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By John R. Bradshaw (Auth.)

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Density as high as this is difficult to distinguish from calcification but a measurement of Hounsfield numbers within the area will help to differentiate these two conditions (see Figure 66). Figure 92 CT pathology—contrast enhancement Following the administration of an iodinated contrast medium, many brain lesions show areas of increased density when compared to the unenhanced scan. This density is the result of two processes present in many brain lesions: (i) increased perfusion by blood vessels supplying the lesion or the affected adjacent brain, and (ii) breakdown of the normal blood-brain barrier, thus allowing contrast medium to leak into and opacify the affected tissue.

They are: TR (repetition time), time for one complete cycle; TE (time to echo), time from initial RF pulse to resonant signal; TI (time to inversion), time from initial RF pulse to second inverting pulse {see inversion recovery sequence). These may be represented as shown in Figure 99 in a hypothetical (but quite useless) pulse sequence. Inversion recovery (IR). In this sequence two RF pulses are applied: the first swings the magnetization vector through 180° and after a short interval ('time to inversion' or TI) the vector is inverted by a 90° pulse.

So far as the patient is concerned, the magnet field may alter pacemaker rhythms, dislodge cochlear implants and cause intracranial ferromagnetic aneurysm clips to undergo torsion; such patients should be excluded from the vicinity of the magnet. Other surgical clips do not appear to present any hazard. Metallic objects such as hairpins, jewellery or dentures may cause local degradation of the image, or become detached and turn into projectiles. The patient lies within the bore of the magnet. This space is like a tunnel and may give rise to claustrophobia.

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