Magnetic Resonance Imaging - Wikipedia

Magnetic
resonance
imaging
Magnetic resonance imaging (MRI) is a medical imaging technique used in radiology

to form pictures of the anatomy and the physiological processes inside the body. MRI
scanners use strong magnetic fields, magnetic field gradients, and radio waves to
generate images of the organs in the body. MRI does not involve X-rays or the use of
ionizing radiation, which distinguishes it from computed tomography (CT) and
positron emission tomography (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.[1]
Magnetic resonance imaging
0:06
Para-sagittal MRI of the head, with

aliasing artifacts (nose and forehead
appear at the back of the head)
Synonyms Nuclear magnetic

resonance imaging
(NMRI), magnetic
resonance
tomography (MRT)
ICD-9-CM 88.91 (http://icd9c
m.chrisendres.co
m/index.php?srcht
ype=procs&srchtex
t=88.91&Submit=S
earch&action=sear
ch)
MeSH D008279 (https://m

eshb.nlm.nih.gov/r
ecord/ui?ui=D008
279)
MedlinePlus 003335 (https://me

dlineplus.gov/enc
y/article/003335.h
tm)
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 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.[2] Certain atomic nuclei are able to
absorb radio frequency (RF) energy when placed in an external magnetic field; the
resultant evolving spin polarization can induce an RF signal in a radio frequency coil
and thereby be detected.[3] 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. In clinical and research MRI, hydrogen atoms are most
often used to generate a macroscopic polarized radiation that is detected by the
antennas.[3] 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 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
i Diff i MRI df i l MRI d h ili f MRI
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
systems has led to concerns about cost effectiveness and overdiagnosis.[4][5]
Mechanism
Construction and physics
Schematic of a cylindrical superconducting MR scanner.

Top: cross section of the cylinder with primary coil,
gradient coils and RF transmit coilsBottom: longitudinal
section of the cylinder and table, showing the same coils
and the RF receive coil.
In most medical applications, hydrogen nuclei, which consist solely of a proton, 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 around the area
to be imaged First energy from an oscillating 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.[6]
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.
A mobile MRI unit visiting Glebefields

Health Centre, Tipton, England
Audio recording
0:55
A short extract of a 20-minute
scanning session, recorded
outside the above unit
Problems playing this file? See media
help.
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,[7][8] 10.5T,[9] 11.7T.[10] Even higher field whole-body MRI systems
e.g. 14 T and beyond are in conceptual proposal[11] or in engineering design.[12] 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.[13]
Lower field strengths are also used in a portable MRI scanner approved by the FDA in
2020.[14] 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 (SQUIDs).[15][16][17]
T1 and T2
Effects of TR and TE on MR signal

Examples of T1-weighted, T2-weighted and
PD-weighted MRI scans
Diagram of changing magnetization and spin

orientations throughout spin-lattice
relaxation experiment
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 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).[18] 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 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.[19] Subsequently, the rate at
which this happens is simply the reciprocal of the relaxation time: .
Similarly, the time in which it takes for Mxy to return to zero is T2, with the rate
.[20] 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:
Signal T1-weighted T2-weighted
Fat[21][22]
Subacute hemorrhage[22]
Melanin[22] More water content,[21] as in

edema, tumor, infarction,
Protein-rich fluid[22]
inflammation and infection[22]
[22]
Slowly flowing blood
Extracellularly located
High Paramagnetic or diamagnetic methemoglobin in subacute
substances, such as hemorrhage[22]
gadolinium, manganese,
Fat
copper[22]
Pathology
Cortical pseudolaminar
necrosis[22]
Anatomy
Gray matter darker than white White matter darker than grey
Intermediate
matter[23] matter[23]
Bone[21]
Urine Bone[21]
CSF Air[21]
Air[21] Low proton density, as in

calcification and fibrosis[22]
[21]
More water content, as in
Low
edema, tumor, infarction, Paramagnetic material, such as
inflammation, infection, deoxyhemoglobin, intracellular
hyperacute or chronic methemoglobin, iron, ferritin,

hemorrhage[22] hemosiderin, melanin[22]
Low proton density as in Protein-rich fluid[22]

calcification[22]
Diagnostics
Usage by organ or system
Patient being positioned for MR study

of the head and abdomen
MRI has a wide range of applications in medical diagnosis and around 50,000
scanners are estimated to be in use worldwide.[24] MRI affects diagnosis and
treatment in many specialties although the effect on improved health outcomes is
disputed in certain cases.[25][26]
Radiologist interpreting MRI images

of head and neck
MRI is the investigation of choice in the preoperative staging of rectal and prostate
cancer and has a role in the diagnosis, staging, and follow-up of other tumors,[27] as
well as for determining areas of tissue for sampling in biobanking.[28][29]
Neuroimaging
MRI diffusion tensor imaging of white
matter tracts
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 and the
cerebellum. 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,
Alzheimer's disease and epilepsy.[30][31][32] 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.[33] 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.[34][35][36] 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.[37]
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.[38][39]
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.[40] The authors conclude that MRI cannot be
reliably used to assist in making a clinical diagnosis of ADHD.[40]
Cardiovascular
MR angiogram in congenital heart

disease
Cardiac MRI is complementary to other imaging techniques, such as

echocardiography, cardiac CT, and nuclear medicine. It can be used to assess the
structure and the function of the heart.[41] Its applications include assessment of
myocardial ischemia and viability, cardiomyopathies, myocarditis, iron overload,
vascular diseases, and congenital heart disease.[42]
Musculoskeletal
Applications in the musculoskeletal system include spinal imaging, assessment of
joint disease, and soft tissue tumors.[43] Also, MRI techniques can be used for
diagnostic imaging of systemic muscle diseases including genetic muscle
diseases.[44][45]
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.[46] Blood
vessels flow artifacts can be reduced by applying saturation pulses above and below
the region of interest.[47]
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. 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.[48][49][50][51]
Angiography
Magnetic resonance angiography
Magnetic resonance angiography (MRA) generates pictures of the arteries to evaluate

them for stenosis (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).[52]
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.[53]
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.[6] 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.[54] 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%.[55] 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.[56]
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.[57]
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.[58] 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.[59] 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 should be performed as soon as
possible after the scan to remove the agent from the body promptly.[60][61]
In Europe, where more gadolinium-containing agents are available, a classification of

agents according to potential risks has been released.[62][63] 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.[64]
Sequences
An MRI sequence is a particular setting of radiofrequency pulses and gradients,
resulting in a particular image appearance.[65] The T1 and T2 weighting can also be
described as MRI sequences.
Overview table
This table does not include uncommon and experimental sequences.

Main clinical
Group Sequence Abbr. Physics Example
distinctions
Spin echo Lower signal for

more water
content,[66] as in
edema, tumor,
infarction,
inflammation,
infection,
Measuring hyperacute or
spin–lattice chronic
relaxation by hemorrhage.[67]
T1 weighted T1 using a short High signal for
repetition time fat[66][67]
(TR) and echo
High signal for
time (TE).
paramagnetic
substances, such as
MRI contrast
agents[67]
Standard foundation
and comparison for
other sequences
T2 weighted T2 Measuring Higher signal for

spin–spin more water
relaxation by content[66]
using long TR
Low signal for fat[66]
and TE times
− Note that this only
applies to standard
Spin Echo (SE)
sequences and not
the more modern
Fast Spin Echo
(FSE) sequence
(also referred to as
Turbo Spin Echo,
TSE), which is the
most commonly
used technique
today. In FSE/TSE,
fat will have a high
signal.[68]
Low signal for

paramagnetic
substances[67]
Standard foundation
and comparison for
other sequences
Long TR (to Joint disease and

Proton reduce T1) and injury.[70]
density PD short TE (to High signal from
weighted minimize meniscus tears.[71]
T2).[69] (pictured)
Gradient Maintenance
echo (GRE) of a steady,
residual
Steady-state Creation of cardiac
transverse
free SSFP MRI videos
magnetisation
precession (pictured).[72]
over
successive
cycles.[72]
Spoiled
gradient
Low signal from
recalled echo
Effective T2 hemosiderin deposits
T2* (GRE) with a
or "T2-star" (pictured) and
long echo time
hemorrhages.[73]
and small flip
angle[73]
Susceptibility- SWI Spoiled Detecting small

recalled echo hemorrhage (diffuse
(GRE), fully axonal injury pictured)
flow or calcium.[74]
compensated,
long echo
time,
combines
phase image
with
magnitude
image[74]
Fat
suppression by High signal in edema,
Short tau setting an such as in more
inversion STIR inversion time severe stress
recovery where the fracture.[76] Shin
signal of fat is splints pictured:
zero.[75]
High signal in lacunar

Fluid
infarction, multiple
Fluid- suppression by
sclerosis (MS)
Inversion attenuated setting an
FLAIR plaques, subarachnoid
recovery inversion inversion time
haemorrhage and
recovery that nulls
meningitis
fluids
(pictured).[77]
Simultaneous
suppression of
Double cerebrospinal High signal of multiple
inversion DIR fluid and white sclerosis plaques
recovery matter by two (pictured).[78]
inversion
times.[78]
Diffusion Conventional DWI Measure of High signal within

weighted Brownian minutes of cerebral
(DWI) motion of infarction
[80]
water
molecules.[79]
Reduced T2
weighting by
taking multiple
conventional
Low signal minutes
Apparent DWI images
after cerebral
diffusion ADC with different
infarction
coefficient DWI weighting,
(pictured).[82]
and the
change
corresponds to
diffusion.[81]
Mainly
tractography
(pictured) by Evaluating white
an overall matter deformation
greater by tumors[83]
Diffusion Brownian
DTI Reduced fractional
tensor motion of
water anisotropy may
molecules in indicate
dementia.[84]
the directions
of nerve
fibers.[83]
Perfusion Measures Provides

weighted changes over measurements of
(PWI) time in blood flow
Dynamic susceptibility-
In cerebral
susceptibility DSC induced signal
infarction, the
contrast loss due to
infarcted core and
gadolinium
the penumbra have
contrast
decreased perfusion
injection.[85]
and delayed
Arterial spin ASL Magnetic
arterial blood contrast arrival
below the (pictured).[86]
imaging slab,
which
subsequently
enters the
region of
interest.[87] It
does not need
gadolinium
contrast.[88]
Measures
changes over
time in the
Faster Gd contrast
shortening of
uptake along with
Dynamic the spin–
other features is
contrast DCE lattice
suggestive of
enhanced relaxation (T1)
malignancy
induced by a
(pictured).[90]
gadolinium
contrast
bolus.[89]
Localizing brain
Changes in
activity from
oxygen
performing an
Blood- saturation-
assigned task (e.g.
Functional oxygen-level dependent
BOLD talking, moving
MRI (fMRI) dependent magnetism of
fingers) before
imaging hemoglobin
surgery, also used in
reflects tissue
research of
activity.[91]
cognition.[92]
Magnetic Time-of-flight TOF Blood entering Detection of

resonance the imaged aneurysm, stenosis, or
angiography area is not yet dissection[93]
(MRA) and magnetically
venography saturated
giving it a
much higher
signal when
using short
echo time and
flow
compensation.
Two gradients
with equal
magnitude, but
opposite
Phase-
direction, are Detection of
contrast
PC- used to aneurysm, stenosis, or
magnetic
MRA encode a dissection
resonance (VIPR)
phase shift, (pictured).[93]
imaging
which is
proportional to
the velocity of
spins.[94]
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.[95] 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,[96] and to provide information on tumor metabolism.[97]
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).[98] The high
procurement and maintenance costs of MRI with extremely high field strengths[99]
inhibit their popularity. However, recent compressed sensing-based software
algorithms (e.g., SAMV[100]) have been proposed to achieve super-resolution without
requiring such high field strengths.
Real-time
CC
0:16
Real-time MRI of a human heart at a

resolution of 50 ms
0:08
Real-time MRI of a human heart (2-

chamber view) at 22 ms
resolution[101]
0:36
Real-time MRI of a vocal tract while

singing, at 40 ms resolution
Real-time magnetic resonance imaging (RT-MRI) refers to the continuous monitoring

of moving objects in real time. Traditionally, real-time MRI was possible only with low
image quality or low temporal resolution. An iterative reconstruction algorithm
removed limitations. Radial FLASH MRI (real-time) yields a temporal resolution of 20
to 30 milliseconds for images with an in-plane resolution of 1.5 to 2.0 mm.[102] Real-
time MRI adds information about diseases of the joints and the heart. In many cases
MRI examinations become easier and more comfortable for patients, especially for
the patients who cannot calm their breathing[103] or who have arrhythmia.
Balanced steady-state free

precession (bSSFP) imaging gives
better image contrast between the
blood pool and myocardium than
FLASH MRI, at the cost of severe
banding artifact when B0
inhomogeneity is strong.[103]
Interventional MRI
The lack of harmful effects on the patient and the operator make MRI well-suited for
interventional radiology, where the images produced by an MRI scanner guide
minimally invasive procedures. Such procedures use no ferromagnetic
instruments.[104]
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.[105]
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 °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.[106]
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 could potentially be
imaged with MRI. Such nuclei include helium-3, lithium-7, carbon-13, fluorine-19,
oxygen-17, sodium-23, phosphorus-31 and xenon-129. 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.[107] 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.[108]
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.[109] In principle,
heteronuclear magnetization transfer MRI could be used to detect the presence or
absence of specific chemical bonds.[110][111]
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
t di d t t t f i h d f i i i 31P t ti ll
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.[112]
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.[113]
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.[114] A new class of gene targeting MR contrast agents has been
introduced to show gene action of unique mRNA and gene transcription factor
proteins.[115][116] These new contrast agents can trace cells with unique mRNA,
microRNA and virus; tissue response to inflammation in living brains.[117] The MR
reports change in gene expression with positive correlation to TaqMan analysis,
optical and electron microscopy.[118]
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.[119] The SENSitivity
Encoding (SENSE)[120] and Generalized Autocalibrating Partially Parallel Acquisitions
(GRAPPA)[121] 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.[122] 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[123])
T2-mapping[124]
Quantitative susceptibility mapping
(QSM)
Quantitative fluid flow MRI (i.e.
some cerebrospinal fluid flow
MRI[125])
Magnetic resonance elastography
(MRE)[126]
Quantitative MRI aims to increase the reproducibility of MR images and
interpretations, but has historically require longer scan times.[122]
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.[127] 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,[128] or by
fitting MR signal evolution to a multi-parameter model.[129][130]
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.[131] Contraindications to MRI include most cochlear
implants and cardiac pacemakers, shrapnel, and metallic foreign bodies in the eyes.
Magnetic resonance imaging in pregnancy appears to be safe, at least during the
second and third trimesters if done without contrast agents.[132] 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.[133] Some patients experience
claustrophobia and may require sedation or shorter MRI protocols.[134][135] Amplitude
and rapid switching of gradient coils during image acquisition may cause peripheral
nerve stimulation.[136]
MRI uses powerful magnets and can therefore cause magnetic materials to move at
great speeds posing a projectile risk and may cause fatal accidents [137] However as
millions of MRIs are performed globally each year,[138] fatalities are extremely
rare.[139]
MRI machines can produce loud noise, up to 120 dB(A).[140] 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.[25][26]
Artifacts
Motion artifact (T1 coronal study of cervical

vertebrae)[141]
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.[141]
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.[1]
Being non-invasive and non-damaging, MRI can be used to study the anatomy of
plants, their water transportation processes and water balance.[142] 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.[143]
In palaeontology it is used to examine the structure of fossils.[144]
Forensic imaging provides graphic documentation of an autopsy, which manual

autopsy does not. CT scanning provides quick whole-body imaging of skeletal and
parenchymal alterations, whereas MR imaging gives better representation of soft
tissue pathology.[145] All that being said, MRI is more expensive, and more time-
consuming to utilize.[145] Moreover, the quality of MR imaging deteriorates below
10 °C.[146]
History
In 1971 at Stony Brook University, 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,[147]
f ll db h i f li i i l l d i 1974 b h i f h
thoracic cavity of a mouse. Lauterbur called his imaging method zeugmatography, a
term which was replaced by (N)MR imaging.[1] In the late 1970s, physicists Peter
Mansfield and Paul Lauterbur developed MRI-related techniques, like the echo-planar
imaging (EPI) technique.[148]
Raymond Damadian’s work into nuclear magnetic resonance (NMR) has been
incorporated into MRI, having built one of the first scanners.[149]
Advances in semiconductor technology were crucial to the development of practical

MRI, which requires a large amount of computational power. This was made possible
by the rapidly increasing number of transistors on a single integrated circuit chip.[150]
Mansfield and Lauterbur were awarded the 2003 Nobel Prize in Physiology or
Medicine for their "discoveries concerning magnetic resonance imaging".[151]
See also
Medicine
portal
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 resonance elastography
Magnetic Resonance Imaging
(journal)
Magnetic resonance microscopy
Nobel Prize controversies –
Physiology or medicine
Rabi cycle
Robinson oscillator
Sodium MRI
Virtopsy
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Further reading
Blümer P (1998). Blümler P,

Blümich B, Botto RE, Fukushima E
(eds.). Spatially Resolved Magnetic
Resonance: Methods, Materials,
Medicine, Biology, Rheology,
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Magnetic Resonance Microscopy:
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Materials Science, Agriculture and
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527-28403-0.
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Materials. Clarendon Press.
ISBN 978-0-19-850683-6.
Eustace SJ, Nelson E (June 2004).
"Whole body magnetic resonance
imaging" (https://www.ncbi.nlm.nih.
gov/pmc/articles/PMC421763) .
BMJ. 328 (7453): 1387–8.
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tps://doi.org/10.1136%2Fbmj.328.7
453.1387) . PMC 421763 (https://w
ww.ncbi.nlm.nih.gov/pmc/articles/
PMC421763) . PMID 15191954 (htt
91954) .
Farhat IA, Belton P, Webb GA
(2007). Magnetic Resonance in
Food Science: From Molecules to
Man. Royal Society of Chemistry.
ISBN 978-0-85404-340-8.
Fukushima E (1989). NMR in
Biomedicine: The Physical Basis.
Springer Science & Business
Media. ISBN 978-0-88318-609-1.
Haacke EM, Brown RF, Thompson
M, Venkatesan R (1999). Magnetic
resonance imaging: Physical
principles and sequence design.
New York: J. Wiley & Sons.
ISBN 978-0-471-35128-3.
Jin (1998). Electromagnetic
Analysis and Design in Magnetic
Resonance Imaging. CRC Press.
ISBN 978-0-8493-9693-9.
Kuperman V (2000). Magnetic
Resonance Imaging: Physical
Principles and Applications.
Academic Press. ISBN 978-0-08-
053570-8.
Lee SC, Kim K, Kim J, Lee S, Han Yi
J, Kim SW, et al. (June 2001). "One
micrometer resolution NMR
microscopy". Journal of Magnetic
Resonance. 150 (2): 207–13.
Bibcode:2001JMagR.150..207L (htt
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doi:10.1006/jmre.2001.2319 (http
s://doi.org/10.1006%2Fjmre.2001.
2319) . PMID 11384182 (https://pu
bmed.ncbi.nlm.nih.gov/11384182)
.
Liang ZP, Lauterbur PC (1999).
Principles of Magnetic Resonance
Imaging: A Signal Processing
Perspective (https://archive.org/det
ails/principlesofmagn00zhip) .
Wiley. ISBN 978-0-7803-4723-6.
Mansfield P (1982). NMR Imaging in
Biomedicine: Supplement 2
Advances in Magnetic Resonance.
Elsevier. ISBN 978-0-323-15406-2.
Pykett IL (May 1982). "NMR
imaging in medicine". Scientific
American. 246 (5): 78–88.
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ientificamerican0582-78) .
PMID 7079720 (https://pubmed.nc
bi.nlm.nih.gov/7079720) .
Rinck PA (ed.). "The history of MRI"
(http://www.magnetic-resonance.or
g/ch/20-01.html) . TRTF/EMRF.
Sakr, HM; Fahmy, N; Elsayed, NS;
Abdulhady, H; El-Sobky, TA;
Saadawy, AM; Beroud, C; Udd, B (1
July 2021). "Whole-body muscle
MRI characteristics of LAMA2-
related congenital muscular
dystrophy children: An emerging
pattern". Neuromuscular Disorders.
31 (9): 814–823.
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Schmitt F, Stehling MK, Turner R
(1998). Echo-Planar Imaging:
Theory, Technique and Application
(https://archive.org/details/springe
r_10.1007-978-3-642-80443-4) .
Springer Berlin Heidelberg.
ISBN 978-3-540-63194-1.
Simon M, Mattson JS (1996). The
pioneers of NMR and magnetic
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Sprawls P (2000). Magnetic
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External links
Rinck PA (ed.). "MRI: A Peer-

Reviewed, Critical Introduction" (htt
p://www.magnetic-resonance.org) .
European Magnetic Resonance
Forum (EMRF)/The Round Table
Foundation (TRTF).
A Guided Tour of MRI: An

introduction for laypeople (https://n
ationalmaglab.org/education/magn
et-academy/learn-the-basics/storie
s/mri-a-guided-tour) National High
Magnetic Field Laboratory
The Basics of MRI (http://www.cis.r
it.edu/htbooks/mri/) . Underlying
physics and technical aspects.
Video: What to Expect During Your

MRI Exam (http://www.imrser.org/P
atientVideo.html) from the
Institute for Magnetic Resonance
Safety, Education, and Research
(IMRSER)
Royal Institution Lecture – MRI: A
Window on the Human Body (http://
www.vega.org.uk/video/programm
e/73)
A Short History of Magnetic
Resonance Imaging from a
European Point of View (https://we
b.archive.org/web/2007041303270
5/http://www.emrf.org/FAQs%20M
RI%20History.html)
How MRI works explained simply
using diagrams (https://www.howe
quipmentworks.com/mri_basics/)
Real-time MRI videos:
Biomedizinische NMR Forschungs
GmbH (http://www.biomednmr.mp
g.de/index.php?option=com_conte
nt&task=view&id=132&Itemid=39) .
Paul C. Lauterbur, Genesis of the
MRI (Magnetic Resonance
Imaging) notebook, September
1971 (https://digital.sciencehistory.
org/works/0c483j46q) (all pages
freely available for download in
variety of formats from Science
History Institute Digital Collections
at digital.sciencehistory.org (http
042542/https://digital.sciencehisto
ry.org/) )
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Magnetic

Magnetic resonance imaging (MRI) is a medical imaging technique used in radiology

Para-sagittal MRI of the head, with

Synonyms Nuclear magnetic

MeSH D008279 (https://m

MedlinePlus 003335 (https://me

Construction and physics

Schematic of a cylindrical superconducting MR scanner.

A mobile MRI unit visiting Glebefields

Effects of TR and TE on MR signal

Diagram of changing magnetization and spin

which this happens is simply the reciprocal of the relaxation time: .

.[20] Magnetization as a function of time is defined by the Bloch equations.

The standard display of MR images is to represent fluid characteristics in black-and-

Melanin[22] More water content,[21] as in

Air[21] Low proton density, as in

hyperacute or chronic methemoglobin, iron, ferritin,

Low proton density as in Protein-rich fluid[22]

Patient being positioned for MR study

Radiologist interpreting MRI images

Though MRI is used widely in research on mental disabilities, based on a 2024

MR angiogram in congenital heart

Cardiac MRI is complementary to other imaging techniques, such as

Magnetic resonance angiography

Magnetic resonance angiography (MRA) generates pictures of the arteries to evaluate

Techniques involving phase accumulation (known as phase contrast angiography)

Gadolinium-based contrast reagents are typically octadentate complexes of

In Europe, where more gadolinium-containing agents are available, a classification of

This table does not include uncommon and experimental sequences.

Spin echo Lower signal for

T2 weighted T2 Measuring Higher signal for

Low signal for

Long TR (to Joint disease and

Susceptibility- SWI Spoiled Detecting small

High signal in lacunar

Diffusion Conventional DWI Measure of High signal within

Perfusion Measures Provides

Magnetic Time-of-flight TOF Blood entering Detection of

Magnetic resonance spectroscopic imaging (MRSI) combines both spectroscopic

Real-time MRI of a human heart at a

Real-time MRI of a human heart (2-

Real-time MRI of a vocal tract while

Real-time magnetic resonance imaging (RT-MRI) refers to the continuous monitoring

Balanced steady-state free

A specialized growing subset of interventional MRI is intraoperative MRI, in which an

Magnetic resonance guided

Multinuclear imaging is primarily a research technique at present. However, potential

Molecular imaging by MRI

To achieve molecular imaging of disease biomarkers using MRI, targeted MRI

After a number of early suggestions for using arrays of detectors to accelerate

Examples of quantitative MRI methods are:

T1-mapping (notably used in

Hyperpolarized gas MRI

Motion artifact (T1 coronal study of cervical

In palaeontology it is used to examine the structure of fossils.[144]

Forensic imaging provides graphic documentation of an autopsy, which manual

Advances in semiconductor technology were crucial to the development of practical

Amplified magnetic resonance

1. Rinck, Peter A. (2024). Magnetic