MRI teqnique Revision Dr / Kareem El Akhal

A) MCQ
1) Which of the following is considered an “active” implant?
a) Implanted infusion pump
b) Magnetic dentures
c) Cerebrospinal fluid shunt with a programmable valve
d) Swan-Ganz catheter
2) Which of the following is not currently acceptable terminology for the
safety of a device in MRI?
a) MR Unsafe
b) MR Conditional
c) MR Compatible
d) MR Safe
3) Concerning safety labeling of devices, which of the following statements
is true?
a) A large silicone implant cannot be rated as MR Safe if it contains a single tiny
non-ferromagnetic clip deep inside it.
b) An MR Conditional device is safe to scan provided the majority of specified
conditions are followed.
c) Any implant containing a permanent magnet is MR Unsafe.
d) If an implant does not undergo movement or heating under rigorous ASTM
testing, it can be rated MR Safe.
4) Which of the following pacemaker scenarios would invoke the greatest
MR safety concern?
a) Scanning a patient with retained epicardial leads
b) Scanning a patient with a temporary transvenous pacemaker
c) Scanning a patient within 6 weeks of placement
d) Scanning a patient with a legacy/non-conditional pacemaker
 MRI teqnique Revision Dr / Kareem El Akhal

5) Concerning acoustic noise due to gradients, which statement is false?

a) It is due to vibration of the gradient coils due to rapidly switched electrical
currents.
b) Acoustic noise in MRI may be temporarily uncomfortable, but it poses no real
risk to hearing.
c) Echo-planar sequences are especially loud.
d) All patients and accompanying family members should be required to use ear
protection.
6) Which of the following physical effects is not the result of gradient
activity?
a) Acoustic noise
b) Vertigo
c) Peripheral nerve stimulation
d) Metal implant heating
7) How many sets of gradient coils does the typical MRI scanner use?
a) 1 b) 2 c) 3 d) 4
8) All of the following are trade-offs for the use of low SAR RF-pulses except
b) More slice cross-talk
c) Longer minimum TE values
d) Longer imaging time
e) Fewer slices for a given TR
9) Altering the following image acquisition parameters by themselves will
have no effect on SAR, except for
a) Number of signals averaged
b) Slice width
c) Receiver bandwidth
d) Use of parallel imaging
e) RF pulse shape or duration
 MRI teqnique Revision Dr / Kareem El Akhal

10) Concerning the thermal effects of RF-irradiation as used in MRI, which

statement is true?
a) T1 relaxation with energy transfer from nuclei to the lattice makes a
significant contribution to tissue heating.
b) The RF magnetic and electric fields point in opposite directions.
c) The coexistent electric field (E), not the magnetic field (B1) per se, is
responsible for nearly all the RF-thermal effects in MRI.
d) About half of transmitted RF power is absorbed by nuclei.
11) Concerning the use of RF-transmit body coils
a) They are required for clinical spine imaging
b) They are required for clinical head imaging
c) They are required for clinical knee imaging
d) They are required for phosphorus spectroscopy of the calf muscle
12) The torque on an unsaturated metal object brought near a cylindrical
bore MR scanner is maximal
a) When first entering the door of the MR scanner room
b) At scanner isocenter in the middle of the bore
c) At scanner isocenter at the edge of the bore
d) Just inside the edge of the magnet bore opening
13) Translational force on an unsaturated metal object brought near a
cylindrical bore MR scanner is maximal
a) When first entering the door of the MR scanner room
b) At scanner isocenter in the middle of the bore
c) At scanner isocenter at the edge of the bore
d) Just inside the edge of the magnet bore opening
14) To avoid auditory damage during MRI, all patients should be offered:
a) Headphones b) Earplugs
c) Anti-noise devices d) All the above.
 MRI teqnique Revision Dr / Kareem El Akhal

15) In preparation for the MRI examination, patients should be encouraged

to:
a) Wear their own clothing to feel "at home" with the study
b) Wear a wrist watch so they are aware of the length of the exam
c) Keep their hearing aid in to hear the commands and requests of the
technologist
d) Change into a hospital gown or a scrub suit provided by the imaging center
and known to be MR safe (containing no metallic components such as snaps
and/or zippers)
16) If a patient has a cardiac arrest during MR imaging, the technologist
should:
a) Call a code and direct them to the scan room
b) Quench the magnet
c) Begin CPR while the patient remains within the MR scan room
d) Begin CPR while transferring the patient out of the scan room
17) When scanning patients to rule out brain tumors, what is the weighted
images acquired to evaluate the extent of the lesion, after injection of
gadolinium?
a) T1
b) T2
c) Proton density
d) T2* gradient echo
18) Inversion-recovery (IR) sequences are helpful to
a) Improve T2 weighting
b) Improve signal-to-noise (SNR)
c) Shorten imaging time
d) Improve tissue contrast
 MRI teqnique Revision Dr / Kareem El Akhal

19) which of the following appears hypointense in post IV contrast MRI

examination of the brain?
a) Frontal sinus mucosa
b) Basal ganglia
c) Pituitary gland
d) Pineal gland
20) Which of the following is the predominant biologic effect of radio-
frequency fields?
a) Induced voltages
b) Hypothermia
c) Tissue heating
d) Magnetic hemodynamic effect
21) Which of the following factors would be most appropriate to produce a
TI-weighted image?
a) TR = 2,000, TE = 20.
b) TR = 500, TE = 100.
c) TR = 500, TE = 20.
d) TR = 200 TE = 100.
22) Axial landmark is at level of
a) eye brows b) external auditory meatus
c) middle of patients d) none
23) Coronal landmark at level of
a) glabella b) external auditory meatus
c) at level of nose d) none
24) Longitudinal landmark at level of
a) at level of nose b) glabella
c) external auditory meatus d) none
 MRI teqnique Revision Dr / Kareem El Akhal

25) Pituitary is best visualised by

a) coronal
b) saggital
c) axial
d) both a. b
26) Evaluation of neck vessel
a) coronal
b) axial
c) saggital
d) none
27) Spin echo compared to fast spin echo is
a) t1short, T2 short
b) t1long, T2 short
c) long T1. Long t2
d) all of above
28) The wall of Mri scanner room is lined with
a) concrete
b) zinc
c) lead
d) all of above
29) Faraday cage is lined with
a) steel b) copper
c) Concrete d) none
NB
Any emergency (technical-Medical) remove patients first

frostbite
Quench may cause
hypothermia
 MRI teqnique Revision Dr / Kareem El Akhal

B) Written questions
1) List three intrinsic parameters for MRI imaging.
………………………………………………………………………………………
………………………………………………………………………………………
……………………………………………………………………………………….
2) List three extrinsic parameters for MRI imaging.
………………………………………………………………………………………
………………………………………………………………………………………
………………………………………………………………………………………
3) Enumerate sequences in case of stroke
………………………………………………………………………………………
………………………………………………………………………………………
4) Indications of gadolinium in.brain
………………………………………………………………………………………
………………………………………………………………………………………
C) Very important Case
Multiple sclerosis. Sagital FLAiR

Convusion ( epilepsy , seizures ) control FLAiR

Convulsion in Pediatric T1 inversion recovery

FLAiR mainly Used in brain, cervical spinal cord

STiR mainly used in Musculoskeletal

T1: hypointense
Hemangioma
T2: Hy perintense