MAGNETIC RESONANCE IMAGE

SRTLE: A survival guide

Prepared by
HS-NEGAN

January 8, 2022

1st version
Magnetic Resonance image

SECTION I: Physics and Instrumentation

• Atomic structure

The atom consists of a central nucleus and orbiting electrons

The most abundant atom in the human body is hydrogen

• Motion in the atom

Three types of motion are present within the atom :

1. Electrons spinning on their own axis

2. Electrons orbiting the nucleus
3. The nucleus itself spinning about its own axis.

1|Page HS- NEGAN |

Magnetic Resonance image

• MR- active nuclei

characterized by their tendency to align their axis of rotation to an applied magnetic field.

✓ The law of electromagnetic induction refers to the connection between electric and
magnetic fields and motion
✓ Faraday’s law determines that a moving electric field produces a magnetic field and
vice versa.

MR-active nuclei have a net electrical charge (electric field) and are spinning (motion),
and, therefore, automatically acquire a magnetic field.

• The hydrogen nucleus

The isotope of hydrogen called protium is the most commonly used MR-active nucleus in
MRI.

✓ It is used because hydrogen is very abundant in the human body and because the
solitary proton gives it a relatively large magnetic moment

2|Page HS- NEGAN |

 Magnetic Resonance image

• Alignment

1. Parallel alignment:
Alignment of magnetic moments in the same direction as the
main B0 field
2. Antiparallel alignment: 1. Low-energy nuclei do not have enough energy to
Alignment of magnetic moments in the opposite direction to oppose the main B0 field
the main B0 field . 2. High-energy nuclei do have enough energy to
oppose the main B0 field.

• Net magnetic vector ( NMV )The total magnetic moment of the nucleus is the
vector sum of all the magnetic moments of protons in the nucleus.

3|Page HS- NEGAN |

Magnetic Resonance image

Precession AndPrecessional (Larmor) Frequency

In addition, magnetic moments of MR-active nuclei have different precessional

frequencies at different field strengths.

For hydrogen, for example:

1. At 1.5 T, the Precessional frequency is 63.87 MHz (42.58 MHz × 1.5 T).
2. At 1.0 T, the Precessional frequency is 42.57 MHz (42.58 MHz × 1.0 T).
3. At 0.5 T, the Precessional frequency is 21.29 MHz (42.58 MHz × 0.5 T).

Phase::refers to the position of magnetic moments on their precessional path at any

moment in time.

1. Out of phase or incoherent: magnetic moments of hydrogen are at different places

on the precessional path at a moment in time.
2. In phase or coherent:magnetic moments of hydrogen are at the same place on the
precessional path at a moment in time.

4|Page HS- NEGAN |

Magnetic Resonance image

Resonance
✓ Resonance is a phenomenon that occurs when an object is exposed to an oscillating
perturbation that has a frequency close to its own natural frequency of oscillation.
✓ Resonance is achieved by transmitting an RF pulse called an RF excitation pulse.

Pulse timing parameters

The TR :

✓ the time from the application of one RF excitation pulse to the application of the next RF
excitation pulse for each slice and is measured in millisecond.
✓ The TR thus determines the amount of T1 relaxation that has occurred when signal is read.

The TE :

✓ the time from the application of the RF excitation pulse to the peak of signal induced in the
receiver coil and is also measured in millisecond.
✓ TE thus controls the amount of T2 relaxation that has occurred when signal is read .

5|Page HS- NEGAN |

Magnetic Resonance image

Image weighting and contrast

Relaxation therefore results in recovery of magnetization in the longitudinal plane and
decay of coherent magnetization in the transverse plane.

1. The recovery of longitudinal magnetization is caused by a process termed T1

recovery.
2. The decay of coherent transverse magnetization is caused by a process termed T2
decay.

T1 weighting
✓ TR controls the amount of T1 contrast.
✓ For T1 weighting, the TR must be short and the TE must also be short
✓ T1-weighted images are used for anatomy and pathology postcontrast enhancement

T2 weighting
✓ TE controls the amount of T2 contrast.
✓ For T2 weighting, the TE must be long and the TR must also be long
✓ T2-weighted images are used for pathology

Proton density weighting

✓ A long TR combined with a short TE
✓ PD-weighted images are used for anatomy and pathology

6|Page HS- NEGAN |

Magnetic Resonance image

Spin-echo pulse sequences

Fast inversion recovery )STIR and FLAIR)

This sequence is typically used to suppress the signal from either

✓ CSF - FLAIR
✓ Fat – STIR

USES:

STIR:is an extremely important sequence in musculoskeletal imaging because normal

bone, which contains fatty marrow, is suppressed, and lesions within bone such as bone
bruising and tumors are seen more clearly

FLAIR : is used in brain and spine imaging to see periventricular and cord lesions more
clearly because high signal from CSF that lies adjacent is nulled.

It is especially useful in visualizing

1. multiple sclerosis plaques

2. acute subarachnoid hemorrhage
3. meningitis.

multiple sclerosis plaques

Flair will be suppress ( nullifies ) signal

intensity from pure Fluid ( CSF ) and keep
MS lesion because it’s not purefluid like
CSF

7|Page HS- NEGAN |

Magnetic Resonance image

Gradient-echo pulse sequences

Gradient-echo sequences use gradients to rephase the magnetic moments of hydrogen nuclei and
usually flip angles less than 90°.

Both of these strategies permit a shorter TE and TR than in spin-echo pulse sequences

Although faster than RF rephasing, inhomogeneities are not compensated for in this type of
sequence. Magnetic susceptibility artifacts therefore increase

Spatial Encoding
Gradient Axes - There are three gradient coils situated within the bore of the magnet

The z gradient- (from head to foot of the patient).

The y gradient- (from the back to the front of the patient).
The x gradient- (from right to left of the patient)

8|Page HS- NEGAN |

 Magnetic Resonance image
1. High signal-to-noise ratio (SNR)
2. Good contrast-to-noise ratio (CNR)
Protocol optimization 3. High spatial resolution
4. Short scan time.

1. Signal-to-noise ratio (SNR)

The SNR is defined as the ratio of the amplitude of signal received to the average
amplitude of the background noise.

✓ Noise represents frequencies that exist randomly in space and time.

The position of the coil is also very

important for maximizing SNR.

To induce maximum signal, the coil

must be positioned in the transverse
plane perpendicular to B0.

2. Contrast-to-noise ratio (CNR)

CNR is defined as the difference in the SNR between two adjacent areas

✓ The most critical factor affecting image quality.

It is important to maximize the CNR so that pathology is clearly seen as distinct from
normal anatomy or so that one structure is clearly seen next to another

1. CNR is improved by increasing the signal from pathology or structures that are
important to see
2. CNR is improved by decreasing signal from normal structures

9|Page HS- NEGAN |

Magnetic Resonance image

3. Spatial resolution

Spatial resolution is the ability to distinguish between two points as separate and distinct,
and is controlled by the voxel size.

✓ Small voxels result in high spatial resolution, as small structures are easily
differentiated. Large voxels result in low spatial resolution,

In large voxels, individual signal intensities are averaged together and not represented as
distinct within the voxel. This is calledpartialvoluming

The voxel size is affected by:

1. slice thickness
2. FOV
3. number of pixels or image matrix

4. Scan time
The scan time is the time to complete data acquisition or the time to fill k-space

10 | P a g e HS- NEGAN |
Magnetic Resonance image

Chapter 8 Artifact

11 | P a g e HS- NEGAN |
Magnetic Resonance image

Chapter 9 Instrumentation:
All MRI scanners must therefore incorporate the following:

1. A powerful magnet to create magnetic field

2. A shim system to improve the homogeneity of the magnetic field
3. A gradient system to create linear slopes in field strength in any direction
4. An RF transmission system to generate and transmit pulses of electromagnetic radiation
5. A set of RF receiver coils to detect signal from the patient
6. A computer system to allow input of parameters and displaying images
7. A computer subsystem capable of coordinating the application of RF pulses and gradientsand
reconstructing the acquired data into images and storing them.

Magnet shielding - Shielding is achieved in one of two ways:

1. passive shielding : which requires the scanner to be surrounded by large steel plates.
2. active shielding :which uses additional solenoid magnets.

Shim system

✓ The function of the shim system is to ensure homogeneity of the magnetic field within the
imaging volume.

12 | P a g e HS- NEGAN |
Magnetic Resonance image

RF receiver coils

Faraday’s law :
If a receiver coil placed in the area of a moving magnetic field a voltage is induced in the coil
This voltage called MR signal

RF coils :
Used to transmit the excitation pulse and collect the RF signal form hydrogen proton .

1- Volume coils – large coil (body coil )

Better RF homogeneity than surface coils

2- surface coils – small coil ( rectal coil )

Used to improve the SNR & single intensity

3- phase array coils – multiple independent channels

Consist of multiple coils and receivers .

Has the advantages of both a surface coil (improved SNR) and those of the larger volume coils
(increased coverage)

Therefore the phase array coils can be used either to

1. Examine large areas such as the entire length of the spinal cord,
2. Improve signal uniformity and intensity in small areas such as the breast

13 | P a g e HS- NEGAN |
Magnetic Resonance image

Magnetism

The types of magnetism are defined in the following sections :

Paramagnetism

Paramagnetic substances add to (increase) the applied magnetic field

Paramagnetic elements including: calcium, oxygen, and many metals including aluminum,
titanium, and platinum.

Diamagnetism

Diamagnetic substances slightly oppose (decrease) the applied magnetic field

Diamagnetic elements including : including hydrogen and helium, and quite a few metals such as
gold, silver, and lead.

Ferromagnetism

Ferromagnetic substances are strongly attracted to, and align with the applied magnetic field
Causes geometric distortion of images in MRI patients with ferromagnetic implants.
There are just four naturally occurring elements that are ferromagnetic at a normal ambient
temperature :iron , nickel , cobalt , gadolinium.

14 | P a g e HS- NEGAN |
Magnetic Resonance image

SECTION II: Patient Care

safety zones

The aim of using zones is to prevent unauthorized access to areas where the high magnetic field
may cause injury or death. The ACR defines the zones as follows:

Zone I
all areas that are freely accessible to the general public. This area is typically out- side the MR
environment itself .
Zone II
It is in Zone II that the answers to MR screening questions, patient histories, medical insurance
questions, etc. are typically obtained.”
Zone III
The region in which free access by unscreened non-MR personnel or ferromagnetic objects or
equipment can result in serious injury or death.
Zone IV.
The physical confines of the room within which the MR scanner is located.

1. MR safe :An item that poses no known hazards in all MR imaging environments
2. MR conditional :An item that has been demonstrated to pose no known hazards in a specified
MR environment with specified conditions of use.
3. MR unsafe :An item that is known to pose hazards in all MR environments.
4. NO access with cardiac pacemaker.

15 | P a g e HS- NEGAN |
Magnetic Resonance image

All centres should have a proper screening policy which includes checking for:

a. Pacemakers - Cardiac pacemakers have long been considered a contraindication in MRI

b. aneurysm clips .
c. intra-ocular foreign bodies
d. metal devices or prostheses
e. cochlear implants
f. spinal implants and stimulators
g. possibility of early pregnancy
h. removal of all jewellery, credit cards, money, watches, etc.

16 | P a g e HS- NEGAN |
Magnetic Resonance image

SECTION IIV: Imaging Procedures and Protocols

Head

Axial/oblique FLAIR/EPI

This sequence provides a rapid acquisition with suppression of CSF signal. It may be useful when
examining peri-ventricular or cord lesions such as MS plaques

Axial/oblique GRE/EPI T1/T2

Due to sensitivity to magnetic susceptibilities, these sequences demonstrate haemorrhage better

than SE and FSE.

Axial DWI

This sequence is important in the investigation of early stroke.

Temporal lobes

Coronal 3D incoherent (spoiled) GRE T1 For hippocampal measurements.

Hippocampal atrophy is presently considered the most sensitive indicator of hippocampal disease
especially in Alzheimer’s disease and schizophrenia

Posterior fossa and internal auditory meatus

Pituitary fosssa - As anatomical detail and contrast enhancement are important, an incoherent
(spoiled) GRE sequence is required.

The high-resolution technique and/or the 3D FSE (or BGRE) sequence often diagnoses or rules
out an acoustic neuroma without contrast.

Thyroid and parathyroid glands - Coronal SE/FSE T1

Axial/coronal SE/FSE T1 - Slices are displaced inferiorly for retrosternal goitre

Axial/coronal SE/FSE PD/T2 - Tissue suppression/STIR is sometimes required for the

parathyroid glands.

17 | P a g e HS- NEGAN |
Magnetic Resonance image

18 | P a g e HS- NEGAN |
Magnetic Resonance image

19 | P a g e HS- NEGAN |
Magnetic Resonance image

1. Which of the following involves emission of a signal from the patient?

a) CT
b) MRI
c) Diagnostic ultrasound
d) Projection radiography

2. A patient is evaluated for brain tumor by a series of magnetic resonance images.

Contrast media is injected to demonstrate the extent of the lesion. Which of the
following pulse sequence will best demonstrate it?

a) PD weighted
b) T2 weighted
c) T1 weighted
d) T2* weighted

3. Which of the following most likely reduces the phase aliasing artifact in the magnetic
resonance imaging?

a) Changing the applied echo time

b) Using a spin echo pulse sequence
c) Increasing the gap between slices
d) Increasing FOV in the phase direction

4. Which of the following Repetition Time (TR) and Echo Time (TE) will produce a
gradient echo T1 weighted image?

a) Long TR, short TE, large flip angle

b) Long TR, long TE, small flip angle
c) Short TR, short TE, large flip angle
d) Short TR, short TE, small flip angle

5. Which of the following MRI system components reconstructs the images using the
Fourier transform?

a) Receiver amplifier
b) Array processor
c) Host computer
d) Gradient coil

20 | P a g e HS- NEGAN |
Magnetic Resonance image

6. Which of the following rotation occurs on stimulation of hydrogen nuclei by an external

magnetic field?

a) Swinging
b) Resonance
c) Relaxation
d) Precession

7. Certain magnetic resonance images appear with truncation artifacts. Which of the
following is the most likely correction?

a) Increase the field of view

b) Decrease the field of view
c) Increase the number of slices
d) Increase the phase encoding matrix

8. A T1 and T2 MRI were obtained for a patient complaining of severe back pain. The
Neurologist is concerned about presence of cord lesion and request additional images.
Which of the following additional pulse sequence should be performed to confirm the
diagnosis?

a) Time of flight magnetic resonance angiography

b) Phase contrast magnetic resonance angiograph
c) Fluid Attenuated Inversion Recovery (FAIR)
d) Short Tau Inversion Recovery (STIR)

9. Which of the following Radio Frequency (RF) antenna effects cause?

a) Better reception on your car radio

b) RF interference artifacts
c) Thermal injury
d) Flames

10. Which of the following plates could be used to surround the MRI room in order to
accomplish the passive magnetic shielding?

a) Copper
b) Lead
c) Steel
d) Iron

21 | P a g e HS- NEGAN |
Magnetic Resonance image

11. MRI scan room walls are lined to accomplish radio frequency shielding which of the
following is the most likely material?

a) Iron
b) Lead
c) Steel
d) Cooper

12. Respiratory monitoring is done in sedated patients during magnetic resonance imaging.
Which of the following is the most likely method?

a) ECG gating
b) Pulse oximeter
c) Peripheral gating
d) Verbal communication

13. Which of the following is the standard dose of gadolinium (mL/kg of body weight) for
imaging of the central nervous system?

a) 0.1 mL/kg
b) 0.2 ml/kg
c) 1.0 mL/kg
d) 2.0 mL/kg

14. Which of the following is the routine patient position in MRI procedure?

a) Prone
b) Supine
c) Right lateral decubitus
d) Left lateral decubitus

15. Which of the following is the normal power of magnetic field used in MRI?

a) 0.15 T
b) 1.5 T
c) 15 T
d) 150 T

16. One Tesla (1tesla) is equivalent of?

a) 10 gauss
b) 100 gauss
c) 1000 gauss
d) 10000 gauss

22 | P a g e HS- NEGAN |
Magnetic Resonance image

17. Which of the following factors determines the proton resonant frequency of tissue in
magnetic resonance imaging?

a) Applied post processing technique

b) Type of radiofrequency coil used
c) Direction of the magnetic field
d) Strength of the magnetic field

18. Which of the following is most likely to track motion during MRI cardiac triggering?

a) Pulse oximeter
b) Electrocardiogram
c) Sphygmomanometer
d) Automatic power injector

19. Which of the following the term "T1" in magnetic resonance imaging is used for?

a) Time repetition
b) Echo delay time
c) Time relaxation
d) Radiofrequency

20. Which of the following should be done to reduce the scan time in MRI imaging?

a) Use the shortest TR possible

b) Use the highest TR possible
c) Use special RF coils
d) Use the available TE

21. Which of the following is absolute contra-indication for MRI imaging?

a) Pregnancy
b) Sickle cell crisis
c) Cardiac pacemaker
d) Head injury patients

22. Which of the following is used to correct the field inhomogeneity in magnetic resonance
imaging?

a) Shielding
b) Shimming
c) Triggering
d) Warming

23 | P a g e HS- NEGAN |
Magnetic Resonance image

23. Which of the following magnetic resonance image sequence presents fat as bright and
water as dark?

a) T1 weighted
b) T2 weighted
c) T2* weighted
d) Proton density

24. Which of the following knee rotations help to obtain a sagittal view for the anterior
cruciate ligament in magnetic resonance imaging?

a) 0° or 5° internal rotation
b) 0° or 4° external rotation
c) 6-10° internal rotation
d) 5-10° external rotation

25. Which of the following is the appearance of infarction on brain MRI T1 and T2
weighted images?

a) Dark on T1/ dark on T2

b) Bright on T1/ dark on T2
c) Bright on T1/ bright on T2
d) Dark on T1/ bright on T2

26. Which of the following MR image will be produced by using the following technique
parameters (800 ms Repetition Time (TR) 15-35 ms Echo Time (TE) 20° Flip Angle )?

a) T2 GRE
b) PCMRA
c) T1 weighted
d) Proton density

27. Which of the following is the most likely site if technologists suffer injuries during MRI
procedures?

a) Head and neck

b) Lumbosacral spine
c) Lower leg and feet
d) Arms and shoulders

24 | P a g e HS- NEGAN |
Magnetic Resonance image

28. Which of the following substances when placed in the presence of an external magnetic
field show strong attraction, alignment and retain magnetization even after the applied
field has been removed?

a) Plastic
b) Diamagnetic
c) Para magnetic
d) Ferromagnetic

29. Which of the following is most likely to interact strongly with magnets in MRI imaging?

a) Nickel
b) Copper
c) Titanium
d) Aluminium

30. Which of the following is the effect of using gadolinium-based contrast media on the
scanned tissue relaxation times?

a) Increases T2 relaxation times

b) Decreases T1 relaxation times
c) Increases T1 relaxation times
d) less effect on T1 or T2

31. The liquids used to cool the wire in the main magnetic field o f a superconducting
magnet are known as ?

a) Neon gases
b) Plasma
c) Cryogens
d) None ofthe above

32. Which of the following could occur during an MRI procedure as a result of sudden loss
of absolute zero temperature in the magnet coil and leading to helium escaping from the
cryogen?

a) Precession
b) Quenching
c) Irradiation
d) Recovery

25 | P a g e HS- NEGAN |
Magnetic Resonance image

33. An infant is brought for brain MRI, Which of the following is most likely to
differentiate grey from white matter?

a) Inversion recovery
b) Spoiled gradient echo
c) T1-weighted spin echo
d) T2-weighted spin echo

34. A patient is evaluated for orbital mass by a series of magnetic resonance images. Which
of the following pulse sequences helps to null signal from fat?

a) Fast Spin Echo (SE)

b) Fast Gradient Echo (GE) Imaging
c) Short Ti Inversion Recovery (STIR)
d) Fluid Attenuation Inversion Recovery (FLAIR)

35. Which of the following MRI pulse sequences can be used for suppression of signal from
adipose tissue?

a) SSFP
b) STIR
c) CSE
d) TOF

36. Examined for possible tear with MRI which of the following is most likely to suppress
the signal from fat?

a) Proton Density
b) T1 Weighted Image
c) T2 Weighted Image
d) Short TI inversion recovery( STIR)

37. Which of the following type of image will be produced by using the following
parameters (see table)? Repetition Time (TR) 50 ms, Echo Time (TE) Flip Angle 5 ma
120?

a) Proton density
b) T2* weighting
c) T2 weighting
d) T1 weighting

26 | P a g e HS- NEGAN |
Magnetic Resonance image

38. Which of the following is the color of the area of high signal in MRI image ?

a) Grey
b) Black
c) White
d) Dark grey

39. The area of high signal in MRI image appears as?

a) Black
b) White
c) Dark grey
d) Grey

40. Which of the following sequences best evaluates the collateral supporting structures of
the knee joint for a patient with acute injury?

a) Axial T1 with contrast

b) Axial T2 with contrast
c) Coronal GRE T1
d) Axial DWI

41. Which of the following K space filling option should the technologist apply, if he wishes
to reduce the MRI scan time without affecting image resolution and Signal to Noise
Ratio (SNR)?

a) Free induction decay

b) Gradient echo
c) Spin echo
d) Spin-spin

42. Gradient echo images are requested during MRIexamination which of the following are
the most likely parameters?

a) Long TR and long TE

b) Long TR and short TE
c) Short TR and long TE
d) Short TR and short TE

43. Which of the following artifact is a result of using a field of view smaller than the
excited body part?

a) Phase miss-mapping
b) Chemical shift
c) Cross talk
d) Aliasing

27 | P a g e HS- NEGAN |
Magnetic Resonance image

44. A chest MR image reveals ghosting of the anatomy across the image in the phase
encoding direction which of the following is the most useful method to solve the
problem?

a) Careful explanation of the procedure to patient

b) Administration of antispasmodic agents
c) Use of peripheral gating technique
d) Use of cardiac gating technique

45. Which of the following is produced when an electric current flows through wire?

a) X-rays
b) Radiation
c) Gamma rays
d) Magnetic field

46. Which of the following is the possible cause of metal-like artifact's appearance in fast
spin echo MR imaging?

a) Radio frequency coil malfunctions

b) Use of wrong radio frequency coil
c) Fluctuations from hemorrhagic lesion
d) Patient movement during the scanning

47. When a slice is selected in MRI imaging, which of the following happens in the rest of
the patient's body?

a) RF distributed
b) Larmor frequencies change
c) Larmor frequencies stay the same
d) Rotation of magnetization by RF excitation pulse

48. A 65-year-old patient is referred for a brain MR study. The referring physician reports
placement of a titanium alloy brain clips for an intracranial aneurysm 5 years ago.
Which of the following would be the most appropriate action regarding imaging this
case?

a) perform the exam using 0.5 Tesla systems or less

b) perform the exam with using open magnet systems
c) perform the study regardless the system type or field strength
d) It is contraindicated to perform the exam as titanium alloy is ferromagnetic

28 | P a g e HS- NEGAN |
Magnetic Resonance image

49. Which of the following is considered one of the advantages of Magnetic Resonance
Angiography (MRA) procedure?

a) No contrast media used

b) Rapid large Field of View (FOV)
c) No regional signal loss from stents
d) Display delayed retrograde collateral filling

50. How to solve chemical shift artifact in MRI ?

a) Increase time increase FOV

b) decrease time increase FOV
c) Decrease time decrease FOV
d) Increase time decrease FOV

51. Which of the following MR image is produced due to difference in the transverse
relaxation characteristic of tissues?

a) T1 weighted
b) T2 weighted
c) Proton density
d) T1 inversion recovery

52. Which of the following MRI coils provide a uniform signal intensity level throughout a
cross section of anatomy?

a) Linear
b) Surface
c) Volume
d) Flat array

53. Remedy for moiré artifact?

54. Which of the following artifact appears duplication of moving anatomy across the phase
of the MRI image?

a) Aliasing
b) Chemical shift
c) Phase mis-mapping
d) Magnetic susceptibility

29 | P a g e HS- NEGAN |
Magnetic Resonance image

55. A patient is evaluated for breast cancer by , Which of the following pulse sequence will
best demonstrate it?

a) T1 GRE
b) T2 FSE
c) T1 FSE
d) .

56. Patient come to radiology department and the contrast been injection and before scan
begging the patient ask to leave because he have important meeting and will come back
after 2 hour . which of the following is appropriate action ?

a) Talk with radiologist

b) cancel the exam
c) let him leave and back after two hour
d) Reschedule the exam

57. A screening questionnaire for patients about to undergo MRI should include
information about

a) Prior injuries
b) Prior surgery and implants
c) Pregnancy
d) All of the above

58. Absolute contraindications to MRI include:

1. Intracranial vascular clips, unless they are KNOWN to be safe

2. Cardiac pacemakers, unless they are KNOWN to be safe
3. Pregnancy
4. Intraocular, ferrous foreign bodies

a) 1 only
b) 1and2only
c) 1,2,and3only
d) 1,2,and4only

59. Which of the following implants, which would be considered acceptable to scan by
MRI?

a) Ferrous aneurysms clips

b) Neurostimulators
c) Cardiac pacemakers
d) Heart valves

30 | P a g e HS- NEGAN |
Magnetic Resonance image

60. Magnetic field shielding can be achieved either actively or passively. Passive shielding
can be achieved by lining the MRI room with

a) Copper
b) Steel
c) Lead
d) None of the above

61. RF shielding can be achieved by lining the MRI room with

a) Copper
b) Steel
c) Lead
d) None of the above

62. For optimum operation of MRI systems, the ambient temperature and relative humidity
should remain between

a) 30°F and 50°F/30% and 50%

b) 65°F and 75°F/50% and 70%
c) 70°F and 90°F/70% and 100%
d) No specific temperature or humidity range

63. One of the following modalities does not use ionizing radiation?

a) Conventional radiography
b) Fluoroscopy
c) MRI
d) CT scan

64. The most active nuclei in human body in MRI imaging are?

a) Oxygen
b) Hydrogen
c) Nitrogen
d) Carbon

65. The time internal between the sets of RF pulses is called the?

a) Time repetition
b) Echo delay time
c) Time relaxation
d) Radiofrequency

31 | P a g e HS- NEGAN |
Magnetic Resonance image

66. The unit of measuring the magnetic field is?

a) Kilovolt
b) Miliampire
c) Tesla
d) Rad

67. All of these are image acquisition techniques in MRI except?

a) Spin - echo (SE)

b) Spin - echo - fat sat
c) Inversion recovery
d) Time repetition

68. Which of the following is very useful for evaluating cerebral aneurysm and vascular
occlusive disease?

a) Fluoroscopy
b) Projection of radiography
c) Conventional tomography
d) MRA

69. One of the main advantage of MRI compared with other imaging modalities is?

a) As Excellent soft tissue discrimination

b) Has no contra - indication
c) Improved contrast resolution
d) Improved spatial resolution

70. Which of the following best describes MRI superiority to Computed tomography in
diagnosing disc herniation?

a) Low exposure to X- radiation

b) Short examination scan time
c) Better visualization of soft tissue
d) Better visualization of bony structures

71. To reduce the scan time in MRI imaging we have to?

a) Use the shortest TR possible

b) Use the highest TR possible
c) Use special RF coils
d) Not use RF coils

32 | P a g e HS- NEGAN |
Magnetic Resonance image

72. All of these equipments are required to produce magnetic resonance image except?

a) Magnet
b) Radiofrequency source
c) Cathode and anode
d) Image processor

73. All of these are types of RF coils used in magnetic resonance imaging except?

a) The volume coil

b) The surface coil
c) The phased coil
d) The oil coil

74. One of the problems that face most patients in MRI room is?

a) Claustrophobia
b) Cold place
c) Imaging by MRI is painful
d) Injection of contrast

75. Which of the following substances when placed in the presence of an external magnetic
field show strong attraction, alignment and retain magnetization even after the applied field
has been removed?

A. Plastic
B. Diamagnetic Dia = no magnetic
C. Para magnetic Para = small magnetic
D. Ferromagnetic Ferro = strong magnetic

76. The contrast media used in imaging the central nervous system by MRI is?

a) Gastro - grafine
b) Ba-sulphate
c) Gadolinium
d) Biligram

77. One of the patient preparation for MRA is?

a) NPO for 2 days

b) NPO for 4-6 hours
c) Give castor oil 80 ml on night
d) NPO 24 hours

33 | P a g e HS- NEGAN |
Magnetic Resonance image

78. To Achieve a T2 weighted images in the spin echo pulse sequence?

a) TR must be short and TE must be long

b) Both TR and TE must be short
c) Both TR and TE must be long
d) TR must be long and TE short

79. When hydrogen nuclei are placed in an external magnetic field they?

a) Interact with surrounding air

b) Align parallel and anti-parallel with the field
c) Rotate counter clockwise
d) Align parallel with the field

80. The following is not part of the MRI instrumentation?

a) RF coil
b) Transducer
c) Gradient coil
d) RF amplifier

81. Which of the following does not affect image resolution in MRI?

a) Type of the RF coil

b) Field of view of the image
c) Slice thickness of the image
d) Image matrix

82. In conventional SE pulse sequence the scan time is determined by the product of?

a) TR , number of phase encoding steps , and Number of signal averages

b) TR , Number of slices , and number of phase encoding steps
c) TR , TE , Number of phase encoding steps , and number of signal averages
d) TR , number of frequency steps , and number of phase encoding steps

83. The following artifact is a result of using a field of view smaller than the excited body
part?

a) Chemical shift artifact

b) Phase miss - mapping artifact
c) Cross talk artifact
d) Aliasing artifact

34 | P a g e HS- NEGAN |
Magnetic Resonance image

84. The following parameter does not affect the scan time?

a) Type of pulse sequence

b) Field of view
c) Number of signal averages
d) Echo time

85. Patient come to Do MRI scan and he-didn’t remove the insulin pump while the scan and
after the scan he leave the department, which of the following the mistake have occur in
this situation?

a) recharge insulin pump

b) change insulin pump battery
c) reformat insulin pump
d) .

86. How to improve SNR ?

a) Short TR – Short TE
b) Long TR – Long TE
c) Long TR – Short TE
d) Short TR – Short TE

87. Which of the following is the most appropriate position of the RF coil in order to receive
a good signal ?

a) Parallel to the patient body part

b) Parallel to the Z axis
c) As close as possible to the magnet bore
d) Perpendiculars to the Z axis

88. Which of the following is the appearance for GlioblastomainT2 flair ?

a) Hyper-intense
b) Hypo-intense
c) .
d) .
89. Patient come for follow up brain MRIto accurate the tumor diagnosis but the patient
not sure about if she had pacemaker or not , what is the right action in this situation ?

a) Do the exam because she had the scan before this time
b) Cancel the exam
c) .
d) .

35 | P a g e HS- NEGAN |
Magnetic Resonance image

90. If the patient undergo breast MRI and the patient suffer claustrophobia , which of the
following is the right position for the patient in this situation ?

a) Supine – head first

b) Supine – feet first
c) Prone – head first
d) Prone – feet first

91. Patient have meningitis and show enhancement in the scalp , which sequence should
take ?

a) T1 without contrast
b) T1 with contrast
c) T2 flair without contrast
d) T2 flair with contrast

92. Patient suffer of hydronephrosis and the radiologist request the exam include all organ
which of the following is the scan ?

a) MRI Angiography
b) MRI venography
c) MRI Urography
d) MRI abdomen

93. Patient come from ER and suspected aneurysm ,which of the following id the beat
modality to accurate the diagnosis ?

a) CT
b) X-ray
c) MRI
d) US

94. Which of the following is the beat modality to show the pituitary gland ?
a) CT
b) X-ray
c) MRI
d) US

95. The best section( view ) use for the pituitary gland in MRI ?

a) Sagittal
b) Coronal GRE T1 +pre/post contrast + dynamic + breath hold technique.
c) Axial
d) .

36 | P a g e HS- NEGAN |
Magnetic Resonance image

96. The sequence that use for epilepsy ?

97. MRI epilepse in Cornalsection , which of the following you will see ?

a) Hippcampus
b) .
c) .
d) .

98. Glioblastoma showin Flair

Hemorrhagic component. They are surrounded by vasogenic-
a) Hyper- intense ( bright )
type edema
b) Hypo- intense ( dark )
c) .
T2/FLAIR
d) .
◦ hyperintense
◦ surrounded by vasogenic edema
◦ flow voids are occasionally seen

99. Patient arrived to radiology department for MRI brain with contrast , what is the suspected
diagnosis?

A) headache
B) Parkinson's disease
C) .
D) .

100. MRI exam preparation ( zone )

a) 1
b) 2
c) 3
d) 4

101. Which zone the magnet scanner should be ?

102. In the MRI department – sedation material found in ?( zone )

103. MRI patient monitor place in ( zone )

37 | P a g e HS- NEGAN |
Magnetic Resonance image

104. Contrast media for liver

a) Primovist
b) .
c) .
d) .

105. CM used in MRI ?

a) Gadolinium
b) .
c) .
d) .

106. MRI ( BMI) 27.7 Hight = 170 Wight = 80

a) 1.7
b) 27
c) 55
d) 80

107. MRI female pt have contrast scan and her BMI is 28.38 kg/m2, contrast
concentration 0.5, what contrast amount required?

a) 10
b) 14
c) 16
d) .

108. Patient with pacemaker come to MRI department to scan , which of the following
the appropriate action

A) Do the exam
B) Cancel the exam
C) Change to other modality
D) Ask the patient about the manufactured material

109. Patient undergo knee replacement and come to MRI , which o the following the
appropriate action

E) Do the exam
F) Cancel the exam
G) Change to other modality
H) Ask the patient about the manufactured material

38 | P a g e HS- NEGAN |
Magnetic Resonance image

39 | P a g e HS- NEGAN |