

  38. Identify the normal anatomic location of the abdomen components on diagrams and scan images.

  39. Describe the normal MR tissue characteristics of the components of the abdomen.

  40. Describe and discuss imaging planes and pulse sequence parameters that maximize the diagnostic value of an MR scan of the abdomen.

  41. Discuss the different types of MRA procedures, when they are used and the characteristics of the resultant images.

  42. Identify common pathology of the abdomen on MR images.

  43. Review the anatomy of the musculoskeletal system.

  44. Identify the normal anatomic location of musculoskeletal system components on diagrams and scan images.

  45. Describe and discuss the imaging planes and pulse sequencing parameters that maximize the diagnostic value of an MR scan of the upper extremity, lower extremity, shoulder girdle and pelvic girdle.

  46. Identify common pathological conditions seen in the musculoskeletal system on MR images.

  47. Review the components of the soft tissue pelvis including the male and female reproductive systems.

  48. Identify the normal anatomic location of the components of the male and female pelvis on diagrams and scan images.

  49. Describe the normal MR tissue characteristics of the components of the male and female pelvis.

  50. Describe and discuss imaging planes and pulse sequence parameters that maximize the diagnostic value of an MR scan of the pelvis including the male and female reproductive systems.

  51. Identify common pathology of the pelvis, including the male and female reproductive systems and their tissue characteristics on MR images.

  52. Review the components of the chest, heart, mediastinum, brachial plexus and breast.

  53. Identify the normal anatomic location of the components of the chest, heart, mediastinum, brachial plexus and breast on diagrams and scan images.

  54. Describe the normal MR tissue characteristics of the components of the chest, heart, mediastinum, brachial plexus and breast.

  55. Describe and discuss imaging planes and pulse sequence parameters that maximize the diagnostic value of an MR scan of the chest, heart, mediastinum, brachial plexus and breast.

  56. Discuss the various saturation techniques used in breast imaging.

  57. Identify common pathology of the chest, heart, mediastinum, brachial plexus and breast on MR images.


Content

  1. Imaging Considerations

    1. Coil types




    1. Pulse sequences




    1. Parameters (phase/frequency direction)




    1. Flow and motion effects




    1. Motion reduction techniques




    1. Contrast agents




    1. Artifacts




    1. Windowing




  1. Imaging Planes

    1. Positioning criteria




    1. Axial, sagittal, coronal

      1. Movement and direction

        1. Inferior – Superior

        2. Left – Right

        3. Posterior – Anterior

        4. Oblique




    1. Anatomy best demonstrated




    1. Slice thickness




  1. Signal Characteristics

    1. Proton density vs. T1-weighted vs. T2-weighted of normal anatomy




    1. Spin-echo vs. gradient-echo




    1. With and without contrast agents




  1. General Considerations

    1. Evaluation of MR orders

      1. Patient identification

      2. Verification of procedure(s) ordered

      3. Establishes Patient rapport

        1. Explains procedure

        2. Proper screening of patient

          1. Screening for metal on patient

          2. Screening for metal inside of patient

          3. Screening for physical indications that may contraindicate exam and/or hinder exam results

          4. Determines any contrast contraindications

      4. Patient Preparation

        1. Appropriate disrobing and gowning

        2. Removing items that are contraindicated in the MRI suite and/or may cause artifacts

      5. Room preparation

        1. Clean and organized exam environment maintained

        2. Necessary supplies and accessory equipment available

      6. Patient assistance

      7. Patient monitoring

      8. Exam evaluation

      9. Patient dismissal




  1. Considerations for Routine MR Procedures

    1. Patient instructions




    1. Patient positioning






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