Continuing Education for MRI Technologists, Radiologic Technologists, and other Medical Imaging Professionals.

6019-106 Pulse Sequences, Oldies and Newbies

This online activity was recorded at the ARMRIT 2019 East Coast, Semi-Annual Meeting, Delray Beach Marriott, Florida May 31 & June 1

Educational Objectives
At the conclusion of this presentation the audience members will have an understanding of

• what a pulse sequence is
• how pulse sequences work
• how pulse sequences are presented in a diagram
• how some of the newer pulse sequences work

Outline:  The purpose of this presentation is to briefly review some of the traditional pulse sequences, and take a look at what some of the new pulse sequences do and how they work.

• First, what is relaxation and why do we discuss this in a pulse sequence presentation?
  1. Equilibrium state,     b. Spin up and spin down,     c. Excitation,        d. T1 and T2 relaxation
• What is a pulse sequence?
  1. “sequence" of pulsing gradients and RF
  2. Causes a disturbance of the state of the tissues
  3. How they respond provides information about the tissue
• Spin echo and Turbo Spin Echo
  1. What is, and what are the results of the 90 pulse
  2. What is, and what are the results of the 180 pulse
  3. Multiple echoes in a train
• Gradient echo
  1. How do we get T1 and T2 contrast?
  2. Rapid acquisitions
  3. Sensitive to T2*
• BLADE/Propeller
  1. Rotate around the center of k-space
     1. Phase encoding direction will be each direction at some time during acquisition
  2. Creates a dispersion of “phase” information 360 around the center
     1. No common direction of phase encoding means no consistency in phase misrepresentation. No motion artifact
  3. Total k-space filling takes much longer than cartesian filling due to oversampling of center each time
     1. Motion correction techniques are NOT a shorter scan time technique.
     2. Allowing ample scan time to fill k-space means better motion suppression
  4. Challenges can be getting the image contrast expected in T1
     1. Echo trains need to be longer to create a wide enough “blade"
     2. Newer advancements have tackled this but older methods use Inversion Recovery to obtain good T1 contrast and still use BLADE filling
• MEDIC/MERGE
  1. A gradient echo that collects a short, rapid train of echoes and places each in a single line of k-space
  2. Blends contrast over several adjacent echoes
  3. Increases SNR due to multiple echoes per line
  4. Longer scan than traditional GRE
• SWI
  1. Gradient echo based sequence
  2. Sensitive to T2* effects due to particular parameters
  3. Uses 3 planes flow comp
  4. Longer scans inherently, so don’t expect short scans
  5. Show blood pools well,
• Dixon
  1. Collects and Uses in-phase and opposed-phase echoes
  2. Prior GRE based, now TSE
  3. In and out phases used to calculate out fat and water
  4. TSE works same as regular TSE
     1. Traditional pulsing collects train of in-phase echoes then followed by a second train of out-phase echoes
     2. New versions can collects both in and out phase in one train

Continuing Education Credit
This program has been approved by the Association for Medical Imaging Management (AHRA) for 1.0 hours ARRT Category A continuing education credit.

Certificates of Credit are accepted by the American Registry of Magnetic Resonance Imaging Technologists (ARMRIT) and the American Registry of Radiologic Technologists (ARRT).

Tuition
ICPME accepts American Express, MasterCard, and Visa. Tuition for this course includes unlimited access to the course and your Certificate of Credit.

Please note: tuition payments are non-refundable.

How to Enroll and Participate
Estimated time to complete this activity is 1.00 hours.

• Click ENROLL NOW, CONTINUE through the shopping cart, CONFIRM ORDER, and ACCESS COURSE NOW.
• Once you are enrolled, you can return to this course anytime by logging to your account at www.icpme.us.
• To access the course, click on MY ACCOUNT, then click on the course title.

How to Receive Credit

• To access the posttest and evaluation, login to your account at icpme.us and click on the course title.   
• Click the icons for POSTTEST and for EVALUATION.
• A passing grade of at least 75% is required to receive credit. You may take the test up to three times.
• Upon receipt of a passing grade, you will be able to print a certificate of credit from your account at icpme.us.

Your online account serves as a permanent record of credit certificates earned through icpme.us.

Questions?
Contact ICPME:
information@icpmed.com

Jointly Provided by

About the American Registry of
Magnetic Resonance Imaging Technologists
Because MRI is a Specialty

The mission of the American Registry of Magnetic Resonance Imaging Technologists (ARMRIT) is to recognize individuals qualified as specialists and to promote high standards of patient care and safety in the diagnostic medical imaging modality of Magnetic Resonance Imaging (MRI) technology including: interventional MRI, cardiovascular MRI, functional MRI, and MRI breast imaging.

ARMRIT is the first certifying organization to:
1.    Recognize MRI technology as a distinct medical imaging specialty utilizing non-ionizing radiation.
2.    Require MRI clinical experience and competency for eligibility.
3.    Promote formal MRI education with MRI clinical training.
4.    Recognize MRI schools that offer full-time educational program leading to a career in MRI.

Certification through the Registry is open to qualified technologists in all imaging fields who have documented MR clinical experience and/or formal education completed through schools dedicated to MRI technologists.

For more information about ARMRIT or to apply for certification, visit ARMRIT.org.

DISCLAIMER
Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contraindications and/or dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.