MRI machine
   HOME

TheInfoList



OR:

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 revea ...
technique used in
radiology Radiology ( ) is the medical specialty that uses medical imaging to diagnose diseases and guide treatment within the bodies of humans and other animals. It began with radiography (which is why its name has a root referring to radiation), but tod ...
to generate pictures of the
anatomy Anatomy () is the branch of morphology concerned with the study of the internal structure of organisms and their parts. Anatomy is a branch of natural science that deals with the structural organization of living things. It is an old scien ...
and the
physiological Physiology (; ) is the science, scientific study of function (biology), functions and mechanism (biology), mechanisms in a life, living system. As a branches of science, subdiscipline of biology, physiology focuses on how organisms, organ syst ...
processes inside the body. MRI scanners use strong
magnetic field A magnetic field (sometimes called B-field) is a physical 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 ...
s, magnetic field gradients, and
radio wave Radio waves (formerly called Hertzian waves) are a type of electromagnetic radiation with the lowest frequencies and the longest wavelengths in the electromagnetic spectrum, typically with frequencies below 300 gigahertz (GHz) and wavelengths g ...
s to form images of the organs in the body. MRI does not involve
X-rays An X-ray (also known in many languages as Röntgen radiation) is a form of high-energy electromagnetic radiation with a wavelength shorter than those of ultraviolet rays and longer than those of gamma rays. Roughly, X-rays have a wavelength ran ...
or the use of
ionizing radiation Ionizing (ionising) radiation, including Radioactive decay, nuclear radiation, consists of subatomic particles or electromagnetic waves that have enough energy per individual photon or particle to ionization, ionize atoms or molecules by detaching ...
, which distinguishes it from
computed tomography A computed tomography scan (CT scan), formerly called computed axial tomography scan (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 or ...
(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 metabolic processes, and in other physiological activities including blood flow, r ...
(PET) scans. MRI is a medical application of
nuclear magnetic resonance Nuclear magnetic resonance (NMR) is a physical phenomenon in which nuclei in a strong constant magnetic field are disturbed by a weak oscillating magnetic field (in the near field) and respond by producing an electromagnetic signal with a ...
(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 Medical diagnosis (abbreviated Dx, Dx, or Ds) is the process of determining which disease or condition explains a person's symptoms and signs. It is most often referred to as a diagnosis with the medical context being implicit. The information ...
, staging and follow-up of disease. Compared to CT, MRI provides better contrast in images of soft tissues, e.g. in the
brain The brain is an organ (biology), organ that serves as the center of the nervous system in all vertebrate and most invertebrate animals. It consists of nervous tissue and is typically located in the head (cephalization), usually near organs for ...
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 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 at the University of Manchester based on the 1909 Geiger–Marsden gold foil experiment. Aft ...
are able to absorb
radio frequency Radio frequency (RF) is the oscillation rate of an alternating electric current or voltage or of a magnetic, electric or electromagnetic field or mechanical system in the frequency range from around to around . This is roughly between the u ...
(RF) energy when placed in an external
magnetic field A magnetic field (sometimes called B-field) is a physical 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 ...
; the resultant evolving spin polarization can induce an 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 then detected by RF antennas close to the subject being examined. It is a process similar to masers. 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 Water is an inorganic compound with the chemical formula . It is a transparent, tasteless, odorless, and Color of water, nearly colorless chemical substance. It is the main constituent of Earth's hydrosphere and the fluids of all known liv ...
and
fat In nutrition science, nutrition, biology, and chemistry, fat usually means any ester of fatty acids, or a mixture of such chemical compound, compounds, most commonly those that occur in living beings or in food. The term often refers specif ...
. 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 Nuclear may refer to: Physics Relating to the nucleus of the atom: * Nuclear engineering * Nuclear physics * Nuclear power * Nuclear reactor * Nuclear weapon * Nuclear medicine *Radiation therapy *Nuclear warfare Mathematics * Nuclear space * ...
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 Diffusion-weighted magnetic resonance imaging (DWI or DW-MRI) is the use of specific MRI sequences as well as software that generates images from the resulting data that uses the diffusion of water molecules to generate contrast (vision), contrast ...
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 A health system, health care system or healthcare system is an organization of people, institutions, and resources that delivers health care services to meet the health needs of target populations. There is a wide variety of health systems aroun ...
s has led to concerns about cost effectiveness and
overdiagnosis Overdiagnosis is the diagnosis of disease that will never cause symptoms or death during a patient's ordinarily expected lifetime and thus presents no practical threat regardless of being pathologic. Overdiagnosis is a side effect of screening ...
.


Mechanism


Construction and physics

In most medical applications,
hydrogen Hydrogen is a chemical element; it has chemical symbol, symbol H and atomic number 1. It is the lightest and abundance of the chemical elements, most abundant chemical element in the universe, constituting about 75% of all baryon, normal matter ...
nuclei, which consist solely of a
proton A proton is a stable subatomic particle, symbol , Hydron (chemistry), H+, or 1H+ with a positive electric charge of +1 ''e'' (elementary charge). Its mass is slightly less than the mass of a neutron and approximately times the mass of an e ...
, 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 (sometimes called B-field) is a physical 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 ...
around the area to be imaged. First, energy from an oscillating magnetic field is temporarily applied to the patient at the appropriate
resonance Resonance is a phenomenon that occurs when an object or system is subjected to an external force or vibration whose frequency matches a resonant frequency (or resonance frequency) of the system, defined as a frequency that generates a maximu ...
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 Thermodynamic equilibrium is a notion of thermodynamics with axiomatic status referring to an internal state of a single thermodynamic system, or a relation between several thermodynamic systems connected by more or less permeable or impermeable ...
. 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 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, ...
, 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 A uniform is a variety of costume worn by members of an organization while usually participating in that organization's activity. Modern uniforms are most often worn by armed forces and paramilitary organizations such as police, emergency serv ...
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. 3T MRI systems, also called 3 Tesla MRIs, have stronger magnets than 1.5 systems and are considered better for images of organs and soft tissue. 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 A squid (: squid) is a mollusc with an elongated soft body, large eyes, eight cephalopod limb, arms, and two tentacles in the orders Myopsida, Oegopsida, and Bathyteuthida (though many other molluscs within the broader Neocoleoidea are also ...
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 and inflammation, revealing white matter lesions, and assessing zonal anatomy in the
prostate The prostate is an male accessory gland, accessory gland of the male reproductive system and a muscle-driven mechanical switch between urination and ejaculation. It is found in all male mammals. It differs between species anatomically, chemica ...
and
uterus The uterus (from Latin ''uterus'', : uteri or uteruses) or womb () is the hollow organ, organ in the reproductive system of most female mammals, including humans, that accommodates the embryonic development, embryonic and prenatal development, f ...
. 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. Accordingly, physicists and engineers usually define magnetization as the quanti ...
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 = R_1. Similarly, the time in which it takes for Mxy to return to zero is T2, with the rate \frac = R_2. Magnetization as a function of time is defined by the Bloch equations. 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 Medical diagnosis (abbreviated Dx, Dx, or Ds) is the process of determining which disease or condition explains a person's symptoms and signs. It is most often referred to as a diagnosis with the medical context being implicit. The information ...
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 The rectum (: rectums or recta) is the final straight portion of the large intestine in humans and some other mammals, and the Gastrointestinal tract, gut in others. Before expulsion through the anus or cloaca, the rectum stores the feces te ...
and
prostate cancer Prostate cancer is the neoplasm, uncontrolled growth of cells in the prostate, a gland in the male reproductive system below the bladder. Abnormal growth of the prostate tissue is usually detected through Screening (medicine), screening tests, ...
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 conti ...
and the
cerebellum The cerebellum (: cerebella or cerebellums; 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 it or eve ...
. The contrast provided between
grey Grey (more frequent in British English) or gray (more frequent in American English) is an intermediate color between black and white. It is a neutral or achromatic color, meaning that it has no chroma. It is the color of a cloud-covered s ...
and
white matter White matter refers to areas of the central nervous system that are mainly made up of myelinated axons, also called Nerve tract, tracts. Long thought to be passive tissue, white matter affects learning and brain functions, modulating the distr ...
makes MRI the best choice for many conditions of the
central nervous system The central nervous system (CNS) is the part of the nervous system consisting primarily of the brain, spinal cord and retina. The CNS is so named because the brain integrates the received information and coordinates and influences the activity o ...
, including demyelinating diseases,
dementia Dementia is a syndrome associated with many neurodegenerative diseases, characterized by a general decline in cognitive abilities that affects a person's ability to perform activities of daily living, everyday activities. This typically invo ...
,
cerebrovascular disease Cerebrovascular disease includes a variety of medical conditions that affect the blood vessels of the brain and the cerebral circulation. Arteries supplying oxygen and nutrients to the brain are often damaged or deformed in these disorders. Th ...
,
infectious diseases 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 neurodegenerative disease and the cause of 60–70% of cases of dementia. The most common early symptom is difficulty in remembering recent events. As the disease advances, symptoms can include problems wit ...
and
epilepsy Epilepsy is a group of Non-communicable disease, non-communicable Neurological disorder, neurological disorders characterized by a tendency for recurrent, unprovoked Seizure, seizures. A seizure is a sudden burst of abnormal electrical activit ...
. Since multiple images are taken milliseconds apart, it can show how the brain responds to different stimuli, enabling researchers to study both functional and structural brain abnormalities in psychological disorders. MRI also is used in guided stereotactic surgery and radiosurgery 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 Neuroimaging is the use of quantitative (computational) techniques to study the neuroanatomy, structure and function of the central nervous system, developed as an objective way of scientifically studying the healthy human brain in a non-invasive ...
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'' in 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 Echocardiography, also known as cardiac ultrasound, is the use of ultrasound to examine the heart. It is a type of medical imaging, using standard ultrasound or Doppler ultrasound. The visual image formed using this technique is called an ec ...
, cardiac CT, and
nuclear medicine Nuclear medicine (nuclear radiology, nucleology), is a medical specialty involving the application of radioactivity, radioactive substances in the diagnosis and treatment of disease. Nuclear imaging is, in a sense, ''radiology done inside out'', ...
. 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, iron overload, vascular diseases, and congenital heart disease.


Musculoskeletal

Applications in the musculoskeletal system include spinal imaging, assessment of
joint A joint or articulation (or articular surface) is the connection made between bones, ossicles, or other hard structures in the body which link an animal's skeletal system into a functional whole.Saladin, Ken. Anatomy & Physiology. 7th ed. McGraw- ...
disease, and soft tissue tumors. MRI techniques can also be used for diagnostic imaging of systemic muscle diseases including genetic muscle diseases. Swallowing movements of the throat and esophagus can cause motion artifacts over the imaged spine. Therefore, a saturation pulse applied over this region can help to avoid these artifacts. Motion artifacts arising due to the pumping of the heart can be reduced by timing the MRI pulse according to heart cycles. Blood vessel flow artifacts can be reduced by applying saturation pulses above and below the region of interest.


Liver and gastrointestinal

Hepatobiliary MRI is used to detect and characterize lesions of the
liver The liver is a major metabolic organ (anatomy), organ exclusively found in vertebrates, which performs many essential biological Function (biology), functions such as detoxification of the organism, and the Protein biosynthesis, synthesis of var ...
,
pancreas The pancreas (plural pancreases, or pancreata) is an Organ (anatomy), organ of the Digestion, digestive system and endocrine system of vertebrates. In humans, it is located in the abdominal cavity, abdomen behind the stomach and functions as a ...
, and
bile duct A bile duct is any of a number of long tube-like structures that carry bile, and is present in most vertebrates. The bile duct is separated into three main parts: the fundus (superior), the body (middle), and the neck (inferior). Bile is requ ...
s. 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. 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 Angiography or arteriography is a medical imaging technique used to visualize the inside, or lumen, of blood vessels and organs of the body, with particular interest in the arteries, veins, and the heart chambers. Modern angiography is perfo ...
(MRA) generates pictures of the arteries to evaluate them for
stenosis Stenosis () is the abnormal narrowing of 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'' as a term is usually used when narrowing ...
(abnormal narrowing) or
aneurysm An aneurysm is an outward :wikt:bulge, bulging, likened to a bubble or balloon, caused by a localized, abnormal, weak spot on a blood vessel wall. Aneurysms may be a result of a hereditary condition or an acquired disease. Aneurysms can also b ...
s (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, 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 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 The United States Food and Drug Administration (FDA or US FDA) is a List of United States federal agencies, federal agency of the United States Department of Health and Human Services, Department of Health and Human Services. The FDA is respo ...
(FDA) in the
United States The United States of America (USA), also known as the United States (U.S.) or America, is a country primarily located in North America. It is a federal republic of 50 U.S. state, states and a federal capital district, Washington, D.C. The 48 ...
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 The United States of America (USA), also known as the United States (U.S.) or America, is a country primarily located in North America. It is a federal republic of 50 U.S. state, states and a federal capital district, Washington, D.C. The 48 ...
are that dialysis patients should only receive gadolinium agents where essential and that dialysis 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 biochemistry, a metabolite is an intermediate or end product of metabolism. The term is usually used for small molecules. Metabolites have various functions, including fuel, structure, signaling, stimulatory and inhibitory effects on enzymes, c ...
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 Metabolism (, from ''metabolē'', "change") is the set of life-sustaining chemical reactions in organisms. The three main functions of metabolism are: the conversion of the energy in food to energy available to run cellular processes; the co ...
. 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 Fluoroscopy, x-ray fluoroscopy, CT scan, computed tomography, magnetic resonance imaging, or ultraso ...
, 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) that results in a significant, observable magnetic permeability, and in many cases, a significant magnetic coercivity, allowing the material to form a permanent magnet. Ferromagne ...
instruments. A specialized growing subset of interventional MRI 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 Ablation ( – removal) is the removal or destruction of something from an object by vaporization, chipping, erosion, erosive processes, or by other means. Examples of ablative materials are described below, including spacecraft material for as ...
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 gives a strong signal. However, any nucleus with a net
nuclear spin Nuclear may refer to: Physics Relating to the nucleus of the atom: * Nuclear engineering * Nuclear physics * Nuclear power * Nuclear reactor * Nuclear weapon * Nuclear medicine *Radiation therapy *Nuclear warfare Mathematics * Nuclear space * ...
could potentially be imaged with MRI. Such nuclei include
deuterium Deuterium (hydrogen-2, symbol H or D, also known as heavy hydrogen) is one of two stable isotopes of hydrogen; the other is protium, or hydrogen-1, H. The deuterium nucleus (deuteron) contains one proton and one neutron, whereas the far more c ...
, helium-3, lithium-7, carbon-13,
fluorine Fluorine is a chemical element; it has Chemical symbol, symbol F and atomic number 9. It is the lightest halogen and exists at Standard temperature and pressure, standard conditions as pale yellow Diatomic molecule, diatomic gas. Fluorine is extre ...
-19, oxygen-17,
sodium Sodium is a chemical element; it has Symbol (chemistry), symbol Na (from Neo-Latin ) and atomic number 11. It is a soft, silvery-white, highly reactive metal. Sodium is an alkali metal, being in group 1 element, group 1 of the peri ...
-23,
phosphorus Phosphorus is a chemical element; it has Chemical symbol, symbol P and atomic number 15. All elemental forms of phosphorus are highly Reactivity (chemistry), reactive and are therefore never found in nature. They can nevertheless be prepared ar ...
-31 and xenon-129. 2H, 23Na and 31P are naturally abundant in the body, so they can be imaged directly. Naturally abundant deuterium at the concentration of around 15mM can be imaged, but suffers from low gamma sensitivity and quadripolar Relaxation (NMR). Deuterium imaging however has a sparse chemical shift spectra making it possible to develop tailored multiband selective RF pulses for metabolite selective imaging. Thus, metabolic imaging, similar to what's done with Carbon-13 is possible with Deuterium metabolic imaging (DMI) for insights into vivo metabolic processes. As well, the short T2 of deuterium allows it to be signal averaged rapidly, making up for some of its physical shortcomings. 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 (QSM) * Quantitative fluid flow MRI (i.e. some cerebrospinal fluid flow MRI) * Magnetic resonance elastography (MRE) Quantitative MRI aims to increase the
reproducibility Reproducibility, closely related to 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 ...
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 Xenon is a chemical element; it has symbol Xe and atomic number 54. It is a dense, colorless, odorless noble gas found in Earth's atmosphere in trace amounts. Although generally unreactive, it can undergo a few chemical reactions such as the ...
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 implant A cochlear implant (CI) is a surgically implanted Neuroprosthetics, neuroprosthesis that provides a person who has moderate-to-profound sensorineural hearing loss with sound perception. With the help of therapy, cochlear implants may allow for imp ...
s and cardiac pacemakers, shrapnel, and metallic foreign bodies in the
eyes An eye is a sensory organ that allows an organism to perceive visual information. It detects light and converts it into electro-chemical impulses in neurons (neurones). It is part of an organism's visual system. In higher organisms, the ey ...
. Magnetic resonance imaging in pregnancy 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 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 Hearing loss is a partial or total inability to hear. Hearing loss may be present at birth or acquired at any time afterwards. Hearing loss may occur in one or both ears. In children, hearing problems can affect the ability to acquire spo ...
,
tinnitus Tinnitus is a condition when a person hears a ringing sound or a different variety of sound when no corresponding external sound is present and other people cannot hear it. Nearly everyone experiences faint "normal tinnitus" in a completely ...
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 Low back pain or wiktionary:lumbago#Etymology, lumbago is a common musculoskeletal disorders, disorder involving the muscles, nerves, and bones of the back, in between the lower edge of the ribs and the lower fold of the buttocks. Pain can var ...
; 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 Nuclear magnetic resonance (NMR) is a physical phenomenon in which nuclei in a strong constant magnetic field are disturbed by a weak oscillating magnetic field (in the near field) and respond by producing an electromagnetic signal with a ...
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 Forensic science combines principles of law and science to investigate criminal activity. Through crime scene investigations and laboratory analysis, forensic scientists are able to link suspects to evidence. An example is determining the time and ...
imaging provides graphic documentation of an
autopsy An autopsy (also referred to as 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 deat ...
, which manual autopsy does not. CT scanning provides quick whole-body imaging of skeletal and
parenchyma upright=1.6, Lung parenchyma showing damage due to large subpleural bullae. Parenchyma () is the bulk of functional substance in an animal organ such as the brain or lungs, or a structure such as a tumour. In zoology, it is the tissue that ...
l alterations, whereas MR imaging gives better representation of soft tissue
pathology Pathology is the study of disease. The word ''pathology'' also refers to the study of disease in general, incorporating a wide range of biology research fields and medical practices. However, when used in the context of modern medical treatme ...
. 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 university, public research university in Stony Brook, New York, United States, on Long Island. Along with the University at Buffalo, it is on ...
, 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 (EPI) technique. Raymond Damadian's work into
nuclear magnetic resonance Nuclear magnetic resonance (NMR) is a physical phenomenon in which nuclei in a strong constant magnetic field are disturbed by a weak oscillating magnetic field (in the near field) and respond by producing an electromagnetic signal with a ...
(NMR) has been incorporated into MRI, having built one of the first scanners. Advances in
semiconductor A semiconductor is a material with electrical conductivity between that of a conductor and an insulator. Its conductivity can be modified by adding impurities (" doping") to its crystal structure. When two regions with different doping level ...
technology were crucial to the development of practical MRI, which requires a large amount of
computational power A computation is any type of arithmetic or non-arithmetic calculation that is well-defined. Common examples of computation are mathematical equation solving and the execution of computer algorithms. Mechanical or electronic devices (or, historic ...
. This was made possible by the rapidly increasing number of
transistors A transistor is a semiconductor device used to Electronic amplifier, amplify or electronic switch, switch electrical signals and electric power, power. It is one of the basic building blocks of modern electronics. It is composed of semicondu ...
on a single
integrated circuit An integrated circuit (IC), also known as a microchip or simply chip, is a set of electronic circuits, consisting of various electronic components (such as transistors, resistors, and capacitors) and their interconnections. These components a ...
chip. Mansfield and Lauterbur were awarded the 2003
Nobel Prize in Physiology or Medicine The Nobel Prize in Physiology or Medicine () is awarded yearly by the Nobel Assembly at the Karolinska Institute for outstanding discoveries in physiology or medicine. The Nobel Prize is not a single prize, but five separate prizes that, acco ...
for their "discoveries concerning magnetic resonance imaging".


See also

* Amplified magnetic resonance imaging * Cerebrospinal fluid flow MRI * Electron paramagnetic resonance * High-definition fiber tracking * High-resolution computed tomography * History of neuroimaging * International Society for Magnetic Resonance in Medicine * Jemris * List of neuroimaging software * Magnetic immunoassay *
Magnetic particle imaging Magnetic particle imaging (MPI) is an emerging non-invasive Tomography, tomographic technique that directly detects Superparamagnetic Iron Oxide Nanoparticles, superparamagnetic nanoparticle tracers. The technology has potential applications in dia ...
* Magnetic resonance elastography * ''Magnetic Resonance Imaging'' (journal) * Magnetic resonance microscopy * Nobel Prize controversies – Physiology or medicine * Rabi cycle * Robinson oscillator * Sodium MRI * Virtopsy


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