Spectral Presaturation With Inversion Recovery
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Magnetic resonance imaging (MRI) is a
medical imaging Medical imaging is the technique and process of imaging the interior of a body for clinical analysis and medical intervention, as well as visual representation of the function of some organs or tissues (physiology). Medical imaging seeks to rev ...
technique used in radiology to form pictures of the anatomy and the
physiological Physiology (; ) is the scientific study of functions and mechanisms in a living system. As a sub-discipline of biology, physiology focuses on how organisms, organ systems, individual organs, cells, and biomolecules carry out the chemical ...
processes inside the body. MRI scanners use strong
magnetic field A magnetic field is a vector field that describes the magnetic influence on moving electric charges, electric currents, and magnetic materials. A moving charge in a magnetic field experiences a force perpendicular to its own velocity and to ...
s, magnetic field gradients, and
radio wave Radio waves are a type of electromagnetic radiation with the longest wavelengths in the electromagnetic spectrum, typically with frequencies of 300 gigahertz (GHz) and below. At 300 GHz, the corresponding wavelength is 1 mm (short ...
s to generate images of the organs in the body. MRI does not involve X-rays or the use of
ionizing radiation Ionizing radiation (or ionising radiation), including nuclear radiation, consists of subatomic particles or electromagnetic waves that have sufficient energy to ionize atoms or molecules by detaching electrons from them. Some particles can travel ...
, which distinguishes it from
computed tomography A computed tomography scan (CT scan; formerly called computed axial tomography scan or CAT scan) is a medical imaging technique used to obtain detailed internal images of the body. The personnel that perform CT scans are called radiographers ...
(CT) and
positron emission tomography Positron emission tomography (PET) is a functional imaging technique that uses radioactive substances known as radiotracers to visualize and measure changes in Metabolism, metabolic processes, and in other physiological activities including bl ...
(PET) scans. MRI is a medical application of nuclear magnetic resonance (NMR) which can also be used for imaging in other NMR applications, such as NMR spectroscopy. MRI is widely used in hospitals and clinics for medical diagnosis, staging and follow-up of disease. Compared to CT, MRI provides better contrast in images of soft tissues, e.g. in the brain or abdomen. However, it may be perceived as less comfortable by patients, due to the usually longer and louder measurements with the subject in a long, confining tube, although "open" MRI designs mostly relieve this. Additionally,
implants Implant can refer to: Medicine *Implant (medicine), or specifically: **Brain implant **Breast implant **Buttock implant **Cochlear implant **Contraceptive implant **Dental implant **Fetal tissue implant **Implantable cardioverter-defibrillator ** ...
and other non-removable metal in the body can pose a risk and may exclude some patients from undergoing an MRI examination safely. MRI was originally called NMRI (nuclear magnetic resonance imaging), but "nuclear" was dropped to avoid negative associations. Certain
atomic nuclei The atomic nucleus is the small, dense region consisting of protons and neutrons at the center of an atom, discovered in 1911 by Ernest Rutherford based on the 1909 Geiger–Marsden gold foil experiment. After the discovery of the neutron in ...
are able to absorb radio frequency (RF) energy when placed in an external
magnetic field A magnetic field is a vector field that describes the magnetic influence on moving electric charges, electric currents, and magnetic materials. A moving charge in a magnetic field experiences a force perpendicular to its own velocity and to ...
; the resultant evolving spin polarization can induce a RF signal in a radio frequency coil and thereby be detected. In other words, the nuclear magnetic spin of protons in the hydrogen nuclei resonates with the RF incident waves and emit coherent radiation with compact direction, energy (frequency) and phase. This coherent amplified radiation is easily detected by RF antenas close to the subject being examined. It is a process similar to
masers A maser (, an acronym for microwave amplification by stimulated emission of radiation) is a device that produces coherent electromagnetic waves through amplification by stimulated emission. The first maser was built by Charles H. Townes, James ...
. In clinical and research MRI, hydrogen atoms are most often used to generate a macroscopic polarized radiation that is detected by the antennas. Hydrogen atoms are naturally abundant in humans and other biological organisms, particularly in water and fat. For this reason, most MRI scans essentially map the location of water and fat in the body. Pulses of radio waves excite the
nuclear spin In atomic physics, the spin quantum number is a quantum number (designated ) which describes the intrinsic angular momentum (or spin angular momentum, or simply spin) of an electron or other particle. The phrase was originally used to describe th ...
energy transition, and magnetic field gradients localize the polarization in space. By varying the parameters of the pulse sequence, different contrasts may be generated between tissues based on the relaxation properties of the hydrogen atoms therein. Since its development in the 1970s and 1980s, MRI has proven to be a versatile imaging technique. While MRI is most prominently used in diagnostic medicine and biomedical research, it also may be used to form images of non-living objects, such as mummies. Diffusion MRI and functional MRI extend the utility of MRI to capture neuronal tracts and blood flow respectively in the nervous system, in addition to detailed spatial images. The sustained increase in demand for MRI within
health system Health, according to the World Health Organization, is "a state of complete physical, mental and social well-being and not merely the absence of disease and infirmity".World Health Organization. (2006)''Constitution of the World Health Organiza ...
s has led to concerns about cost effectiveness and overdiagnosis.


Mechanism


Construction and physics

In most medical applications, hydrogen nuclei, which consist solely of a
proton A proton is a stable subatomic particle, symbol , H+, or 1H+ with a positive electric charge of +1 ''e'' elementary charge. Its mass is slightly less than that of a neutron and 1,836 times the mass of an electron (the proton–electron mass ...
, that are in tissues create a signal that is processed to form an image of the body in terms of the density of those nuclei in a specific region. Given that the protons are affected by fields from other atoms to which they are bonded, it is possible to separate responses from hydrogen in specific compounds. To perform a study, the person is positioned within an MRI scanner that forms a strong
magnetic field A magnetic field is a vector field that describes the magnetic influence on moving electric charges, electric currents, and magnetic materials. A moving charge in a magnetic field experiences a force perpendicular to its own velocity and to ...
around the area to be imaged. First, energy from an
oscillating Oscillation is the repetitive or periodic variation, typically in time, of some measure about a central value (often a point of equilibrium) or between two or more different states. Familiar examples of oscillation include a swinging pendulum ...
magnetic field is temporarily applied to the patient at the appropriate resonance frequency. Scanning with X and Y gradient coils causes a selected region of the patient to experience the exact magnetic field required for the energy to be absorbed. The atoms are excited by a RF pulse and the resultant signal is measured by a receiving coil. The RF signal may be processed to deduce position information by looking at the changes in RF level and phase caused by varying the local magnetic field using gradient coils. As these coils are rapidly switched during the excitation and response to perform a moving line scan, they create the characteristic repetitive noise of an MRI scan as the windings move slightly due to magnetostriction. The contrast between different tissues is determined by the rate at which excited atoms return to the equilibrium state. Exogenous contrast agents may be given to the person to make the image clearer. The major components of an MRI scanner are the main magnet, which polarizes the sample, the shim coils for correcting shifts in the homogeneity of the main magnetic field, the gradient system which is used to localize the region to be scanned and the RF system, which excites the sample and detects the resulting NMR signal. The whole system is controlled by one or more computers. MRI requires a magnetic field that is both strong and uniform to a few parts per million across the scan volume. The field strength of the magnet is measured in teslas – and while the majority of systems operate at 1.5 T, commercial systems are available between 0.2 and 7 T. Whole-body MRI systems for research applications operate in e.g. 9.4T, 10.5T, 11.7T. Even higher field whole-body MRI systems e.g. 14 T and beyond are in conceptual proposal or in engineering design. Most clinical magnets are superconducting magnets, which require liquid helium to keep them at low temperatures. Lower field strengths can be achieved with permanent magnets, which are often used in "open" MRI scanners for claustrophobic patients. Lower field strengths are also used in a portable MRI scanner approved by the FDA in 2020. Recently, MRI has been demonstrated also at ultra-low fields, i.e., in the microtesla-to-millitesla range, where sufficient signal quality is made possible by prepolarization (on the order of 10–100 mT) and by measuring the Larmor precession fields at about 100 microtesla with highly sensitive superconducting quantum interference devices (
SQUID True squid are molluscs with an elongated soft body, large eyes, eight arms, and two tentacles in the superorder Decapodiformes, though many other molluscs within the broader Neocoleoidea are also called squid despite not strictly fitting t ...
s).


T1 and T2

Each tissue returns to its equilibrium state after excitation by the independent relaxation processes of T1 ( spin-lattice; that is, magnetization in the same direction as the static magnetic field) and T2 ( spin-spin; transverse to the static magnetic field). To create a T1-weighted image, magnetization is allowed to recover before measuring the MR signal by changing the repetition time (TR). This image weighting is useful for assessing the cerebral cortex, identifying fatty tissue, characterizing focal liver lesions, and in general, obtaining morphological information, as well as for post-contrast imaging. To create a T2-weighted image, magnetization is allowed to decay before measuring the MR signal by changing the echo time (TE). This image weighting is useful for detecting
edema Edema, also spelled oedema, and also known as fluid retention, dropsy, hydropsy and swelling, is the build-up of fluid in the body's Tissue (biology), tissue. Most commonly, the legs or arms are affected. Symptoms may include skin which feels t ...
and inflammation, revealing white matter lesions, and assessing zonal anatomy in the prostate and uterus. The information from MRI scans comes in the form of image contrasts based on differences in the rate of relaxation of nuclear spins following their perturbation by an oscillating magnetic field (in the form of radiofrequency pulses through the sample). The relaxation rates are a measure of the time it takes for a signal to decay back to an equilibrium state from either the longitudinal or transverse plane.
Magnetization In classical electromagnetism, magnetization is the vector field that expresses the density of permanent or induced magnetic dipole moments in a magnetic material. Movement within this field is described by direction and is either Axial or Di ...
builds up along the z-axis in the presence of a magnetic field, B0, such that the magnetic dipoles in the sample will, on average, align with the z-axis summing to a total magnetization Mz. This magnetization along z is defined as the equilibrium magnetization; magnetization is defined as the sum of all magnetic dipoles in a sample. Following the equilibrium magnetization, a 90° radiofrequency (RF) pulse flips the direction of the magnetization vector in the xy-plane, and is then switched off. The initial magnetic field B0, however, is still applied. Thus, the spin magnetization vector will slowly return from the xy-plane back to the equilibrium state. The time it takes for the magnetization vector to return to its equilibrium value, Mz, is referred to as the longitudinal relaxation time, T1. Subsequently, the rate at which this happens is simply the reciprocal of the relaxation time: \frac = R1. Similarly, the time in which it takes for Mxy to return to zero is T2, with the rate \frac = R2. Magnetization as a function of time is defined by the
Bloch equations In physics and chemistry, specifically in nuclear magnetic resonance (NMR), magnetic resonance imaging (MRI), and electron spin resonance (ESR), the Bloch equations are a set of macroscopic equations that are used to calculate the nuclear magneti ...
. T1 and T2 values are dependent on the chemical environment of the sample; hence their utility in MRI. Soft tissue and muscle tissue relax at different rates, yielding the image contrast in a typical scan. The standard display of MR images is to represent fluid characteristics in black-and-white images, where different tissues turn out as follows:


Diagnostics


Usage by organ or system

MRI has a wide range of applications in medical diagnosis and around 50,000 scanners are estimated to be in use worldwide. MRI affects diagnosis and treatment in many specialties although the effect on improved health outcomes is disputed in certain cases. MRI is the investigation of choice in the preoperative staging of rectal and
prostate cancer Prostate cancer is cancer of the prostate. Prostate cancer is the second most common cancerous tumor worldwide and is the fifth leading cause of cancer-related mortality among men. The prostate is a gland in the male reproductive system that sur ...
and has a role in the diagnosis, staging, and follow-up of other tumors, as well as for determining areas of tissue for sampling in biobanking.


Neuroimaging

MRI is the investigative tool of choice for neurological cancers over CT, as it offers better visualization of the posterior cranial fossa, containing the
brainstem The brainstem (or brain stem) is the posterior stalk-like part of the brain that connects the cerebrum with the spinal cord. In the human brain the brainstem is composed of the midbrain, the pons, and the medulla oblongata. The midbrain is cont ...
and the
cerebellum The cerebellum (Latin for "little brain") is a major feature of the hindbrain of all vertebrates. Although usually smaller than the cerebrum, in some animals such as the mormyrid fishes it may be as large as or even larger. In humans, the cerebel ...
. The contrast provided between grey and white matter makes MRI the best choice for many conditions of the central nervous system, including demyelinating diseases, dementia, cerebrovascular disease,
infectious diseases An infection is the invasion of tissues by pathogens, their multiplication, and the reaction of host tissues to the infectious agent and the toxins they produce. An infectious disease, also known as a transmissible disease or communicable dise ...
,
Alzheimer's disease Alzheimer's disease (AD) is a neurodegeneration, neurodegenerative disease that usually starts slowly and progressively worsens. It is the cause of 60–70% of cases of dementia. The most common early symptom is difficulty in short-term me ...
and epilepsy. Since many images are taken milliseconds apart, it shows how the brain responds to different stimuli, enabling researchers to study both the functional and structural brain abnormalities in psychological disorders. MRI also is used in guided
stereotactic surgery Stereotactic surgery is a minimally invasive form of surgical intervention that makes use of a three-dimensional coordinate system to locate small targets inside the body and to perform on them some action such as ablation, biopsy, lesion, injec ...
and
radiosurgery Radiosurgery is surgery using radiation, that is, the destruction of precisely selected areas of tissue using ionizing radiation rather than excision with a blade. Like other forms of radiation therapy (also called radiotherapy), it is usually u ...
for treatment of intracranial tumors, arteriovenous malformations, and other surgically treatable conditions using a device known as the N-localizer. New tools that implement artificial intelligence in healthcare have demonstrated higher image quality and morphometric analysis in neuroimaging with the application of a denoising system. The record for the highest spatial resolution of a whole intact brain (postmortem) is 100 microns, from Massachusetts General Hospital. The data was published in NATURE on 30 October 2019. Though MRI is used widely in research on mental disabilities, based on a 2024 systematic literature review and meta analysis commissioned by the Patient-Centered Outcomes Research Institute (PCORI), available research using MRI scans to diagnose ADHD showed great variability . The authors conclude that MRI cannot be reliably used to assist in making a clinical diagnosis of ADHD .


Cardiovascular

Cardiac MRI is complementary to other imaging techniques, such as
echocardiography An echocardiography, echocardiogram, cardiac echo or simply an echo, is an ultrasound of the heart. It is a type of medical imaging of the heart, using standard ultrasound or Doppler ultrasound. Echocardiography has become routinely used in t ...
,
cardiac CT A computed tomography scan (CT scan; formerly called computed axial tomography scan or CAT scan) is a medical imaging technique used to obtain detailed internal images of the body. The personnel that perform CT scans are called radiographers ...
, and nuclear medicine. It can be used to assess the structure and the function of the heart. Its applications include assessment of myocardial ischemia and viability, cardiomyopathies,
myocarditis Myocarditis, also known as inflammatory cardiomyopathy, is an acquired cardiomyopathy due to inflammation of the heart muscle. Symptoms can include shortness of breath, chest pain, decreased ability to exercise, and an irregular heartbeat. The ...
, iron overload, vascular diseases, and congenital heart disease.


Musculoskeletal

Applications in the musculoskeletal system include spinal imaging, assessment of joint disease, and soft tissue tumors. Also, MRI techniques can be used for diagnostic imaging of systemic muscle diseases including genetic muscle diseases. Swallowing movement of throat and oesophagus can cause motion artifact over the imaged spine. Therefore, a saturation pulse applied over this region the throat and oesophagus can help to avoid this artifact. Motion artifact arising due to pumping of the heart can be reduced by timing the MRI pulse according to heart cycles. Blood vessels flow artifacts can be reduced by applying saturation pulses above and below the region of interest.


Liver and gastrointestinal

Hepatobiliary MR is used to detect and characterize lesions of the liver, pancreas, and bile ducts. Focal or diffuse disorders of the liver may be evaluated using diffusion-weighted, opposed-phase imaging and dynamic contrast enhancement sequences. Extracellular contrast agents are used widely in liver MRI, and newer hepatobiliary contrast agents also provide the opportunity to perform functional biliary imaging. Anatomical imaging of the bile ducts is achieved by using a heavily T2-weighted sequence in magnetic resonance cholangiopancreatography (MRCP). Functional imaging of the pancreas is performed following administration of
secretin Secretin is a hormone that regulates water homeostasis throughout the body and influences the environment of the duodenum by regulating secretions in the stomach, pancreas, and liver. It is a peptide hormone produced in the S cells of the duode ...
. MR enterography provides non-invasive assessment of inflammatory bowel disease and small bowel tumors. MR-colonography may play a role in the detection of large polyps in patients at increased risk of colorectal cancer.


Angiography

Magnetic resonance angiography (MRA) generates pictures of the arteries to evaluate them for
stenosis A stenosis (from Ancient Greek στενός, "narrow") is an abnormal narrowing in a blood vessel or other tubular organ or structure such as foramina and canals. It is also sometimes called a stricture (as in urethral stricture). ''Stricture'' ...
(abnormal narrowing) or aneurysms (vessel wall dilatations, at risk of rupture). MRA is often used to evaluate the arteries of the neck and brain, the thoracic and abdominal aorta, the renal arteries, and the legs (called a "run-off"). A variety of techniques can be used to generate the pictures, such as administration of a paramagnetic contrast agent ( gadolinium) or using a technique known as "flow-related enhancement" (e.g., 2D and 3D time-of-flight sequences), where most of the signal on an image is due to blood that recently moved into that plane (see also FLASH MRI). Techniques involving phase accumulation (known as phase contrast angiography) can also be used to generate flow velocity maps easily and accurately. Magnetic resonance venography (MRV) is a similar procedure that is used to image veins. In this method, the tissue is now excited inferiorly, while the signal is gathered in the plane immediately superior to the excitation plane—thus imaging the venous blood that recently moved from the excited plane.


Contrast agents

MRI for imaging anatomical structures or blood flow do not require contrast agents since the varying properties of the tissues or blood provide natural contrasts. However, for more specific types of imaging, exogenous contrast agents may be given intravenously,
orally The word oral may refer to: Relating to the mouth * Relating to the mouth, the first portion of the alimentary canal that primarily receives food and liquid **Oral administration of medicines ** Oral examination (also known as an oral exam or oral ...
, or intra-articularly. Most contrast agents are either paramagnetic (e.g.: gadolinium, manganese, europium), and are used to shorten T1 in the tissue they accumulate in, or super-paramagnetic (SPIONs), and are used to shorten T2 and T2* in healthy tissue reducing its signal intensity (negative contrast agents). The most commonly used intravenous contrast agents are based on chelates of gadolinium, which is highly paramagnetic. In general, these agents have proved safer than the iodinated contrast agents used in X-ray radiography or CT.
Anaphylactoid reactions Anaphylaxis is a serious, potentially fatal allergic reaction and medical emergency that is rapid in onset and requires immediate medical attention regardless of use of emergency medication on site. It typically causes more than one of the follow ...
are rare, occurring in approx. 0.03–0.1%. Of particular interest is the lower incidence of nephrotoxicity, compared with iodinated agents, when given at usual doses—this has made contrast-enhanced MRI scanning an option for patients with renal impairment, who would otherwise not be able to undergo contrast-enhanced CT. Gadolinium-based contrast reagents are typically octadentate complexes of gadolinium(III). The complex is very stable (log K > 20) so that, in use, the concentration of the un-complexed Gd3+ ions should be below the toxicity limit. The 9th place in the metal ion's coordination sphere is occupied by a water molecule which exchanges rapidly with water molecules in the reagent molecule's immediate environment, affecting the magnetic resonance relaxation time. In December 2017, the Food and Drug Administration (FDA) in the United States announced in a drug safety communication that new warnings were to be included on all gadolinium-based contrast agents (GBCAs). The FDA also called for increased patient education and requiring gadolinium contrast vendors to conduct additional animal and clinical studies to assess the safety of these agents. Although gadolinium agents have proved useful for patients with kidney impairment, in patients with severe kidney failure requiring dialysis there is a risk of a rare but serious illness, nephrogenic systemic fibrosis, which may be linked to the use of certain gadolinium-containing agents. The most frequently linked is gadodiamide, but other agents have been linked too. Although a causal link has not been definitively established, current guidelines in the United States are that dialysis patients should only receive gadolinium agents where essential and that
dialysis Dialysis may refer to: *Dialysis (chemistry), a process of separating molecules in solution **Electrodialysis, used to transport salt ions from one solution to another through an ion-exchange membrane under the influence of an applied electric pote ...
should be performed as soon as possible after the scan to remove the agent from the body promptly. In Europe, where more gadolinium-containing agents are available, a classification of agents according to potential risks has been released. In 2008, a new contrast agent named gadoxetate, brand name Eovist (US) or Primovist (EU), was approved for diagnostic use: This has the theoretical benefit of a dual excretion path.


Sequences

An MRI sequence is a particular setting of radiofrequency pulses and gradients, resulting in a particular image appearance. The T1 and T2 weighting can also be described as MRI sequences.


Specialized configurations


Magnetic resonance spectroscopy

Magnetic resonance spectroscopy (MRS) is used to measure the levels of different metabolites in body tissues, which can be achieved through a variety of single voxel or imaging-based techniques. The MR signal produces a spectrum of resonances that corresponds to different molecular arrangements of the isotope being "excited". This signature is used to diagnose certain metabolic disorders, especially those affecting the brain, and to provide information on tumor metabolism. Magnetic resonance spectroscopic imaging (MRSI) combines both spectroscopic and imaging methods to produce spatially localized spectra from within the sample or patient. The spatial resolution is much lower (limited by the available SNR), but the spectra in each voxel contains information about many metabolites. Because the available signal is used to encode spatial and spectral information, MRSI requires high SNR achievable only at higher field strengths (3 T and above). The high procurement and maintenance costs of MRI with extremely high field strengths inhibit their popularity. However, recent compressed sensing-based software algorithms (''e.g.'', SAMV) have been proposed to achieve super-resolution without requiring such high field strengths.


Real-time


Interventional MRI

The lack of harmful effects on the patient and the operator make MRI well-suited for
interventional radiology Interventional radiology (IR) is a medical specialty that performs various minimally-invasive procedures using medical imaging guidance, such as x-ray fluoroscopy, computed tomography, magnetic resonance imaging, or ultrasound. IR performs bo ...
, where the images produced by an MRI scanner guide minimally invasive procedures. Such procedures use no
ferromagnetic Ferromagnetism is a property of certain materials (such as iron) which results in a large observed magnetic permeability, and in many cases a large magnetic coercivity allowing the material to form a permanent magnet. Ferromagnetic materials ...
instruments. A specialized growing subset of
interventional MRI Interventional magnetic resonance imaging, also Interventional MRI or IMRI, is the use of magnetic resonance imaging (MRI) to do interventional radiology procedures. Because of the lack of harmful effects on the patient and the operator, MR is we ...
is intraoperative MRI, in which an MRI is used in surgery. Some specialized MRI systems allow imaging concurrent with the surgical procedure. More typically, the surgical procedure is temporarily interrupted so that MRI can assess the success of the procedure or guide subsequent surgical work.


Magnetic resonance guided focused ultrasound

In guided therapy, high-intensity focused ultrasound (HIFU) beams are focused on a tissue, that are controlled using MR thermal imaging. Due to the high energy at the focus, the temperature rises to above 65 °C (150 Â°F) which completely destroys the tissue. This technology can achieve precise ablation of diseased tissue. MR imaging provides a three-dimensional view of the target tissue, allowing for the precise focusing of ultrasound energy. The MR imaging provides quantitative, real-time, thermal images of the treated area. This allows the physician to ensure that the temperature generated during each cycle of ultrasound energy is sufficient to cause thermal ablation within the desired tissue and if not, to adapt the parameters to ensure effective treatment.


Multinuclear imaging

Hydrogen has the most frequently imaged nucleus in MRI because it is present in biological tissues in great abundance, and because its high
gyromagnetic ratio In physics, the gyromagnetic ratio (also sometimes known as the magnetogyric ratio in other disciplines) of a particle or system is the ratio of its magnetic moment to its angular momentum, and it is often denoted by the symbol , gamma. Its SI u ...
gives a strong signal. However, any nucleus with a net
nuclear spin In atomic physics, the spin quantum number is a quantum number (designated ) which describes the intrinsic angular momentum (or spin angular momentum, or simply spin) of an electron or other particle. The phrase was originally used to describe th ...
could potentially be imaged with MRI. Such nuclei include
helium-3 Helium-3 (3He see also helion) is a light, stable isotope of helium with two protons and one neutron (the most common isotope, helium-4, having two protons and two neutrons in contrast). Other than protium (ordinary hydrogen), helium-3 is the ...
, lithium-7, carbon-13,
fluorine Fluorine is a chemical element with the symbol F and atomic number 9. It is the lightest halogen and exists at standard conditions as a highly toxic, pale yellow diatomic gas. As the most electronegative reactive element, it is extremely reacti ...
-19, oxygen-17, sodium-23, phosphorus-31 and
xenon-129 Naturally occurring xenon (54Xe) consists of seven stable isotopes and two very long-lived isotopes. Double electron capture has been observed in 124Xe (half-life ) and double beta decay in 136Xe (half-life ), which are among the longest measured ...
. 23Na and 31P are naturally abundant in the body, so they can be imaged directly. Gaseous isotopes such as 3He or 129Xe must be hyperpolarized and then inhaled as their nuclear density is too low to yield a useful signal under normal conditions. 17O and 19F can be administered in sufficient quantities in liquid form (e.g. 17O-water) that hyperpolarization is not a necessity. Using helium or xenon has the advantage of reduced background noise, and therefore increased contrast for the image itself, because these elements are not normally present in biological tissues. Moreover, the nucleus of any atom that has a net nuclear spin and that is bonded to a hydrogen atom could potentially be imaged via heteronuclear magnetization transfer MRI that would image the high-gyromagnetic-ratio hydrogen nucleus instead of the low-gyromagnetic-ratio nucleus that is bonded to the hydrogen atom. In principle, heteronuclear magnetization transfer MRI could be used to detect the presence or absence of specific chemical bonds. Multinuclear imaging is primarily a research technique at present. However, potential applications include functional imaging and imaging of organs poorly seen on 1H MRI (e.g., lungs and bones) or as alternative contrast agents. Inhaled hyperpolarized 3He can be used to image the distribution of air spaces within the lungs. Injectable solutions containing 13C or stabilized bubbles of hyperpolarized 129Xe have been studied as contrast agents for angiography and perfusion imaging. 31P can potentially provide information on bone density and structure, as well as functional imaging of the brain. Multinuclear imaging holds the potential to chart the distribution of lithium in the human brain, this element finding use as an important drug for those with conditions such as bipolar disorder.


Molecular imaging by MRI

MRI has the advantages of having very high spatial resolution and is very adept at morphological imaging and functional imaging. MRI does have several disadvantages though. First, MRI has a sensitivity of around 10−3 mol/L to 10−5 mol/L, which, compared to other types of imaging, can be very limiting. This problem stems from the fact that the population difference between the nuclear spin states is very small at room temperature. For example, at 1.5 teslas, a typical field strength for clinical MRI, the difference between high and low energy states is approximately 9 molecules per 2 million. Improvements to increase MR sensitivity include increasing magnetic field strength and hyperpolarization via optical pumping or dynamic nuclear polarization. There are also a variety of signal amplification schemes based on chemical exchange that increase sensitivity. To achieve molecular imaging of disease biomarkers using MRI, targeted MRI contrast agents with high specificity and high relaxivity (sensitivity) are required. To date, many studies have been devoted to developing targeted-MRI contrast agents to achieve molecular imaging by MRI. Commonly, peptides, antibodies, or small ligands, and small protein domains, such as HER-2 affibodies, have been applied to achieve targeting. To enhance the sensitivity of the contrast agents, these targeting moieties are usually linked to high payload MRI contrast agents or MRI contrast agents with high relaxivities. A new class of gene targeting MR contrast agents has been introduced to show gene action of unique mRNA and gene transcription factor proteins. These new contrast agents can trace cells with unique mRNA, microRNA and virus; tissue response to inflammation in living brains. The MR reports change in gene expression with positive correlation to TaqMan analysis, optical and electron microscopy.


Parallel MRI

It takes time to gather MRI data using sequential applications of magnetic field gradients. Even for the most streamlined of MRI sequences, there are physical and physiologic limits to the rate of gradient switching. Parallel MRI circumvents these limits by gathering some portion of the data simultaneously, rather than in a traditional sequential fashion. This is accomplished using arrays of radiofrequency (RF) detector coils, each with a different 'view' of the body. A reduced set of gradient steps is applied, and the remaining spatial information is filled in by combining signals from various coils, based on their known spatial sensitivity patterns. The resulting acceleration is limited by the number of coils and by the signal to noise ratio (which decreases with increasing acceleration), but two- to four-fold accelerations may commonly be achieved with suitable coil array configurations, and substantially higher accelerations have been demonstrated with specialized coil arrays. Parallel MRI may be used with most MRI sequences. After a number of early suggestions for using arrays of detectors to accelerate imaging went largely unremarked in the MRI field, parallel imaging saw widespread development and application following the introduction of the SiMultaneous Acquisition of Spatial Harmonics (SMASH) technique in 1996–7. The SENSitivity Encoding (SENSE) and Generalized Autocalibrating Partially Parallel Acquisitions (GRAPPA) techniques are the parallel imaging methods in most common use today. The advent of parallel MRI resulted in extensive research and development in image reconstruction and RF coil design, as well as in a rapid expansion of the number of receiver channels available on commercial MR systems. Parallel MRI is now used routinely for MRI examinations in a wide range of body areas and clinical or research applications.


Quantitative MRI

Most MRI focuses on qualitative interpretation of MR data by acquiring spatial maps of relative variations in signal strength which are "weighted" by certain parameters. Quantitative methods instead attempt to determine spatial maps of accurate tissue relaxometry parameter values or magnetic field, or to measure the size of certain spatial features. Examples of quantitative MRI methods are: * T1-mapping (notably used in cardiac magnetic resonance imaging) * T2-mapping *
Quantitative susceptibility mapping Quantitative Susceptibility Mapping (QSM) provides a novel contrast mechanism in Magnetic Resonance Imaging (MRI) different from traditional Susceptibility Weighted Imaging. The voxel intensity in QSM is linearly proportional to the underlying ti ...
(QSM) * Quantitative fluid flow MRI (i.e. some cerebrospinal fluid flow MRI) *
Magnetic resonance elastography Magnetic resonance elastography (MRE) is a form of elastography that specifically leverages Magnetic resonance imaging, MRI to quantify and subsequently map the mechanical properties (Elasticity (physics), elasticity or stiffness) of soft tissue. F ...
(MRE) Quantitative MRI aims to increase the
reproducibility Reproducibility, also known as replicability and repeatability, is a major principle underpinning the scientific method. For the findings of a study to be reproducible means that results obtained by an experiment or an observational study or in a ...
of MR images and interpretations, but has historically require longer scan times. Quantitative MRI (or qMRI) sometimes more specifically refers to multi-parametric quantitative MRI, the mapping of multiple tissue relaxometry parameters in a single imaging session. Efforts to make multi-parametric quantitative MRI faster have produced sequences which map multiple parameters simultaneously, either by building separate encoding methods for each parameter into the sequence, or by fitting MR signal evolution to a multi-parameter model.


Hyperpolarized gas MRI

Traditional MRI generates poor images of lung tissue because there are fewer water molecules with protons that can be excited by the magnetic field. Using hyperpolarized gas an MRI scan can identify ventilation defects in the lungs. Before the scan, a patient is asked to inhale hyperpolarized xenon mixed with a buffer gas of helium or nitrogen. The resulting lung images are much higher quality than with traditional MRI.


Safety

MRI is, in general, a safe technique, although injuries may occur as a result of failed safety procedures or human error. Contraindications to MRI include most cochlear implants and cardiac pacemakers,
shrapnel Shrapnel may refer to: Military * Shrapnel shell, explosive artillery munitions, generally for anti-personnel use * Shrapnel (fragment), a hard loose material Popular culture * ''Shrapnel'' (Radical Comics) * ''Shrapnel'', a game by Adam ...
, and metallic foreign bodies in the eyes.
Magnetic resonance imaging in pregnancy Medical imaging in pregnancy may be indicated because of pregnancy complications, intercurrent diseases or routine prenatal care. Options Options for medical imaging in pregnancy include the following: *Magnetic resonance imaging (MRI) without ...
appears to be safe, at least during the second and third trimesters if done without contrast agents. Since MRI does not use any ionizing radiation, its use is generally favored in preference to CT when either modality could yield the same information. Some patients experience claustrophobia and may require sedation or shorter MRI protocols. Amplitude and rapid switching of gradient coils during image acquisition may cause peripheral nerve stimulation. MRI uses powerful magnets and can therefore cause
magnetic materials A magnet is a material or object that produces a magnetic field. This magnetic field is invisible but is responsible for the most notable property of a magnet: a force that pulls on other ferromagnetic materials, such as iron, steel, nickel, ...
to move at great speeds, posing a projectile risk, and may cause fatal accidents. However, as millions of MRIs are performed globally each year, fatalities are extremely rare. MRI machines can produce loud noise, up to 120 dB(A). This can cause hearing loss, tinnitus and hyperacusis, so appropriate hearing protection is essential for anyone inside the MRI scanner room during the examination.


Overuse

Medical societies issue guidelines for when physicians should use MRI on patients and recommend against overuse. MRI can detect health problems or confirm a diagnosis, but medical societies often recommend that MRI not be the first procedure for creating a plan to diagnose or manage a patient's complaint. A common case is to use MRI to seek a cause of low back pain; the American College of Physicians, for example, recommends against imaging (including MRI) as unlikely to result in a positive outcome for the patient.


Artifacts

An MRI artifact is a visual artifact, that is, an anomaly during visual representation. Many different artifacts can occur during magnetic resonance imaging (MRI), some affecting the diagnostic quality, while others may be confused with pathology. Artifacts can be classified as patient-related, signal processing-dependent and hardware (machine)-related.


Non-medical use

MRI is used industrially mainly for routine analysis of chemicals. The nuclear magnetic resonance technique is also used, for example, to measure the ratio between water and fat in foods, monitoring of flow of corrosive fluids in pipes, or to study molecular structures such as catalysts. Being non-invasive and non-damaging, MRI can be used to study the anatomy of plants, their water transportation processes and water balance. It is also applied to veterinary radiology for diagnostic purposes. Outside this, its use in zoology is limited due to the high cost; but it can be used on many species. In palaeontology it is used to examine the structure of fossils. Forensic imaging provides graphic documentation of an
autopsy An autopsy (post-mortem examination, obduction, necropsy, or autopsia cadaverum) is a surgical procedure that consists of a thorough examination of a corpse by dissection to determine the cause, mode, and manner of death or to evaluate any di ...
, which manual autopsy does not. CT scanning provides quick whole-body imaging of skeletal and
parenchyma Parenchyma () is the bulk of functional substance in an animal organ or structure such as a tumour. In zoology it is the name for the tissue that fills the interior of flatworms. Etymology The term ''parenchyma'' is New Latin from the word π ...
l alterations, whereas MR imaging gives better representation of soft tissue pathology. All that being said, MRI is more expensive, and more time-consuming to utilize. Moreover, the quality of MR imaging deteriorates below 10 Â°C.


History

In 1971 at
Stony Brook University Stony Brook University (SBU), officially the State University of New York at Stony Brook, is a public research university in Stony Brook, New York. Along with the University at Buffalo, it is one of the State University of New York system's ...
, Paul Lauterbur applied magnetic field gradients in all three dimensions and a back-projection technique to create NMR images. He published the first images of two tubes of water in 1973 in the journal ''Nature'', followed by the picture of a living animal, a clam, and in 1974 by the image of the thoracic cavity of a mouse. Lauterbur called his imaging method zeugmatography, a term which was replaced by (N)MR imaging. In the late 1970s, physicists Peter Mansfield and Paul Lauterbur developed MRI-related techniques, like the
echo-planar imaging The physics of magnetic resonance imaging (MRI) concerns fundamental physical considerations of MRI techniques and technological aspects of MRI devices. MRI is a medical imaging technique mostly used in radiology and nuclear medicine in order ...
(EPI) technique. Raymond Damadian’s work into nuclear magnetic resonance (NMR) has been incorporated into MRI, having built one of the first scanners. Advances in semiconductor technology were crucial to the development of practical MRI, which requires a large amount of
computational power Moore's law is the observation that the Transistor count, number of transistors in a dense integrated circuit (IC) doubles about every two years. Moore's law is an observation and Forecasting, projection of a historical trend. Rather than a la ...
. This was made possible by the rapidly increasing number of transistors on a single
integrated circuit An integrated circuit or monolithic integrated circuit (also referred to as an IC, a chip, or a microchip) is a set of electronic circuits on one small flat piece (or "chip") of semiconductor material, usually silicon. Large numbers of tiny ...
chip. Mansfield and Lauterbur were awarded the 2003 Nobel Prize in Physiology or Medicine for their "discoveries concerning magnetic resonance imaging".


See also

*
Amplified magnetic resonance imaging Amplified magnetic resonance imaging (aMRI) is an MRI method which is coupled with video magnification processing methods to amplify the subtle spatial variations in MRI scans, to enable better visualization of tissue motion. aMRI can enable better ...
* Cerebrospinal fluid flow MRI * Electron paramagnetic resonance *
High-definition fiber tracking High definition fiber tracking (HDFT) is a tractography technique where data from MRI scanners is processed through computer algorithms to reveal the detailed wiring of the brain and to pinpoint fiber tracts. Each tract contains millions of neurona ...
* High-resolution computed tomography * History of neuroimaging * International Society for Magnetic Resonance in Medicine * Jemris * List of neuroimaging software *
Magnetic immunoassay Magnetic immunoassay (MIA) is a type of diagnostic immunoassay using magnetic beads as labels in lieu of conventional enzymes (ELISA), radioisotopes (RIA) or fluorescent moieties ( fluorescent immunoassays) to detect a specified analyte. MIA involv ...
* Magnetic particle imaging *
Magnetic resonance elastography Magnetic resonance elastography (MRE) is a form of elastography that specifically leverages Magnetic resonance imaging, MRI to quantify and subsequently map the mechanical properties (Elasticity (physics), elasticity or stiffness) of soft tissue. F ...
* ''Magnetic Resonance Imaging'' (journal) *
Magnetic resonance microscopy Magnetic resonance microscopy (MRM, μMRI) is magnetic resonance imaging (MRI) at a microscopic level down to the scale of microns. The first definition of MRM was MRI having voxel resolutions of better than 100 Î¼m. Nomenclature Magnetic r ...
* Nobel Prize controversies – Physiology or medicine * Rabi cycle * Robinson oscillator * Sodium MRI *
Virtopsy Virtopsy is a virtual alternative to a traditional autopsy, conducted with scanning and imaging technology. The name is a portmanteau of "virtual" and "autopsy" and is a trademark registered to Richard Dirnhofer (de), the former head of the Insti ...


References


Further reading

* * * * * * * * * * * * * * * * * *


External links

*
A Guided Tour of MRI: An introduction for laypeople
National High Magnetic Field Laboratory
The Basics of MRI
''Underlying physics and technical aspects''.

from the Institute for Magnetic Resonance Safety, Education, and Research (IMRSER)
Royal Institution Lecture – MRI: A Window on the Human Body


* ttps://www.howequipmentworks.com/mri_basics/ How MRI works explained simply using diagrams
Real-time MRI videos: Biomedizinische NMR Forschungs GmbH
* Paul C. Lauterbur
Genesis of the MRI (Magnetic Resonance Imaging) notebook, September 1971
(all pages freely available for download in variety of formats from Science History Institute Digital Collections a
digital.sciencehistory.org
{{DEFAULTSORT:Magnetic Resonance Imaging 1973 introductions 20th-century inventions American inventions Articles containing video clips Biomagnetics Cryogenics Discovery and invention controversies Radiology