MRI protocol for Muscle Injuries

MRI Technique for Muscle Injuries
While recognizing that each patient is unique, certain generalizations may be helpful in designing an appropriate

MRI protocol for Muscle Injuries
 Marker. Placing a skin marker over the area of the patient’s symptoms allows you to correlate clinical complaints with imaging abnormalities.
Coil. The choice of a coil will be dictated by the desired field of view and spatial resolution. With experience (and a good anatomic atlas!), scanning of both extremities usually is not necessary.

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Imaging planes. 
The sagittal and coronal planes generally approximate the long axes of limb muscles. These
“longitudinal” imaging planes are useful for depicting the longitudinal extent of myotendinous abnormalities (e.g., the size of a retracted tear).
Sagittal images are especially helpful for evaluating abnormalities at the anterior and posterior aspects of an extremity, while including the adjacent bone as an anatomic reference. Similarly, coronal images are particularly useful for assessing medial and lateral abnormalities.

Pulse Sequences

• T1-weighted images provide a favorable ratio of signal-to-noise, while aiding in characterization of hemorrhagic lesions (e.g., hematoma, hemorrhagic neoplasm) or abnormal accumulations of fat (e.g., muscular atrophy, mature myositis ossificans, lipoma).
• Fat-suppressed T2-weighted and inversion recovery (IR) fast spin-echo (FSE) images are more sensitive to the presence of edema and hemorrhage than long TE images that are not fat suppressed. However, compared to T2-weighted images, the altered dynamic range on fat-suppressed T2 and IR-FSE images may make specific diagnosis of soft-tissue masses more difficult.
• Gradient-echo sequences accentuate paramagnetic effects. This “blooming” effect may indicate the presence of hemosiderin, foreign bodies, postoperative changes, or gas, and thus help in honing a differential diagnosis.