What’s New?

MRININJA 3.2.57 — Controlling Fluid Signal: TR, TE, Flip Angle, Presaturation, Black-Blood, TONE (New Parameter Deep Dive, Direct Sequel to 9213)

Date: September 11, 2026

• Added new parameter deep dive Controlling Fluid Signal — TR, TE, Flip Angle, Presaturation, Black-Blood Preparation, and Ramp (TONE) Pulses (ID 9598), the direct, explicitly-requested sequel to Stationary Tissue vs. Flowing Fluid (9213), registered under the MRI Parameters cluster (9501) rather than the physics-fundamentals numbering (92xx), matching the established site-wide distinction between "why" (physics-cluster) and "how to control it" (parameter-cluster) pages already used for Chemical Shift→Bandwidth and SWI→QSM.
• Six console-level levers developed individually, each with a worked clinical example, exactly as requested: TR (shorter TR widens contrast between saturated background and unsaturated fresh fluid); TE (longer TE increases both spin-echo time-of-flight washout and intravoxel dephasing — the two distinct mechanisms already established on 9213, now shown to share the same TE-dependence); flip angle (the asymmetric Ernst-angle effect: flip angles above background tissue's own Ernst angle disproportionately suppress saturated background while comparatively sparing fresh, not-yet-saturated inflow — the reason TOF sequences use unusually high flip angles); presaturation (directional flow suppression before the imaging volume, cross-referenced rather than re-derived from the existing REST Slab page); black-blood preparation (framed explicitly as the active, geometry-independent solution to the plane-dependent passive-washout limitation established on 9213 Section 4, cross-referenced to the VWI Universal Technique Master); and ramp (TONE) RF pulses.
• TONE (Tilted Optimized Non-saturating Excitation) independently verified before inclusion rather than assumed from memory: confirmed as a real, widely-implemented ramped-flip-angle technique via multiple independent sources, including a 2025/2026 PMC study reporting concrete clinical parameter values (TONE ramp percentages, starting flip angles) directly used in the Section 7.2 worked example. Developed explicitly as the direct solution to the depth-dependent progressive-saturation problem already established on 9213 (Sections 4.2, 4.4) — a deliberate, satisfying closure of the connection promised when that page was written.
• A synthesis table (Section 8) maps each of the six levers to the specific fluid-signal problem it is best suited to solve, and a common-errors section explicitly warns against reaching for a technical fix (black-blood preparation) where a free geometric one (repositioning or plane choice, per the Antialiasing Options and Strategies page's already-established principle) would have solved the same problem at no scan-time cost.
• Explicitly scoped out, per instruction, and forward-referenced as the next planned page in this series: the comparative behaviour of fluid signal across 2D vs. 3D vs. multiple overlapping thin-slab (MOTSA) acquisition strategies.
• Updated 9213's own Section 9 ("What Comes Next") and its Recommended Reading Path card, converting the previously generic "forthcoming flow-control parameter deep dive" placeholder text into real hyperlinks now that this page exists — completing the forward-reference loop opened when 9213 was published.
• Backfilled 2 quiz questions immediately (tecnica_fluidctrl_01/02, category tecnica_pura). meta.count updated to 1088; meta.version bumped to 5.2.
• Registered in data/mrininja-relations.json under the 9501 parameter cluster, with reciprocal links to 9213, 9207, 9586 (REST Slab), 9305 (VWI Universal Master), and 9594 (Antialiasing Strategies); added to the Section 20 complete-index table and the "Related MRI Parameter Deep Dives" card on 9501 itself.

MRININJA 3.2.56 — Stationary Tissue vs. Flowing Fluid: Comparative MR Signal Behaviour and Acquisition-Plane Dependence (New Physics Deep Dive)

Date: September 10, 2026

• Added new child page Stationary Tissue vs. Flowing Fluid: Comparative MR Signal Behaviour and the Effect of Acquisition Plane (ID 9213), a twelfth child of the MRI Physics master (9201) and the explicit comparative/applied companion to the existing Flow, Motion, and Diffusion Physics page (9207).
• Anti-duplication check performed before writing: 9207 was read in full first. It already covers time-of-flight (flow-related enhancement) physics, phase-contrast physics, and flow artefacts (ghosting, intravoxel dephasing, misregistration) in depth. It does not cover the spin-echo time-of-flight "washout" mechanism, the acquisition-plane dependence of flow signal, or fluid-by-fluid clinical correlation — the three gaps this new page fills, explicitly positioned as extending rather than repeating 9207 (a prerequisite blockquote at the top states this scope split explicitly), matching the precedent already established for 9206→9596 (Chemical Shift) and 9011→9016 (SWI→QSM) on this platform.
• Central requested content: a full, worked explanation of why the identical pulse sequence, on the identical vessel, produces qualitatively different flow signal depending solely on whether the acquisition plane is perpendicular (cross-sectional, maximal spin turnover per TR) or parallel/in-plane (longitudinal, progressive saturation along the vessel's course) to the vessel's long axis — developed as a direct, single-variable-changed worked comparison (Section 4.3), with the clinically-documented "entry-slice phenomenon" presented as direct, named evidence of the same underlying mechanism (Section 4.4).
• The spin-echo time-of-flight loss ("washout") mechanism developed as the explicit mirror image of gradient-echo flow-related enhancement (Section 3): both trace to the identical physical fact (rapid replacement of spins within the excited region), differing only in whether the sequence needs one RF event (gradient-echo, resistant to loss) or two RF events on the same spins (spin-echo, prone to loss) per echo.
• Fluid-by-fluid worked examples covering every case explicitly requested: arterial blood (full range of TOF/FRE behaviour), venous blood (cross-referenced to the vascular semiotics page's slow-flow pseudo-pathology pitfall rather than repeated), CSF (aqueductal flow void, spinal flow void sign, entry-slice pseudolesion pitfall), and urine in the bladder (static baseline behaviour contrasted with the genuinely flow-driven ureteral jet sign).
• Sourced from Lisanti et al. 2007 (AJR Am J Roentgenol 188:716-725, the primary, directly relevant original review on CSF motion-related MR phenomena, including the entry-slice phenomenon terminology) and a 2025 AJNR paper on the spinal CSF flow void sign in dural leak localisation — both independently verified by search before inclusion, with exact terminology ("entry-slice phenomenon," "TOF loss," "flow-related enhancement") cross-checked against the primary source rather than assumed from memory.
• Explicitly scoped out, per instruction, and forward-referenced as a planned next deep dive (Section 9): the parameter-level toolkit for deliberately controlling flow signal (bandwidth, TR/TE, flip angle, 3D acquisition, presaturation, black-blood preparation, ramp/tailored RF pulses) — this page covers only the underlying "why," not the "how to control it."
• Backfilled 3 quiz questions immediately (physics_flowplane_01/02/03, category physics). meta.count updated to 1086; meta.version bumped to 5.1.
• Registered in data/mrininja-relations.json as a proper child of 9201, with reciprocal links to 9207, 9311 (vascular signal semiotics), 9305 (VWI universal master), and 9586 (REST slab). A forward-link paragraph added to the end of 9207's own body pointing readers to this new companion page.

MRININJA 3.2.55 — Vascular Lumen, Wall and Perivascular Tissue: MR Anatomy and Signal Semiotics (New Deep Dive, Child of the VWI Universal Master)

Date: September 3, 2026

• Added new technique deep dive Vascular Lumen, Wall and Perivascular Tissue — MR Anatomy and Signal Semiotics (ID 9311), second child of the VWI Universal Technique Master (9305), alongside the Intracranial Arteries territory page (9310).
• Deliberately, strictly limited to directly visible MR signal findings, per explicit instruction: every entry on the page — lumen, wall, and perivascular tissue alike — is described purely in terms of validated signal behaviour (T1/T2/PD/TOF appearance, enhancement pattern) rather than histological or pathological concepts without an independent, documented MR signal correlate. Where a plaque/wall component is discussed (lipid core, fibrous cap, calcification, haemorrhage), the description is anchored to a specific, cited histological-MRI validation study rather than general pathology-textbook knowledge.
• Signal criteria sourced from newly verified literature: the T2/PD/STIR lipid-core-vs-fibrous-cap contrast relationship and the all-sequence calcification signal void, cross-validated in both carotid and — via a dedicated ex vivo 3T histological correlation study newly added to this platform's bibliography (Jiang et al., AJNR 2017;38(9):1716-1722, PMID 28684455, DOI 10.3174/ajnr.A5266) — intracranial plaque; the post-contrast-enhancement-based lipid-rich-necrotic-core criterion and intact-vs-thin/ruptured fibrous cap criterion from a multicentre carotid MRI substudy; the methaemoglobin-mechanism explanation and a quantitative (~1.5× muscle signal) T1 threshold for intraplaque/intramural haemorrhage detection; and a T2*/T1 combination criterion for distinguishing haemosiderin-only from combined haemosiderin/methaemoglobin (i.e. blood-product age) on T2* imaging.
• A genuine scientific-accuracy caveat carried through from this platform's existing content: Section 4.3 explicitly notes that a hypointense, "calcified-appearing" wall region is not invariably true calcium — recent QSM-histopathology correlation work has shown some such regions instead reflect iron-related material — directly cross-referencing both the platform's QSM deep dive and the Wilson's Disease brain MRI page's identical "describe the signal, don't assume the material" principle, applied here to a different anatomical context.
• A dedicated Section 6 integrates all three layers (lumen + wall + perivascular) into a single table restating the already-established diagnostic patterns (ICAD, vasculitis, dissection, aneurysm instability, RCVS) purely in terms of the signal combination that defines each, without repeating the clinical/reporting content already developed on the territory-specific protocol pages.
• Backfilled 2 quiz questions immediately (neuro_vwsem_01/02, category neuro_cranio). meta.count updated to 1083; meta.version reaches 5.0.
• Registered in data/mrininja-relations.json as a proper child of 9305 (added to its child_pages); reciprocal links added on 9310, 9016 (QSM), and 1108 (Wilson's Disease). The parent master's "Related Content" section updated with a new "Cross-Territory Technique Deep Dives" card.

MRININJA 3.2.54 — 9310 (Intracranial VWI): Corrected Scope Confusion Between VWI-Specific and Companion Brain Sequences

Date: September 3, 2026

• Correction made directly in response to feedback: Section 4.1 of the Intracranial VWI child page (9310) previously listed DWI/ADC, T2-weighted brain, and FLAIR as "Mandatory Core Sequences" alongside the genuine vessel wall imaging sequences (3D black-blood T1 pre/post-contrast, TOF MRA) — implying, incorrectly, that these generic brain sequences are intrinsic to the vessel wall imaging technique itself. They are not: they are standard components of the Brain generic protocol, included in an intracranial VWI session specifically because the leading clinical indication for intracranial VWI is stroke work-up, where DWI supports the culprit-lesion correlation (Section 7.1) — an entirely separate clinical rationale from VWI's own wall-visualisation purpose.
• Section 4 restructured into three clearly separated subsections: 4.1 Mandatory Core VWI Sequences (now containing only the three sequences intrinsic to the technique — 3D black-blood T1 pre-contrast, 3D black-blood T1 post-contrast, TOF/CE-MRA lumen reference); 4.2 Companion Brain-Protocol Sequences (new — DWI/ADC, T2, FLAIR, explicitly labelled as borrowed from the Brain protocol for the stroke indication specifically, not required for every VWI examination); 4.3 Conditional VWI-Specific Sequences (the pre-existing conditional table, renumbered).
• All subsequent Section 4 subsections renumbered accordingly (4.3→4.4 Rationale Summary, 4.4→4.5 Sequence Matching, 4.5→4.6 Fat Suppression, 4.6→4.7 Slice Positioning), and every internal cross-reference to the renumbered sections corrected.
• Section 8.1 (Sequence Order Logic) updated to explicitly flag steps 1–3 (DWI, T2, FLAIR) as companion sequences included only for the stroke indication, with an explicit note that they may be omitted for a non-stroke VWI examination (e.g. isolated aneurysm-wall assessment); a new row added to the Section 8.4 Common Avoidable Errors table specifically addressing the risk of treating companion brain sequences as intrinsic VWI requirements (or vice versa, treating a genuine VWI protocol as incomplete without them regardless of indication); the Section 9 QC checklist's DWI item annotated as indication-dependent rather than universal.
• The Section 8.3 Fast Salvage Protocol table and the parent Universal Technique Master (9305) already correctly reflected only the three VWI-specific core sequences and required no change.
• No new references, no changes to data/mrininja-relations.json, sitemap.xml, or game/data/questions.json — this is a content-scope correction confined to the body of 9310.

MRININJA 3.2.53 — Vessel Wall Imaging Cluster Restructured: New Territory-Agnostic Universal Master (9305), 9310 Re-Parented as Intracranial-Specific Child

Date: September 3, 2026

• Architectural correction made directly in response to feedback: the page published as v3.2.52 (9310) was framed as a "Generic Standard Protocol" but its content — Circle of Willis coverage, MCA/ACA/PCA/basilar-specific parameters, the ASNR 2017 consensus — was in fact entirely specific to the intracranial vascular territory, not genuinely territory-agnostic. This was flagged directly and corrected rather than only noted.
• Added a new, genuinely territory-independent master page, MRI Vessel Wall Imaging — Universal Technique Master (ID 9305), covering the physics, terminology, and clinical logic shared across every vascular bed to which vessel wall imaging (VWI) is applied — intracranial, extracranial carotid/vertebral, aortic, and coronary — independent of which territory a specific examination targets.
• 9310 re-parented: retitled from "Generic Standard Protocol" to "Intracranial Arteries (Dedicated Protocol)", type changed from master to child, parent_master set to 9305; its introduction rewritten to explicitly state it assumes the new parent's shared-technique content as already known and to focus only on what is intracranial-specific. All internal navigation (breadcrumb, related-content cards) updated to reflect the new hierarchy in both directions.
• Central new content requested and delivered: a structured cross-territory comparison (Section 4 of 9305) covering resolution, coil choice, dominant black-blood technique, gating requirements, and dominant clinical question across all four territories, plus the underlying engineering logic (vessel calibre and intrinsic motion) explaining why these differences exist rather than simply listing them.
• Historical correction of real diagnostic value: properly re-attributed the technique's true origin to extracranial carotid atherosclerosis imaging (the Toussaint 1996 and Yuan 2001 papers already verified and corrected in v3.2.52, now correctly positioned as the technique-origin foundational references on the universal master rather than as supporting citations on an intracranial-only page) — the intracranial and aortic/coronary applications are properly framed as later extensions of this original carotid-derived work.
• A third black-blood mechanism (DANTE) introduced, alongside DIR and MSDE, sourced from the carotid/combined carotid-intracranial technical literature, with a comparison table (Section 9.1) explaining the flow-direction sensitivity and typical territory of each of the three mechanisms plus the cardiac-gated inversion-recovery approach used aortically/coronarily.
• A newly verified reference added: Desai MY, Stone JH, Foo TK, Hellmann DB, Lima JA, Bluemke DA. "Delayed Contrast-Enhanced MRI of the Aortic Wall in Takayasu's Arteritis: Initial Experience." AJR Am J Roentgenol. 2005;184(5):1427-1431. PMID: 15855090. DOI: 10.2214/ajr.184.5.01841427 — independently verified via search before inclusion, the original validation of the aortic delayed-enhancement technique underlying the Section 5.2 early-vs-delayed contrast-timing comparison.
• Backfilled 2 quiz questions specific to the new cross-territory content (neuro_vwiu_01/02, category neuro_cranio). meta.count updated to 1081; meta.version bumped to 4.9.
• Registered 9305 in data/mrininja-relations.json as a proper master with 9310 as its sole current child_pages entry; reciprocal links updated on 1101, 9101, 9301, 9588, 9593, and 9591 to point to 9305 in addition to their existing 9310 links.

MRININJA 3.2.52 — MRI Vessel Wall Imaging — Generic Standard Protocol (New Master Page, with Major Bibliography Correction)

Date: September 3, 2026

• Added new master page MRI Vessel Wall Imaging — Generic Standard Protocol (ID 9310), a black-blood, high-resolution intracranial arterial wall imaging technique, integrated from a fully-drafted external document supplied by Andrea, opening a new "Vascular / Vessel Wall Imaging" subsection under the OTHER macrocategory (added to data/navigation.php).
• Significant, systematic bibliography fabrication discovered and fully corrected before publication: independent verification of every one of the 8 checkable references in the supplied document (a 9th, a coronary-plaque biomechanics paper with a weak topical fit for an intracranial-specific page, was dropped rather than risk further unverified fabrication) found that 7 of 8 contained real, material errors — not minor typos. Specific errors found and corrected: reference [1] (the primary ASNR consensus statement) had a completely fabricated author list bearing no resemblance to the real 14-author byline; reference [2] had a fabricated title, wrong journal (stated as Clin Neuroradiol; actually Radiology), wrong volume/pages, wrong DOI, and wrong PMID; reference [6] had a wrong journal (stated as Invest Radiol; actually Stroke), wrong year, wrong volume/pages, wrong DOI, wrong PMID, and an altered title; reference [7] had a fabricated title and wrong volume/pages/DOI/PMID; references [3], [5], and [8] each had a single wrong identifier (PMID, DOI, or volume/pages/DOI respectively) against an otherwise correct citation. Only reference [9] (Yuan et al. 2001, Circulation) was fully correct as supplied. Every correction was independently re-verified against PubMed, PMC, AJNR, Radiology/RSNA, and institutional repository sources before being used in the published page.
• This finding was disclosed directly and transparently rather than silently patched, consistent with this platform's standing policy of independently verifying every citation before publication regardless of the source of a draft — including drafts the person believes were already produced with this platform's own rigor in a separate session.
• The underlying technical/clinical content of the supplied document — black-blood physics (DIR vs. MSDE), 3D isotropic acquisition rationale, slice positioning and Circle of Willis coverage requirements, the culprit-lesion diagnostic framework, enhancement grading, and the full QC/reporting/technologist-pearls structure — was assessed as sound, standard MRI technique knowledge and was preserved essentially unchanged; the fabrication problem was confined specifically to bibliographic metadata, not to clinical or physical claims.
• Cross-linked to the Brain master (1101), Contrast Media master (9101), the ASL master (9301, for complementary haemodynamic/perfusion assessment referenced in the conditional-sequences table), and three relevant parameter deep dives (Parallel Imaging 9588, for the CS-acceleration discussion; Fold-over Direction 9593; Slice Gap 9591).
• Reserved the 9311–9319 ID block for this master's own future clinical child pages, already explicitly enumerated in the master page's own text: intracranial atherosclerotic disease (ICAD), intracranial vasculitis, intracranial dissection, aneurysm wall imaging (AWE), RCVS vs vasospasm vs vasculitis differential, moyamoya vasculopathy, cervical artery dissection (extracranial), and aortic/coronary VWI (body).
• Backfilled 2 quiz questions immediately (neuro_vwi_01/02, category neuro_cranio). meta.count updated to 1079; meta.version bumped to 4.8.
• Registered in data/mrininja-relations.json with reciprocal links to 1101, 9101, 9301, 9588, 9593, and 9591.

MRININJA 3.2.51 — QSM: Philips-Specific Acquisition Pathway Added (Section 8.1)

Date: September 2, 2026

• Added a new Section 8.1 to the QSM deep dive (9016), answering a direct follow-up question: Philips has no separate, selectable "QSM sequence" as an acquisition mode — QSM is obtained by post-processing phase data from an existing product sequence, via either the 3D FFE (Fast Field Echo) product sequence in multi-echo mode, or — more practically for departments already performing routine SWI — the existing clinical SWIp product sequence with magnitude and phase raw data explicitly saved via "Save raw data" = yes for subsequent "Delayed reconstruction."
• Sourced directly from the vendor-specific implementation appendix of the 2024 ISMRM consensus paper already cited as this page's primary reference (Bilgic et al., Magn Reson Med, DOI 10.1002/mrm.30006) — no new, unverified source introduced; the detail was simply not yet extracted into the page's own vendor-implementation section when originally published.
• No structural, reference-numbering, or other content changes; a single, additive subsection.

MRININJA 3.2.50 — Quantitative Susceptibility Mapping (QSM): New Sequence/Technique Deep Dive

Date: September 2, 2026

• Added new dedicated deep dive Quantitative Susceptibility Mapping (QSM) — Physics, Processing Pipeline, and Brain Clinical Applications (ID 9016), positioned in the MRI Sequences cluster as a direct extension of the existing SWI page (9011).
• Anti-duplication check performed before writing: 9011 already contained a brief (~10-line) QSM subsection within its Section 8. This subsection was deliberately not re-derived — instead, it was condensed into a two-sentence summary with a real hyperlink to this new dedicated page, following the same "anchor page → full deep dive" pattern already established for Chemical Shift (9206 → 9596). The 9011 "Closest Sequence Family" related-content card was also updated with a direct link.
• Full three-stage processing pipeline developed in technical depth: phase unwrapping, background field removal (SHARP/V-SHARP/RESHARP/PDF/LBV/iHARPERELLA algorithm families), and dipole inversion (TKD vs. optimisation-based methods — MEDI, iLSQR, FANSI), including the underlying physical reason the inversion is ill-posed (the dipole kernel's zero-cone at the magic angle, ≈54.7° to B0) and the resulting streaking-artefact failure mode.
• Sourced from the 2024 ISMRM Electro-Magnetic Tissue Properties Study Group consensus (Bilgic et al., Magn Reson Med 91:1834-1862, PMID 38247051, DOI 10.1002/mrm.30006) as the primary authoritative implementation reference — verified via independent bibliographic cross-check (Johns Hopkins repository, PubMed, PMC, Wiley) before inclusion, with its specific recommendations (monopolar 3D multi-echo GRE, exact phase unwrapping, SHARP/PDF background field removal, regularised optimisation-based inversion, whole-brain reference region) summarised as a dedicated Section 5.
• Two major, current brain clinical applications developed with real citation verification: (1) Parkinson's disease nigrosome-1/"swallow-tail sign" iron-accumulation imaging, explicitly cross-linked to this platform's Gaucher Disease child page (1109) and its GBA-associated parkinsonism discussion, including a very recent (2025) study directly comparing nigrosome-1 findings between idiopathic and GBA-associated PD; (2) multiple sclerosis paramagnetic rim lesions (PRLs), sourced to the original 2013 Absinta et al. 7T description and a 2025 large multicentre PRL specificity/sensitivity study, with the genuinely significant, current fact that the 2024 revision of the McDonald MS diagnostic criteria now recognises PRLs as supportive diagnostic evidence.
• Explicitly cross-referenced this platform's Wilson's Disease child page (1108) on the general interpretive principle that susceptibility hypointensity should not be assumed to represent a specific metal without verification — framing QSM as precisely the tool that allows that kind of source-attribution question to be investigated rigorously.
• No invented DOIs, PMIDs, or author names; the ISMRM consensus citation and the foundational Absinta 2013 PRL paper were independently verified by search before inclusion; several supporting clinical/technical papers are cited descriptively (without a fabricated specific author/journal/year combination) where full bibliographic detail could not be independently confirmed within the session's research budget, consistent with this platform's standing no-invented-citation policy.
• Backfilled 2 quiz questions immediately (tecnica_qsm_01/02, category tecnica_pura). meta.count updated to 1077; meta.version bumped to 4.7.
• Registered in data/mrininja-relations.json with reciprocal links to SWI (9011) and all three neurodegeneration/metabolic Brain child protocols (1107 Alzheimer's, 1108 Wilson's Disease, 1109 Gaucher Disease).

MRININJA 3.2.49 — MRI Brain Dedicated Protocol for Gaucher Disease (New Child Page)

Date: September 2, 2026

• Added new dedicated child protocol MRI Brain — Dedicated Protocol for Gaucher Disease (ID 1109), third child of the Brain generic master (1101) in the neurodegeneration/metabolic disease sub-cluster, alongside Alzheimer's Disease (1107) and Wilson's Disease (1108), following the same 14-section pathology child-page template.
• Central organising principle deliberately different from the Wilson's Disease sibling page: rather than presenting a confident "classic pattern," this page states explicitly and repeatedly — sourced directly from the dedicated neuroradiological literature — that brain MRI in Gaucher disease, including neuronopathic type 2 and type 3 disease, is frequently normal or shows only non-specific change. Section 1.2 and the reporting-error table (Section 9.4) both explicitly instruct that a normal MRI in a clinically symptomatic type 2/3 patient is an expected finding, not evidence against neurological involvement — the inverse teaching point from Wilson's disease, where absence of a sign is uninformative but presence is highly specific.
• Phenotype-organised structure (type 1 non-neuronopathic / type 2 acute neuronopathic / type 3 chronic neuronopathic) used throughout, given that MRI's clinical role differs fundamentally across the three phenotypes — for type 1, the emphasis is the emerging GBA-associated Parkinson's disease (GBA-PD) structural biomarker application (substantia nigra SWI/T2*, hippocampal volumetry linked to memory impairment); for type 3, the emphasis is the specific, if uncommon, thalamic/dentate nucleus and temporal lobe/amygdala/hippocampal DWI-restriction findings; type 2 is explicitly flagged as comparatively under-documented in vivo given its rapid, often fatal clinical course.
• No single named/pathognomonic radiological sign exists for this disease (unlike Wilson's "face of the giant panda"); Section 7 explicitly states this and instead tabulates described findings by phenotype, to avoid implying a level of pattern-recognition confidence the evidence does not support.
• Sourced from Perucca et al. 2018 (Neuroradiology, the primary original case series describing thalamic/dentate nucleus and DWI-restriction findings), the SENOPRO multidisciplinary study (Tullo et al. 2023, Int J Mol Sci, DOI 10.3390/ijms24108844, hippocampal volume/memory correlation and GBA-PD rates in type 1), Koens et al. 2021 (Parkinsonism Relat Disord, PMID 33745796, comparative metabolic-disease MRI review), the original clinical description of horizontal supranuclear gaze palsy (Patterson et al. 1993, Neurology), and the GBA-PD structural neuroimaging biomarker review documenting the substantia nigra T2/nigral-hyperechogenicity correlation. No invented DOIs, PMIDs, or author names — every source independently verified by search before inclusion.
• Explicitly distinguished Gaucher disease's characteristically horizontal supranuclear gaze palsy from Niemann-Pick disease type C's classically vertical palsy in the differential diagnosis section (Section 8), a clinically important discriminator between two lysosomal storage disorders that otherwise overlap substantially on imaging.
• Backfilled 2 quiz questions immediately (neuro_gaucher_01/02, category neuro_cranio). meta.count updated to 1075; meta.version bumped to 4.6.
• Updated the Brain master page (1001/1101) "Dedicated Child Protocols" card and Reading Path to list all three neurodegeneration/metabolic child protocols together.
• Registered in data/mrininja-relations.json as a proper child of 1101, with reciprocal links added to both sibling child protocols (1107 Alzheimer's, 1108 Wilson's Disease).

MRININJA 3.2.48 — MRI Brain Dedicated Protocol for Wilson's Disease (New Child Page)

Date: September 2, 2026

• Added new dedicated child protocol MRI Brain — Dedicated Protocol for Wilson's Disease (ID 1108), child of the Brain generic master (1101), following the established 14-section pathology child-page template (matching the structure used for the Alzheimer's Disease dedicated protocol, 1107).
• Comprehensive, sequence-utility-focused coverage as explicitly requested: a dedicated Section 6 walks through the specific clinical utility of each mandatory sequence — T2/FLAIR (primary detection, classic named-sign sequence), T1 (essential for the hepatic-predominant globus pallidus/putamen/mesencephalon hyperintensity pattern that a T2/FLAIR-only protocol would miss entirely), SWI/T2*/GRE, DWI/ADC (with a dedicated, validated weighted cranial DWI severity scale), and MRS (NAA reduction for neurodegeneration vs. myo-inositol reduction for a superimposed hepatic-encephalopathy component).
• All classic named radiological signs verified against their original source publications rather than cited from memory: the "face of the giant panda" sign (Hitoshi, Iwata & Yoshikawa, J Neurol Neurosurg Psychiatry 1991, PMID 1895127 — confirmed as the original 1991 description via independent bibliographic cross-check), the "double panda sign" (Jacobs et al., Neurology 2003, PMID 14557570), and the "trident sign" (Parekh & Agrawal, Oxford Med Case Reports 2014, PMID 25988011); the reported ~14% frequency of the panda sign (Prashanth et al. 2010, 100-case comparative series) explicitly used to caution against treating its absence as evidence against the diagnosis.
• A scientific accuracy correction deliberately built into the page rather than repeating a common oversimplification: SWI/T2* hypointensity in Wilson's disease is widely assumed to directly represent copper deposition, but copper is only weakly paramagnetic; a post-mortem 7T MRI correlative study is cited showing the hypointensity predominantly reflects iron accumulation secondary to neurodegeneration, and the mandatory reporting checklist (Section 9.2) and common-errors table (Section 9.4) both instruct reporting this as "paramagnetic mineral deposition" rather than asserting a specific metal.
• Sourced from the updated 2024/2025 EASL-ERN Clinical Practice Guidelines on Wilson's disease (Socha et al., J Hepatol, DOI 10.1016/j.jhep.2024.11.007) as the primary current guideline, with the original 2012 EASL guideline (Ferenci et al., PMID 22340672) retained as historical/superseded context; plus Sinha et al. 2006, Prashanth et al. 2010, Kim et al. 2006 (paediatric treatment-reversibility), and Roh et al. 1994 for the core clinical-radiological correlation evidence base. No invented DOIs, PMIDs, or author names — every cited paper independently verified by search before inclusion.
• Cross-linked to the ASL master protocol (9301) given isolated case-report evidence of ASL-detected regional CBF reduction in Wilson's disease (Section 6.6), and to the platform's FLAIR/SWI/DWI sequence pages.
• Updated the Brain master page (1001/1101) "Related Brain Child Protocols" section to list both the Alzheimer's and Wilson's disease dedicated protocols; corrected the same site-wide related-content CSS class omission bug already fixed on other pages in this cluster (missing semantic-related-content class causing a duplicate-render risk) while editing this section.
• Backfilled 2 quiz questions immediately (neuro_wilson_01/02, category neuro_cranio). meta.count updated to 1073; meta.version bumped to 4.5.
• Registered in data/mrininja-relations.json as a proper child of 1101, with reciprocal links added to 1107 (Alzheimer's, sibling neurodegeneration child) and 9301 (ASL master).

MRININJA 3.2.47 — ASL Labeling Scheme Techniques and Parameters (New Technical Child Page of the ASL Master)

Date: September 1, 2026

• Added new technical child page Arterial Spin Labeling — Labeling Scheme Techniques and Parameters (ID 9302), first child of the ASL master (9301), opening the reserved 9302–9309 block.
• Built directly from real console data: seven photographs of an actual Philips MRI console's Advanced Parameters panel, reviewed across four distinct saved ASL protocols (ASL_SinglePhase, ASL_MultiPhase, pCASL, and 4D-TRANCE/STAR Angio) plus the console's own built-in help documentation defining each labeling-scheme option (pCASL, STAR, STAR Angio, FAIR, Time-SLIP).
• Full cross-vendor terminology verification performed before writing, not assumed: confirmed that Philips' "STAR"/"FAIR" correspond to the general PASL family (Siemens product name "FAIR Q2TIPS"; GE/research literature "PICORE-Q2TIPS"), each using TI/TI1/TI2-family sub-parameters on Siemens/GE versus Philips' single "label delay" field; and that Philips' "pCASL" corresponds directly to Siemens "PCASL" and GE's "3D ASL" product, each using Labeling Duration (LD) and Post-Labeling Delay (PLD) terminology. Sourced against the 2024 ISMRM OSIPI ASL Lexicon consensus report (Suzuki et al., Magn Reson Med 91:1743-1760, PMID 37876299) — a paper developed specifically to harmonise this exact cross-vendor terminology divergence — plus foundational technique papers (Edelman & Chen 1998 EPISTAR/STAR, Kim & Tsekos 1997 FAIR, Wong/Buxton/Frank 1998 and Luh et al. 1999 QUIPSS II/Q2TIPS).
• Two fundamental labeling-physics families explicitly distinguished as the page's organising principle: pulsed (PASL — STAR/FAIR, single instantaneous inversion pulse, "label thickness/gap/delay" sub-parameters) versus pseudo-continuous (pCASL, ~1.5-2 second continuous labeling train, "label distance/post label delay" sub-parameters) — explicitly flagged as non-interchangeable despite superficial naming similarity, extending the same disambiguation discipline already established elsewhere in this parameter cluster (e.g. slice gap vs. slice-encoding oversampling, fold-over direction vs. fat shift direction).
• Angiographic ASL-derived techniques (STAR Angio, Time-SLIP, 4D-TRANCE) developed as a distinct application of the same underlying labeling physics, with a full worked parameter comparison table (Section 6.2) showing exactly how label thickness, delay, phases, and resolution are re-tuned between perfusion and angiographic use — directly sourced from the reviewed 4D-TRANCE protocol (300 mm label thickness, 200 ms label delay, 140 slices at 1.22×1.30×1.30 mm, non-contrast time-resolved 3D angiography).
• Multi-phase (time-resolved) ASL parameters (phases, duration, phase interval) explained as the STAR-family technical implementation of the multi-PLD concept already introduced generically on the parent master, with real observed values from both the perfusion (8 phases / 4000 ms / 250 ms interval) and angiographic (8 phases / 1850 ms / 200 ms interval) protocols.
• An honest gap explicitly flagged rather than papered over: the reviewed Philips console did not expose a separate, user-editable pCASL "labeling duration" field, unlike Siemens/GE where LD is directly editable — noted as a possible interface-tier limitation rather than assumed to reflect an absent underlying parameter (Section 4.3).
• Backfilled 2 quiz questions immediately (neuro_aslp_01/02, category neuro_cranio). meta.count updated to 1071; meta.version bumped to 4.4.
• Registered in data/mrininja-relations.json as a proper child of 9301 (parent_master/child_pages linkage); the parent master's "Related Child Protocols" placeholder text updated with a real hyperlink. Cross-linked to two relevant existing parameter deep dives (Slice Gap 9591, for the shared RF-profile-transition-band rationale behind PASL's label gap; Fold-over Direction 9593).

MRININJA 3.2.46 — Arterial Spin Labeling (ASL) — Generic Standard Protocol (New Master Page)

Date: August 22, 2026

• Added new master page Arterial Spin Labeling (ASL) — Generic Standard Protocol (ID 9301), a non-contrast, quantitative cerebral blood flow (CBF) perfusion MRI technique, integrated from a fully-drafted external document supplied by Andrea, verified and converted into the platform's standard 12-section master template.
• Pre-integration verification performed per standing editorial policy: both backbone consensus references — Alsop et al. 2015 (Magn Reson Med 73:102-116, PMID 24715426, DOI 10.1002/mrm.25197) and Lindner et al. 2023 (Magn Reson Med 89:2024-2047, PMID 36695294, DOI 10.1002/mrm.29572) — independently confirmed via search against multiple bibliographic sources (Johns Hopkins, Erasmus University, Wiley Online Library, PubMed) before publication, matching the supplied document exactly; no invented DOIs or PMIDs found across the full 10-reference, A-E stratified bibliography.
• Placed under the OTHER macrocategory, new "Perfusion Imaging" subsection, per explicit instruction, rather than as a child of the Brain master (1101) under HEAD — a deliberate architectural choice worth noting: the existing DSC MR Perfusion page (1181) sits as a HEAD/Brain child instead. This asymmetry is flagged transparently rather than silently resolved, since ASL's content is framed generically (protocol design, labeling physics, quantification model) in a manner consistent with this platform's other cross-cutting OTHER-macrocategory masters (Contrast Media 9101, MRI Physics 9201) rather than as a single-organ clinical indication list.
• Assigned ID 9301, opening a new numeric block immediately after the Whole-Body MRI Multiple Myeloma master (9300), reserving 9302–9309 for ASL's own future clinical child pages (already explicitly enumerated in the master page's own text: tumour grading and treatment response, neurodegenerative dementia differential AD/FTD/DLB, steno-occlusive disease and Moyamoya, epilepsy, acute stroke, paediatric protocols, and multi-PLD/time-encoded advanced technique).
• Cross-linked bidirectionally with the Brain master (1101) and the DSC MR Perfusion page (1181, the complementary gadolinium-based perfusion technique referenced throughout this page's tumour-grading discussion) via relations.json; also linked to three relevant existing parameter deep dives (2D vs 3D Acquisition 9584, Fold-over Direction 9593, Parallel Imaging 9588) at the specific points in the text where they are directly referenced (3D readout SNR advantage, EPI distortion mechanism, ExploreASL/vendor acceleration compatibility).
• Preserved the full technical depth of the supplied document without abridgement: the complete PCASL quantification kinetic model (Buxton single-compartment equation), the full labeling-plane positioning technical reference (C2/C3 anatomy, common positioning errors, angulation-efficiency relationship), the complete artefact-reduction table (arterial transit artefact, motion, labeling plane malposition, 2D EPI-specific artefacts, insufficient averaging), and the full vendor implementation comparison table.
• Backfilled 2 quiz questions immediately (neuro_asl_01/02, category neuro_cranio, matching the established convention for perfusion-related content). meta.count updated to 1069; meta.version bumped to 4.3.
• Added "Perfusion Imaging" as a new subsection under the OTHER macrocategory in data/navigation.php.

MRININJA 3.2.45 — Acquisition Bandwidth / Receiver Bandwidth (New Parameter Deep Dive, Second Child of the Chemical Shift Anchor)

Date: August 22, 2026

• Added new parameter deep dive Acquisition Bandwidth (Receiver Bandwidth) (ID 9597), seventeenth child of the MRI Parameters Overview and Classification master page (9501), following the established 21-section deep-dive template — the second of two child pages promised by the Chemical Shift — Theoretical Foundations anchor page (9596).
• Vendor terminology treated in unusual depth per explicit request (Section 3): the three fundamentally different vendor representations — Siemens/Canon bandwidth-per-pixel (Hz/Px), GE total-matrix bandwidth (kHz, independent of resolution), and Philips indirect Water-Fat Shift (WFS, pixels) — developed with full worked cross-vendor conversion formulas and numeric examples (GE 50 kHz / 256-matrix ≈ 195 Hz/Px; Philips WFS-to-Hz/Px via the chemical-shift equation). A fourth naming layer — Variable/Optimised Bandwidth (GE/Fujifilm "Variable Bandwidth", Siemens "Optimized Bandwidth", Philips "Optimized Water/Fat Shift", Canon "Matched Bandwidth") — sourced independently from both an educational technical resource and a Siemens-published cross-vendor acronym comparison chart, cross-checked against each other rather than relied on from a single source.
• Three central relationships developed exactly as requested: (1) with signal — the SNR ∝ 1/√BW square-root relationship, with a worked numeric example (doubling bandwidth costs ≈30% SNR, not 50%); (2) with the number of acquirable slices — bandwidth directly shortens each slice's loop time (T_slice), raising the TR-ceiling N_max_per_package established on the companion Number of Slices page (9590), developed as a genuinely under-used practical lever for avoiding a concatenation (Example 3); (3) with chemical shift artefact — a full quantitative table of pixel-shift values across bandwidth and field-strength combinations, extending the equation already established on the companion Chemical Shift page (9596) with concrete worked numbers.
• Sourced from Graessner 2013 (MAGNETOM Flash, foundational dwell-time/bandwidth technical article), mriquestions.com's dedicated Receiver Bandwidth and Narrow Bandwidth pages, a Siemens-published MRI Acronyms Cross-Vendor Comparison chart, a patent/technical document independently confirming Philips WFS field-strength-specific values, and a real quantitative geometric-distortion-vs-bandwidth study (200–815 Hz/voxel range). No invented DOIs, PMIDs, or author names.
• Five worked clinical examples: cross-vendor protocol translation (concrete GE-to-Siemens conversion), orbit/optic-nerve bandwidth increase for chemical shift management, fitting an extra slice without triggering a concatenation, Variable Bandwidth in a multi-echo sequence, and 1.5T-to-3T protocol migration — the last two explicitly cross-referencing worked examples already published on the companion Chemical Shift page, developed here from the bandwidth-lever side specifically.
• Updated the Chemical Shift anchor page (9596): its "Bandwidth (planned next)" placeholder text in both the Recommended Reading Path and the Related MRI Parameter Deep Dives card converted to real hyperlinks now that this page exists; the anchor page's Section 20 forward-reference remains pointing to the still-forthcoming Fat Shift Direction page.
• Backfilled 3 quiz questions immediately (tecnica_bw_01/02/03, category tecnica_pura). meta.count updated to 1067; meta.version bumped to 4.2.
• Registered in data/mrininja-relations.json with reciprocal links from 9501, from 9596 (its parent anchor), and from three closest sibling deep dives (9590, 9593, 9591); added to the Section 20 complete-index table and the "Related MRI Parameter Deep Dives" card on 9501 itself.

MRININJA 3.2.44 — Bug Fix: Focus-Icon Row Overflow on the Home Protocol Index

Date: August 22, 2026

• Fixed a CSS layout bug on the home protocol index (render_home() in core/functions.php, unchanged): each master protocol card displays one small "⌕" focus-icon per associated parameter deep dive. The .focus-icons container was set to display: inline-flex with no flex-wrap rule, defaulting to nowrap — meaning the icon row was always forced onto a single line regardless of how many deep dives a master page had.
• This was a latent, pre-existing defect that had not been visually apparent until the MRI Parameters Overview master page (9501) accumulated 16 associated deep dives over the course of this cluster's development (9581 through 9596) — at that count, the un-wrapped icon row overflowed past the right edge of the master card's green rounded box, spilling outside its border and background, with the overflowing icons rendered outside the box's clickable/interactive area.
• Fix: added flex-wrap: wrap; and max-width: 100%; to the .focus-icons rule in assets/css/style.css. Icon rows now wrap onto additional lines within the master card's own box as needed, remaining fully contained and clickable regardless of how many deep dives a master page accumulates.
• No HTML, PHP routing, or content changes were required — this was purely a CSS containment fix. No other .focus-icons rule exists elsewhere in the stylesheet to conflict with this change.

MRININJA 3.2.43 — Chemical Shift — Theoretical Foundations (New Parameter Deep Dive, Cluster Anchor for Bandwidth and Fat Shift Direction)

Date: August 22, 2026

• Added new parameter deep dive Chemical Shift — Theoretical Foundations (ID 9596), sixteenth child of the MRI Parameters Overview and Classification master page (9501), following the established 21-section deep-dive template.
• Anti-duplication check performed before writing: a full physics-cluster treatment of chemical shift already exists at Chemical Shift and Fat/Water Physics (9206, physics cluster, July 2026), covering the electron-shielding origin, ppm scale, quantitative water-fat frequency values, Type 1/Type 2 artefact mechanisms, and fat-suppression technique comparison in full depth. This new page deliberately does not re-derive that content — it is explicitly framed as the parameter-cluster companion, reframing chemical shift around the two console-actionable parameters it motivates (bandwidth, fat shift direction) rather than repeating the underlying physics.
• Discovered and fulfilled an existing forward-reference: 9206's own Section 4.1 already stated that the bandwidth-dependent pixel-shift relationship would be "discussed practically... in the MRI Parameters cluster" — this new page is that promised treatment. The placeholder prose in 9206 was updated to a real hyperlink to 9596 rather than left as a vague forward pointer.
• Explicitly architected as an anchor page for two forthcoming child parameter deep dives, per the specific request that this page serve as the shared foundation: Bandwidth (developing the "how much" lever — the pixel-shift equation, typical values by sequence/field strength, SNR/SAR trade-offs, vendor conventions) and Fat Shift Direction (developing the "which way" lever — spatial axis selection, worked anatomical examples, interaction with fold-over direction). Both are explicitly flagged in Section 20 as the immediate next planned additions to this cluster.
• Vendor terminology sourced directly from the person's own Philips console screenshots reviewed earlier in this cluster's development: the live "WFS (pix) / BW (Hz): 0.734 / 591.9" summary-panel readout and the separate "Water-fat shift: maximum" Contrast-tab preference field, contrasted explicitly with the Siemens/GE/Canon convention of specifying bandwidth directly in Hz/pixel without a standalone pixel-shift display.
• Explicit contrast drawn with the companion Fold-over Direction page (9593): EPI's dominant geometric distortion (phase-axis, low effective bandwidth) and chemical shift misregistration (frequency-axis, typically high readout bandwidth in EPI) are two genuinely different axis/mechanism pairs that share only a superficial "low bandwidth causes more artefact" logic — developed as a dedicated comparison in Section 10 and Section 18.2, to pre-empt a plausible point of confusion between the two pages.
• References deliberately minimal and non-duplicative: this page points to 9206's own bibliography for the full physics citation set rather than re-listing Proctor & Yu 1950 and Dickinson 1950 with new relevance notes; only the two landmark papers are reused (properly re-cited) for direct context.
• Backfilled 3 quiz questions immediately (tecnica_chsh_01/02/03, category tecnica_pura), maintaining the practice established after the v3.2.41 catch-up release. meta.count updated to 1064; meta.version bumped to 4.1.
• Registered in data/mrininja-relations.json with reciprocal links from 9501, from 9206 (physics cluster), and from its three closest sibling parameter deep dives (9593, 9594, 9595); added to the Section 20 complete-index table and the "Related MRI Parameter Deep Dives" card on 9501 itself.

MRININJA 3.2.42 — Slice Oversampling in the Slice-Encoding Direction, 3D (New Parameter Deep Dive)

Date: August 22, 2026

• Added new parameter deep dive Slice Oversampling in the Slice-Encoding Direction (3D) (ID 9595), fifteenth child of the MRI Parameters Overview and Classification master page (9501), following the established 21-section deep-dive template.
• Framed explicitly as the through-slab, 3D analogue of in-plane phase oversampling (companion page 9585): a 3D acquisition excites the whole slab with one RF pulse and resolves position through the slab using a second, phase-encoded (not frequency-encoded) partition axis, which therefore inherits the same Nyquist-sampling wrap-around vulnerability as in-plane phase encoding.
• Central distinguishing fact developed in depth (Section 7): unlike in-plane phase oversampling, which is frequently near-zero net cost via NEX halving, slice-encoding-direction oversampling has no routine equivalent compensation — because 3D scan time scales linearly with partition count, every additional oversampled partition adds real, largely uncompensated scan time, confirmed directly against patent/technical literature explicitly distinguishing free readout-direction oversampling from costed phase- and slice-encode oversampling.
• The "nothing outside, nothing wraps" principle established as this page's central practical message, directly extending the geometric-planning-first logic of the companion Antialiasing Options and Strategies page (9594) to the 3D slab-boundary case: if a slab is correctly and generously planned against the localiser so the true anatomy never approaches its boundary, no oversampling is required at all, at zero scan-time cost — illustrated as a full worked example (knee cartilage 3D TSE, Example 3).
• Introduced and properly sourced the distinct but related "boundary slice aliasing" mechanism (RF excitation-profile transition bands/sidelobes at the slab edge, as opposed to pure geometric Nyquist wrap), and explicitly disambiguated this page from the unrelated, similarly-named companion Slice Gap page (9591) — same disambiguation discipline already applied to slice-scan-order-vs-profile-order (9592) and fold-over-direction-vs-fat-shift-direction (9593).
• Typical oversampling levels tabulated by clinical application as requested (Section 4): whole-brain 3D T1 (~15–25%), joint cartilage 3D TSE (~0–10%, frequently a plan-only zero-oversampling case), whole-spine/long-segment 3D (~10–20%), and research-grade thin multi-slab 3D diffusion (a dedicated, actively-researched design parameter rather than a single default percentage), plus a concrete, vendor-documented GE default-margin example (128 acquired / 124 displayed partitions).
• Sourced from Li et al. 2023 (Magn Reson Med, boundary slice aliasing mechanism and blip-reversed k_z-oversampled correction) and Wu et al. 2016 (Magn Reson Med, NPEN slab-profile-encoding correction method), both new to the site; reused, properly re-cited Pruessmann 1999 and Lauterbur 1973. No invented DOIs, PMIDs, or author names.
• Backfilled 3 quiz questions in game/data/questions.json immediately (tecnica_sos_01/02/03, category tecnica_pura) — applying the lesson from the previous quiz catch-up release (v3.2.41) so this omission does not recur. meta.count updated to 1061; meta.version bumped to 4.0.
• Registered in data/mrininja-relations.json with reciprocal links from 9501 and from its five closest sibling deep dives (9585, 9591, 9590, 9584, 9594); added to the Section 20 complete-index table and the "Related MRI Parameter Deep Dives" card on 9501 itself. Reciprocal HTML links added directly on 9591 and 9594 (modern card format); reciprocal registry links added for 9585 and 9584 via relations.json only, consistent with the mixed HTML-generation-era pattern already documented for this cluster.

MRININJA 3.2.41 — Quiz Questions Catch-Up: Fascial Structures and Parameter Deep Dive Cluster

Date: August 22, 2026

• Backfilled 12 quiz questions in game/data/questions.json for the six most recently published pages, which had been missed at the time each page was created: Fascial Structures master (9400), Number of Slices (9590), Slice Gap (9591), Slice Scan Order (9592), Fold-over Direction (9593), and Antialiasing Options and Strategies (9594) — two questions per page, following the site's standing schema and ID convention exactly (tecnica_pura category and tecnica_<short>_NN id prefix for the five technical parameter pages, matching the existing convention used for 9581/9582/9585/9586/9588/9589; body category for the clinical Fascial Structures master, following the convention used elsewhere on the site for organ/tissue-system master pages).
• All 12 new ids verified against the existing question bank before insertion to rule out collisions; every question conforms to the required schema (id, category, difficulty, question, four options, correct_index, explanation, source_ref).
• meta.count updated from 1046 to 1058; meta.version bumped from 3.8 to 3.9 per the standing versioning rule.
• No pre-existing questions were modified, reordered, or removed.

MRININJA 3.2.40 — Antialiasing Options and Strategies: Content Update (In-Plane FOV Rotation and Standalone Phase-Direction Strategy)

Date: August 22, 2026

• Regenerated Antialiasing Options and Strategies (v1.1), incorporating two additional geometric/planning strategies that were requested to be added rather than treated as a minor supporting detail.
• In-plane FOV rotation (angulation) established as its own antialiasing mechanism (Section 2.3): rotating the acquisition FOV to align with an anatomy's true oblique axis can either bring previously out-of-FOV anatomy fully inside coverage (a smaller, correctly-angled rectangle can contain what a larger non-rotated one could not, or could only contain inefficiently), or — when full coverage still is not achieved — relocate where any residual wrap lands, walking it away from a diagnostically critical structure at zero cost in scan time or SNR. Added as new Example 6 (obliquely-positioned forearm/wrist protocol).
• Phase-encoding direction elevated from a supporting/fallback measure to a standalone, first-line strategy (Section 2.4): because wrap-around is functionally a phase-axis-only phenomenon, anatomy that fits comfortably on one in-plane axis but not the other can be completely resolved simply by assigning phase encoding to the comfortable axis, with no other technique required — restructured Section 13's decision hierarchy so this check happens alongside repositioning and rotation at Step 1, rather than being reserved until after suppression/acquisition-based fixes have already been tried. Added as new Example 5 (shoulder MRI phase-direction swap as a complete, standalone fix).
• Restructured the page's category framework from four to explicitly group repositioning, in-plane rotation, and phase-direction assignment together as a single "geometric / planning-based, zero-cost" category (Section 1), updated throughout Sections 2.2, 4, 5.1, 7, 8, 9, 13, 15, 16, and 18 to reflect the three-strategy bundle consistently rather than treating rotation and phase-direction choice as isolated addenda.
• Updated vendor terminology table (Section 3) to include in-plane rotation/angulation field names across Siemens, GE, Philips, and Canon.
• No new evidence gaps introduced beyond the existing SENSE R=1 qualification (Section 19); the in-plane rotation and phase-direction-swap principles are grounded in the same well-sourced general phase/frequency-assignment logic already cited from mri-q.com [6] for the companion Fold-over Direction page, extended here to the continuous-rotation case and restated as a standalone strategy rather than requiring new citation.

MRININJA 3.2.39 — Antialiasing Options and Strategies (New Synthesis Deep Dive)

Date: August 22, 2026

• Added new parameter deep dive Antialiasing Options and Strategies (ID 9594), fourteenth child of the MRI Parameters Overview and Classification master page (9501). Unlike the preceding thirteen pages in this cluster, this page is explicitly a synthesis / decision-hub page rather than a single-parameter deep dive: it does not re-derive physics already covered on the companion FOV, Phase Oversampling, REST Slab, and Fold-over Direction pages, but instead organises every antialiasing tool on the platform into a four-category framework (acquisition-based, suppression-based, reconstruction-based, practical/positioning) and provides an explicit decision hierarchy for choosing between them.
• Practical/positioning strategies developed as their own first-class category, in direct response to the explicit request that this page cover practical ideas — not only technical parameters — such as avoiding placing additional anatomy adjacent to the region being examined, and physically repositioning anatomy that is already present out of the region that generates wrap-around artefact. Arms-up positioning for abdominal/pelvic imaging and contralateral-limb management for extremity imaging are developed as the leading worked examples, and Section 13.1 establishes explicit priority: positioning-based strategies are unconditionally free in both scan time and SNR (Section 7, Section 8 comparative tables), and should be considered before any technical fix.
• The SENSE/ASSET "reduction factor 1" incidental antialiasing effect addressed with deliberate technical precision, in direct response to the specific observation that using SENSE without acceleration (R=1) produces an antialiasing effect. Verified rather than accepted at face value: in the strict original SENSE formulation, R=1 involves no deliberate undersampling and therefore no formal "unfolding" step — directly confirmed by a technical demonstration showing SENSE reconstruction at R=1 mathematically reduces to simple sensitivity-weighted combination without unfolding. The genuine, defensible basis for the clinically observed effect is instead traced to vendor implementations that acquire coil-sensitivity reference/calibration data over a region larger than the final prescribed imaging FOV ("reference oversampling"), which can incidentally help resolve FOV-insufficiency wrap through the same coil-sensitivity-difference logic used for deliberate acceleration — a real but vendor/implementation-dependent phenomenon, presented as a qualified bonus layer rather than a primary, reliable strategy, with the distinction stated explicitly and repeatedly (Sections 5.2, 9, 15, 19, Example 5) to avoid overclaiming.
• Sourced additionally from Kurihara et al. 2002 AJR (SENSE clinical-practice original description) and a technical arXiv demonstration of SENSE R=1 behaviour, alongside reused, properly re-cited foundational references (Pruessmann 1999 SENSE, Lauterbur 1973) and technical teaching resources (IMAIOS e-MRI, mriquestions.com). No invented DOIs, PMIDs, or author names.
• Five worked clinical examples: abdominal MRI with arms-up positioning (first-line, zero-cost strategy), abdominal MRI with arms unavailable (correct escalation to REST slab), knee MRI contralateral-limb management via coil selection, whole-spine MRI layered multi-strategy defence, and a SENSE R=1 incidental-benefit case explicitly framed as a bonus rather than a planned primary defence.
• Registered in data/mrininja-relations.json with reciprocal links from 9501 and from its five closest sibling deep dives (9581 FOV, 9585 Phase Oversampling, 9586 REST Slab, 9593 Fold-over Direction, 9588 Parallel Imaging); added to the Section 20 complete-index table and the "Related MRI Parameter Deep Dives" card on 9501 itself. Reciprocal HTML links added directly on 9586 and 9593 (modern card format); reciprocal registry links added for 9581, 9585, and 9588 via relations.json only, consistent with the mixed HTML-generation-era pattern already documented for this cluster.

MRININJA 3.2.38 — Fold-over Direction / Phase-Encoding Direction (New Parameter Deep Dive)

Date: August 21, 2026

• Added new parameter deep dive Fold-over Direction (Phase-Encoding Direction) (ID 9593), thirteenth child of the MRI Parameters Overview and Classification master page (9501), following the established 21-section deep-dive template.
• Standing editorial principle established explicitly for this page and going forward for every future parameter deep dive on this platform: Section 3 (Units, Terminology and Vendor Nomenclature) is treated as deliberately exhaustive, documenting every vendor-specific field name and acronym for the parameter rather than a single generic label — a direct response to explicit direction that acronym/synonym completeness applies to all parameter pages, not only this one.
• Core physics developed from first principles: the frequency-encoding vs phase-encoding asymmetry (continuous single-readout sampling vs discrete, TR-by-TR sampling) as the foundational reason motion ghosting, wrap-around, and — for EPI — geometric distortion all concentrate specifically on the phase-encoding axis; the practically-free frequency-direction oversampling convention explaining why wrap-around is functionally a phase-axis-only clinical concern despite Nyquist physics technically applying to both axes.
• Rigorous terminology verification rather than assumption: Siemens' "Phase enc. dir." field and its A>>P/P>>A/R>>L/L>>R/H>>F/F>>H directional-arrow notation confirmed directly against real Siemens protocol exports (Human Connectome Project Q1 Reference Manual, MGH fMRI protocol PDFs) rather than assumed generic phrasing; the documented Siemens-vs-GE default axial phase-encoding divergence (A>>P vs P-A) sourced to a specific, named technical blog post rather than presented as an unattributed claim.
• Explicit, deliberate disambiguation from two adjacent, easily-confused console fields: "fold-over suppression" (phase oversampling — the companion 9585 page, a mitigation technique applied after this page's direction choice is made) and "fat shift direction" (a separate, co-located Philips console field governing chemical-shift misregistration direction, flagged for its own future dedicated page) — following the same disambiguation discipline established for "slice scan order" vs "profile order" on the companion 9592 page.
• EPI geometric distortion developed as the single most clinically consequential sequence-specific behaviour on this page, sourced to the foundational Jezzard & Balaban 1995 Magnetic Resonance in Medicine correction paper, with quantitative distortion-magnitude and field-strength-scaling context from the broader technical literature.
• Five worked clinical examples: axial brain (left-right phase, classic eye-ghosting-avoidance teaching case), axial brain EPI (Siemens/GE vendor-default divergence and cross-site harmonisation), sagittal lumbar spine (superior-inferior phase, cord/disc protection), extremity joint imaging (rectangular-FOV scan-time saving), and high-field diffusion MRI in susceptibility-prone frontal/temporal regions.
• Registered in data/mrininja-relations.json with reciprocal links from 9501 and from its four closest sibling deep dives (9585 Phase Oversampling, 9581 FOV, 9588 Parallel Imaging, 9592 Slice Scan Order); added to the Section 20 complete-index table and the "Related MRI Parameter Deep Dives" card on 9501 itself. Reciprocal HTML links added directly on 9588 and 9592 (modern card format); reciprocal registry links added for 9581 and 9585 via relations.json only, since both predate the current related-content-grid HTML convention used from 9586 onward.

MRININJA 3.2.37 — Cross-Linking Update: REST Slab / Presaturation Band ↔ Slice Cluster

Date: August 21, 2026

• No new page in this entry. During work on the parameter deep-dive cluster, a request for a "Presaturation Band / Presat Slabs" deep dive was checked against the existing catalogue first — REST Slab / Presaturation Band (9586, June 2026) already exists as a complete, 21-section, 4-example deep dive and was not duplicated.
• Added reciprocal cross-links between 9586 and the three most recently added slice-cluster deep dives — Number of Slices (9590), Slice Gap (9591), and Slice Scan Order (9592) — none of which existed when 9586 was originally written and were therefore missing from its "Related MRI Parameter Deep Dives" card.
• Specifically noted the topical overlap between 9586's Example 2 (TOF brain MRA venous saturation band placement) and 9592's Example 2 (TOF neurovascular direction/saturation logic), with each page now pointing readers to the other for the complementary half of the same underlying mechanism (9586 for the full REST-slab technical treatment; 9592 for the scan-direction/order framing).

MRININJA 3.2.36 — Slice Scan Order (New Parameter Deep Dive)

Date: August 21, 2026

• Added new parameter deep dive Slice Scan Order (ID 9592), twelfth child of the MRI Parameters Overview and Classification master page (9501), following the established 21-section deep-dive template.
• Scope defined as two related but distinct decisions: temporal excitation pattern (sequential vs interleaved — the shared cross-talk mechanism with the companion Slice Gap page, treated here from the "when" rather than the "how much separation" angle) and spatial acquisition direction (e.g. head-to-foot vs foot-to-head), which is a workflow convention for static anatomy but a first-order contrast-generating design decision for flow-sensitive sequences (TOF MRA inflow enhancement and directional saturation).
• Explicit, deliberate terminology disambiguation from "k-space profile order": flagged in Section 1 as a critical distinction and reinforced in Sections 3, 5.1, 12 and 15 — slice scan order (which physical slice, in what order) is a genuinely different console parameter from profile order (k-space line ordering within one slice's own echo train), confirmed as separate fields in separate tabs (Geometry vs Contrast) on the Philips console reviewed for this page.
• Vendor terminology verified against the same Philips console screenshots reviewed for the Number of Slices and Slice Gap pages: "Slice scan order: HF" in the Geometry tab (spatial direction) explicitly distinguished from "profile order: linear" in the separate Contrast tab (unrelated k-space parameter).
• Two substantial, properly-sourced clinical mechanisms developed in full: (1) TOF MRA flow-direction/saturation-band logic, sourced to a dedicated IMAIOS e-MRI technical resource and a 2019 Cardiovascular Diagnosis and Therapy review (Kuo et al.), plus a Johns Hopkins publication record on TOF pseudostenosis; (2) cardiac short-axis "stair-step" inter-breath-hold misregistration, sourced to a dedicated 2003 volunteer quantification study (Swingen, Seethamraju, Jerosch-Herold — Int J Cardiovasc Imaging) reporting ~3.0 mm through-plane / ~4.2 mm in-plane centroid misregistration, and a 2008 J Cardiovasc Magn Reson slice-to-volume registration correction paper (Chandler et al.).
• Five worked clinical examples spanning brain post-contrast T1 (brief, cross-referencing the Slice Gap page's own full treatment rather than duplicating it), neurovascular TOF MRA direction, cardiac short-axis stair-step, whole-body multi-station clinically-driven reordering, and dynamic liver MRI (included specifically as a contrasting 3D example to clarify that the 2D slice-order temporal-sampling concern does not apply to 3D dynamic acquisition).
• No invented DOIs, PMIDs, or author names; all seven references independently verified by search before inclusion.
• Registered in data/mrininja-relations.json with reciprocal links from 9501 and from its four closest sibling deep dives (9591, 9590, 9583, 9588); added to the Section 20 complete-index table and the "Related MRI Parameter Deep Dives" card on 9501 itself.

MRININJA 3.2.35 — Slice Gap (New Parameter Deep Dive)

Date: August 21, 2026

• Added new parameter deep dive Slice Gap (ID 9591), eleventh child of the MRI Parameters Overview and Classification master page (9501), following the established 21-section deep-dive template.
• Scope explicitly distinguished from both companion pages: Slice Thickness (9583) answers "how much tissue does each slice represent"; Number of Slices (9590) answers "how many are needed and can the sequence deliver them in time/SAR budget"; this page answers a third, different question — "how much of the anatomy between slices is deliberately left unsampled, and is that acceptable." Central original framing: the missed-tissue fraction g/(Δz+g), presented as a direct, quantifiable coverage sacrifice distinct from the SNR trade-off of thickness and the time/SAR trade-off of slice count.
• Central technical content: the RF slice-profile transition-skirt origin of cross-talk, worse for 180° pulses (STIR, FLAIR, TSE refocusing) than 90° excitation; interleaved acquisition order presented explicitly as the primary, coverage-preserving alternative to gap, with gap positioned as a supplementary/fallback measure rather than the default first-line defence; the explicit distinction between 2D gap (cross-talk purpose) and 3D "slice oversampling" (wrap-prevention purpose) as unrelated concepts governed by different physics.
• Vendor terminology verified against an actual Philips console (Advanced Parameters, Geometry tab, same screenshots reviewed for the Number of Slices page): the absolute-millimetre "gap (mm)" field within the Stack block, "user defined" mode. The Siemens Distance Factor percentage-of-thickness convention is treated as a distinct, deliberately flagged cross-vendor translation risk (Section 3, Section 12, Section 15, Section 18.3) since copying the raw numeric value across the percentage/absolute-mm boundary silently changes the actual gap delivered.
• Quantitative sourcing handled with explicit evidence-category honesty: the commonly cited "~10% for optimised RF pulses, up to ~50% for simple sinc pulses" gap-percentage range is sourced to US Patent 10,114,096 and explicitly labelled as patent/technical literature rather than peer-reviewed clinical evidence, both inline and in Section 19's evidence-gap discussion — no attempt to dress up an engineering-literature figure as a validated clinical threshold.
• Sourced additionally from IMAIOS e-MRI (cross-talk mechanism teaching resource), the standard Haacke and Bernstein MRI physics textbooks, and (reused, properly re-cited) Setsompop et al. 2012 and Larkman et al. 2001 for the SMS slice-group-spacing distinction. No invented DOIs, PMIDs, patent numbers, or author names.
• Five worked clinical examples spanning the full range of clinical gap priorities: MS brain surveillance (near-zero gap), IAC/vestibular schwannoma screening (negative gap/overlap), rapid whole-spine triage (deliberate large gap, explicitly flagged as a non-default, documented trade-off), post-contrast spine T1 cross-talk troubleshooting, and multi-station whole-body station-boundary overlap — deliberately non-overlapping with the brain-specific post-contrast cross-talk example already present on the companion Slice Thickness page.
• Registered in data/mrininja-relations.json with reciprocal links from 9501 and from its four closest sibling deep dives (9583, 9590, 9584, 9588); added to the Section 20 complete-index table and the "Related MRI Parameter Deep Dives" card on 9501 itself.

MRININJA 3.2.34 — Number of Slices (New Parameter Deep Dive)

Date: August 21, 2026

• Added new parameter deep dive Number of Slices (ID 9590), tenth child of the MRI Parameters Overview and Classification master page (9501), following the established 21-section deep-dive template.
• Scope explicitly distinguished from the companion Slice Thickness page (9583): that page answers "how much tissue does each slice represent"; this page answers "how many slices are required, and can the sequence deliver that many within the TR/SAR budget of a single pass, or must the acquisition be split." The two parameters combine multiplicatively to determine coverage but diverge sharply in downstream consequences (SNR/partial-volume vs. acquisition time/SAR/package-splitting).
• Central technical content: the 2D multi-slice TR-slice-loop-time ceiling (N_max_per_package = TR / T_slice) and its step-function scan-time cost when crossed — contrasted explicitly with the linear, non-ceiling scan-time cost of adding partitions in 3D acquisitions; the comparatively direct (vs. slice thickness's indirect) SAR relationship, since every additional 2D slice within a TR requires its own RF pulse; and the effective-ceiling-multiplication logic of simultaneous multi-slice (SMS/multiband) acceleration.
• Weighting-specific worked examples (Section 17), directly responding to the requirement that this page show how the parameter behaves differently across weightings: T1 TSE (short TR aggressively triggers concatenations), T2/PD TSE (long TR gives comfortable single-package headroom), STIR (the inversion pulse and TI wait roughly halve the achievable slice-count ceiling relative to a non-IR sequence at the same TR), single-shot EPI/DWI/fMRI (SMS effectively removes the ceiling as a binding constraint), and 3D MPRAGE (the same T1-weighting that is ceiling-bound in 2D becomes a smooth linear time cost in 3D).
• Vendor terminology verified against an actual Philips console (Advanced Parameters, Geometry tab, screenshots reviewed directly): Stacks → type/slices/slice gap/slice orientation/fold-over direction/fat shift direction/slice scan order, with the resolved "Act. TR (ms)" displayed live in the summary panel as a direct visible expression of the TR–slice-count coupling. Cross-vendor "package-splitting" terminology (Siemens "Concatenations", GE "Acquisitions", Philips "Packages") verified against a multi-site clinical trial imaging protocol document (NCT00988052) rather than assumed.
• Sourced additionally from Setsompop et al. 2012 (blipped-CAIPI SMS, verified DOI/PMID), Runge & Heverhagen 2022 (textbook chapter formalising the "slice loop time" concept), Bollmann et al. 2018 (paired short-TR/SMS vs. longer-TR/no-SMS fMRI acquisition parameters, used for the Example 4 worked comparison), and Jack et al. 2008 (ADNI MPRAGE 176-partition standard, used for Example 5). No invented DOIs, PMIDs, or author names — one initially drafted citation (a preprint reference) was corrected mid-session after its true authorship was verified by search rather than assumed.
• Registered in data/mrininja-relations.json with reciprocal links from 9501 and from its four closest sibling deep dives (9583 Slice Thickness, 9584 2D vs 3D, 9588 Parallel Imaging, 9589 NEX/NSA); added to the Section 20 complete-index table and the "Related MRI Parameter Deep Dives" card on 9501 itself.

MRININJA 3.2.33 — MRI of Fascial Structures (New Master Page)

Date: August 20, 2026

• Added new master page MRI of Fascial Structures — Generic Standard Protocol (ID 9400) — a cross-regional, topic-based master page covering the fascial system (superficial fascia, deep/investing fascia, aponeuroses, intermuscular septa) as a technical and interpretive backbone shared across four disease categories: traumatic/mechanical (Morel-Lavallée lesion, myo-aponeurotic injury, muscle hernia), infective (necrotizing and non-necrotizing fasciitis), inflammatory/autoimmune (eosinophilic fasciitis, morphea/localized scleroderma spectrum), and neoplastic (superficial and desmoid-type fibromatosis, fascia-based sarcoma).
• Architectural rationale: placed under the MUSCLE macrocategory as a fifth, pathology-type subdivision alongside Trauma/Mechanical, Tumour/Infection, Neuromuscular, and Metabolic/Systemic Disorders — the same disease-category organising logic (rather than a single-limb anatomical scope) already used by those four existing muscle masters, and the natural section a musculoskeletal-radiology reader would browse for this content. The deep fascia is anatomically the investing envelope of muscle compartments, and the infective differential central to this page (necrotizing fasciitis vs. pyomyositis) is already the shared subject matter of the Muscle Tumors and Infection master (2201); OTHER was considered and rejected, since that macrocategory is reserved for universal cross-cutting technique/administrative topics (safety, preparation, contrast media, physics, EBM methodology) that apply identically to every protocol on the platform regardless of anatomy, which does not describe a tissue type with its own four-category disease taxonomy.
• Placed in the MUSCLE macrocategory, subsection "Fascial Structures", added to data/navigation.php as a fifth MUSCLE subsection; assigned the 9400 numeric block (kept within the existing 9xxx cross-cutting/reference numbering space rather than the 2xxx muscle block, since its child pages — e.g. cervical or perineal necrotizing fasciitis — will extend beyond a single-limb muscle protocol base even though the category itself sits under MUSCLE), leaving 9401+ free for the planned dedicated child pages (necrotizing fasciitis first).
• Central technical content: fat-suppression technique selection specific to thin, fat-embedded fascial structures (spectral/Dixon post-contrast, STIR pre-contrast for off-isocentre anatomy, STIR never post-contrast), field-of-view and coverage principles for a plane-like structure that characteristically extends beyond the clinically apparent abnormality, and a generic, entity-agnostic reporting framework (thickness, signal, extent, enhancement pattern, compartment involvement) designed to be inherited by every future child page.
• Sourced primarily from the two Kirchgesner et al. (Insights Imaging, 2018 and 2019) fascia-focused pictorial reviews — normal anatomy/autoimmune involvement, and trauma/infection/neoplastic classification respectively — which had not previously been cited anywhere on the platform.
• Cross-linked and reconciled with the existing Muscle in Tumors and Infection master page (2201): 2201's "Related Child Protocols" note, which had previously earmarked necrotizing soft-tissue infection as a future child of 2201 itself, has been updated to route that future child page to the new Fascial Structures master (9400) instead, since the disease is primarily fascial rather than muscular in substrate and spans regions (neck, perineum, trunk) outside a muscle-specific extremity protocol's scope. 2201's own necrotizing-infection content (Sections 1.2, 2.2, 10) is retained as the muscle-specific cross-reference and pyomyositis differential.
• Reciprocal links added on 9101 (Contrast Media) and 9201 (MRI Physics — Fundamentals and Principles).

MRININJA 3.2.32 — MRI Pituitary Gland for Germinoma (New Child Page)

Date: August 14, 2026

• Added new child page MRI Pituitary Gland for Germinoma (ID 1203) — second pathology child of the Pituitary Gland master (1201), and explicit companion to the Diabetes Insipidus child page (1202) delivered previously.
• Scope explicitly distinguished from 1202 in Section 1.1: the DI page addresses the specific scenario of an initially occult germinoma discovered through longitudinal stalk-thickening surveillance; this page addresses germinoma as an already-identified or strongly suspected mass — full characterisation, subtype differentiation from non-germinomatous germ cell tumours (NGGCTs), and mandatory craniospinal staging.
• Documents the germinoma-vs-NGGCT morphological differential (larger size, T1-hyperintense foci, and stronger enhancement favouring NGGCT; every bifocal lesion in one 85-patient comparative cohort was a germinoma, none an NGGCT) and makes whole-spine contrast-enhanced MRI a MANDATORY, not conditional, staging component, given leptomeningeal dissemination reported in 10-15% of patients at diagnosis.
• Deliberately detailed, counter-intuitive DWI section: unlike most other tumour differentials on the site where restricted diffusion is a reasonably reliable hypercellularity marker, a dedicated histopathology-correlated original study found only around one-third of germinomas showed predominantly restricted diffusion, just over half showed normal diffusion, and a small minority showed genuinely increased diffusion — explicitly flagged (Sections 5.2, 5.6, 6.2) as meaning a normal ADC value must NOT be used as evidence against the diagnosis, a specific, named exception to a heuristic that holds more reliably elsewhere in this knowledge base.
• Sourced from Wu et al. 2017 (J Neurooncol, 85-patient germinoma-vs-NGGCT comparative study), Douglas-Akinwande et al. 2009 (Acad Radiol, histopathology-correlated DWI study), and Yang et al. 2023 (Front Pediatr, comprehensive contemporary review).
• Registered as the second pathology child of 1201, using the same lightweight callout-link convention already established for 1202 (this master still lacks a standard Related-Content grid block, per the note already flagged in v3.2.31). Reciprocal cross-links added with 1202 (explicit companion relationship) and with the existing Brain Tumour child page (1105, WHO classification cross-reference).

MRININJA 3.2.31 — MRI Pituitary Gland for Diabetes Insipidus (New Child Page)

Date: August 13, 2026

• Added new child page MRI Pituitary Gland for Diabetes Insipidus (ID 1202) — the first genuine pathology child page under the Pituitary Gland master (1201), which previously had only one deep-dive page (1281, half-dose gadolinium DCE analysis) and no standard pathology children.
• Explicitly scoped around the actual clinical/imaging division of labour: central-vs-nephrogenic DI is a clinical/biochemical distinction made BEFORE imaging (water deprivation test, copeptin) and is not an MRI question; this protocol's role begins only once central DI is confirmed, focusing on posterior pituitary bright spot assessment and, critically, structuring the differential and LONGITUDINAL SURVEILLANCE strategy for pituitary stalk thickening.
• Central finding, reported with genuine evidence weight: an initially normal or ‘idiopathic’ central DI presentation can conceal an occult germinoma not yet visible on imaging — grounded directly in landmark cohort data (germinoma diagnosed a mean of ~1.3 years after stalk thickening was first identified; idiopathic-appearing presentations accounting for a substantial share of all paediatric germinomas at one specific centre). A specific biannual surveillance interval recommendation for the first 2-3 years is documented as a deliberate, core protocol feature (Section 4.4) rather than an afterthought, explicitly distinguished from a single-timepoint diagnostic study.
• Documents the neoplastic-vs-benign stalk-thickening differential (germinoma, Langerhans cell histiocytosis, lymphocytic infundibulo-neurohypophysitis) using quantified adult cohort risk features (male sex, younger age, greater stalk thickness, multiple anterior pituitary deficiencies), and explicitly distinguishes pituitary stalk interruption syndrome (a fixed, congenital, non-progressive triad) from these acquired, potentially neoplastic processes — a genuinely consequential interpretive distinction given their different clinical implications.
• Sourced from Leger et al. 1999 (JCEM, landmark 26-patient paediatric longitudinal cohort), Maghnie et al. 2000 (NEJM), Mootha et al. 1997 (JCEM, UCSF cohort), and Devuyst et al. 2020 (Eur J Endocrinol, 38-patient adult cohort).
• Registered as the first pathology child of 1201. Since this master page does not yet have a standard ‘Related Content’ grid block (unlike newer master pages on the site), a lightweight callout link matching the page's own existing style (already used for the 1281 deep-dive link) was added rather than importing a different site convention — flagged as a possible future harmonisation task, not executed as part of this scoped delivery. Reciprocal cross-link added with the existing Brain Tumour child page (1105), given the explicit germinoma/pineal-region cross-reference in Sections 4.3 and 5.3.

MRININJA 3.2.30 — MRI Orbits for Inflammatory/Infectious Disease and Vascular Lesions (Two New Child Pages) — Orbit / Visual Disorders 7-Page Roster Complete

Date: August 10, 2026

• Added two new child pages, completing the originally-planned seven-page roster of orbit-proper pathology under the Orbit / Visual Disorders master (1301): MRI Orbits for Inflammatory or Infectious Disease (ID 1307) and MRI Orbits for Vascular Lesions (ID 1308).
• 1307 is built around the single most consequential imaging task in this category — reliably distinguishing drainable abscess from phlegmonous cellulitis, since this determines surgical versus medical management. DWI is elevated from the generic protocol's ‘mandatory in modern protocol’ status to genuinely non-negotiable, grounded in original evidence that DWI improved diagnostic confidence in nearly all abscess cases and confirmed abscess in a majority even without contrast. A deliberately staged interpretive approach is documented explicitly: preseptal-vs-postseptal first, then abscess-vs-no-abscess, then posterior/intracranial extension — mirroring the genuinely staged clinical decision-making (admission, then surgical decision, then escalation) this protocol supports. Built around the Chandler five-stage classification (1970), still in continuous clinical use.
• 1308 documents provocative (Valsalva/positional) imaging as the defining diagnostic tool for orbital varix — explicitly framed as conceptually related to, but mechanistically distinct from, the contrast-timing-based dynamic imaging already established in the Orbital Tumour (1302) and Globe (1305) child pages, since here the variable is position/pressure rather than contrast timing. Grounded in a landmark 158-patient original study. Also documents carotid-cavernous fistula secondary signs (enlarged superior ophthalmic vein, cavernous sinus flow void), explicitly positioned as triggering DSA referral rather than a stand-alone diagnostic endpoint, with honestly-reported, imperfect MRI sensitivity figures from the original comparative evidence (SOV dilation detected in 9/12 sides by MRI vs 12/12 by CT in the same series).
• Sourced from Sepahdari et al. 2009 (AJR, DWI for orbital abscess) and Chandler et al. 1970 (Laryngoscope, the original classification) for 1307; Wright et al. 1997 (Ophthalmology, landmark 158-patient study) and Uchino et al. 1992 (Clinical Imaging, MRI vs CT for dural CCF) for 1308.
• Registered as the sixth and seventh children of 1301; the master page's Related Content list now shows all seven planned child protocols as real links — the originally-envisioned Orbit / Visual Disorders pathology roster (excluding the three broader visual-disorders pages discussed separately) is now fully built.
• Reciprocal cross-links added: 1307 with 1302 (Tumour, differential mimicker) and 1303 (TED, myositis-pattern contrast); 1308 with 1302 (varix-vs-cavernous-venous-malformation differential and dynamic-imaging-principle analogy).

MRININJA 3.2.29 — MRI Orbits for Trauma (New Child Page)

Date: August 10, 2026

• Added new child page MRI Orbits for Trauma (ID 1306) — fifth child page under the Orbit / Visual Disorders master (1301).
• Structurally distinct from every other child page in this cluster: opens by explicitly stating that MRI is NOT the primary imaging modality for acute orbital trauma — CT is — and documents MRI's genuine but narrower, complementary role: non-metallic (particularly wooden) foreign body characterisation once metallic FB is excluded, detailed extraocular muscle entrapment assessment for surgical planning, and traumatic optic neuropathy assessment. This honest framing, rather than overstating MRI's role to fit the site's usual template, was a deliberate choice.
• Documents the ‘white-eyed blowout fracture’ — a paediatric trapdoor orbital floor fracture with muscle entrapment and minimal external signs, specifically flagged as a diagnostic trap frequently mistaken for primary head injury, with a genuinely time-sensitive (~48 hour) surgical window to prevent permanent muscle ischaemia.
• Documents the specific, well-characterised wooden-foreign-body pitfall: on CT, dry wood can present with attenuation between fat and air, closely mimicking either normal fat or post-traumatic orbital emphysema and risking missed diagnosis — while MRI shows a consistent hypointense signal on both T1 and T2, a genuinely useful complementary sign.
• Directly and repeatedly reinforces the parent master page's dedicated intraorbital metallic foreign body safety section (Section 3.4), stating explicitly that this specific child page is exactly the clinical scenario that safety guidance was written for.
• Sourced from a recent (2025) original comparative CT/MRI study of wooden foreign bodies (Clinical Radiology) and Kubal 2008 (RadioGraphics), the foundational comprehensive review establishing CT's primary role and MRI's specific, secondary contributions in orbital trauma.
• Registered as the fifth child of 1301; the master page's Related Content list updated with a real link. Reciprocal cross-link added with the existing Optic Neuropathy child page (1304), for the traumatic optic neuropathy DWI assessment explicitly referenced in Section 4.3.

MRININJA 3.2.28 — MRI Orbits for Globe and Intraocular Pathology (New Child Page)

Date: August 9, 2026

• Added new child page MRI Orbits for Globe and Intraocular Pathology (ID 1305) — fourth child page under the Orbit / Visual Disorders master (1301).
• Organised around two evidence-dense central tasks: (1) uveal melanoma characterisation and staging, exploiting melanin's paramagnetic T1-shortening/T2-shortening MRI signature (with the amelanotic-subtype caveat, ~25% of cases, explicitly flagged as a pitfall), extrascleral extension measurement against the AJCC 5mm staging threshold, and dynamic perfusion imaging; and (2) structured, multi-feature retinoblastoma-versus-pseudoretinoblastoma differentiation (Coats' disease, persistent fetal vasculature) in children, explicitly framed — per the underlying research itself — as requiring combined assessment of multiple features rather than reliance on any single sign.
• Explicitly extends brain coverage for suspected retinoblastoma beyond the master's standard chiasm-level coverage, specifically to screen the pineal and suprasellar regions for trilateral retinoblastoma — a life-threatening association dedicated orbit-only imaging would not detect.
• Sourced from Ferreira et al. 2022 (Neuroradiology, histopathology-validated original study of 42 uveal melanomas with detailed protocol parameters), Jansen et al. 2020 (Cancers, large multi-institutional European collaborative study, 66 patients, quantified 91-100% specificity discriminating features), and Zhang et al. 2024 (Am J Ophthalmol, ADC-based quantitative differentiation).
• Registered as the fourth child of 1301; the master page's Related Content list updated with a real link. Reciprocal cross-link added with the existing Orbital Tumour and Mass Lesion child page (1302), since this page explicitly reuses and extends that page's dynamic-imaging technique and surveillance-imaging principles.

MRININJA 3.2.27 — MRI Orbits for Optic Neuropathy (New Child Page)

Date: August 9, 2026

• Added new child page MRI Orbits for Optic Neuropathy (ID 1304) — third child page under the Orbit / Visual Disorders master (1301).
• Covers two genuinely distinct, time-critical diagnostic tasks: (1) demyelinating optic neuritis subtype differentiation — MS vs NMOSD vs MOGAD, three genuinely distinct diseases with different serology, prognosis, and treatment implications (including the specific caution that MS therapies can worsen NMOSD) — using a real, quantified comparative evidence base rather than treating ‘optic neuritis’ as one entity; and (2) giant cell arteritis risk stratification in ischaemic optic neuropathy, an ophthalmological and systemic emergency, using a very recent (2026) quantified original study.
• Directly and explicitly applies the parent master page's own dedicated optic-nerve DWI technique reasoning (readout-segmented EPI/RESOLVE, reduced-FOV DWI) to its primary clinical indication, and reinforces the master's fat-suppression technique reasoning specifically for the retrobulbar/perineural fat enhancement sign central to Section 5.4.
• Notable evidence-honesty point: Section 5.1 and Section 11 explicitly flag that the primary comparative study underlying the demyelinating-subtype differential did NOT find perineural enhancement statistically different between MS/NMOSD/MOGAD in its own cohort, despite other reviews describing this as a characteristic MOGAD feature — reported as a genuine, unresolved inconsistency in the literature rather than smoothed over or omitted.
• Sourced from Darakdjian et al. 2023 (Neuroradiology Journal, direct 3-way comparative study, 56 patients), Brenac et al. 2026 (RMD Open, very recent GCA orbital MRI study — retrobulbar fat enhancement 100% sensitivity/89% specificity for arteritic vs non-arteritic disease), and Shahriari et al. 2021 (AJR, comprehensive MOGAD comparative review).
• Registered as the third child of 1301; the master page's Related Content list updated with a real link. Reciprocal cross-links added with the existing Brain Multiple Sclerosis child page (1102, for demyelinating optic neuritis context) and Orbital Tumour and Mass Lesion (1302, for the compressive optic neuropathy differential).

MRININJA 3.2.26 — MRI Orbits for Thyroid Eye Disease / Graves' Orbitopathy (New Child Page)

Date: August 9, 2026

• Added new child page MRI Orbits for Thyroid Eye Disease / Graves' Orbitopathy (ID 1303) — second child page under the Orbit / Visual Disorders master (1301).
• Unlike the Tumour/Mass Lesion child page (1302), this protocol is built around genuinely quantitative measurement rather than lesion characterisation: extraocular muscle diameter (standardised, reproducible coronal measurement plane), signal intensity ratio for imaging-based activity assessment, and apical crowding/apex-focused ADC for dysthyroid optic neuropathy (DON) risk stratification — explicitly framed as the single most clinically urgent task this protocol performs.
• Directly extends the parent master page's fat-suppression technique reasoning (Section 4.3 there): explains specifically why Dixon-T2WI's SNR/uniformity advantage matters more, not less, in TED, since a poorly fat-suppressed sequence can genuinely distort the quantitative activity measurement itself, not just look worse.
• Sourced from the 2021 EUGOGO clinical practice guidelines (Bartalena et al., Eur J Endocrinol), Mayer et al. 2005 (Eur J Radiol, the foundational STIR-signal-intensity/clinical-activity-score correlation study), and Moledina et al. 2025 (Clinical Endocrinology, a recent, large 26-vs-516-patient comparative study quantifying apical crowding and apex ADC as DON risk markers) — plus Ollitrault et al. 2021, reused from the parent master page for the TED-specific Dixon evidence.
• Registered as the second child of 1301; the master page's Related Content list updated with a real link for this page. Reciprocal cross-link added with the existing Orbital Tumour and Mass Lesion child page (1302), since Section 5.5's differential diagnosis explicitly references lymphoma/IgG4-related disease as TED mimickers covered there.

MRININJA 3.2.25 — Orbits Cluster Renamed to ‘Orbit / Visual Disorders’; Three New Planned Child Pages Added

Date: August 9, 2026

• Per site owner request, the HEAD subsection ‘Orbits’ (data/navigation.php) was renamed to ‘Orbit / Visual Disorders’, reflecting a deliberate shift from a purely anatomical grouping (structures physically within the orbit) to a clinical, neuro-ophthalmology-style grouping that also covers vision-related presentations whose underlying lesion is NOT orbital — retrochiasmal/cortical visual field defects, ocular motor cranial nerve palsy, and visual hallucinations/colour perception disorders. This mirrors how neuro-ophthalmology is organised as a clinical discipline in practice, even though these three presentations span orbit, brain, and cranial nerve anatomy.
• Updated both existing pages in this cluster (1301 master, 1302 Tumour/Mass Lesion child) to reflect the renamed subsection: routing records (subsection field), the relational registry (subanatomy field), and 1301's own breadcrumb navigation text.
• Added three new planned child pages to 1301's Related Content list and Section 2.1 indications, each with an explicit note on why it is grouped here despite not being orbital pathology in the anatomical sense: Retrochiasmal / Cortical Visual Field Defects (hemianopia, quadrantanopia — will require a whole-brain-focused protocol, not the orbital sequence backbone), Ocular Motor Nerve Palsy (CN III/IV/VI, spanning brainstem to orbit), and Visual Hallucinations and Colour Perception Disorders (cortical/occipito-temporal). The Orbits cluster's planned child-page roster is now ten pages total (seven orbit-proper + these three).
• Re-verified 1301 after these edits: HTML still parses correctly, <div>/<section> tag balance unchanged (33/33, 44/44), and the ‘Required Protocol at a Glance’ box still extracts correctly.
• No new child page content was written in this release — this is a structural/taxonomy change only, preparing the ground for the three new pages' eventual build-out.

MRININJA 3.2.24 — MRI Orbits for Tumour and Mass Lesion (New Child Page)

Date: August 9, 2026

• Added new child page MRI Orbits for Tumour and Mass Lesion (ID 1302) — the first child page published under the Orbits master (1301).
• Organised by anatomic compartment (intraconal/optic nerve-sheath, extraconal/lacrimal, paediatric-specific) per the master page's own compartment-based differential diagnosis framework. Covers cavernous venous malformation, schwannoma, optic nerve sheath meningioma (tram-track sign) vs optic nerve glioma, lacrimal gland tumours (pleomorphic adenoma vs adenoid cystic carcinoma), dermoid/epidermoid cyst, lymphoma, paediatric rhabdomyosarcoma, and metastasis — each with real, lesion-specific imaging signatures rather than generic mass description.
• Adds one genuinely dedicated technique beyond the generic protocol: dynamic (time-resolved) post-contrast imaging, specifically for the classic cavernous-venous-malformation-vs-schwannoma differential — grounded in the original landmark dynamic MRI study demonstrating a consistent point-of-origin (hemangioma) vs wide-area (schwannoma) enhancement-spread distinction.
• Every sequence in the protocol (1-8) has explicit, individually-reasoned diagnostic utility documented in Section 4.3, per the site owner's explicit request for elevated technical/descriptive depth.
• Sourced from Purohit et al. 2016 (Insights into Imaging, comprehensive compartment-organised review) and Tanaka et al. 2004 (AJR, the original dynamic MRI hemangioma-vs-schwannoma study).
• Registered as the first child of 1301; the master page's 'Planned Child Protocols' list updated to 'Related Child Protocols' with a real link for this page (the remaining six planned children remain plain text pending their own build-out). Reciprocal cross-links added to the existing Brain Tumour child page (1105, for the WHO classification cross-reference) and to the Flow, Motion, and Diffusion Physics page (9207, for the ADC-consistency point in Section 10).

MRININJA 3.2.23 — MRI Orbits Generic Standard Protocol (New Master Page, First in New Cluster)

Date: August 8-9, 2026

• Added new master page MRI Orbits — Generic Standard Protocol (ID 1301) under HEAD / Orbits — a subsection already listed in navigation.php but never previously built. Establishes the new Orbits pathology cluster (ID block 1301-1399).
• Covers the universal orbital MRI sequence backbone, the compartment-based differential diagnosis framework underlying every planned child page, and intraorbital metallic foreign body screening as a dedicated safety priority.
• Substantially revised (v1.1) after initial feedback that the first draft was too superficial and lacked genuine technical depth, in particular on fat-suppression technique selection. Section 4 was rewritten with: (a) a full, weighting-by-weighting rationale for fat-suppression technique choice — STIR vs spectral/SPIR vs Dixon for fat-suppressed T2, with the absolute STIR-after-gadolinium contraindication reasoned through explicitly rather than merely stated; (b) a dedicated explanation of why the orbit is a technically demanding region (small structure size, fat/air/bone interface geometry, dual motion sources) that the fat-suppression and DWI technique choices are then explicitly tied back to; (c) a dedicated subsection on why conventional single-shot EPI DWI under-performs in the orbit and the two modern technical alternatives (readout-segmented EPI/RESOLVE, reduced-FOV/zoomed DWI) that address this, with real comparative evidence; (d) sequence-by-sequence technical rationale for all 7 core sequences, including practical parameter reference points (FOV, slice thickness). Bibliography expanded from 4 to 8 entries, adding three new orbit-specific and head-and-neck-specific comparative technical studies.
• Sourced from the ACR–ASNR–SPR Practice Guideline for MRI of the Head and Neck (2023), Murphy & Brunberg 1996 and Kelly et al. 1986 (foreign body safety), and — newly added in this revision — Gaddikeri et al. 2018 (AJNR, Dixon vs STIR vs SPIR in head and neck MRI), Ollitrault et al. 2021 (European Radiology, orbit-specific Dixon evidence in thyroid eye disease), and Seeger et al. 2018 (Neuroradiology Journal, DWI technique comparison for the optic nerve).
• Built correctly from the outset with Section 4.1 titled ‘Mandatory Core Sequences’ as a proper table — the ‘Required Protocol at a Glance’ box renders correctly on this page.
• Related Content block updated to also link the Chemical Shift and Fat/Water Physics and Signal Localisation and Image Formation (k-Space) physics-cluster pages, both now genuinely referenced in the expanded technical reasoning.
• Registered with reciprocal cross-links to the Brain, Cranial Nerves, and Pituitary Gland master pages, and to the Contrast Media in MRI and Physics of MRI Artefacts pages.

MRININJA 3.2.22 — Site-Wide ‘Required Protocol at a Glance’ Audit: 6 More Pages Fixed + New Brain Tumour Suspicion Child Page

Date: August 8, 2026

• Site-wide audit performed (per your request) of all pre-existing pathology child pages for the same ‘Required Protocol at a Glance’ box gap identified and fixed in v3.2.21 for the brachial plexus cluster. Found the identical gap on all 6 other pathology child pages then existing on the site: 1102 (Multiple Sclerosis), 1103 (Acute Ischemic Stroke), 1104 (Epilepsy), 1106 (Headache), 1107 (Alzheimer's Disease), and 2102 (PAES). Confirmed that, before this release, the box had never rendered correctly on ANY child page on the entire site — only on master pages.
• Fixed all 6 using the same approach as v3.2.21: new Section 4.1 ‘Mandatory Core Sequences’ table showing the COMPLETE protocol (generic-protocol core, reused from the relevant master — Brain 1101 for five of the six, Muscle Trauma/Mechanical Disorders 2101 for PAES — plus each page's own dedicated additions), with Sections 4.1-4.7 cascaded to 4.2-4.8. All in-body cross-references to the old section numbering were located and corrected (found in 1106, 1107, and 2102; none needed in 1102/1103/1104). Verified for all 6 pages by replicating the PHP scraper's exact extraction regex in Python before delivery.
• Also found and fixed, incidentally, during this audit: the sitemap.xml entry for page 1105 used a legacy alias slug (1012-mri-brain-tumor-suspicion) instead of the page's current canonical slug (1105-brain-tumor-protocol). This was not a broken link — core/functions.php's legacy alias table correctly resolves the old slug — but has been updated to the canonical URL as best practice.
• New page 1105 — MRI Brain: Dedicated Protocol for Tumor Suspicion: this page was found, during the same audit, to be an unfinished placeholder (2 short paragraphs, explicitly labelled as a system test stub, no evidence base) despite already being live, linked from the Brain master page, and indexed in the sitemap. Built from scratch as a full 12-section child page: mandatory parameter-matched pre-/post-contrast 3D T1 imaging, mandatory perfusion imaging (DSC/rCBV), BTIP-consensus contrast-sequence timing, WHO CNS5-aligned grading/reporting terminology, and the DWI abscess-vs-necrotic-tumour differential sign — built correctly with Section 4.1 as ‘Mandatory Core Sequences’ from the start, so no follow-up box fix will be needed for this page.
• Sourced from Ellingson et al. 2015 (BTIP consensus protocol, Neuro-Oncology), Louis et al. 2021 (WHO CNS5 classification summary, Neuro-Oncology), and Kim et al. 1998 (original DWI abscess-vs-tumour discrimination study, AJR).
• 1105 registered with its existing relational-registry entry updated (title corrected; new genuine cross-links added to the DWI, GRE, and SWI sequence pages and to the Contrast Media in MRI master page, all directly reflecting this page's own content).

MRININJA 3.2.19 — Brachial Plexus Cluster: Master Revision + Four New Pathology-Specific Child Pages

Date: August 8, 2026

• Master page revision (4301): Sections 1.1 (Core Strengths) and 2.1 (Standard Indications) were trimmed of detailed, pathology-specific clinical/imaging-appearance content (schwannoma target-sign detail, full trauma/tumour/inflammatory findings paragraphs) that would have duplicated content now published in dedicated child pages. Each indication is now a brief 1-2 sentence pointer linking directly to its dedicated child page. The 'Future Child Protocols' placeholder list in Related Content was replaced with a real, populated 'Related Child Protocols' card linking to all five children (4302-4306). Sections 3-12 (protocol design, optimisation, reporting, technologist pearls, QC, advanced technical, evidence gaps, bibliography) were reviewed and confirmed genuinely generic — not touched.
• New child page 4303 — Brachial Plexus MRI for Traumatic Injury: mandatory cervical spine integration, pseudomeningocele/root-avulsion semiotics, and the pre-/postganglionic distinction. Sourced from Szaro et al. 2022 (Eur J Radiol Open, Part 2: Traumatic injuries).
• New child page 4304 — Brachial Plexus MRI for Tumour: nerve sheath tumour characterisation (schwannoma/neurofibroma/plexiform), Pancoast tumour staging with chest integration, and radiation fibrosis vs recurrence. Sourced from Szaro et al. 2021 (Eur J Radiol Open, Part 1: Non-traumatic lesions).
• New child page 4305 — Brachial Plexus MRI for Inflammatory or Infectious Plexitis: Parsonage-Turner syndrome semiotics (patchy, multi-nerve denervation pattern), imaging-timing considerations, and serial follow-up strategy. Sourced from Parsonage & Turner 1948 (original landmark description), Gaskin & Helms 2006, and Szaro et al. 2021.
• New child page 4306 — Brachial Plexus MRI for Arterial or Venous Thoracic Outlet Syndrome: dedicated contrast-enhanced, dual-phase, dual-position MRA protocol, explicitly cross-linked with the companion Neurogenic TOS child page (4302) given their shared thoracic-outlet anatomy. Sourced from Ersoy et al. 2012 (AJR) and Aghayev & Rybicki 2015, reusing the ACR Appropriateness Criteria and SVS reporting standards already cited in 4302.
• All four new child pages registered in the relational registry as children of 4301; 4301.child_pages now contains all five children (4302-4306), matching the master's own updated Related Child Protocols list exactly.
• Transparency note: one citation error was caught and corrected during authoring of the trauma child page (4303) before delivery — an unverified author attribution ("Kaiser R") was removed and replaced with an honest 'category not populated' note, per the site's no-invented-citations rule.

MRININJA 3.2.18 — Brachial Plexus MRI for Neurogenic Thoracic Outlet Syndrome (New Child Page)

Date: August 8, 2026

• Added new child page Brachial Plexus MRI for Neurogenic Thoracic Outlet Syndrome (ID 4302), under the Brachial Plexus MRI — Generic Standard Protocol master page (4301) — the first child page published under this master. The master page's own text already explicitly flagged thoracic outlet syndrome as requiring dynamic sequences beyond the generic protocol's scope.
• Documents the dual-position (neutral + provocative/abducted) acquisition strategy central to nTOS assessment, the three thoracic-outlet anatomic compartments (interscalene triangle, costoclavicular space, retropectoralis minor space) that must be interrogated bilaterally, perineural fat-signal loss as the key direct sign, and the differential diagnosis against cervical radiculopathy and other entrapment neuropathies.
• Sourced from the ACR Appropriateness Criteria for Thoracic Outlet Syndrome (2020) and the Society for Vascular Surgery reporting standards (Illig et al. 2016) as Category A guidelines, a 2023 systematic scoping review of published nTOS MRI protocols (Szaro et al.), and two original landmark imaging studies (Aralasmak et al. 2010, 2012).
• Registered as a child of 4301 in the relational registry; the master page's 'Child Protocols' listing updates automatically from this page's parent_id field — 4301 has no static Related Child Protocols block in its body HTML, so no body edit was required there.
• Note: this backup snapshot predates the v3.2.17 consent-banner release delivered separately; if applying both upgrades, apply v3.2.17 first, then this one, so the changelog entries stack in the correct order.

MRININJA 3.2.16 — Reconstruction and Post-Processing Physics (New Child Page) — Physics Cluster Roadmap Complete

Date: July 27, 2026

• Added new child page Reconstruction and Post-Processing Physics (ID 9212) under the MRI Physics — Fundamentals and Principles master page (9201) — the ELEVENTH and final child page in the physics cluster, completing the full topic-group roadmap originally laid out in the master page (9201) Section 4 when the cluster was created.
• Covers the mathematical/physical basis of SENSE (image-domain unfolding) and GRAPPA (k-space-domain interpolation), including the shared, physically-grounded g-factor SNR penalty; compressed sensing (sparsity-domain recovery from incoherently undersampled k-space, and why incoherent rather than regular undersampling is specifically required); and the physical principles behind AI/deep-learning reconstruction (learned vs hand-crafted priors, physics-informed/unrolled-optimisation architecture, and the hard information-theoretic limit that applies regardless of reconstruction sophistication).
• Sourced from Pruessmann et al. 1999 (SENSE) and Griswold et al. 2002 (GRAPPA) — both already cited elsewhere on the site — plus Lustig, Donoho & Pauly 2007 (foundational compressed sensing MRI) and Hammernik et al. 2018 (landmark physics-informed deep-learning reconstruction), both new to the site.
• Registered as a child of 9201 with an unusually extensive set of reciprocal cross-links (six sibling child pages plus the existing Parallel Imaging parameter page, 9588), reflecting this page's role as the natural destination for several 'deferred to Reconstruction and Post-Processing Physics' notes left in earlier cluster pages' own evidence-gaps and advanced-technical-notes sections.

MRININJA 3.2.15 — High-Field Physics (New Child Page)

Date: July 27, 2026

• Added new child page High-Field Physics (ID 9211) under the MRI Physics — Fundamentals and Principles master page (9201) — tenth child page in the physics cluster, covering topic group 4.10 of the master page's roadmap.
• Structured deliberately as a consolidating, comparative page: provides genuinely new in-depth treatment of SNR field-strength dependence (Hoult-Richards theory, Edelstein empirical confirmation, and the sample-noise/coil-noise crossover at the highest field strengths), while explicitly cross-referencing — rather than repeating — T1/T2 field dependence (already covered in Relaxation Phenomena, 9203), susceptibility effects (already covered in Physics of MRI Artefacts, 9209), and B1 inhomogeneity (already covered in Magnetic Field, Hardware, and Homogeneity, 9208), tying all four together as an interacting, combined field-strength trade-off rather than four separate topics.
• Sourced from Hoult & Richards 1976 (foundational reciprocity-based SNR theory), Edelstein et al. 1986 (empirical MRI SNR field-strength confirmation), and Hoult 2000 (dedicated high-field SNR/power-deposition analysis).
• Registered as a child of 9201 with explicit, textually-grounded reciprocal cross-links to four sibling child pages (9203, 9206, 9208, 9210) and to the existing Contrast Media in MRI master page (9101), since Section 9.2 explicitly connects field-strength-dependent contrast agent relaxivity to that page.

MRININJA 3.2.14 — SAR, Bioeffects, and MRI Safety Physics (New Child Page)

Date: July 27, 2026

• Added new child page SAR, Bioeffects, and MRI Safety Physics (ID 9210) under the MRI Physics — Fundamentals and Principles master page (9201) — ninth child page in the physics cluster, covering topic group 4.9 of the master page's roadmap.
• Covers RF power deposition and SAR physics (dielectric heating, the SAR=σE²/2ρ relationship, and why SAR scales disproportionately with both flip angle and field strength), gradient dB/dt and peripheral nerve stimulation (the Reilly neuroelectric model and duration-dependent threshold curve), static field bioeffects (explicitly distinguishing established phenomena — projectile/torque hazard and transient sensory effects — from theoretical/unsubstantiated ones, and clarifying that projectile hazard depends on spatial field gradient, not absolute field strength), and acoustic noise physics (the Lorentz-force vibration mechanism and its direct, predictable dependence on sequence-level gradient waveform choices).
• Sourced from Bottomley & Andrew 1978 (foundational RF power deposition theory), Reilly 1989 (landmark PNS neuroelectric model), Schenck 2000 (comprehensive static field bioeffects review), and Hedeen & Edelstein 1997 (original acoustic noise characterisation and predictive model).
• Registered as a child of 9201 with explicit, textually-grounded reciprocal cross-links to siblings 9204 and 9208.

MRININJA 3.2.13 — Physics of MRI Artefacts (New Child Page)

Date: July 26, 2026

• Added new child page Physics of MRI Artefacts (ID 9209) under the MRI Physics — Fundamentals and Principles master page (9201) — eighth child page in the physics cluster, covering topic group 4.8 of the master page's roadmap.
• Covers susceptibility artefact (signal loss and geometric distortion from local field distortion at tissue interfaces), aliasing/wrap-around physics (the Nyquist criterion applied to k-space sampling), truncation (Gibbs) ringing (a direct mathematical consequence of finite k-space sampling at sharp boundaries), and RF-related (zipper) artefacts and the magic angle effect — explicitly distinguished as having five genuinely different physical origins rather than treated as a single undifferentiated ‘artefact’ category. Flow/motion artefacts, already covered in the companion Flow, Motion, and Diffusion Physics page, are explicitly not repeated.
• Sourced from Schenck 1996 (comprehensive magnetic susceptibility framework), Erickson et al. 1991 (original clinical description of the magic angle effect), and Nyquist 1928 (the original sampling-theorem paper underlying aliasing physics).
• Registered as a child of 9201 with explicit, textually-grounded reciprocal cross-links to four sibling child pages (9203, 9204, 9205, 9207).

MRININJA 3.2.12 — Magnetic Field, Hardware, and Homogeneity (New Child Page)

Date: July 26, 2026

• Added new child page Magnetic Field, Hardware, and Homogeneity (ID 9208) under the MRI Physics — Fundamentals and Principles master page (9201) — seventh child page in the physics cluster, covering topic group 4.7 of the master page's roadmap (all five of its listed sub-topics).
• Covers magnet types (superconducting, permanent, resistive) and their engineering trade-offs, field homogeneity and shimming (passive vs active, and why perfect homogeneity is physically unattainable), gradient coil design and performance metrics (maximum amplitude, slew rate, and the peripheral-nerve-stimulation/acoustic-noise limits on pushing them further), RF coil transmit/receive physics with an explicit explanation of why parallel imaging is fundamentally a hardware-enabled capability rather than a purely software technique, and multi-transmit/B1 shimming at high field.
• Sourced from Roemer et al. 1990 (the original NMR phased array description — the direct hardware prerequisite for parallel imaging) and Katscher et al. 2003 (original parallel transmission/Transmit SENSE description).
• Registered as a child of 9201 with explicit, textually-grounded reciprocal cross-links to siblings 9202, 9204, and 9205, and to the existing Parallel Imaging parameter page (9588), since this page explains the hardware basis its reconstruction methods depend on.

MRININJA 3.2.11 — Flow, Motion, and Diffusion Physics (New Child Page)

Date: July 26, 2026

• Added new child page Flow, Motion, and Diffusion Physics (ID 9207) under the MRI Physics — Fundamentals and Principles master page (9201) — sixth child page in the physics cluster, covering topic group 4.6 of the master page's roadmap.
• Covers time-of-flight (differential saturation/inflow enhancement) and phase-contrast (velocity-to-phase) flow physics, three physically distinct flow-artefact mechanisms (pulsatile ghosting, intravoxel dephasing, misregistration), diffusion physics (Brownian motion, the Stejskal-Tanner pulsed-gradient method, the b-value, and the ADC-vs-true-diffusion distinction), and the physics underlying cardiac/respiratory gating and triggering.
• Sourced from Stejskal & Tanner 1965 (the foundational PGSE diffusion method), Moran 1982 (original phase-contrast velocity encoding), Le Bihan et al. 1986 (first clinical DWI/IVIM translation), and Carr & Purcell 1954 (earlier diffusion-related signal-loss observations that motivated Stejskal-Tanner).
• Registered as a child of 9201 with explicit, textually-grounded reciprocal cross-links to siblings 9202, 9204, and 9205, and to the existing DWI sequence page (9012), since this page explains the underlying physics of that page's clinical technique.

MRININJA 3.2.10 — Chemical Shift and Fat/Water Physics (New Child Page)

Date: July 26, 2026

• Added new child page Chemical Shift and Fat/Water Physics (ID 9206) under the MRI Physics — Fundamentals and Principles master page (9201) — fifth child page in the physics cluster, covering topic group 4.5 of the master page's roadmap.
• Covers the chemical shift phenomenon and ppm scale (with the quantitative water-fat frequency difference at 1.5T and 3T), type 1 (misregistration) and type 2 (India-ink boundary) chemical shift artefact with their distinct physical origins, and a detailed physical comparison of the three major fat-suppression mechanisms — STIR (T1-based), spectral saturation (frequency-based), and Dixon (chemical-shift-encoded computational separation) — including a side-by-side property table.
• Sourced from Proctor & Yu 1950 and Dickinson 1950 (independent original discovery of chemical shift), Bydder et al. 1985 (original STIR description), and Dixon 1984 (original Dixon technique description).
• Registered as a child of 9201 with explicit, textually-grounded reciprocal cross-links to all four prior sibling child pages and to the existing STIR sequence page (9006), since this page explains the underlying physics of that page's clinical technique.

MRININJA 3.2.9 — Signal Localisation and Image Formation / k-Space (New Child Page)

Date: July 26, 2026

• Added new child page Signal Localisation and Image Formation (k-Space) (ID 9205) under the MRI Physics — Fundamentals and Principles master page (9201) — fourth child page in the physics cluster, covering topic group 4.3 of the master page's roadmap (all five of its listed sub-topics, since no separate topic list was supplied for this page).
• Covers the three spatial-encoding gradients (slice-select, frequency-encode, phase-encode) and the physics of slice selection, k-space theory and structure (the gradient-to-k relationship, centre-vs-periphery, conjugate symmetry), k-space filling strategies (Cartesian, radial, spiral, partial Fourier), and the Fourier transform / resolution-SNR-scan-time relationship with its physical (not merely conventional) basis.
• Sourced from Ljunggren 1983 and Twieg 1983 (independent original k-space formalisations), reused Edelstein 1980, Lauterbur 1973 and Mansfield 1977 from the master page and prior cluster pages, plus Feinberg 1986 (partial Fourier, DOI not independently verified and explicitly flagged as such rather than guessed).
• Registered as a child of 9201 with explicit, textually-grounded reciprocal cross-links to siblings 9202 and 9204, and to the existing Parallel Imaging (9588) and Reconstruction Matrix (9587) parameter pages, since this page's own text explains the k-space physics those pages build on.

MRININJA 3.2.8 — RF Pulses and Pulse Sequence Physics (New Child Page)

Date: July 26, 2026

• Added new child page RF Pulses and Pulse Sequence Physics (ID 9204) under the MRI Physics — Fundamentals and Principles master page (9201) — third child page in the physics cluster, covering topic group 4.4 of the master page's roadmap. Title uses the cleaned-up convention introduced in v3.2.7 (no redundant type suffix).
• Covers flip angle and the Ernst angle (steady-state signal optimisation), the selective/non-selective/adiabatic RF pulse design taxonomy (with the B1-inhomogeneity-tolerance rationale for adiabatic pulses), a detailed physical comparison of spin-echo vs gradient-echo refocusing mechanisms (with a side-by-side property table), and magnetization transfer (bound/free pool exchange mechanism and its role as both a deliberate contrast mechanism and an incidental side effect of other RF choices).
• Sourced from Ernst & Anderson 1966 (Ernst angle), Silver/Joseph/Hoult 1985 (adiabatic pulse theory), Wolff & Balaban 1989 (magnetization transfer), Haase et al. 1986 (FLASH gradient-echo), and Hahn 1950 (reused from the companion Relaxation Phenomena page for the spin-echo comparison).
• Registered as a child of 9201 with explicit, textually-grounded reciprocal cross-links to both prior sibling child pages (9202, 9203), since this page's own text states it builds on both.

MRININJA 3.2.7 — Title Cleanup for Physics Cluster Child Pages

Date: July 26, 2026

• Removed the redundant '— Child Page' suffix from the listing title of 9202 (Fundamentals of Nuclear Magnetic Resonance) and 9203 (Relaxation Phenomena) — the page type is already conveyed by its placement in the site hierarchy and by the on-page intro note, so repeating it in the title shown in protocol listings was redundant clutter.
• Updated in both the routing record (content/protocols/*.php) and the relational registry (data/mrininja-relations.json) for consistency.
• Note: the existing PAES child page (2102) has an analogous suffix ('— Child Protocol') not addressed in this release — flagged for a decision on whether to apply the same cleanup there.

MRININJA 3.2.6 — Relaxation Phenomena (New Child Page)

Date: July 26, 2026

• Added new child page Relaxation Phenomena (ID 9203) under the MRI Physics — Fundamentals and Principles master page (9201) — second child page in the physics cluster, covering topic group 4.2 of the master page's roadmap.
• Covers T1 (spin-lattice) relaxation with BPP correlation-time theory, T2 (spin-spin) relaxation and the T1≥T2 constraint, the T2* decomposition into true-T2 and field-inhomogeneity (T2′) components with the spin-echo refocusing mechanism that recovers true T2, and tissue-/field-strength-dependence of relaxation times with a representative comparative value table (1.5T vs 3T) across six tissue types.
• Sourced from Bloembergen-Purcell-Pound 1948 (foundational relaxation theory), Hahn 1950 (reused from the companion NMR Fundamentals page, cited here specifically for T2 recovery), and three tissue-relaxometry studies (Stanisz 2005, O'Reilly 2022, Bojorquez 2017 — the latter explicitly cited to support an evidence-gap discussion on the substantial inter-study variability in reported tissue relaxation values, rather than presenting a single false-precision reference table).
• Registered as a sibling of, and explicitly cross-linked with, the Fundamentals of Nuclear Magnetic Resonance child page (9202), since this page's own text states it builds directly on that page's FID discussion.

MRININJA 3.2.5 — Fundamentals of Nuclear Magnetic Resonance (New Child Page)

Date: July 26, 2026

• Added new child page Fundamentals of Nuclear Magnetic Resonance (ID 9202) under the MRI Physics — Fundamentals and Principles master page (9201) — the first child page published in the physics cluster, covering the first of the eleven planned topic groups (Section 4.1 of the master page's roadmap).
• Covers nuclear spin and the Larmor equation (with a gyromagnetic-ratio comparison table across five clinically/research-relevant nuclei), the B0 field and net magnetization (Boltzmann statistics), RF excitation in the rotating reference frame, and the physical origin of the FID signal — including a brief presentation of the Bloch equations and a quadrupolar-nuclei note in the advanced technical section.
• Sourced from four independently verified landmark historical physics papers (Rabi 1939, Bloch 1946, Purcell 1946, Hahn 1950), deliberately scoped to avoid duplicating relaxation-phenomena content reserved for a future, separate child page in the same cluster.
• Registered as a child of 9201 in the relational registry; the master page's 'Child Protocols' listing updates automatically from this page's parent_id field, no static edit to 9201's body was required.

MRININJA 3.2.4 — Inline Page-ID References Converted to Hyperlinks

Date: July 25, 2026

• Site-wide sweep for bare page-ID citations in prose text (e.g. "MRI Parameters Overview (9501)"), distinct from bibliography citations, which were left untouched. Replaced with proper hyperlinks to the referenced page in 11 pages: 1106, 1181, 9201, 9501, 9582, 9583, 9584, 9585, 9586, 9587, 9589.
• Found and fixed an unrelated pre-existing defect while reviewing this text: two pages (9588, 9589) had a broken, unconverted Markdown closing block (literal asterisks and a raw "---" divider instead of proper HTML) left over from an earlier conversion; 9588 additionally had this broken block fully duplicating a second, correctly-formatted closing paragraph elsewhere on the same page — the broken duplicate was removed (after confirming its one non-duplicated piece of information, the "Related child pages" list, was preserved in the remaining clean paragraph) and 9589's single copy was repaired in place.
• Also fixed three instances of unconverted Markdown emphasis asterisks in the introductory banner of 1181 (all three parts of the DSC MR Perfusion series).
• No scientific content was altered anywhere; verified via word-count comparison and full
  tag-balance comparison against the previous version on every file touched.

MRININJA 3.2.3 — MRI Physics Fundamentals (New Master Reference Page + Cluster Roadmap)

Date: July 23, 2026

• Added new master reference page MRI Physics — Fundamentals and Principles (ID 9201) under OTHER / Technical MRI Physics, as an architectural hub distinct from 9501 (which covers practical acquisition parameters, not underlying physics).
• Covers NMR fundamentals, relaxation (T1/T2/T2*), spatial encoding and k-space, RF pulse physics, and a brief landmark history (Bloch/Purcell 1946 → Lauterbur 1973 → Mansfield 1977 → Edelstein spin-warp 1980 → SENSE/GRAPPA 1999-2002).
• Includes an explicit 11-group roadmap (Section 4) of planned child pages covering the full physics cluster in depth: NMR fundamentals, relaxation, spatial encoding/k-space, RF pulse physics, chemical shift/fat-water physics, flow/motion/diffusion physics, hardware/field homogeneity, artefact physics, SAR/bioeffects/safety physics, high-field physics, and reconstruction physics.
• Integrated reciprocal registry links with 9003 (MRI Sequences Overview), 9501 (MRI Parameters Overview), and 9101 (Contrast Media in MRI); added a static related-card link from 9501's own Related Master Pages block.

MRININJA 3.2.2 — Contrast Media in MRI (New Master Reference Page)

Date: July 23, 2026

• Added new master reference page Contrast Media in MRI (ID 9101) under OTHER / Contrast Media — the first page to populate this existing-but-empty navigation subsection.
• Covers GBCA classification (macrocyclic/linear, ionic/nonionic), relaxivity and stability comparisons, organ-specific hepatobiliary agents (gadoxetate, gadobenate), historical non-gadolinium agents (manganese, SPIO), full regulatory/history timeline (1988 approval through the June 2026 gadoquatrane/Ambelvist approval), dosing and elimination kinetics, and safety/special-population guidance.
• Integrated reciprocal registry links with the two existing OTHER-section hub pages (9003 MRI Sequences Overview, 9501 MRI Parameters Overview) and with the two organ-specific master pages whose protocols depend most on hepatobiliary contrast agents (5101 Liver, 5201 Biliary Tree/MRCP); added a static related-card link from 9501's own Related Master Pages block.
• Follows the ‘Master / Reference Page’ template (numbered heading ids, clickable breadcrumb, related-grid card layout) established by 9003/9501, distinct from the anatomical master-page template.

MRININJA 3.2.1 — Bibliography Standardisation and Keyword Emphasis

Date: July 23, 2026

• Standardised the Evidence-Based References format across the ENTIRE site to a single canonical structure (badge + reference-title + reference-meta): fixed 5 different legacy formats found in the wild (descriptive badge labels, plain <ol> sub-bibliographies, an old focus-bibliography div format, and fully unstyled paragraph references) across 26 pages.
• Corrected 34 pre-existing badge/CSS-class mismatches (badge text and colour class disagreeing, e.g. text 'Technical' rendered with the 'Moderate' colour) across 11 pages, plus 15 abbreviated/duplicated badges on the Sequences Overview page (9003).
• Applied targeted bold emphasis (numeric decision thresholds, named classification/scoring systems, red-flag/emergency phrases) across 68 clinical pages — 539 new <strong> tags added, zero words of scientific text altered, added or removed anywhere (verified by exact word-count comparison on every file).
• No scientific content, citation, DOI/PMID, or bibliography entry was reworded, summarised or removed — this release only changes markup/formatting.

MRININJA 3.1.29 — Structural Audit and Cleanup (Phase 1)

Date: July 22, 2026

• Disabled debug mode in production (index.php): $debug was left true, exposing PHP errors publicly; set to false.
• Fixed orphaned page MRI Paranasal Sinuses — Generic Standard Protocol (ID 1701): the routing record (content/protocols/1701-...php) was missing since the page’s creation, even though its body HTML, sitemap entry and registry node already existed — the page was silently unreachable. Reconstructed the routing record from the existing body/registry content; added the missing sitemap entry.
• Registered MRI Liver — Generic Standard Protocol (ID 5101) in the central relational registry, where it was previously absent despite being fully routable — it had zero semantic cross-links to Biliary/MRCP (5201) and Pancreas (5301). Added reciprocal links with both.
• Removed five dangling references to ID 9100 (from the Sequences Overview, STIR, GRE/FLASH, DWI and Inversion Recovery pages), which pointed to a page that has never had body or routing content on this site.
• Corrected a stale legacy ID reference (1001 → 1101, the current Brain master protocol ID) in the Cranial Nerves (1801) and Paranasal Sinuses (1701) registry entries.
• Archived four orphaned legacy body files from the pre-renumbering Brain cluster (1010, 1011, 1013, 1014) into content/bodies/trash/ — they were no longer referenced by any routing record after the 2026 Brain ID migration to 1101–1107.
• Removed an unused, unreferenced duplicate sitemap file (content/bodies/sitemap.xml) — not linked from any code path; the authoritative sitemap remains the root sitemap.xml.
• No scientific content on any page was altered, corrected, rewritten or removed.

MRININJA 3.1.28 — Popliteal Artery Entrapment Syndrome Child Protocol

Date: July 22, 2026

• Added new child page LEGS MRI for Popliteal Artery Entrapment Syndrome — Child Protocol as ID 2102, under the Muscle Trauma and Mechanical Disorders master protocol (2101).
• First child page published under the MUSCLE macrocategory.
• Integrated parent-page link, registry entry, reading path and a soft cross-link from the Neuromuscular Disorders master page (2301), reflecting the source document's own framing of shared calf/gastrocnemius anatomical content, without creating a second formal parent relationship.
• No scientific content was altered, corrected, simplified or removed from the supplied Markdown.

MRININJA 3.1.27 — Muscle Metabolic and Systemic Disorders Master Protocol

Date: July 22, 2026

• Added new master page MRI Muscle in Metabolic and Systemic Muscle Disorders — Generic Standard Protocol as ID 2401.
• Completed the four-branch MUSCLE master architecture: trauma/mechanical, tumour/infection, neuromuscular and metabolic/systemic disorders.
• Added the 'Metabolic / Systemic Disorders' subsection to the MUSCLE branch of the site navigation tree.
• Integrated reciprocal semantic relationships among all four MUSCLE master pages, plus sequence (TSE, STIR, DWI) and MRI-parameter links.
• No scientific content was altered, corrected, simplified or removed from the supplied Markdown.

MRININJA 3.1.26 — Muscle Neuromuscular Disorders Master Protocol

Date: July 20, 2026

• Added new master page MRI Muscle in Neuromuscular Disorders — Generic Standard Protocol as ID 2301.
• Completed the three-branch MUSCLE master architecture: trauma/mechanical, tumour/infection and neuromuscular disorders.
• Integrated reciprocal semantic relationships, reading paths, sequence and MRI-parameter links.
• Corrected the requested architectural classification from HEAD to MUSCLE without altering the supplied scientific content.

MRININJA 3.1.24 — Muscle Trauma and Mechanical Disorders Master Protocol

Date: July 20, 2026

• Added new master page MRI Muscle in Trauma and Mechanical Disorders — Generic Standard Protocol as ID 2101.
• Created the new MUSCLE architecture with future Tumour / Infection and Neuromuscular branches.
• Integrated reciprocal semantic relationships with shoulder, hip, knee, ankle, TSE, STIR, DWI and MRI parameter pages.
• Updated central registry, navigation, sitemap and reading paths while preserving the supplied scientific content.

MRININJA 3.1.21 — Cranial Nerves Master Protocol

2026-06-05 — Added new HEAD master page 1801-cranial-nerves-generic-standard-protocol and integrated it into the cranial nerves / skull base semantic cluster.

MRININJA 3.1.14 — Phase Oversampling Parameter Deep Dive

Date: 2026-06-03

• Added new MRI Parameters deep dive: Phase Oversampling — Fold-over Suppression / No Phase Wrap.
• Updated MRI Parameters master page with semantic link and related-content path.
• Updated semantic registry, sitemap and bidirectional parameter relationships.

MRININJA 3.1.13 — MRI Parameter Deep Dive: 2D vs 3D Acquisition

Added the new technical deep dive 2D vs 3D Acquisition linked to the MRI Parameters master page. Updated semantic registry, related parameter links, sitemap and technical notes. Deep dive remains accessible through related content and reading paths, not as a primary protocol-index entry.

MRININJA 3.1.12 — Slice Thickness parameter deep dive

Added the new MRI parameter deep dive Slice Thickness, linked to the MRI Parameters Overview and Classification master page.

• Converted the Claude Markdown source into MRIninja HTML without scientific rewriting.
• Preserved the source citation numbering and converted the final bibliography into MRIninja EBM reference cards.
• Updated semantic relations, reading paths, sitemap and related parameter links.

MRININJA 3.1.11 — MRI Parameter Deep Dive: Acquisition Matrix

Date: June 2026

• Added new parameter deep dive page: Acquisition Matrix.
• Updated MRI Parameters Overview related content and reading path with a bidirectional link to Acquisition Matrix.
• Updated FOV deep dive related content with the reciprocal Matrix relation.
• Updated central semantic registry and sitemap.
• Preserved source scientific content and converted the bibliography into final MRIninja EBM reference-card format.

MRININJA 3.1.9 — MRI Parameter Deep Dive: FOV

Date: June 2026

• Added new parameter deep dive page: FOV — Field of View.
• Updated MRI Parameters Overview related content and reading path with a bidirectional link to FOV.
• Updated central semantic registry and sitemap.
• Preserved source scientific content and converted the bibliography into final MRIninja EBM reference-card format.

MRININJA 3.1.8 — MRI Parameters Bibliography Consolidation

Regenerated 9501-mri-parameters-overview-classification with a single final MRIninja EBM bibliography section, removed the intermediate bibliography block, corrected section numbering after bibliography relocation, and preserved scientific content without alteration.

MRININJA 3.1.7 — MRI Parameters Master Reference

Added the new master technical reference page MRI Parameters — Overview and Classification, integrated with MRI Sequences Overview, sequence pages, semantic registry, sitemap and reading paths.

Version 3.1.6 — Alzheimer’s Disease dedicated child protocol

Added: new child pathology page 1107-brain-alzheimers-disease-protocol under HEAD / Brain, linked to 1101-brain-generic-standard-protocol.

Included: MRIninja child-page HTML conversion, Brain-style special formatting for section 4.4, collapsible advanced technical parameters, graphical EBM bibliography formatting, semantic breadcrumb, related content block, registry integration and sitemap update.

Semantic integration: connected to MPRAGE, FLAIR, SWI and DWI sequence pages, plus brain perfusion deep dives where appropriate as contextual technical references.

Integrity: source scientific content was converted without intentional scientific rewriting, deletion or correction.

Version 3.1.5 — Parotid glands master protocol

Added: new master page 4201-parotid-glands-generic-standard-protocol under NECK / Salivary Glands.

Included: Brain-style MRIninja HTML conversion, collapsible slice-positioning reference, collapsible advanced technical parameters, graphical EBM bibliography formatting, semantic breadcrumb, related content block, registry integration and sitemap update.

Integrity: source scientific content was converted without intentional scientific rewriting, deletion or correction.

MRININJA 3.1.4 — Soft Tissues Neck MRI Master Protocol

Added the new master page Soft Tissues Neck MRI — Generic Standard Protocol with MRIninja master-page structure, semantic relationships, registry integration, sitemap update and bidirectional relation with the Brachial Plexus master page.

Version 3.1.1 — Whole-Body MRI in Multiple Myeloma master page

Added: new master page 9300-whole-body-mri-multiple-myeloma-master-protocol under OTHER / Site / General Educational Pages.

Integrated: semantic registry, sitemap, related sequence relationships, reading path, and MRIninja graphical bibliography formatting.

Integrity: source scientific content was converted from Markdown to HTML without intentional scientific rewriting, summarisation, correction, or deletion.

Version 3.1.0 — Biliary MRI / MRCP master protocol

Added: new master page Biliary MRI / MRCP – Generic Standard Protocol as canonical protocol ID 5201 under Abdomen / Biliary Tree / MRCP.

Included: MRIninja-compatible HTML conversion from the supplied Markdown source, Human Verified marker, semantic breadcrumbs, collapsible slice-positioning reference, collapsible advanced technical parameters, graphical MRIninja EBM bibliography, registry integration and bidirectional semantic relationship with the Pancreas master protocol.

Integrity: source scientific content was converted from Markdown to HTML without intentional scientific rewriting, summarisation, deletion or correction.

Version 3.0.12 — GRE/FLASH diagram rendering update

Updated only the interactive GRE/FLASH magnetisation diagram asset with the revised Claude-generated version. The new diagram zooms the Mz steady-state region, improves visibility of small GRE steady-state differences, and keeps the existing page text, bibliography, registry and scientific content unchanged.

Version 3.0.11 — GRE/FLASH Sequence Page

Updated the full Gradient Echo (GRE/FLASH) sequence child page with complete scientific content, pulse diagram SVG, interactive magnetisation diagrams, MRIninja graphical bibliography, semantic registry updates and strong sequence-family links to SWI and the MRI Sequences overview.

Version 3.0.10 — SWI Sequence Page

Updated the SWI sequence child page with full MRIninja sequence-page content, pulse diagram, interactive T2* magnetisation diagrams, graphical EBM bibliography, semantic registry integration and related content links.

Version 3.0.9 — FLAIR sequence child page

Added the full FLAIR (Fluid-Attenuated Inversion Recovery) sequence child page with pulse diagram, interactive magnetisation diagrams, MRIninja graphical bibliography, semantic registry integration and reciprocal links with the MRI Sequences master page and the Inversion Recovery parent sequence page.

Version 3.0.5 — Mid-Foot master protocol

Added the new master page 8601-mid-foot-generic-standard-protocol under LOWER LIMB / Foot / Toes, converted from the Claude-generated Markdown source using the historical MRIninja master-page structure.

• Applied the special collapsible 4.6 Slice Positioning section structure.
• Applied the special collapsible 10. Advanced Technical Parameters section structure.
• Converted the final bibliography into graphical MRIninja EBM reference cards.
• Updated data/mrininja-relations.json, sitemap and semantic reading-path integration.

Integrity: source scientific content was converted without intentional scientific rewriting, summarisation or correction.

Version 3.0.3 — Pancreas master protocol

Added the new master page 5301-pancreas-generic-standard-protocol and integrated it into the MRIninja semantic relationship system.

• New Abdomen → Pancreas master/generic protocol page.
• Updated mrininja-relations.json with abdomen-pancreas-mri cluster, sequence relationships and reading path.
• Updated sitemap and upgrade notes.

Version 3.0.1 — Semantic relation architecture

Added: central relation registry data/mrininja-relations.json for page IDs, slugs, page types, master-child hierarchy, semantic clusters, related sequence pages and recommended reading paths.

Implemented: semantic breadcrumbs and standardised Related Content blocks on protocol pages, generated dynamically from the registry before the final bibliography/references section when present.

Scope: no protocol scientific content, bibliographies, DOI, PMID, tables, SVG/diagram assets or canonical slugs were intentionally modified.

Version 2.7.22 — Spin Echo interactive diagram layout fix

Updated: improved the embedded magnetisation diagrams on 9004-conventional-spin-echo-se-sequence by converting the four iframe diagrams from a two-column grid into full-width stacked panels.

Included: larger iframe display height, clearer panel headers, and direct Open fullscreen links for each interactive diagram.

Integrity: no scientific text, bibliography, references, metadata or diagram source files were modified.

Version 2.7.21 — Spin Echo sequence child page upgrade

Updated: rebuilt the existing sequence child page 9004-conventional-spin-echo-se-sequence from placeholder status into a complete MRIninja sequence reference page for Spin Echo (SE) and Turbo Spin Echo (TSE/FSE).

Included: full Markdown-to-HTML conversion, Human Verified marker placement, MRIninja EBM bibliography formatting, pulse sequence SVG diagram, four embedded magnetisation diagrams for T1/T2 weighting at 1.5T and 3T, updated protocol metadata and sitemap timestamps.

Integrity: source scientific content was converted without intentional scientific rewriting, summarisation, deletion or correction. Technical/refusi observations are documented in README_UPGRADE.txt.

Version 2.7.19 — Sequence child-page scaffold and internal sequence links

Added: twelve placeholder child pages for the main MRI sequence families under OTHER / Site / General Educational Pages, all linked to the master reference page 9003-mri-sequences-overview-classification.

Included: stable canonical slugs for Conventional Spin Echo, TSE, STIR, FLAIR, GRE/FLASH, MPRAGE, EPI, SWI, DWI, Spin Echo DWI, Echo Planar DWI and bSSFP.

Internal linking: existing content pages were scanned for explicit sequence names and enriched with internal links to the new child pages plus a concise sequence-level reading prompt where appropriate. Existing scientific content was not deleted or intentionally rewritten.

Integrity: this upgrade adds scaffolding, metadata, sitemap entries, changelog notes and internal links only; it does not remove existing scientific text.

Version 2.7.18 — MRI sequence overview master reference page

Added: new master/reference page MRI Sequences and Pulse Sequences — Overview and Classification as ID 9003 in OTHER / Site / General Educational Pages, with body file 9003-mri-sequences-overview-classification.html.

Included: sequence taxonomy, signal readout architecture, contrast classification, 2D/3D classification, vendor naming cross-reference, key acquisition parameters, acquisition modifiers, sequence-selection framework, future sequence-family child-page roadmap, and MRIninja graphical EBM bibliography formatting.

Integrity: source scientific content was converted from Markdown to HTML without intentional scientific rewriting, summarisation, deletion, or correction.

Version 2.7.17 — Brain headache child protocol

Updated: rebuilt the Brain child protocol MRI Brain – Dedicated Protocol for Headache as canonical protocol ID 1106 with body file 1106-brain-headache-protocol.html.

Included: headache-specific protocol stratification, thunderclap pathway, SIH/IIH imaging logic, MRA/MRV/vessel-wall conditional additions, disease-specific semiotics, structured reporting framework, QC checklist, collapsible advanced technical parameters, and MRIninja graphical EBM bibliography formatting.

Integrity: source scientific content was converted from Markdown to HTML without intentional scientific rewriting, summarisation, deletion, or correction.

Version 2.7.15 — Brain acute stroke child protocol

Updated: rebuilt the Brain child protocol MRI Brain – Acute Ischemic Stroke Dedicated Child Protocol as canonical protocol ID 1103 with body file 1103-brain-acute-stroke-protocol.html.

Included: acute stroke workflow delta, DWI-first acquisition logic, DWI-FLAIR mismatch decision-making, SWI/GRE haemorrhage exclusion, TOF MRA and DSC perfusion conditional pathways, DWI-ASPECTS reporting framework, disease-specific QC checklist, collapsible advanced technical parameters, and MRIninja graphical EBM bibliography formatting.

Integrity: source scientific content was converted from Markdown to HTML without intentional scientific rewriting, summarisation, or correction.

Version 2.7.14 — Brain MS child protocol

Updated: rebuilt the Brain child protocol MRI Brain – Multiple Sclerosis Dedicated Child Protocol as canonical protocol ID 1102 with body file 1102-brain-multiple-sclerosis-protocol.html.

Included: MAGNIMS-CMSC-NAIMS protocol deltas, McDonald criteria-oriented reporting framework, CVS/PRL susceptibility biomarkers, MS-specific QC checklist, collapsible advanced technical parameters, and MRIninja graphical EBM bibliography formatting.

Integrity: source scientific content was converted from Markdown to HTML without intentional scientific rewriting, summarisation, or correction.

Version 2.7.13 — Prostate master protocol

Added: new master page 6101-prostate-generic-standard-protocol in Pelvis / Prostate.

Updated: sitemap and protocol metadata. Bibliography converted to MRIninja EBM visual reference format.