MODULE III MR IMAGING AND APPLICATIONS

3.1.0 To Understand Nuclear Magnetic Resonance Imaging and its applications

3.1.1 To explain the principle of NMR imaging
3.1.2 To define precession
3.1.3 To define Longitudinal and Transverse relaxation time
3.1.4 To explain the system components of NMR system
3.1.5 To describe important magnets used in MRI
3.1.6 To list the applications of MRI

MAGNETIC RESONANCE IMAGING SYSTEM

It uses magnetic fields and radio frequency signals to obtain anatomical information about the human
body as cross-sectional images in any direction and can easily identify healthy and diseased tissue.
NMR images are map of the distribution density of hydrogen nuclei in cellular water and lipids. No
ionizing radiation used and therefore no hazards and the penetration of bone and air without attenuation
make it a better non-invasive imaging technique.

3.1.1 To explain the principle of NMR imaging

1.PRINCIPLE OF NMR IMAGING:
Magnetic Moment: All materials contain nuclei that are either protons or neutrons or a combination of
both. Nuclei containing an odd number of protons or neutrons or both in combination, possess a nuclear
‘spin’ and a magnetic moment which has both magnitude and direction.

The magnetic moments of the nuclei making up the tissue are randomly aligned and have zero net
magnetization (M = 0). When a material is placed in a magnetic field B0, some of the randomly oriented
nuclei experience an external magnetic torque which tends to align the individual parallel or anti-
parallel magnetic moments to the direction of an applied magnetic field. There is a slight excess of
nuclei aligned parallel with the magnetic field and this gives the tissue a net magnetic moment M0.
With the magnetic moments being randomly oriented with respect to one another, the components in
the X-Y plane cancel one another while the Z components along the direction of the applied magnetic
field add up to produce this magnetic moment M0.

3.1.2 To define precession

2.PRECISION:
According to the electromagnetic theory, any nucleus such as a hydrogen proton which possesses a
magnetic moment attempts to align itself with the magnetic field in which it is placed. This results in a
precession or wobbling of the magnetic moment about the applied magnetic field with a resonant
angular frequency, w0 (called the Larmor frequency) are determined by a constant γ (the magnetogyric
ratio) and the strength of the applied magnetic field B0. Each nuclide possesses a characteristic value
for γ but w0 and B0 are related as follows:
w0 = γ B0
3.1.3 To define Longitudinal and Transverse relaxation time
FREE INDUCTION DECAY (FID):
In NMR, there are more protons in a low energy state than in a high energy state. The excited proton
tends to return to its low-energy state with spontaneous decay and re-emissions of energy at a later time
‘t’ in the form of radio wave photons. This decay produces a “free induction decay” (FID) signal that
is the fundamental form of the nuclear signal obtainable from an NMR system.
If in a static field, RF waves of the right frequency are passed through the tissue some of the
parallel protons will absorb energy and excited to a higher energy in the anti-parallel direction.
Sometime later, the RF frequency absorbed will be emitted as electromagnetic energy of the same
frequency as the RF source. The amount of energy required to flip protons from the parallel to the anti-
parallel orientation is directly related to the magnetic field strength.

EXCITATION:
If tissue is subjected to another magnetic field, say a bar magnet placed along the Y-axis, this would
cause net magnetization to shift slightly from the Z-axis (B0 magnetic field direction). Applying an RF
pulse at the resonant frequency of the protons in the tissue will perform this function. An RF pulse of
sufficient duration and power to rotate Mo through 90° is referred to as 90° RF pulse. In addition, the
net magnetic moment, M now precesses with the same characteristic frequency wo, because the
individual magnetic moments causing this shift in M are now all in phase with the applied radio waves.
It is possible to shift the net magnetization M to any desired angle of deflection by applying the
resonant frequency pulse for the appropriate amount of time. M can even be completely inverted and
the corresponding pulse is called 180° RF pulse.

EMISSION:
When the RF pulse is turned off, the net tissue magnetization begins to swing back towards the Z-axis
(direction of Bo), inducing an NMR signal in the receiver coil placed perpendicular to the moving
magnetic vector. Individual magnetic moments begin to dephase with one another, some apparently
rotating a bit faster than the resonant frequency w0, and the others a bit slower. The component of
M in the X-Y plane disappears as the individual magnetic moment components on that plane cancel
out each other. The amplitude (A) of the initial signal received by the coil is proportional to the
magnitude of the component of M in the X-Y plane (Mxy). The amplitude of this signal decays in an
exponential with time t.

(I) RELAXATION TIME T1 or longitudinal relaxation:

T1 is referred to as the spin-lattice relaxation process as it characterizes the time for the perturbed
nuclei to re-align themselves with the existing lattice structure of the host material. This is also called
longitudinal relaxation as it is the time constant that describes the recovery of the Z component of M
to its equilibrium value Mo which is along the direction of the applied magnetic field.

(II) RELAXATION TIME T2 or transverse relaxation:

T2 is called spin-spin relaxation as it indicates the time required for perturbed, in-phase spins to de-
phase with respect to each other. It is also called the transverse relaxation process as it is relation to
the decay of the component of M in the X-Y plane which is conventionally perpendicular to the Z-axis
or the direction of the applied magnetic field B0. Transverse relaxation is faster than longitudinal
relaxation so that the spin-spin relaxation time constant T2 is always smaller than the spin-lattice
relaxation time constant T1.
3.1.4 To explain the system components of NMR system
4.SYSTEM COMPONENTS OF NMR SYSTEM

The basic components of an NMR imaging system are shown in Fig. These are:
• A magnet, which provides a strong uniform, steady, magnet field B0;
• An RF transmitter, which delivers radio-frequency magnetic field to the sample;
• A gradient system, which produces time-varying magnetic fields of controlled spatial nonuniformity;
• A detection system, which yields the output signal; and
• An imager system, including the computer, which reconstructs and displays the images.

1.The Magnet:
The magnetic field must be extremely uniform and constant in time .The signal-to-noise ratio increases
with the magnetic field strength therefore it must be as large as possible. Four factors characterize the
performance of the magnets used in MR systems; field strength, temporal stability, homogeneity and
bore size. Magnetic field can be produced by means of four different ways, i.e., permanent magnets,
electromagnets, resistive magnets and super-conducting magnets.
2.RF Transmitter System:
In order to activate the nuclei to emit a useful signal, energy must be transmitted into the sample. For
this the RF transmitter system is used. The system consists of RF transmitter, RF power amplifier and
RF transmitting coils. The RF transmitter consists of an RF crystal oscillator at the Larmor frequency.
The RF voltage is gated with the pulse envelopes from the computer interface to generate RF pulses
that excite the resonance. These pulses are amplified to levels varying from 100 W to several kW
depending on the imaging method and are fed to the transmitter coil. The RF coils can be either a
single coil serving as both transmitter and receiver or two separate coils that. In both cases, all coils
generate RF fields orthogonal to the direction of the main magnetic field. Saddle-and solenoidal-
shaped RF coils are typical geometries for the RF coils. The coils are tuned to the NMR frequency and
are usually isolated from the remainder of the system by enclosure in an RF shielding cage. For
magnetic fields in the range of 0.05 to 2 T used for imaging of the human body, the resonant
frequencies fall in the radio-frequency band.

3.Gradient System for Spatial Coding: Gradients are loops of wire or thin conductive sheets on a
cylindrical shell lying just inside the bore of an MR scanner. When current is passed through these coils
a secondary magnetic field is created. This gradient field slightly distorts the main magnetic field in a
predictable pattern, causing the resonance frequency of protons to vary in as a function of position.
The primary function of gradients, therefore, is to allow spatial encoding of the MR signal. Three sets
of gradient coils are used in nearly all MR systems: the x-, y-, and z-gradients. Each coil set is driven by
an independent power amplifier and creates a gradient field whose z-component varies linearly along
the x-, y-, and z-directions, respectively. The design of the -gradients is usually based on circular
(Maxwell) coils, while the transverse (x- and y-) gradients typically have a saddle coil configuration.
Applying a gradient causes a frequency variation of protons as a function of position along the
direction of the gradient. This change in frequency can be used for spatial encoding
4.Detection System: The function of the detection system (receiver) is to detect the nuclear
magnetization and generate an output signal for processing by the computer.
Some of the commonly available coils are:
• Body Coils: – Constructed on cylindrical coils forms with diameter ranging from 50 to 60 cm to
entirely surround the patient’s body.
• Head Coils: – Designed only for head imaging, with typical diameter of 28 cm.
• Surface coils: – Orbit/ear coil: flat, planar ring-shaped coil with 10 cm diameter;
Following the receiver coil is a matching network which couples it to the pre-amplifier in order to
maximize energy transfer into the amplifier.
When the radiofrequency source is switched off the magnetic vector returns to its resting state, and
this causes a signal (also a radio wave) to be emitted. It is this signal which is used to create the MR
images. Receiver coils are used around the body part to improve the detection of the emitted signal.
The intensity of the received signal is then plotted on a grey scale and crosssectional images are built
up.

5. Imager System: The imager system includes the computer for image processing, display system and
control console. The timing and control of RF and gradient pulse sequences for relaxation time
measurements and imaging necessitate the use of a computer. The computer is the source of both
the voltage waveforms of all gradient pulses and the envelopes of the RF pulses. The computer system
collects the nuclear magnetic resonant signal after A/D conversion, corrects, re-composes, displays
and stores it. High speed data are sent from the system controller to the computer. An exclusive high
speed computer is used to reduce the calculating time of these data. Analog-to-digital convertors with
16 bits or higher are used to produce the desired digitized signal data. The images become available
for viewing within about one second after data acquisition. Three dimensional imaging requires more
computer processing power. The reconstructed image data are transmitted to the display console by
a high-capacity image memory disk. The screen of the high resolution monitor can be divided into four
parts, if desired. It is possible to simultaneously display proton density and T1, T2 distribution image.
The image reconstruction software is used to re-build an image, register images, display and position
scanned image processing and register patients. The image display software transfers data registered
in the image data file to the display console for display, sends other image data to the floppy disk or
magnetic tape and also ensures data protection and editing.

3.1.5 To describe important magnets used in MRI

5.EXPLAIN IN DETAIL ABOUT THE MAGNETS USED IN MRI:
The magnetic field must be extremely uniform and constant in time. The signal-to-noise ratio increases
with the magnetic field strength therefore it must be as large as possible. Four factors characterize the
performance of the magnets used in MR systems; field strength, temporal stability, homogeneity and
bore size. Magnetic field can be produced by means of four different ways, i.e., permanent magnets,
electromagnets, resistive magnets and super-conducting magnets.
Permanent magnet: The patient is placed in the gap between a pair of permanently magnetized pole
faces. Permanent magnet materials normally used in MRI scanners include high carbon iron alloys such
as alnico or neodymium iron (alloy of neodymium, boron and iron) and ceramics such as barium ferrite.
Although permanent magnets have the advantages of producing a relatively small fringing field and do
not require power supplies, they tend to be very heavy (up to 100 tons) and produce relatively low fields
of the order of 0.3 T or less.
Electromagnets: It make use of soft magnetic materials such as pole faces which become magnetized
only when electric current is passed through the coils wound around them. Electromagnets require
external electrical power supply.
Resistive magnets: The earlier NMR imaging systems were used resistive magnets. Resistive magnets
make use of large current-carrying coils of aluminium strips or copper tubes. In these magnets, the
electrical power requirement increases proportionately to the square of the field strength which becomes
high as the field strength increases. Moreover, the total power in the coils is converted into heat which
must be dissipated by liquid cooling. For instance, at 0.2 T, the power requirement is nearly 70 kW .At
present, resistive magnets are only used for very low field strength applications, generally limited to
0.02 to 0.06 T.
Superconductive magnets: Most of the modern NMR machines utilize superconductive magnets.
These magnets utilize the property of certain materials, which lose their electrical resistance fully below
a specific temperature. The commonly used superconducting material is Nb Ti (Niobium Titanium)
alloy for which the transition temperature lies at 9 K (–264°C). In order to prevent superconductivity
from being destroyed by an external magnetic field or the current passing through the conductors, these
conductors must be cooled down to temperatures significantly below this point, at least to half of the
transition temperature. Therefore, superconductive magnet coils are cooled with liquid helium which
boils at a temperature of 4.2 K (–269°C). The helium container with its superconductive windings is
enclosed in a vacuum to keep the evaporation rate low. Internal shields cooled with liquid nitrogen
prevent heating. In a superconducting magnet, connection to a current supply is only necessary for
energizing up to the required field strength. After this, the coils are short-circuited and require no
further electrical energy.
The magnetic field is temporarily stable. Due to evaporation of the liquid helium and liquid nitrogen,
the monthly topping of helium and weekly topping of nitrogen is necessary. At present, many magnets
now make use of cryogenic refrigerators that reduce or eliminate the need for refilling the liquid helium
reservoir. Because of their capability to achieving very strong and stable magnetic field strengths
without any continuous power consumption, superconducting magnets have become the most widely
used and preferred source of the main magnetic fields for MRI scanners produced for field strengths of
upto 2 T.
3.1.6 To list the applications of MRI

6.APPLICATIONS OF MRI:

1.Neuroimaging:
MRI is the investigative tool for neurological cancers over CT. 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. Since many images are taken milliseconds apart, it shows how the brain responds to
different stimuli, enabling study of both the functional and structural brain abnormalities.
2.Musculoskeletal:
Applications in the musculoskeletal system include spinal imaging, assessment of joint disease, and
soft tissue tumors. Also, MRI techniques can be used for diagnostic imaging of systemic muscle
diseases.
3.Liver and gastrointestinal:
MR is used to detect and characterize lesions of the liver, pancreas, and bile ducts
4.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. A variety of techniques can be used to generate the pictures, such as
administration of a contrast agent (gadolinium).

The MRI is a powerful diagnostic device to detect the following abnormalities:

 anomalies of the brain and spinal cord
 tumors, cysts, and other anomalies in various parts of the body
 injuries or abnormalities of the joints, such as the back and knee
 certain types of heart problems
 diseases of the liver and other abdominal organs.
Explain principle of operation and process of image formation in MRI machine (8)

MRI uses a powerful magnetic field that makes the hydrogen protons in water molecules, which
comprise between 70% and 80% of the average. Once they are all lined up from the magnetic field,
they are then knocked out of line by radio waves. When the radio waves are stopped, the protons
relax back into line, releasing resonance signals that are transmitted to a computer. Under normal
conditions, these hydrogen proton "bar magnets" spin in the body with their axes randomly aligned
since nothing is pulling them magnetically in the same direction. When the body is placed in a strong
magnetic field, such as an MRI scanner, the protons' axes all line up. This uniform alignment creates a
magnetic vector oriented along the axis of the MRI scanner. Each scanners come in different field
strengths, usually between 0.5 and 1.5 tesla (T). The strength of the magnetic field can be altered
electronically from head to toe using a series of gradient electric coils, and, by altering the local
magnetic field by these small increments, different slices of the body will resonate as different
frequencies are applied. When additional energy, in the form of a radio wave, is added to the magnetic
field, the magnetic vector is deflected. The radio frequency (RF) wave that causes the hydrogen nuclei
to resonate is dependent on hydrogen and the strength of the magnetic field. When the RF source is
switched off the magnetic vector returns to its resting state, and this causes a signal, or radio wave to
be emitted. It's this signal which is used to create the MR images. Receiver coils are used around the
body part in to act as aerials to improve the detection of the emitted signal. The intensity of the
received signal is then plotted on a grey scale and cross sectional images are built up.Multiple
transmitted RF pulses can be used in sequence to emphasise particular tissues or abnormalities. A
different emphasis occurs because different tissues relax at different rates when the transmitted RF
pulse is switched off. The time taken for the protons to fully relax is measured in two ways. The first
is the time taken for the magnetic vector to return to its resting state and the second is the time
needed for the axial spin to return to its resting state. The first is called T1 relaxation, the second is
called T2 relaxation. A MR examination is thus made up of a series of pulse sequences. Different tissues
such as fat and water have different relaxation times and can be identified separately. By using a "fat
suppression" pulse sequence, for example, the signal from fat will be removed, leaving only the signal
from any abnormalities lying within it. Spatial encoding of the MRI signal is accomplished through the
use of gradients (smaller magnetic fields) which perturb the main magnetic field, and cause hydrogen
protons in different locations to precess (move) at slightly different rates. The portion of the gradient
coils and the associated current that is perpendicular to the main magnetic field cause a on the coils.
The gradients are turned on and off very quickly in this process causing them to vibrate causing the
majority of the noise associated with the MRI.

Differentiate between T1 and T2 relaxation time. Explain its importance in image formation. (7)

Tissue can be characterized by two different relaxation times – T1 and T2. Terms such as "T1-
weighted" and "T2-weighted" describes the type of MR pulse sequence employed to generate a series
of images. T1-weighted images are produced by using short TE and TR times. Repetition Time (TR) is
the amount of time between successive pulse sequences applied to the same slice. Time to Echo (TE)
is the time between the delivery of the RF pulse and the receipt of the echo signal.

T1 (longitudinal relaxation time) is the time constant which determines the rate at which excited
protons return to equilibrium. It is a measure of the time taken for spinning protons to realign with
the external magnetic field. T2 (transverse relaxation time) is the time constant which determines the
rate at which excited protons reach equilibrium or go out of phase with each other. It is a measure of
the time taken for spinning protons to lose phase coherence among the nuclei spinning perpendicular
to the main field.

T1-Weighted Scan Basics:

T1-weighted image (also referred to as "spin-lattice" relaxation time) is one of the basic pulse
sequences in MRI and demonstrates differences in the T1 relaxation times of tissues. This
differentiates anatomical structures mainly on the basis of T1 values, for example the scanning
parameters are set (short TR/short TE) to minimize T2 relaxation effects. A T1-weighted image relies
upon the longitudinal relaxation of a tissue's net magnetization vector. Basically, spins aligned in an
external magnetic field (Bo) are put into the transverse plane by an RF pulse. They then slide back
toward the original equilibirum of the Bo. Not all tissues get back to equilibirum equally quickly, and
a tissue's T1 reflects the amount of time its protons' spins realign with the Bo.Fat quickly realigns its
longitudinal magnetization with the Bo, and it therefore appears bright on a T1-weighted image.

T2-Weighted Scans:

T2-weighted scans differentiate anatomical structures mainly on the basis of T2 values, for example
the scanning parameters are set (long TR/long TE) to minimize T1 relaxation effects. On a T1-weighted
scans show tissues with high fat content (such as white matter) appear bright and compartments filled
with water appears dark. On a T2-weighted scan compartments filled with water appear bright and
tissues with high fat content (such as white matter) appear dark.
 SPIN ECHO SEQUENCE:

Spin-echo pulse sequences are one of the earliest developed and still widely used of all MRI pulse
sequences. The pulse sequence timing can be adjusted to give T1-weighted, proton density, and T2-
weighted images. Dual echo and multiecho sequences can be used to obtain both proton density and
T2-weighted images simultaneously.The two variables of interest in spin echo sequences are the
repetition time (TR) and the echo time (TE). All spin echo sequences include a slice selective 90-degree
pulse followed by one or more 180 degree refocusing pulses as shown in the diagrams.