Neuro Imaging: Magnetic Resonance Imaging (MRI)
MRI is a diagnostic procedure which examines body tissue by subjecting
the atomic nuclei of the tissues to a magnetic field. The atomic nuclei
of the tissues are stimulated by the field. Bad tissue responds differently
In recent years, huge advances have occurred with respect to MRI. Up until
approximately 2000, most neuro imaging centers maintained MRI machines
with Tesla field strength 1 to 1.5 magnets. As of recent, the FDA has
approved Tesla field strength 3 magnets for human use. With the use of
Tesla field strength 3 magnets, lesions are now being seen on MRI that
were impossible to detect on the earlier MRI scanners using lesser field
strength magnets. Advancements in software utilized by the MRI scanners
have likewise improved their diagnostic capability.
Where head injury is concerned, Gradient Echo software has proved extremely
valuable. Many teaching institutions are now experimenting with field
strength magnets as high as Tesla 10. It is expected that with the advances
in MRI technology, even extremely mild traumatic brain injury patients
will have demonstratively viewable abnormality on MRI.
An example of this was capitalized on by the Scarlett Law Group during
the case of
Rasmussen versus Shade. Mr. Rasmussen had been rear ended while in stopped traffic in Northern
California. There was less than $500 damage to the rear bumper of Mr.
Rasmussen´s vehicle. Nonetheless, Mr. Rasmussen sustained a traumatic
Following the accident, imaging was done on a T-1 magnet strength MRI scanner
in the Sacramento area. The MRI scanner was read as “normal”.
Several months later, imaging was again done on the T-1 scanner. It too
was read as “normal”.
After contacting the Scarlett Law Group, treating physicians ordered a
repeat MRI, but this time utilizing a T-3 scanner. Two focal lesions in
the anterior and posterior frontal lobes were immediately seen. Given
the coup/contra coup pattern of the lesions, and further given their presence
at the juncture of the grey/white matter of the brain, diagnoses of traumatic
brain injury was conclusively made.
What is unique about this is that in utilizing the lesser strength scanner,
the lesions were not read on the film. However, after looking at the T-3
film, and comparing it to the film derived from the lesser strength MRI
scanner, the abnormalities of the lesions could be vaguely made out. In
other words, no one could have been critical of the earlier readings of
the film from the lesser strength scanners as the lesions were not readily
apparent. However, with the benefit of the T-3 film, the abnormalities
could be seen on the earlier scans though not with the absolute clarity
of the T-3 film.
Where head injury is concerned, it is thought that the admission of the
T-3 film into evidence in the
Rasmussen versus Shade case is the first time a California court (and jury), has had the benefit
of said technology. It is expected to be the norm in years to come.