Using Coils
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Imaging of the wrist carries with it
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some pitfalls and a lot of options.
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The first option is to put the arm up
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over the head in the Superman position.
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Now, for an old geezer like me, extremely uncomfortable
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to lie in that position for 30 minutes or more.
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In fact, for athletes, it's even uncomfortable.
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But, it has an advantage.
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It allows you to take what are very
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flexible coils, put them flatly against the
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wrist, and obtain a small field of view.
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In fact, smaller fields of view than you
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would get if the arm was lying at the side.
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Notice, too, you've got a larger circular
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flat coil and a smaller circular flat coil.
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This one, for a smaller field
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of view but better penetration.
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And this one, for a larger field
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of view, with less penetration.
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But still, this overhead Superman
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position, while uncomfortable, can
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generate some extremely high resolution.
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And we've also got more rigid coils.
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The rigid coils are usually
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used with the arm at the side.
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The hand can be pronated, important in your
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assessment of anatomy, since certain structures,
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like the extensor carpi ulnaris, will shift.
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In the pronated position, or you can
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have a rigid, rectangular coil with the
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arm or hand in the neutral position.
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This would also give you a different
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appearance of the relative positioning
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of certain structures, like tendons,
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relative to skeletal structures.
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So, soft coils, arm over the head.
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Hard coils, arm at the side.
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You can also use the soft
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coils with the arm at the side.
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But you're going to get a smaller field of view
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with higher resolution with the arm over the head.
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This will become more important when
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we deal with the hand and the fingers.
Stephen J Pomeranz, MD
Chief Medical Officer, ProScan Imaging. Founder, MRI Online
ProScan Imaging
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