Concise notes on

Magnetic Resonance Imaging

Source
European Magnetic Resonance Forum
Encyclopaedia of Medical Imaging
Medical Imaging International
Various Websites
Google
Others

 ACCRO & SYNON YM

 ABBRE VIAT ION
 PROCE D URE S
 T E CHNIQ UE S
 MR HIST O RY
 MR SA FE T Y
 P HYSIC S
 MRA
 FAQ

Collected & Compiled By

Mohd FARUQUE

FIRST PAGE WILL BE REDESIGNED WITH THE NAME AND FAME OF

THE EDITORS AND THE MODERATORS AND MEMBERS OF THE
IARRT
1
 Preface
I started to keep notes from Medical Imaging International about the
new application of clinical magnetic resonance imaging in diagnostic
and therapeutic procedures in early 1996,

The idea of compiling such a book came to me when I was interested to

know more about the new feature of magnetic resonance imaging, like
fMRI, iMRI, MRS, combined use of PET/MRS and PET/ MRI etc.

Senior most Medical Technologists and Friends in the capital city,

advised me that it would be extremely helpful if a book of this type can
be compiled and made available to the people who want to have their
eyes in a such book during their every day’s works, specially who
desire to know little bit about MRI.

In September 2006 a raw copy of this compilation was completed and I

took it along with me to a training course about MR application
conducted by Mr Atul Agarwal from Hitachi, Singapore organized by
Medionics Imaging Ltd. He said, “This is a complete concise book of
MR cover many current days MR application and I wish to see the
printed copy of this book”

I explained it to some of my sir and I have came to a determination that

I must compile the book to the user who wants to work in the field of
MRI by enhancing their understanding and concern.

Despite my best efforts there will undoubtedly be a lot of

error/omissions from this work and new word / synonym are being
created all the time. I would greatly welcome any contributions from
readers/users concerning acronyms, synonyms, abbreviations, physics,
procedures, techniques etc., in our own fields that I could not collected,
so that I can make the next edition of this book more comprehensive
and ultimately expand it into a more general work acceptance the entire
discipline of magnetic resonance imaging.

Mohd FARUQUE

2
 How to use this book

I try to put all entry

1 Common abbreviation or Acronym MRI

2 Full text entry Magnetic Resonance Imaging

3 Full/different definitions

▪An imaging technique based on the principles of NMR.

▪Technique for producing images of bodily organs by

measuring the response of atomic nuclei to radio waves
when placed in a strong magnetic field.

▪The MRI machine creates a magnetic field, sends radio

waves through body, and then measures the response
with a computer. This creates an image or picture of the
inside of human body.

▪Scanner applies the magnetic field to a patient to align

the nuclei within the atoms of the patient’s body. RF
pulses are applied; the nuclei release some of the RF
energy and the computer detects these emissions and
generates image of tissue

4 Synonyms NMR (Nuclear Magnetic Resonance)

5 Cross reference to see » MR, MRS, iMR, fMRI

6 Figures are available at the end of the book with #

3
Contents Page #
Acronym & synonym 00

MR Abbreviation 00

Medical Abbreviations 00

Abbreviation used in rapid imaging technique 00

Physics, Techniques and Procedures 00

MR Angiography 00

MR Safety guide 00

MR History 00

Frequently Asked Question 00

Figures and graphs 00

Magnetic resonance angiography 00

Abbreviation used im medical 00

Notes 00

4
This book is dedicated
---to anyone, who tries to teach MRI instead of just reporting
radiological report (like my teacher Prof Dr S A Sobhan,
who was a master of teaching techniques and art).
---And to anyone, whose stumbling feet find the MRI path
difficult, (The book was compiled in the hope rather than the
belief that they may find some help from it).

Mohd FARUQUE

Late Professor S. A. Sobhan

5
 Acknowledgements

I would like to thank the people, whose cooperation and

expertise made possible to complete this book:
Engineer Samir Majumder of HITACHI Bangladesh,
(Medionics Imaging Ltd.).
Dr Md. Nazrul Islam Country Manager Tyco Healthcare-
(USA) in Bangladesh.
Engineer Atul Agrawal from HITACHI Medical System
Singapore.
Media Pro who supports me to publish all of my activities
like Multimedia on MRI (CD ROM), Scientific Seminar on
MRI / MR image (VCD) and this book publication, etc.
---and special thanks to Engineer David S Das of
SHIMADZU (A Q Chowdhury & Co) Bangladesh.

Mohd FARUQUE

6
 About this book

This book was compiled with very a short introduction to

MR Physics, Techniques, Procedures, FAQ etc. to meet the
instant reference for all entry in the field of MR imaging. It is
dedicated to anyone, who would like to know something
about MR Imaging without having to study physics for
years. (In case of Images of MRI, like Artifacts, Accidents,
Burn, Figures, Charts of MR Physics and Techniques
please collect my separate book name:
“MR Images”
If this applies to you, then read this text and image from
front to back at your pace.

7
 How to use this book
I try to put all entry

1 Common abbreviation or Acronym MRI

2 Full text entry Magnetic Resonance Imaging - MRI

3 Full/different definitions

▪An imaging technique based on the principles of NMR.

▪Technique for producing images of bodily organs by

measuring the response of atomic nuclei to radio waves
when placed in a strong magnetic field.

▪The MRI machine creates a magnetic field, sends radio

waves through body, and then measures the response
with a computer. This creates an image or picture of the
inside of human body.

▪Scanner applies the magnetic field to a patient to align

the nuclei within the atoms of the patient’s body. RF
pulses are applied; the nuclei release some of the RF
energy and the computer detects these emissions and
generates image of tissue

4 Synonyms NMR (Nuclear Magnetic Resonance)

5 Cross reference to see » MR, MRS, iMR, fMRI

6 Figures are available on separate book called “MR

Images”.

8
 ►A◄

Most commonly used symbols in MRI

 - (alpha) = flip angle

 - (gamma) = gyromagnetic ratio or magnetogyric

ratio, angular momentum

θ - angle formed between the Mo and Bo

 - (delta) = chemical shift

 - (mu) = vector of the magnetic moment, and (mu) =

permeability

 - (nu) frequency

pi - ratio of the circumference of the circle to its diam

 - (rho) = proton density

 - (tau) = time delay / segment

c - (tauc) = correlation time

 - (chi) = susceptibility

 - (omega) = Larmor frequency

9
Abdominal aortography - AA
MR angiography of the abdominal aorta including its major branches
from the diaphragm to the bifurcation.

Abdominal Compression and Breath Holding

Both techniques are employed whenever short acquisition sequences
are employed, thereby minimizing the stain of the patient.

Abdoscan
Oral magnetic particle, magnetic resonance contrasts media. » OMP

Abnormal low-frequency magnetic activity - ALFMA

Signal with frequencies lower than the usual 8 Hz found in normals.

Absolute zero
The temperature at which all materials have no thermal energy and
some metals lose their electrical resistance (-2730 C, -4590 F).

Absorption (electromagnetic)
Physical process by which the intensity of waves or the number of
particles is diminished as they interact with matter.

Acquisition
The process of collecting / capture data during MR imaging.

Acquisition matrix
The total number of independent data samples in the phase (ø) and
frequency (ƒ) encoded directions. » Image acquisition matrix, raw data
matrix

Acquisition time - TA
The time required for complete data capture during a measurement
protocol. » Image acquisition time

Acquisition window
The time period in a pulse sequence during which the magnetic
resonance signal is acquired.

Active shielding - AS
Method for reducing the stray magnetic field is associated with
electromagnet - in particular, high-field Superconducting magnets.

10
Active Shimming
Several shim coils are attached to a shim tube. Small static currents
with different amplitudes and polarity are adjusted for the shim. The
small magnetic fields, which are generated, compensate for small
inhomogeneities of the main field. After the shim, the main field of a
superconducting magnet will vary by a few ppm only within a measuring
field having a diameter of 50 cm approx.
(Shim by adjusting the currents in the shim coils). » Shimming

Acute clots and deoxyhaemoglobin - Appearance of blood

ADC image / (DW imaging)

ADC images are calculated from diffusion-weighted images with at least
2 b-values. The contrast corresponding to the spatially distributed
diffusion coefficient of the acquired tissues and does not contain T 1 or
T2* parts

Adenosine triphosphate - ATP

Compound formed when ATP is hydrolysed to provide energy for
cellular processes / Compound which plays a central role in energy
metabolism.

Adiabatic fast passage - AFP

1: Technique in MRI for producing a rotation of the magnetic vector by
varying the frequency of an irradiating radio wave. 2: A form of
excitation in NMR where the irradiating magnetic field B1 is swept
through resonance rapidly and relatively and at relatively high power
compared with the slow passage employed in continuous wave (CW)
NMR.

Adiabatic pulses
A category of non-selective RF pulses that can produce uniform flip
angles across non-uniform RF fields. Widely used in conjunction with
surface coils.

Adiabatic pulse
Radiofrequency pulse, which utilizes a swept frequency in combination
with varying amplitude.

Adjustment » Tuning

Administration of Contrast Agent

Administration of a gadolinium chelate can substantially improve lesion
identification and characterization. After injection the MR contrast agent
is distributed into the blood pool and extracellular fluid compartment of
the body. In the brain lesion, enhancement occurs as a result of
11
disruption of the BBB: MR contrast agents do not cross the normal
BBB. The standard dose of gadolinium is 0.1 mmol/kg, which is
equivalent to 0.2 ml/kg. The contrast is generally available in 10 or 20
ml vials. It is injected through the intravenous route and is rapidly
excreted by glomerular filtration through the kidneys. Contrast agents
have half-lives between 1 and 2 hours.

Adrenal angiography
Imaging of the arterial supply and venous drainage of the adrenal
glands.

Adrenal arteriography
Recent years imaging techniques such as ultrasound, CT and MRI have
largely replaced arteriography of adrenal artery.

Adrenal biopsy
Biopsy performed for the differential diagnosis under MR guide.

Adrenal venography
Selective injection of contrast material retrogrately into the adrenal vein
with an angiographic catheter.

Advance spin echo - ASE (Asymmetric spin echo)

Advantages and Disadvantages of MRI » FAQ

Adverse reaction
Any abnormal reaction of a patient to an examination or procedure.
Most frequently they occur in conjunction with the use of contrast
media.

Algorithm
A complex mathematical expression in a form which can be utilized by a
computer to perform some specific calculation.

Aliasing artifact
Generated when measurement object is outside the FOV but still within
the sensitive volume of the coil. Signals from outside the FOV overlap
the image, but on the opposite side.

Alloy - A substance that is a mixture of two or more metals.

Alnico - Alloy used in permanent magnets (aluminum, nickel, cobalt)

Alpha particle (α)

12
Form of radioactivity consisting of 2n + 2p ejected from unstable nuclei.
Can be stopped by a piece of paper.

Alpha pulse - AP
RF pulse used in a GE-PS, which titles the magnetization vector by an
angle  of typically between 0º and 90º.

Alternating current - AC
Electric current that flows first one-way around a circuit, and then the
other way / A current that continuously changes its direction. In the USA
the current changes 120 times per second.

Aluminium-27 MRS
MR spectroscopy using AI-27 which can potentially be used in
gastrointestinal imaging using aluminium-containing contrast medium.

Ambient temperature
Room temperature as opposed to other temperatures encountered in
imaging such as the cryogenic temperatures used in cryomagnets.

Ampére – A - Ampère -The SI unit of electrical current. (I)

Amplitude
The signal height. The greater the amplitude, the larger the number of
protons in the image and the brighter the image. » Amplitude image

Amplitude image - AI
The image which is usually displayed in MRI » PI, PCI/S
The term used in nuclear imaging and MR imaging in completely
different contexts, In MR imaging the amplitude image is the image,
which is usually displayed » phase image, polar coordinate system

Analogue - Raw undefined data, such as no hands on a clock face.

Analogue-to-digital converter - ADC / A/D

Converts the analogue audio frequency signals into digital form, for
example, an MR or ultrasound receiver into digital form so that it can be
stored and processed by the computer.

Anatomical reference points

The following anatomical reference points are provided as a general
guideline for patient positioning. Internal structures of the body may be
located at different positions depending on patient size. When you are
not sure of the exact location of the area of interest, use the standard
protocols provided at your site, and perform a scout scan.
Head protocol - align red cross with orbital/meatal line
13
 Breast protocol - align red cross with nipple
Chest protocol - align red cross with mid-sternum
Abdomen protocol - align red cross with twelfth rib
Pelvic scan - align red cross with ant. Superior iliac spine
The chart below provides reference points for common anatomical
structures.

Level Reference points

C1 Mastoid Tip (most inferior level of skull). Coincides
with foramen magnum
C5-C6 Thyroid Cartilage
C7 Level of shoulder, Vertebral Prominence
T1 1.5 Inches (3.8 cm) superior to suprasternal notch
T2-T3 Suprasternal Notch
T4-T5 Sternal Angle, Second Costal Cartilage
T7 3 inches (7.6 cm) inferior to Sternal Angle
T9-T10 Xiphoid Tip
L3 Bottom of Ribs
L3-L4 Iliac Crest, Umbilicus
L5-S1 Midway between iliac crest and ASIS
S2 Anterior Superior Iliac Supine
Skull Base Mastoid Tip
Pituitary 1.5 inches (3.8 cm) Anterior and Superior to EAM
(ST)
Orbits Orbital-Meatal (OM) Line
Heart (SB) T-4, T-5, Sternal angle
Heart (IA) Fifth or Sixth Rib
Kidneys T-12 through L-3 (RK is higher)
Gallbladder T-9-Xiphoid Tip
Pancreas Xiphoid Tip
Bladder Symphysis Pubis

Anatomical region for MRI examination

Head and Neck
Brain, Temporal Lobes, Posterior Fossa and IAM, Pituitary, Orbits,
T-M Joint, Diffusion, Perfusion, Spectroscopy, Functional, MRA-
Head, MRV, MRI in Steriotaxy, D.B.S., CSF-Flow
CSF-Rhinorrhea, MRA Neck
Spine - C-Spine, D-Spine, L-Spine, Whole Spine
Chest and abdomen
Chest, Heart and great vessels, Breast, Brachial Plexus, Abdominal
Angio, MRCP, MRU, Pelvis, Endorectal
Upper extremity
Shoulder, Humerus, Elbow, Forearm, Wrist and Hand
Lower extremity
Hips, Thigh, Knee Joint, Tibia and Fibula, Ankle, Vascular Imaging
14
Angiography
Imaging of blood vessels using contrast medium injected into the blood
stream of arteries, arteriography or venography,

Angioplasty
A method to dilate and reopen narrowing in the vascular system
commonly performed with noncompliant balloon catheters.

Angular frequency (omega)

Frequency of oscillation or rotation (measured, e.g. in radians/second)
commonly designated by omega: omega = 2·pi·nu, where nu is the
frequency (e.g. in Hertz).

Angular momentum
The angle formed between a precessing object and its imaginary axis.

Angstrom (10-10 meters) - Å

Angstrom unit - Å
The fundamental unit of wavelength: angstrom 10-8 cm or 10-10 meters.

Antenna
A device used to send and/or receive of electromagnetic waves.

Anterior
The direction towards the front of the body in an anatomical coordinate
system.

Anti-parallel alignment
Against the magnetic field in the high-energy state.
Antiparallel proton. Protons in a magnetic field can exhibit two
orientations of their nuclear spin z –component. The orientation can be
either parallel or antiparallel to the field vector.

Aortic valvoplasty - Dilatation of the aortic valves.

Aortography
Imaging of the aorta by injection of contrast material into the ascending
aorta or aortic arch for depiction of the thoracic aorta and the supra-
aortic branches, or the proximal aorta at the level of approximately T-11
to T-12 for demonstration of the abdominal aorta, the renal and visceral
branches as well as lumber and iliac arteries.

Aperture - Opening of the magnet bore.

15
Apparent diffusion coefficient - ADC
The diffusion coefficient as determined from a MRI or MRS
measurement. The word “apparent” is included in recognition of the fact
that the measurement of diffusion may be distorted due to restricted
molecular motion caused by cell membranes and other tissue
compartments.

Appearance of blood on MRI

Bright
Gradient echo pulse sequences
Flow compensation (slow flow)
Short echo time
Thin 2D GE section oriented perpendicular to direction of blood flow
MR contrast agents shorten the T1 relaxation time of blood
Spiral scan pulse sequence
Segmented turbo flash pulse sequence
Dark
Spin echo
Presaturation pulse Long echo time (TE)
Thin 2D SE or FSE section oriented perpendicular to direction of flow
Super paramagnetic iron oxide to shorten T2 relaxation time of blood
Thrombosis and clot formation are complex dynamic processes. Clot
retraction, cellular infiltration, fibrinolysis, red blood cell morphology,
haemoglobin desturation and the development of blood degradation
products interact to affect the MR appearance

Appearance of haemorrhage
Haemoglobin stage MR signal RBC
morphology
Oxyhaemoglobin Centre, hyperintense thin Normal
peripheral rim surrounding
oedema
Deoxyhaemoglobin Isointense Spherocytes
Methemoglobin Hypointense Echinocytes
Macrophases with Hyperintense Blooming of Dehydrated
haemosiderin & ferritin dark signal Lysed
Extrinsic factors such as field strength and pulse sequences also
affect the MR signal
Hyperacute clots and oxyhaemoglobin
OxyHb is present in hyperacute clots for only a few minutes or up to a
few hours. OxyHb contains ferrous iron, lacks unpaired electrons and is
diamagnetic. Therefore, OxyHb does not affect T1 and T2 relaxation
times. The MR signal of hyperacute haematoma can be attributed to its
protein traces containing water content. Hyperacute clots are typically
isointense with GM on T1WI and hyperintense on T2WI.
Acute clots and deoxyhaemoglobin

16
Haemoglobin desaturation from oxyHb to deoxyHb occurs within a few
hours of haemoglobin. As DeoxyHb contains ferrous iron with four
unpaired electrons in a high state, it is strongly paramagnetic. DeoxyHb
lacks the ability to cause proton dipoledipole (PEDD), proton relaxation
enhancement and T1 shortening, appearing isointense with brain
parenchyma on T1WI.
If DeoxyHb is sequestrated within RBCs, as water diffuses freely across
the cell membrane, it experiences a substantial magnetic susceptibility
gradient. This results is phase disperson and subsequential T2 proton
relaxation enhancement (T2-PRE).
The susceptibility effects seen with acute clots become more
pronounced with progressive T2W. Acute clots with DeoxyHb typically
appear moderately hypointense on balanced (long TR/short TE) PS and
profoundly hypointense on T2W or gradient refocused PS.
Subacute clots and methemoglobin
Methemoglobin (MetHb) is present in subacute haematoma and can be
seen from a few days to few moths following haemorrhage. MetHb is
ferric, has five unpaired electrons and is strongly paramagnetic.
Early subacute haematomas have a bright signal on T1WI. The bright
signal typically begins at the haematoma periphery and progresses
inwards. Thus, the centre of early subacute clots remains relatively
isointense on T1WI and the rim becomes hyperintense. In the early
subacute stage of haematoma formation, MetHb is contained within
intact RBCs and preferentially increases T2-PRE. This T2 shortening
results in low signal on long TR/short TE, i.e. proton density weighted
PS. Early subacute clots are profoundly hyperintense on T2W and
gradient refocused PS.
In the late subacute stage, haemolysis results in the accumulation of
extracellular MetHb within the haematoma cavity. MetHb in a free
solution is extremely hyperintense on T1 and T2WI.
Chronic Clots and iron storage
In the early chronic stage, a pool of dilute-free MetHb is surrounded by
the ferritin and hemosiderin containing vascularized wall. At this stage,
clots are typically homogeneously hyperintense on both T1 and T2WI,
with a pronounced hypointense signal rim on T2WI. Oedema and mass
effect diminish and then disappear.
The long-term residue of late chronic hematomas following brain
haemorrhage persists as macrophages laden with iron storage products
remain around the margins old clots for years. Two substances are
present in the late phase of resolving cerebral hematoma namely ferritin
and hemosiderin.
Hemosiderin is isointense on T1 and extremely hypo- intense on T2WI.
Due to strong magnetic susceptibility effects, ferritin and hemosiderin
appear profoundly hypointense on GRE PS.

Arch aortography - AA
17
Imaging of the anatomy and/or pathology of the aortic arch and the
proximal great neck arteries.

Archiving - The storage of the image data for future retrieval

Area resolution
Area resolution is provided by the pixel size. The smaller the pixel, the
better the area resolution.

Aperiodic motion artifacts

The involuntary motion of the patient like peristalsis, swallowing and
blinking of the eye, causes this type of artefacts.
Remedy: Except for the peristalsis, the patient motion is best control by
the cooperation and suitable education. In order to reduce motion
artifacts caused by the bowel movement administration of Glucagon
(IV) or Buscupen (IM). Preprocedural is advisable.

Array coil
An Array coil combines the advantages of smaller coils (high SNR) with
those of larger coils (large measurement field). It comprises multiple
independent coils elements that can be combined depending on the
requirements of the examination. » IPA

Array processor
Portion of the computer that converts raw (time domain) data, using
Fourier transformation, into clinically useful information. Core of the
image processor.

Array processor
Computer system, comprising many parallel processing units, which is
particularly suited to calculations involving array of data (e.g. matrices).

Array process artifacts - APA

The array processor (AP) is part of the computation system. It is a very
fast parallel processor for execution of simultaneous tasks. The array
processor is involved in the signal averaging process during data
acquisition and reconstruction.

Arteriovenous malformation - AVM

A vascular malformation associated with an interwoven network of
dilated arteries and veins.

Artifact
▪An error in the reconstructed image that has no counterpart in reality.

18
▪Signal intensity in the MR image that does not correspond to the
spatial distribution of the tissue in the image plane. Caused primarily by
physiological and system-based factors. » Artefact in MRI

Artifact in MRI
Any irregularity false features noted in an MR image related to imaging
process rather than an anatomical or physiological abnormality. The
random fluctuation of intensity due to noise can be considered
separately from artefacts. Artifacts can be rectified easily when causes
are known. It is necessary to be familiar with specific artifacts since they
can conceal pathological elements or simulate pathology that does not
exist. There are many artifacts noted on MR image, which can be
classified into four main group {a) magnetic field perturbations b) RF
and gradient-related c) motion and flow,} and different categories, viz.

Artefect Description Causes

Aliasing / W / Image wrap around Undersampling in k-space
FO / BF / foldover
Aperiodic repeating densities peristalsis, swallowing,
motion blinking of eye etc.
Array process grille like line array processing error in
across the image computation sys
Bo field Image distortion, strong paramagnetic or
inhomogeneity signal loss ferromagnetic impl
Blurring image blurring patient motion, low-resolution
sampling
Cardiac repeated densities / contraction and relaxation of
motion ghost heart (chest)
Chemical shift dark and bright super imposition of fat and
signal water signals
Coil selection structure noise on improper coil selection at the
image site of exam
Contours Dark boundaries IR null point, Chem shift,
Opposed-phase image,
Motion shear (FE)
Cross talk Artefacts from I-MR short concatenation
needle
Distortion inhomogeneity in gradient non-linearity,
the magnetic ferromagnetic mater
Error in data Stripe in image Bad frequency encoding,
washed Freq channel with problem,
-out image ADCI over range
Flow, Spatial Vascular ghosts, Repetition time asynchrous
misregistration Anomalous with pulsatile flow (FE), Delay
Spin phase intensities in image between phase encoding and
effects frequency encoding
19
 Ghost Displaced Quasi-cyclic motion (heart-
reduplication of beat respiration) motion
image in ph enco di artefacts
K-space RF feed-through / error in k-space filter, bad
related aliasing / foldover data points or spikes.
Magic angle homogeneous of highly anisotropic structure
collagen fibres
Motion repeating densities occurring as the results of
oriented in PD motion
MOTSA stair-step pattern motion and vascular
pulsations
Non-linear Image distortion, Gradient non-linear due to
gradient field Asymmetrical edge design or gradient, amplifier
ringing band in limitations, Interference
multiecho seq between S and SE
Point bright spot of constant offset of the DC
increased signal voltage in …
Quadrature ghost image incorrect/maladjustment of
receiver
Respiratory repeating densities respiration during the
motion scanning
RF feed feed-through k-space image processing
through artifacts error
Slice overlap signal loss multislice acquisition at
multiple angle
Susceptibility signal dropout / presence of paramagnetic
bright spots optic materi
Truncation / Edge ringing, Sharp changes in contrast
Gibbs Syrinx-like stripe (limited extent of k-space)
Zippers / stars Bands through Imperfects faraday case
image centre residual FID stimulated echo

Arthrography
MR arthrography has made arthrography of the knee joints nearly
obsolete, In MRI, even intravenous gadolinium-containing contrast
media results in some enhancement of the joint fluid: called intravenous
MR arthrography.

As Low As Reasonably Achievable - ALARA

Concept stating that whenever ionising radiation is applied to humans, it
should be used with caution.

Asymmetric echo - ASE / AE / A Echo

In SE-PS and GE-PS, echoes occur at an echo time as a result of an
180º pulse or a gradient inversion at TE/2 after the last rephrasing
(refocusing) of the spins. If different time of refocusing is chosen for any
20
two echoes occurring in a multi-echo sequence, the echoes are termed
asymmetrical. » FRACTIONAL ECHO

Asynchronous transfer mode - ATM

ATM is a very recent high-speed protocol for communication between
computers.

Atom
The smallest particle of an element, made up of a tiny central nucleus
surrounded by a cloud of fast moving electrons. The nucleus consists of
one or more “positively charged protons” and also contains neutral
particles called “neutrons”.

Atomic absorption coefficient

The attenuation coefficient expressed per atom of the absorbing
material (instead of per unit length)

Atomic cross-section » Cross-section

Atomic mass
Mass associated with an atom and given in the periodic table of
elements.

Atomic mass number » Mass number

Atomic mass number - # A

The total number of protons and neutrons in a given nucleus.

Atomic mass unit (atomic mass) - AMU

Atomic nucleus
The central part of the atom. Made up of protons and neutrons, it is
much smaller than the entire atom which also consists of the electronic
shell.

Atomic number
Number of protons present in an atomic nucleus. The atomic number
therefore identifies the chemical element. For example, the element
with atomic number 6 is the element C (carbon).

Atomic scattering factor (atomic form factor)

Describe the directional distribution of the scattering of x-rays of a given
wavelength by an atom.

Atomic stopping power

21
Linear stopping power per atom, obtained by dividing the linear
stopping power by the atomic density.

Atomic structure
Principle according to which the various types of atoms are built.

Atomic weight » atomic mass

Attenuation coefficient
A quantification of the energy intensity loss of either electromagnetic or
mechanical waves due to attenuation.

Attenuation correction
Correction applied for the scatter and absorption of photons emitted
from a radioactive tracer distributed within the body.

Auto Centre Frequency » Technical factor

Automated tissue excision and collection - ATEC

MRI guided vacuum-assisted breast biopsy system

Auto Shim » Technical factor

Average life » Half-life

Averaging
▪Technique of summation of signals generally used to increase the SNR
in an imaging procedure.
▪ Mean value of measured signals in a slice, to improve SNR. Averaging
is performed, for example, on a measurement with 2 acquisition.

Axial
A tomographic (cross sectional) imaging plane bisecting the body into
top and bottom parts. » Orthogonal slices

Axis
An imaging line that passes through the centre of the body of mass or
field of force. Three orthogonal reference points representing length,
width, and height (3D). In MRI the conventional x = sagittal, y = coronal,
and z = transaxial.

►B◄
B - Magnetic field

22
b - b-value

B1 - RF torquing pulse,
The induced field in magnetic resonance imaging / the radio frequency
magnetic field

B1R - Receive B1 magnetic field

B1T - Transmit B1 magnetic field

Bo field inhomogeneity artifact

Bo inhomogeneity due to strongly paramagnetic or ferromagnetic
implants and caused distortion image and signal loss in the main
magnetic field, (also called magnetic flux density or induction).

Bo -Vector
Each of the responsive MDMs within the tissue sample precessing
around the stronger Bo.

B1 - Alternating magnetic field

The induced field in MRI » H1 (obsolete), Symbol for the radio frequency
(RF) coil located 90o to Bo

B1 field
The alternating magnetic field of RF radiation generated by a
transmitter coil.
Conventional name for the radiofrequency magnetic induction field used
in an NMR system (» MR Imager) (another symbol historically used is
H1). The B1 field is often conceived of two vectors rotating in opposite
directions, usually in a plane transverse to Bo. At the Larmor frequency,
the vector rotating in the same direction as the processing spins will
interact strongly with the spins.

Bo field - Constant magnetic field of a MR scanner

The static magnetic field of a magnetic resonance system
The constant applied magnetic field in magnetic resonance. (External
magnetic field)

Bo RF
Symbolic reference to the externally applied RF torquing pulse-
originating 90o to Bo

23
Backfolding artefact / blurring artefact
The backfolding artefact projects image contents which fall outside the
imaging FOV back in to the image; the back folded information thus
reappearing on the other side of the image.

Background noise
Usually applies to unwanted electrical noise, which, to a greater or
lesser extent, obscures a signal (or, as a consequence, an image).

Balanced fast field echo / Balanced FFE - BFFE

Balanced fast field echo

Balanced gradient
Any gradient field for which the areas under the positive and negative
gradient lobes between the initial pulse generating xy-magnetization
and the time of the echo (i.e. the middle of the readout process) are
equal.

Bandpass
Electrical circuit which is sensitive only to a specific range of
frequencies. This description could be applied to filters or tuned
amplifiers, and the purpose of such devices is usually to reject
unwanted signals or noise which might otherwise interfere with the
signal of interest.

Bandpass filtering
Selection of a specific range of frequencies (and rejection of all other
frequencies) using either an analogue electronic circuit or computer
processing of a digital signal. Bandpass filtering is used in the receiver
of an MR instrument to reject noise occurring at frequencies outside
those of the signals of interest.

Bandwidth - BW
A term used to describe the frequency range of a signal or the
frequency response of an amplifier, filter or other frequency-sensitive
circuit. » Technical factor, Read out BW, Transmission bandwidth

Base of the natural logarithm » e

Baseline
BOLD imaging: Non-activated image, in contrast to activated image.
See also paradigm. MRS: Background signal from which the peaks rise.

Baseline correction
Post-processing of the spectrum to suppress baseline deviations from
the zero line.
24
Basic image
Image selected as the default for slice positioning. Survey image,
Localizer, Scout. » Post processing image

Basic Principle
MR Active Nuclei
Important MR active nuclei together with their atomic number and
orientation are given in Fig. 2.3, some of which are used in MR
spectroscopy.
Most abundantly available hydrogen nuclei is in the form of water given
in Fig. 2.4
Hydrogen Atom
Hydrogen Atoms are abundantly present in the body.
The hydrogen nucleus is the MR active nucleus used in MRI. The
hydrogen nucleus contains a single proton as shown in Fig. 2.5
Fig. 2.3: Various MR active nuclei with their atomic number with linear
alignment.
Fig. 2.4: The molecular structure of water (H2O)
Fig. 2.5: Hydrogen atom
Fig. 2.6: A spinning top, which is hit, performs a wobbling type of
motion.
Protons in a strong magnetic field show this motion, called precession.
The nucleus of the hydrogen proton depicting its motion is shown in Fig.
2.6
Positive charge, i.e. Proton-it spins at a very high speed.
This combination of spin and charge generates tiny magnetic field.
The strength and direction of this field is represented by a vector called
“magnetic moment”.
Vectors
A vector is a symbol representing the magnitude and direction of the
magnetic field.
A vector is commonly represented by a directed line segment, i.e. an
arrow which denotes its magnitude and its direction. Fig. 2.7 Alignment
of vectors with varying magnitudes
(The orientation of the arrow is space corresponding to the direction of
the vector quantity, the length of the arrow corresponding to the vector
magnitude. Please remember that the arrow is merely a symbol for a
real physical quantity).
Spin magnets behave like vectors. They exhibit a magnetic field that
has both magnitude and direction.
Magnetic Moments
a) A rotating particle has an electric charge. Moving charges, as we
know, are nothing more than electrical currents. An electric current has
an associated magnetic field.
b) Where there is an electrical current, there is also a magnetic field.

25
c) Classically, the magnetic effect of a rotating charge or an electrical
ring current is known as the magnetic moment.
It is like the earth constantly rotates around an axis and has its own
magnetic field. Similarly, protons possessing a positive charge and
continuous motion have their own magnetic field.
Principle
The human body is a chemical composition of several elements, such
as hydrogen, carbon, nitrogen, sodium, phosphorus, potassium, etc. in
various chemical combinations. It has been observed that the atoms of
some of these elements have odd number of protons in their nuclei,
possess magnetic properties. The magnetic properties of the protons of
these elements have been utilized to produce MR signals and images.
The most abundant of these present in the human body are the protons
of hydrogen atom in the form of water and various other organic
compounds such as fats, fluids, cholesterol, etc.
What is MRI?
When a patient is placed in the strong magnetic field in the MRI
scanner, the hydrogen nucleus in the body, align with the applied
external magnetic field when exposed to short burst of electromagnetic
energy in the form of RF pulses. Fig. 2.8 alignment of hydrogen nucleus
in the human body when placed in strong magnetic field
The hydrogen nuclei in the patient’s body absorb its energy and then
generate MR signal. This process of absorbing energy is known as
“magnetic resonance”. It forms the basics of MR imaging. Fig. 2.9
Magnetic Resonance
If radiofrequency equals the precessional frequency, then the
phenomenon of resonance occurs.
Let us compare the resonance stimulations in MR with oscillations
created by various tuning forks Fig. 2.10. When the tuning fork is
vibrated or perturbed, it begins to oscillate at a specific frequency
relative to sound. The pitch corresponds to the oscillation frequency of
the acoustic wave. When you introduce a second tuning fork having the
same frequency of the former, it starts oscillating in response to the
acoustic waves emitted from the former tuning fork. At that moment, the
tuning forks are said to be “resonance”.
Hydrogen nuclei (with single proton) in the absence of external
interference are in random motion and their magnetic moment cancel
each other resulting in overall “null or zero magnetization”.
According to the Law of Quantum mechanics, in the presence of an
external magnetic field, the spinning nuclei may align themselves in two
directions viz. parallel or antiparallel to the external magnetic field
applied. Therefore, when the patient is placed inside the magnetic field,
the hydrogen nuclei (protons) in the body get aligned in proper
orientation and this leads to the patient being magnetized which in turn
emits signals which are captured by the receiver and after a series of
processing, transformation results in the formation of images on the
26
screen. Fig.2.11 The patient is placed in the centre of the huge,
powerful magnetic system Fig. 2.12 Hydrogen protons in human body
The hydrogen protons in the human body are in a random orientation
pointing in different directions as shown in Fig. 2.12A.
As shown in Fig.2.12B under the influence of applied external magnetic
field, the patient’s tiny hydrogen proton magnets tend to align
themselves in the direction of the external magnetic field.
Fig. 2.12C represents a bulk or a net magnetization vector.
In conventional radiology or CT scan, the signal solitarily depends on
one parameter. X-ray beam attenuation coefficient. In MRI, image is
constructed with a set of signals. The image is generated by three
factors.
The three parameters - Proton density.
T1, T2-Relaxation times.
The tiny magnets of the human body are then subjected to an impact of
additional magnetic influences, in the form of radiofrequency waves,
magnetic gradient coils, etc. to derive magnetic resonance signals. The
MR signals obtained have a wide range of specificities, depending on
the strength of the magnetic field, the frequency and duration of
radiofrequency waves (PS), the magnetic gradients employed, the
proton density, the element containing the protons, the chemical
combination of elements, their molecular state, etc.
The various types of signals obtained are labelled as T1, T2 relaxation
signals. The MR signals have specific tissue characteristics. These are
analysed by a computer and reconstructed mathematically by a process
known as “Fourier’s transformation” into sectional images of the human
body, accordingly, as T1WI, PDWI, T2WI.
The various types of images exibit specific tissue characteristics, by
which the tissues can be distinguished.
The behaviour of individual magnetic moments cannot be measured.
The signal measured in MRI is produced by the sum of all magnetic
moments called “net magnetization”.
Net magnetization points in the same direction as the scanned main
magnetic field.
Precession Frequency
Every hydrogen nucleus which constitutes the net magnetization vector
(NMV) spines on its own axis. The influence of external magnetic field
(Bo) produces an additional spin or wobble of NMV around Bo. Like a
spinning top, proton shows wobbling type of motion called “precession”.
This secondary spin is known as ‘precession’ causes the magnetic
moment to follow a circular path around the magnetizing field (B o). This
path is known as the “precessional path” and the speed with which the
NMV wobbles around Bo is known as the “precessional frequency”. The
unit of precessional frequency is MHz.
The precision frequency can be calculated by the Larmor’s equation,
and is higher in stronger magnetic fields.
Larmor’s Equation (Table 2.1)
27
 ω (omega) = Precessional frequency
The precessional frequency in MHz
γ (gamma) = Hydrogen (42.6) MH2T
The gyromagnetic ratio of hydrogen at 1Tesla is 42.58 MHz
* Bo = Magnetic field strength
The magnetic field strength of magnet (in Tesla)
Gyromagnetic ratio (γ) of various nuclei
Nucleus Gyromagnetic ratio MHz/T
H1 42.58
C13 10.71
P31 17.12
The Larmor’s frequency at various field strengths
Field strength Frequency
 0.1T 4.3 MHz
 0.2T 8.6 MHz
 0.3T 12.8 MHz
 0.5T 22.28 MHz
 1.0T 42.58 MHz
 1.5T 63.9 MHz
 2.0T 85.2 MHz
 3.0T 127.8 MHz
 4.7T 200 MHz
The precessional frequency is often called the “Larmor’s frequency” It is
directly proportional to the strength of the magnetic field.
Radiofrequency or Excitation
If radiofrequency pulse having the same frequency as that of the
precessing nuclei is applied, the precessing path of the nuclei will be at
right angles and thus it spirals away which resembles like the wobbling
of a spinning top.
Hence RF pulse at Larmor’s frequency has the following effects:
a) The RF pulse provides sufficient energy to some of the hydrogen
nuclei to align antiparallel to main magnetic field, the in turn cancel out
the magnetic effect of remaining parallel nuclei and thus decrease the
amount of longitudinal magnetization. The decrease in longitudinal
magnetization depends upon the strength and duration of RF pulse.
b) When the decrease of longitudinal magnetization, there is a
corresponding gradual increase in magnetization in transverse plane
(B1). This is because the protons which were in “out of phase” are now
precessing “in phase”. Resonance occurs at 42 MHz when Bo = 1T
Loud Noise during MR Procedure
The continuous movement of the gradient coils during the examination
is very loud. Patient could use ear plugs during MT examination to
make it tolerable.
In the Magnetic Field
Each magnetic field exerts a force on magnetic and magnetizable
particles, including the spin magnets. The effect of this force is depicted
by magnetic field lines (a).
28
The strength of this force at each location in space is known as
“magnetic induction”. However, in MR Technology, the term “magnetic
field strength” is commonly used. The field strength is expressed in
units of Tesla; (T:SI unit) or Gauss (G:T=10.000G).
Tesla is approximately 20.000 times stronger than the earth’s magnetic
field.
A magnetic field of uniform field strength is known as a “homogenous
magnetic field”. Fig. 2.14 field lines in homogenous magnetic field
The field lines of homogenous field are drawn at distance, straight lines
running in parallel (b).
When the magnetic field does not vary with time, it is known as “static
field”.

Beta particle » B

Bilinear rotation decoupling » BIRD

Bimodal slice select RF pulse » BOSS

Binomial pulse
A composite RF pulse which comprises subpulses with durations or
amplitudes in proportion to a binomial sequence (eg.1-1, 1-2-1, 1-3-3-
1).

Bioelectricity
Electricity produced by the human body in various organs like muscle,
brain, heart etc. The voltages generated can be measured using
electromyography, electroencephalography and electrocardiography.

Biological effect of magnetic field

Effect exerted on an individual by static or varying magnetic fields,
either acutely or due to chronic exposure. Also, the effects of RF fields
can be considered a biological effect of magnetic fields, as they contain
time-varying magnetic fields.

Biological half-life » Half-life

Biomagnetometer » MEG, MSI

Biopsy
Method to obtain body tissue or fluid for histological or microbiological
examination guided by fluoroscopy, ultrasound, CT or MR.

Biot - Savart, force of

Force F, which acts upon a current–carrying conductor in a magnetic
field.
29
Bipolar flow-encoding gradient
Gradient field which is turned on for an equal time with the same
positive and negative amplitudes. » Flow quantification

BIR-4 adiabatic pulse

A particularly useful adiabatic pulse which can produce any arbitrary
FLIP ANGLE over a range of frequency offsets and RF pulse powers.
The main application of this type of pulse is in localized MR
spectroscopy and imaging when the excitation is performed with a local
coil.

Birdcage coil
A transmit and receive RF imaging coil which looks like a birdcage and
frequently used in MR imaging for whole-body, head and limb imaging.

Biriani (adiabatic) pulse

A composite pulse based on a combination of BINOMIAL PULSE and
ADIABATIC PULSE principles.

Bit
Smallest digital unit, which can be represented in the hardware of a
computer.

Black blood angiography - BBA

Technique for MRA in which, flowing blood appear dark. » BBI

Black blood imaging - BBI

A generic term that is used for a variety of PS in which flowing blood
appears dark. Although it is used primarily for
imaging, it can be applied to any vascular territory. » BBA

Black boundary artifacts

Well-defined black contours following anatomical structures are seen.
These artifacts are another class of chemical-shift artifacts.

Blipped echo planar imaging - bEPI

Blipped phase encoding

Strategy for incrementing the position of k-space trajectory (» k-space) of
an EPI PS.

Block’s DAT - Dr Block’s data-acquisition technique

MRI technique quickly constructs 3D images of knees- suppressing the
fat signal in bone provides image contrast between bone and the
cartilage surface, so that the technician can view any facet.
30
Bloch equation
A complex mathematical approach describing the motion of the
magnetization vector, M.

Bloch, Felix
American theoretical physicist who discovered and perfected the first
spectroscopy experiment concurrent with and independent of Edward
Purcell.

Blood flow motion artifact

This type of artifacts is caused by the flow of blood throughout the
cardiac cycle. The artifacts are prominent in axial images. An effective
remedy for blood flow motion artifacts is “Spatial Presaturation (SAT)”.

Blood-flow velocity
Velocity of flowing blood, usually measured in cm/s.

Blood oxygen level dependent (contrast) - BOLD

A magnetic resonance GE technique using blood as an endogenous
contrast medium. The best sequence for observing the BOLD effect is
T2W-GE EPI sequence. However, other MR PS, such as spoiled GE
PS is also used. specific to fMRI.

Blood oxygen saturation monitor (pulse oximeter)

The pulse oximeter, when placed on the fingertip of the patient, will
display the heart rate of the patient and percentage of oxygen in the
blood. The pulse oximeter may be placed on any finger of the subject;
however, the index or middle finger has been found to work the best.

Blood-pool agent
Imaging agents, which stay intravascular for a prolonged time period.
They are used for blood-volume imaging or organ PERFUSION IMAGING.
Examples are technetium-labelled red blood cells or albumin for
NUCLEAR IMAGING, CO labelled with 0-15 for PET IMAGING, and various
currently experimental GD components and SUPERPERA-MAGNETIC
CONTRAST MEDIUM for MRI

Blood-pool radionuclide imaging » GATED BLOOD-POOL SCANNING

Blood-pool ventriculography » GATED BLOOD-POOL SCANNING

Blood pressure monitoring

Blood pressure can measure non-invasively at prescribed intervals
throughout the exam. A time interval can be set, at which the monitor
will automatically inflate the cuff on the arm of the patient while in the
31
scanner. An updated blood-pressure reading is displayed with each
measurement interval.

Blood vessel enhancement by selective suppression technique »

BEST

Blurring artifacts
Any mechanism that leads to image blurring in MRI. Blurring comes
most obviously from patient motion, but other mechanisms like low-
resolution sampling lead to image blurring

Body coil
The body coil is installed in the magnet and functions as both a transmit
/ receive coils. It has a large measurement field but does not have the
high SNR of special coils. » RF COIL

Body scanning
Use of a medical imaging system to image the thicker parts of the
human body.

BOLD effect
When neural activity increases, oxygen concentrations in venous blood
as well as local blood flow increases. As oxygen increases, the
magnetic characteristics of erythrocytes approximately that of the
surrounding blood plasma. Transverse magnetization in blood vessels
decays more slowly. This BOLD effect extends T 2 and T2*, measurable
as an increase in signal in the blood volume under examination.

BOLD imaging
BOLD imaging uses local changes in blood flow to indicate the current
level of activity in a region of the brain. Hydrogen protons in human
blood are the signal carriers. Blood works as an intrinsic contrast agent:
local concentrations of oxygen associated with changes in blood flow
are measured (BOLD effect)

Bolus / tracking
▪A method where a preselected bolus is tagged by the system and at a
designated time sequence is detected and recorded.
▪Partial volumes in a vascular section. A small amount of contrast agent
transported by blood flow whose spread is tracked (Bolus Tracking).

Bolus chase technique

Data acquired at multiple imaging stations in succession after single
injection of contrast. Table position and injection rates tailored for target
vasculature.

32
Bolus Track
MRA Technique monitors vessels in real time; start image acquisition
when contrast enters vessel-of-interest. Philips Medical Systems

Bolus tracking » Flow quantification

Bone biopsy
Excision of a small piece of a tissue from bone for microscopic
examination.

Bound proton pool

PROTON bound to macromolecules. Due to their short T2
RELAXATION, these protons are excited in MAGNETIZATION TRANSFER
(MT) experiments, and cross relaxation between these protons and the
free proton pool (i.e. protons in mobile water) can give enhanced
contrast.

Boundary layer separation

A blood-flow pattern often seen at vessel bifurcations. When there is a
large angle between the main flow direction and the vessel wall. The
complex flow pattern may be observed as slow flow reversal locally
reduced signal intensity at TOF MRA.

Breast coil
RADIOFREQUENCY COIL used for MRI of the female breast providing
optimal SNR.

Breast-computer-aided detection MRI B-CAD MRI

Software allows for both kinetic and morphological assessments of
malignancy using MRI images of breast tissue, possibly reducing the
use of invasive biopsy surgical procedures.

Breath holding technique-Single/Multiple » BHT-S/M

To avoid respiratory artifacts, the patient holds his/her breathe during
the entire measurement. Not suitable for use with uncooperative
patients, small children, or anaesthetized patients.

Breath Holding and Abdominal Compression

Both techniques are employed whenever short acquisition sequences
are employed, thereby minimizing the stain of the patient.

Bright blood cine sequence - BB cine sequence

BB CS is used to assess ventricular function and valvular patency. » BB

Bright blood effect

33
Brightly-displayed blood, as an effect of slow flow. Vascular spins are
completely replaced by unsaturated spins during repetition time. In GRE
sequences, the signal is maximum, and blood is displayed bright in the
image.

Bulk susceptibility agent

Type of MR CM which includes SUPERPARAMAGNETIC CONTRAST
MEDIUM. » Superparamagnetic

BURS pulse sequence

Family of fast imaging PS capable of producing images in less than 100
ms. In the basic BURST sequence, a train of low FA pulses generates a
long train of echoes. This complete sequence is performed with the
application of a contrast read gradient, and phase-encoding may be
implemented using short phase-encoding gradients between echoes.
The main advantages of BURST imaging are that it is less demanding
on gradient speed than other fast techniques such as EPI, and it
produces images which are substantially free of SUSCEPTIBILITY
ARTEFACTS. The disadvantage is that the technique is less sensitive
than competing methods.

Butterworth low-pass filter

Complex computational imaging filter used to remove statistical noise
and enhance image quality. It is applied in Fourier (or frequency) space
(» FT), FOURIER FILTERING) to remove or suppress unwanted high
spatial frequencies from an image.

b-value
Diffusion weighting factor. The higher the value b, the stronger the
diffusion weighting.

Byte
Eight digit binary unit used in computer science. A byte contains eight
bits (BIT) and can represent all numbers from 0 (binary number
00000000 to 255 (binary number 11111111). » BINARY SYSTEM

►C◄
Camera
The MR images are exposed on a film with the laser camera connected
to the MRI system.

Cardiac motion artifacts - CMA

Artefact in MR & CT due to cardiac motion. This type of artifacts is
caused by the contraction and relaxation of heart (chest) while the
34
scanning is going on. Remedy: To avoid this type of artifacts, cardiac
gating is mandatory during the procedure.

Carrier wave - CW
RF wave oscillating at the Larmor frequency which carries the signals
containing the tissue information out of the body.

Carr-Purcell Meiboom-Gill sequence - CP MG sequence

Modification of the Carr Purcell magnetic resonance sequence to
reduce the accumulating effects of imperfection in the 180º pulse.

Carr Purcell method

A method for measuring T2, following the Hahn echo, utilizing 180o RF
pulses at T, 3T, 5T, etc., which will create echoes at 2T, 4T, 6T, etc. A
prelude to the train of spin echoes used in the FSE.

Carr-Purcell sequence - CP Sequence

Sequence consisting of a 90º RF pulse followed by a train of repeated
180º RF pulses to produce a train of spin echoes; useful for measuring
T2 values. » CPMG, CP

Carbon (12C)
The basic infrastructure of all organic material consisting of millions of
bonding options and forms.

Carbon - 13 MR spectroscopy
MRS, using carbon as resonating nucleus.

Cardiac-gated 2D phase contrast MRA » CMRA

Cardiac-gated 2D PC (cine) MRA

PC MRA technique using 2D MR data acquisition together with cardiac
gated.

Cardiac imaging » MR cardiology

Cardiac Triggering
In cardiac imaging, the acquisition is generally triggered by an
electrocardiogram and is tied to the RR interval. This effectively
eliminates the blurring and artefact problem inherent in cardiac imaging,
although it limits imaging strategies (ECG, Pg (peripheral gating)).
Cardiac gating uses the programmed TR to deliver the RF pulse and
then monitors the cardiac cycle to determine which signal it uses for
reconstruction. Cardiac gating uses the electrical signal detected by
leads placed on patient’s chest to trigger each RF excitation pulse.

35
Cardiovascular Angiography Analysis System CAAS
CAAS MRV software is designed to enable cardiologists and
radiologists to perform functional analysis or cine-MRI of the heart in an
easy, fast and reliable way. The software provides quick and accurate
automatic segmentation of the endocardial and epicardial contours as
well as papillary muscles on short-axes images

Cardiovascular magnetic resonance imaging » CV MRI

MR cardiology

Carr/Purcell method
A method for measuring T2, following the Hahn echo, utilizing 180o RF
pulses at T, 3T, 5T, etc., which will create echoes at 2T, 4T, 6T, etc.

Cartesian coordinate system

Three reference points 90o relative to each other. In MR applications the
+z-axis is longitudinal, the x-axis and y-axis are transverse but all are
separated by angles of 90o.

Cause of hypointensity - High and low MR signal

Central processing unit - CPU

The part of a computer in which operations are controlled and executed.

Centre » Windowing

Centre frequency
A match of the system’s transmit / receive frequency with the
precessional frequency of the protons being imaged.

Central field of view - CFOV

The area or volume in which objects should be positioned in order to be
imaged.

Cerebral blood flow imaging - CBFI

Methods providing regionalized maps of tissue perfusion.

Cerebrospinal fluid pulsation artifact » CSF pulsation artifact

The remedy for CSF pulsation ghosting is “Gating “to the cardiac cycle,
i.e. plethysmograph (peripheral gating). However, combination of
“Gating” and flow compensation is optimal for cervical and thoracic
imaging.

Cine
A series of rapidly recorded multiple images taken at sequential cycles
of time and displayed on a monitor in a dynamic movie display format.
36
Cine MRI
Method to show/display dynamic processes of cardiac movement, such
as the ejection of blood out of the heart into the aorta, by means of fast
imaging and displaying the resulting images in a sequential-loop, like
movie. The MR images run automatically through the active screen
segment, either in a cycle or forward and backward (yoyo)

Circle of Willis
A large network of interconnecting vascular vessels resembling a circle
and located at the base of the brain.

Charge of an electron » e

Checklist for screening patients » Examination procedure, Safety

Chemical Shift
A variation in the resonance frequency of a nuclear spin due to the
chemical environment around the nucleus. Chemical shift is reported in
ppm.

Chemical shift artefact - CSA

▪Contour artifacts caused by chemical shift may occur with GRE
sequences due to the slight difference in resonant frequency between
fat and water (appr. 3.5 ppm).
▪Appear at the interfaces between water and fat because the
precessional frequency of protons is slightly different in these two
substances.

Chemical shift imaging - CSI

▪Most usually used to describe a sequence for water suppression in
proton MRS and for fat or water suppression in MRI.
▪MR technique, which provides spectral resolution, coupled to a degree
of spatial localization.
▪MR RF PS, which allows differentiation of the chemical components of
tissues.
▪In contrast to single volume spectroscopy (SVS), CSI maps the
metabolic information from a VOI in a spectral matrix. The spatial
encoding requires a minimum measurement time of several minutes.

Chemical shift selective - CHESS

Magnetic resonance radio-frequency pulse sequence that allows
differentiation of the chemical components of tissues.

Cine » Cine MRI

37
Classification of Contrast Agents
Positive relaxation agents
Parenteral (systemic):
Gd-DTPA: Gadopenetetate dimeglumine (Magnevist)
Gd-DTPA-BMA Gadodiamide (Omniscan)
Gd-HPDO3A-Gadoterodole (Prohance)
Gd-BOPTA-Gadobenate dimeglumine
Gastrointestinal (Oral):
Gd-DTPA Ferric ammonium citrate (Geritol) Vegetable oils, Fats,
etc
Negative Relaxation Agents:
Parenteral (systemic):
SPIO- Superparamagnetic iron oxide
USPIO- Ultrasmall superparamagnetic iron oxide
MION- Monocrystalline iron oxide
Gastrointestinal (oral):
OMP- Oral magnetic particles
PFOB- Perfluoro octyl bromide
In post contrast images, the contrast enhancement is increased by
various imaging parameters other than contrast media. Such
parameters include MT, fat suppression techniques, etc.

Claustrophobia
A psychological reaction to being confined to a relatively small area,
i.e., the gantry / tunnel.

Clinical application
Brain Tumors
Although results have proved to be disappointing, especially in the
detection of small calcifications, MRI, is at present superior to CT in its
ability to detect tumor. In comparison with CT, MRI has the advantage
of detecting lesions in the posterior fossa, at the edge of calvanium and
is superior for lesion near the base of skull and the pituitary fossa. MRI
has the added advantage of characterizing tissue better in tumors with
lipomatous component and in tumors appearing as enhancing foci not
distinguishable from vascular structures on CT.
Hemorrhage-Ischemic stroke
Both these condition are easily detected by MRI. For example, the
detection of thrombosis/stenosis is a very promising application of MRA.
It is also possible to separate the hemorrhagic and edematous
component of an infarct. Using special PS, i.e. diffusion imaging, a
stroke can be detected at the onset of ischemia.
Trauma
In comparison with CT, MRI has the advantage of demonstrating the
entire extent of the extracerebral collection plus superior evaluation of
diffuse axonal injury and sequelae of trauma. An added advantage of
MRI when scanning trauma cases is its multiplanar capabilities, i.e. the
38
ability to scan in different planes without moving the patient.
Disadvantages include the longer scanning times and the inability to
demonstrate the bony cranium.
Degenerative diseases
MRI is extremly effective in diagnosing multiple sclerosis, subcortcal
arteriosclerotic encephalopathy, gliosis and syrinx. In the detection of
demyelinating diseases, MRI is clearly superior to CT.
For the above, MRI is proving to be the present method of choice for
examining the brain.
Spine
A major advantage of MRI is that the spinal cord within the thecal sac is
well-visualized without the administration of contrast media. For
example, congenital lesions such as Arnold-Chiary malformation and
intraspinal tumors are demonstrated without the need for myelography
or intrathecal contrast media.
MRI is proving to be the gold standard in the demonstration of
degenerative disk disease and lumber disk herniation: nerve roots,
neural foramina and intervertebral disk spaces are better evaluated on
MRI images.
Thorax
Because of the relatively long data acquisition time, MRI is more
applicable for static parts of the body rather than for the moving parts.
This means that small lung lesions may be missed, but large or
immobile lesions near the mediastinum are demonstrated.
Mediastinum and hili
MRI appears to be superior to CT in evaluation of the mediastinum and
hili due to its higher contrast resolution. This can be attributed to the low
signal (black) from flowing blood within the vessel providing a good
intrinsic contrast to other hilar structures.
Breast, chest wall and pleura
There is a remarkable similarity in the morphological appearance of
MRI and maammography as both the grandular and fibrous structures
are delinated by the stronger signal from surrounding fat.
Although primary tumors of the chest wall and pleura are detected with
MRI, there is no superiority of this modality over CT. A disadvantage of
MRI is its inability to demonstrate small calcifications.
Cardiovascular and flow studies
Cardiac-gated images display impressive anatomical details of the
heart, as well as changes in the arterial lumen. MRI is able to depict
tumors and congenital anomalies. Recent advances in MRI equipment
and software, has enabled the evaluation of coronary arteries on MRA.
Myocardium
Acute myocardium infarction is seen as a region of high signal intensity
on MRI images.
Flow studies
On flow studies, the vascular structures are defined with superb
anatomical detail. The administration of contrast media is not necessary
39
due to the intrinsic contrast between the low/back signal of flowing
blood and the vascular wall. The sensitivity of the vascular tree is
increased through the administration of contrast media.
However, MRI is not the final answer to all cardiac imaging as the
relationship of MRI to other noninvasive imaging technique, i.e.
ultrasonography and isotope image, remain to be defined.
Abdominal MRI
The contours of organs, surrounded by fat, are well displayed.
However, intestinal tract is not well delineated on MRI images as bowel
motion cannot be reduced through the application of a gating technique
and a satisfactory oral contrast medium for the intestinal tract is not yet
available.
Liver
Solid regions are detected equally well on both MRI and CT imaging.
However, the relationship to vascular structures is better displayed on
MRI whilst the demonstration of calcified foci in tumors is better on CT
than MRI. The hepatic, portal and biliary systems are well delineated on
MRI with MRCP a well-established procedure for the evaluation of the
biliary and pancreatic tree.
Kidneys
Tumors, cyst, hydronephrosis, calculi or abscess are successfully
diagnosed with MRI. The renal cortex and medulla is differentiated
assisting in the diagnosis of chronic renal failure.
Ultrasound and IVU remain the first-line standard examinations for
kidney disease with CT being utilized for the diagnosis and staging of
malignant renal tumors. MRU is an alternative for noninvasive imaging
of the ureters.
Adrenals
The ability of MRI to detect adrenal disease is comparable to CT. Whilst
CT demonstrates superior spatial resolution; MRI provides superior soft
tissue contrast.
Pancreas
Recent studies have established the role of MRI in the evaluation of the
pancreas. T1 and T2W PS are helpful in differentiating pancreatic islet
cell tumors from normal tissue.
Pelvis
MRI of the pelvis is superior to CT due to minimal motion artifact in this
region and no beam hardening effect as in CT.
Urinary bladder
The urinary bladder is best examined when filled.
Prostatic hypertrophy
Benign prostatic hypertrophy can be volumetrically quantified from
combind multiplanar MR imaging. Prostatic cancer can be detected at
an earlier stage with MRI than with CT. Endorectal coils for prostate
imaging are utilized for the detection of local spread from prostatic
malignancy.
Female pelvis
40
On MRI images, the uterus, ovaries and follicles are clearly displayed.
The corpus uteri can be distingguished from the cervix and the
myometrium is clearly differentiated from the endometrium. The
changes of the endrometrium in the various phase of the menstrual
cycle and during pregnancy are demonstrated on MRI images.
Although MRI is currently not advocated in pregnancy, it holds great
promise in the demonstration of the fetus and placental site. The ability
of MRI to detect fetal metabolic disorders at an early stage has yet to be
tested. The utilization of MRI for pelvimetry is possible.
The lack of known biologic hazards makes MRI an important potential
tool in the management of obstetric and gynecologic problems.
Extremities and musculoskeletal MRI
Cortical bone and epiphyseal plates appear as signal free areas, whilst
normal bone marrow is seen as high signal intensity on MRI images.
Conventional radiographic techniques are still superior for the
demonstration of bone lesions and fractures. However fat suppressed
MRI PS are highly sensitive in the detection of fractures.
The advantage of musculoskeletal examination by MRI is the superior
soft tissue contrast. Fat, muscle, tendons, ligaments, nerves and blood
vessels have different MRI characteristic and are separately displayed.
In joints, MRI differentiated between fluid collections of different
etiologies. For example, infection, blood, serous fluid, osteomyelitis and
bone marrow tumors are better characterized with MRI. Whilst the
normal bone marrow gives high MRI signals, the intensity of metastatic
infiltrated bone marrow is low.

Coaxial
Occupying the same space or time (coincident).

Coded signals
Signals that contain informative data.

Cognition
The brain’s mental processes involved in knowing, thinking, learning
and jugment.

Coherence
Maintenance of a constant phase relationship between rotating and
oscillating waves or objects. Loss of phase coherence of the spins
results in a decrease in the transverse magnetization and hence a
decrease in the NMR signal.

Coherent (in phase) Gradient Echo Pulse Sequence

These sequences use a variable FA excitation pulse followed by a
frequency encoding gradient rephasing to produce a gradient echo.
Here the steady state is maintained by selecting a TR shorter than the
41
T1 and T2 times of the tissues. In this sequence, the tissues with long
T2 values appear with high signal intensity.
Uses: Increased T2* Dependence, Vary fast scans, Preserves the
transverse signal, Good for angiography, Can be acquired in a volume
acquisition
Disadvantages: More gradient noise to the patient, Poor SNR in 2D
acquisitions compared to spin echo, More magnetic susceptibility
Parameters: To maintain the steady state: FA: 30o-45o, TR 20-50 ms.
To maximize T2*, TE 15-25 ms
Coil - RF coil
One or more loops of a conductor used to create a magnetic field. In
MRI, the term refers to the radiofrequency coil.
When the protons return to the equilibrium, the receiver coil picks up the
signal. Pulsed magnetic RF fields stimulate the spins. These RF pulses
are transmitted. The resulting RF signal has to be received since it
contains the information necessary for image reconstruction.
The types of coils described below are the most commonly used.
Volume coils: Head/body coil, both transmit and receive RF pulses and
are specially called ‘Transceivers’
Surface/local coils: (orbits, ear, wrist, shoulder, joints, etc).
Surface coils can be placed closed to ROI (circular, rectangular,
extremity, wraparound), which gives high SNR since being close to the
anatomy.
The correct choice of a coil gives the best SNR in the ROI.
Surface and local coils are traditionally used to improve the SNR when
imaging the structure neat the skin surface. They only receive only
signal.
Phase array coils: (CTL, TORSO array, etc). It consists of multiple coils
and receivers that used for larger areas.
Body coil is fixed inside the magnet (examination of thorax, abdomen +
pelvis, thigh, leg, body Angio).
Surface coils can be placed closed to region of interest (circular,
rectangular, extremity, wraparound) which gives high SNR since being
closed to the anatomy.
The correct choice of a coil gives the best SNR in ROI.
Volume coils both transmit and receive RF pulse and are specially
called “Transceivers”.
Surface and local coils are traditionally used to improve the signal SNR
when imaging the structure near to the skin surface. They only receive
only signal.
Phased array coils: It consists of multiple coil and receivers. It is used for
larger areas.

Coil, saddle
Specialized coil conventionally used when the static Bo is coaxial with
the coil’s axis versus a surface coil.
42
Coils, crossed
Pair of RF coils oriented at right angles to each other and designed to
minimize their mutually induced magnetic effect.

Coil selection artifacts

Select a proper suitable coil, if you do not enter correct one, the system
will create noise on image. Structured noise caused due to coil
selection. Fig. 7.25A+B
Select a coil from the coil name window. The coil selected should match
the one that is connected.

Collimation - Slice thickness determination

Columns
The frequency-encoded portion of the measurement matrix. » Raw

Comparison of 3 types of magnets

Permanent
Benefits: Drawbacks:
No electrical power needed Temperature sensitive
Good patient acceptance Cannot be switched off
Small fringe field Limited field strength
No refrigerants needed Low signal to noise ratio
Image quality often acceptable Low capital and running cost
Resistive
Good patient acceptance Limited field strength
No refrigerants needed Low signal to noise ratio
Easy to install even in difficult site High power consumption
Advanced imaging possible Need cooling system
Can be switched off
Superconductive
High field strength High capital and running cost
High signal to noise ratio Risk of quenching
Good homogeneity
Advanced imaging possible
Only system for spectroscopy
Permanent
Magnetic field originates from permanently magnetized material. Simple
and cheap to run, heavy and low fields. Coprises large blocks of
magnetic material, usually horseshoe-shaped. Permanent magnetic
field. Requires no power supply or cooling, maximum field strength
0.3T.
Resistive
An electric current flowing through a coil generates magnetic field. A
continuous power and cooling system is necessary. When used with
43
cooper or aluminum conductors, creates maximum field strength of
0.3T.
Superconductive
Current flowing through a superconductor whose circuitry is super
cooled thereby decreasing electrical resistance within the system. Once
current is applied and the desired field strength is reached, no further
power is required. Generate stable and high fields using
superconductive coils. Made of cryogenically cooled Niobium Titanium
alloy with no electric resistance when placed at a temperature close to
absolute zero (-273oC). Need enclosed in a cryostat; helium is used as
the cryogen and nitrogen for precooling.

Combined applications to reduce exposure Bolus - CARE Bolus

CE-MRA Technique monitors vessels in real time; start image
acquisition when contrast enters vessel-of-interest. This ensures
optimal contrast of arterial vessels.

Comb echo - CE - Gradient echo & spin echo

Complex Conjugate
Two complex numbers are complex conjugates of each other if their
real parts are equal and their imaginary parts are opposite in sign.

Compound
Combination, union, or bonding of two or more elements.

Complex Data
Numerical data with a real and an imaginary component.

Component of MRI system

An MR imager consists of several principal components: A magnet to
align the spins (Supercon, Perma or R sys). Magnetic gradient fields to
localized the signals, RF generator and receiver, Documentation,
Computer, Shimming, Shielding, Cooling and Gating system, Pulse
oximeter, Power supply, Anaesthesia, Gradients, Pegating, Phantom,
Camera, Injector, etc.

Computer
As used for NMR, can be divided into central processing unit (CPU),
consisting of instruction, interpretation and arithmetic unit plus fast
access memory, and peripheral devices such as bulk data storage and
input and output devices.

Computer assisted radiology surgery - CARS

Organization based in Europe concerned with computer-aided
technologies.
44
Communicating with the patient while scanning
It is important to maintain voice contact with the patient throughout the
exam. The technologist should routinely establish contact between each
sequence.

Comb echo (CE) » Gradient echo & spin echo

Combined COSY / NOESY » COCONOESY

Computer aided diagnosis - CAD

Computer algorithm designed to detect specific diagnosis features, e.g.
in a breast MRI studies.

Concatenation
Distributing the slice to be measured into multiple measurements.
Possible application:
 For a short TR, increase the number of concatenations to be able to
measure more slices.
 To prevent cross talk in the case of short slice distance, set
concatenation to 2 and use an interleaved slice sequence.

Conductor
Any medium that will allow the flow of electricity. Generally copper (Cu)
is used for commercial electricity and niobium titanium (NbTi) for
superconductive electromagnets.

Contiguous-slice fast-acquisition spin echo » CS FSE

Contiguous slice MEMP

Continuous wave (NMR) - CW

▪In magnetic resonance electromagnetic field that oscillates sinusoidal
with time.
▪A form of spectroscopy in which a constant amplitude electromagnetic
wave is applied.

Contrast weighting / continuous wave - CW

Contrast may be obtained by sensitising the acquisition sequence to a
range of MR parameters including PD.

Contraindication
Inadvisable, unsuitable; in MR contraindications exist that preclude the
procedure on certain patients.

Contrast
45
The relative difference in the signal intensity of/between two adjacent
tissues types in an image. » Technical factor, PS

Contrast Agents
Chemical compound to improve contrast. » MRCM

Contrast detail curve » CD curve

This is one of the most important tools used to quantify the ability of an
imaging system to visualize low-contrast objects.

Contrast enhancement - CE
Use of contrast media to enhance visualization of pathology and
anatomical structures.

Contrast enhanced Fourier-acquired steady state CE-FAST

Contrast-enhanced fast field echo T1 CE-FFET1

(T1W pulse sequence GE-PS)

Contrast-enhanced fast field echo T2 weighted CE FFET2

T2W pulse sequence » GE-PS

Contrast enhanced fast field echo (T2W) » T2 FFE

Contrast-enhanced Fast field echo » CE-FFET1

Contrast enhanced Fast field echo T2W » CE-FFET2

Contrast enhanced Fast low angle shot - CE FLASH

A fast T2W imaging sequence utilizing refocused transverse
coherences. » GE PS

Contrast-enhanced* CE-GRE
Synonym: CE-FFE, gradient echo PSIF, SSFP

Contrast-enhanced MR angiography - CE MRA

The most conceptually simple MRA technique. CE MRA utilizes the T1
reduction of blood through Gadolinium-based contrast agent. Since CE-
MRA is not limited by saturation effects, it allows for large measurement
fields and any orientation. » PS
The introduction of CE MRA has fuelled the rapid growth of MR
applications for evaluating extracranial vessels. The problems of signal
loss from turbulent flow and in-plane flow saturation have been virtually
eliminated with this technique.
Techniques using 3D CE MRA can now be performed within a single
breath-hold on most current imaging systems. This is particularly

46
important for abdominal applications, such as assessment of the renal
arteries.

Contrast, high
Few greys between the brightest and darkest portion of image.

Contrast, latitude
The grey difference between the brightest and darkest diagnostic
portion of an image.

Contrast, low
An image consisting of a relatively large number of greys between the
brightest and darkest portion of the image.

Contrast medium injection rate CM rate

The rate of contrast medium ml per second and the amount of time the
injection will be given.

Contrast medium magnetic resonance angiography

The most conceptually simple MR angiographic technique.

Contrast, subjective
Contrast image scale relative to the viewer’s desires.

Contrast reversal
An image phenomenon where the bright become dark and the darks
become bright. This is usually associated with an extended TR and is
primarily governed by the regional spin density (DS).

Constant magnetic field

Magnetic field of a magnetic MR. » Ho, (Obsolete) B/Bo/Bo field

Constructive interference in the steady state - CISS

Strong T2W 3D GRE technique with high resolution, where two
acquisitions with different excitation levels are performed internally and
are then combined. Prevents streaks ( for example in the inner ear).
MPR or MIP is used for post processing.

Contrast agents
MRI provides excellent soft tissue contrast. However, enhancement
with contrast agents substantially improves the sensitivity and specificity
of lesions. Contrast agents are pharmaceuticals that enhance the
contrast between the lesions and normal structures. Enhancement of
the image contrast between normal and diseased tissue increases the
diagnostic accuracy. Contrast agents are commonly used in clinical
practice for a broad range of indications.
47
Contrast medium - CM
Agent used in imaging to enhance visualization of anatomical
structures.

Contrast to noise ratio - CNR / C-N ratio

It is defined as the difference in the SNR of two adjacent areas. The
factors that affect CNR are the same as that of SNR. Measure for
assessing the ability of imaging or procedure to generate clinically
useful image contrast.

Conventional Spin Echo (CSE) Pulse Sequence

In this pulse sequence, a 90o excitation RF is given followed by 180o
rephasing RF pulse.
Uses
These are the most commonly used pulse sequences
May be used for almost every examination
Produce optimum SNR and CNR
T1, T2 and PD WI is possible
Advantages
Good Image quality, True T2 weighting is possible
Disadvantages
Scan time are relatively long, More RF power deposition in the body.
Parameters
T1W TE 10-20ms, TR 300-600ms, Scan time 4-6min
PD TE 20 ms TR 2000ms Scan time7-15min
T2W TE80 ms TR 2000ms> Scan time7-15min

Convolution - A mathematical operation between two functions.

Convolution Kernels » CK

Conventional MR sequence of brain

Axial T1, T2 and FLAIR, Sagittal-T1WI, Coronal-T2WI (Dedicated
sequence coronal-SPGR, FLAIR, T2WIR WI)

Coordinate
One of several integrating references usually designated numerically or
by letter, that collectively defines a spatial location.

Coordinate transformation
A change in the axes used to represent some spatial quantity.

Coronal
A tomographic imaging plane bisecting the body into front and back
parts. » Orthogonal slice

48
Coronal slice
Cross sectional images from anterior to posterior in the patient’s body.

Correlated spectroscopy for long range coupling » COLOC

Correlation Imaging - CI
The MR imaging technique use to evaluate CE in the kidneys in
tumours and in rheumatic joints disease. » Correlation time

Cortex
Outer layer of an organ or an anatomical part.

Coulomb’s Law
The strength of an electric field is defined as the force, in newtons, that
a test charge experiences, divided by the charge.

Counter current flow - CCF

Flow, which occurs in a direction opposite to that in which consecutive
imaging sections in a 2D multislice MR imaging sequence are acquired.
» GA, SMA, FE, IVIM, FA

Covalent
Bonding process - the combination two or more element by the sharing
of outer electrons, for example, H2O.

Chronic Clots and iron storage » Appearance of blood

Crossed-coil
Coil pair arranged with their magnetic fields at right angles to each other
in such a way as to minimize their mutual electromagnetic interaction.

Cross polarization coil - CP coil

Circularly polarized transmission or receiver coil with two orthogonal
transmission and/or receiver channels. The receiver coil has a better
SNR than linearly polarized coils.

Cross talk artifact

An artificial image created by interslice communication between
adjacent scan slices. This is resolved by increasing the interslice
spacing gap.

Cryogen
Cooling agent to maintain the superconductivity of the magnet (liquid
helium or nitrogen). Used at or near absolute zero. Both liquid helium

49
(LHe) and nitrogen (LN) are generally used in the MRI to optimize
superconductivity.

Cryogenic - Freezing at or near absolute zero.

Cryostat
The assembly or component designed to maintain a constant very low
temperature flow by using cryogenic LHe / LN in MRI.

Cryogenic coils
New coils capable of producing sharper images in less time with out the
need to upgrade to higher field magnets.

Cryomagnet » Superconducting magnet.

Cryostat
An apparatus for maintaining a constant low temperature (as by means
of liquid helium). Requires vacuum chambers to help with thermal
isolation » Dewar

Current
Flow of electrons through a conductor. Current is measured in ampères

►D◄
Daily quality assurance DQA
The daily test ensures the smooth functioning of the system avoiding
inconvenience to the patient. Daily tests take only 20 minutes and are
carried out by the technologist every morning before the patient
examination is resumed. » QC & QA

Dark blood
Special preparation pulse that saturates the blood; for displaying
cardiovascular anatomy.

Dark fluid imaging (FLAIR)

TurboIR technique with a longer effective TE and longer TI for
suppressing fluids. Lesions that are normally covered by bright fluid
signals using conventional T2 contrast are made visible by the Dark
Fluid Technique. The inversion pulse is applied such that the T1
relaxation of the fluid reaches zero crossing at time point TI, resulting in
the signal being “erased”.

Data system » Computer

50
Davy’s experiment
Illustrating the reverse perpendicular concentric lines of magnetic force
created by current flow.

dB/dt
Formula for the temporal change of the magnetic field, read “dB over
dt”.

DB/Dt - dB/dt,
▪Rate of change magnetic flux density with time. Relates to MRI.
▪DB / Dt (delta B/delta t)- the rate of change of the magnetic field
(induction) with time. Because changing magnetic fields can induce
electrical fields, this is one area of potential concern for safety limits.

DC sequence
Turbo SE counterpart to double echo sequence, generally five times as
fast.

Decibel – dB - Unit of measure of intensity of sound.

Decoding - Process of making information useable.

Decoupling
A technical applicator to avoid objectionable interaction of the function
of coils, i.e., the transmitter and receiver coils.

Defocussing » Dephasing

Delay time » Trigger delay (TD)

Delay alternating with nutation for tailored excitation » DANTE

Democritus
Early Greek philosopher (approximately 400 B.C.) who first indicated
that atoms were the fundamental unit of all mass and were both
invisible and indivisible.

Demodulator - Synonymous with detector.

Dephase
The fanning out or separation of signal on the transverse x-y plan. The
greater the dephasing the greater the inhomogeneity and the shorter
the corresponding relaxation time.

Dephasing

51
▪The process by which individual nuclei in tissue lose their syncronicity
due to fluctuations in their precessional rates. In MR the major sources
of dephasing are thermal motion in tissues and nonuniformity of
fieldstrengths.
▪After RF is applied, phase differences appear between precessing
spins, resulting in a decay in transverse magnetization. Caused
primarily by spin-spin interaction and inhomogeniety in the magnetic
field, can also be caused by switching specific gradient fields (flow
dephasing). » Rephasing

Dephasing Gradient
A magnetic field gradient used to dephase transverse magnetization.

Decoupling
When acquiring spectra of nuclei other than protons the effects of
proton coupling can be removed (to improve the S/N ratio and simplify
the spectra) by applying a train of 180° pulses at the proton frequency
while acquiring at the frequency of the other nucleus.

Dedicated seizure protocol » Protocols

Demodulator
Another term for detector, by analog to broadcast radio receivers.
Diffusion ADC mapping » DMAP

DEPTH » SE sequence for spectral localization

Depth-resolved surface spectroscopy - DRESS

Magnetic resonance spectroscopy technique for obtaining a spectrum
at a predetermined depth.

DESS sequence
A 3D GRE technique during which two different GRE (FISP and PSIF)
are acquired during TR. During image reconstruction, the strongly T2 W
PSIF image is added to the FISF image. Application: joint, good
contrast for cartilage.

52
Detector
Portion of the receiver that demodulates the RF NMR signal and
converts it to a lower frequency signal. Most detectors now used are
phase sensitive (e.g. quadrature demodulator/detector), and will also
give phase information about the RF signal.

Deuterium
A stable isotope of hydrogen with a mass approximately twice that of
the usual isotope (D).

Deuterium magnetic resonance imaging - DMRI

MRI using the nuclear spins of deuterium.

Deuterium magnetic resonance spectroscopy - DMRS

MR spectroscopy using deuterium as resonating nucleus.

Dewar
Thermos container to retain liquid gases, such as helium, at low
temperatures (after Sir Janner Dewar).

Diamagnetic
A particular substance that posses the natural properties which will
actually decrease or oppose an adjacent magnetic field due to its
electrons’ rotation / spin properties. An example is gold.

Diamagnetism
Effect resulting in slightly weakened magnetic field when a substance is
introduced into it. Magnetization of a diamagnetic material is opposite
the main magnetic field. The material is considered to have a negative
magnetic susceptibility.

Diameter
An imaginary line through a circle dividing it into two equal halves.

Diffusion
Process by which molecules or other particles move from areas of
higher concentration to areas of lower concentration. When
concentrations are equal, there is a statistical balance, even though the
molecules are constantly under thermal movement.

Diffusion contrast
Diffusion of water molecules along a field gradient reduces the MR
signal. The effect is exponential: Signal = So exp (-b D), in areas of
lower diffusion (diseased tissue), signal loss is less intense, and the
display from these areas is bright.

53
Diffusion MRS - DMRS
Method for determining the diffusion of molecules.

Diffusion weighted imaging - DWI

ADC images are calculated from diffusion-weighted images with at least
2 b-values. The contrast corresponding to the spatially distributed
diffusion coefficient of the acquired tissues and does not contain T 1 or
T2* parts

Diamagnetic
A substance that will slightly decrease a magnetic field when placed
within it (its magnetization is oppositely directed to the magnetic field,
i.e. with a small negative magnetic susceptibility).

Diethylenetriamine-pentacetic acid - DTPA

▪Acid , bound to the gadolinium molecule to serve as a detoxifying
agent.▪Gadopentate dimeglumine as a magnetic resonance contrast
medium

Diffusion imaging - DI
MRI is sensitive to diffusion. The use of a proper PS permits the
acquisition of - DWI.

Diffusion and Perfusion

MRI is basically a spatial distribution map of signal intensity found in a
heterogeneous tissue sample. The five main time factors that affect the
MR appearance are PD, T1, T2, flow and chemical shift.
Diffusion is the movement of molecules due to random thermal motion
and may give us more static, anatomic / pathologic information.
Perfusion is the passage of the fluid through vessels of the target organ
where change is blood oxygenation will occur, thus gives us more
dynamic physiologic / pathologic information. Diffusion & perfusion
change with physiological or pathological state: Although similar at the
macroscopic level (voxel). They are very different at the microscopic
(capillary) level. » FB MSS

Diffusion tensor imaging - DTI

MRI method will enable to better diagnose by 3D maps of nerve
pathway in the brain, heart, muscle, fibre and soft tissue with out dye.

Diffusion weighted - DW
Spin echo-echo planar imaging. A form of EPI where additional gradient
fields (DI) are turned on during the spin preparation phase of spin echo
pulse sequence.

Diffusion weighted imaging - DWI

54
▪The process by which molecules or other particles intermingle and
migrate due to their random thermal motion. NMR provides a sensitive
technique for measuring diffusion of some substances.
▪The use of a proper PS permits the acquisition of DWI, e.g. images in
which areas of rapid proton diffusion can be distinguished from areas
with slow diffusion.
▪MRI is sensitive to motion and flow, and to the relatively low diffusion
effect when the gradients are strong enough. Diffusive movement in
tissue (such as natural diffusion of water) reduces the signal. Of interest
are regions where diffusion is reduced compared to its surrounding
(such as cell membranes, along WM tracts, or in areas of the brain
affected by stroke). Reduced diffusion means the reduction in signal is
less intense: the effected regions are displayed brighter in the image.
In this type of MRI either GRE (or) EPI sequences are used to
demonstrate the areas with restricted diffusion of extra cellular water
such as infracted tissue. High signal intensity appears at the area of
restricted diffusion. DWI is mainly useful in brain to differentiate
salvageable and non-salvageable tissue after brain stroke.

Diffusion-weighted spin echo-EPI - DW SE-EPI

A form of echo-planar imaging where additional gradient fields are
turned on during the spin preparation phase of a spin echo-echo planar
imaging.

Digital audio tape - DAT

Type of magnetic tape archival medium. Provides high storage capacity
and reliability, but deteriorates with time.

Digital converter
The portion of the computer interfaced to convert the analog data into a
digitized reference.

Digital imaging & communication in medicine - DICOM

The DICOM standard enables the transfer of digital medical images and
corresponding information, independent of device and manufacturer. In
addition, DICOM provides an interface to hospital systems based on
other standard.

Digital to analogue converter - DAC

Part of the interface that converts digital numbers from the computer
into analogue

Dipole
A magnetic field characterized by its own magnetic north/south poles
separated by a finite distance.

55
Direct current - DC
A current that flows uninterrupted in one direction

Direct pulsating
A current that flows in one direction while rhythmically pulsating.

Disadvantages and Advantages of MRI » FAQ

Display matrix
The total number of pixel in the selected matrix, calculated by the
product of y (Ø) and x (ƒ) axis.

Display window » Window

Distortion artifacts
Image distortions are caused by inhomogeneity in the magnetic field,
gradient non-linearity or ferromagnetic material in proximity to the
examination.

Dixon two-point method - DTPM

Method used in magnetic resonance imaging to generate water and fat
images

Documentation
According to the tasks involved, computer data and reconstructed
images are stored either in:
I. A fixed storage medium – Magnetic Hard Disks (MHD)
II. A removable storage medium – Magneto Optical disks. (MOD)

Donald Duck
This artifact can take the form of variations in signal intensities or
mispositioning of signals. It is caused by image distortion created by
ferromagnetic implants. Such artifacts can mimic pathology to such an
extent that examinations have to be redone or other diagnostic
modalities have to be used.

Double contrast turbo spin echo - DC TSE

T2 & PD *SC TSE:T1, T2 or PD *MC TSE: T1, T2 & PD

Double echo sequence - DE sequence

Spin echo sequence with two echoes. PD images are also obtained
without increasing the measurement time. They are produced from the
first echo of a T2W double echo sequence.

Doubly balanced mixer » DBM

56
Dorsal mylography - DM - MRI of the thoracic spinal canal.

Double quantum filters » DOF

Double pulse interlaced echo imaging » DOPING

Double resonance sandwich » DORSA

Dual echo fast-acquisition interleaved SE » DEFAISE

Double-oblique slice
Obtained (slice positioning) by rotating an oblique slice about one axis
in the image plane.

Doubly balanced mixer

An electrical device, often referred to as a product detector, which is
used in MRI to convert signals from the laboratory frame of reference to
the rotating frame of reference.

Driven equilibrium Fourier transform - DEFT

Magnetic resonance pulse sequence that uses multiple radiofrequency
pulses of varying angles.

Driven equilibrium magnetization preparation - DE prep

Driven equilibrium fast gradient-recalled acquisition in the steady

state » DE FGR (GRASS) GE-PS

Driven inversion spin echo » DESE

Dual echo fast-acquisition interleaved spin echo » DE FAISE

Dual echo in steady state - DESS

GE-PS (combination of FISP & PSIF)

Dual (echo) fast spin echo » DFSE > SE PS SE PSDI

Duty cycle
Time permitted during which the gradient system can be run at
maximum power. Based on the total time (in %).

Dynamic susceptibility contrast MRI - DSC MRI

Differentiate between tumours and abscess to distinguish malignant
brain tumour and cerebral abscess.

57
 ►E◄
e » Base of the natural logarithm

e » Charge of an electron

e- » Electron
Quantum/particle of negative charge

e+ Positron
Quantum with the energy of an electron but positively charged.

E » Photon energy
The capacity of a system to do work.

Earplugs / Headphones
All patients are required to wear ear protection. Earplugs &
Headphones, which hook into the stereo system so the patient may
enjoy music. The headphones are also part of the noise cancellation
system that helps drown out the knocking noise of the gradients.

Earth magnetic field

The earth’s magnetic field is approximately one half gauss to one
gauss, depending on location.

Echo
A form of magnetic resonance signal from the refocusing of transverse
magnetization.

Echoplanar diffusion imaging - PS

Echo-planar imaging factor - EPI factor

Number of gradient echos of an EPI sequence, acquired after a single
excitation pulse (typically 64 to 128). EPI factor 128 means a
measurement time 128 times faster than a normal GRE sequence.

Echo planar imaging - EPI

EPI is a rapid MRI sequence capable of producing images at video
rates from a slice selective excitation pulse.
●The fastest scan acquisition modes in MRI are the EPI & the GRE PS
●In EPI all the lines of K-space will be filled in one shot. This is called
single shot EPI (SS-EPI).
●If the echoes are generated by multiple 180o pulse, this is termed as
spin echo echoplanar imaging (SE-EPI).
●If the gradients are used for the purpose of rephasing in EPI, then this
sequence is called GE-EPI.
58
●GE-EPI and SS-EPI are faster than SE-EPI
●SS-EPI sequences are more prone to artifacts such as chemical shift,
distortion and blurring.
●In EPI the image may contain more T2*W which can be minimized by
180o inverting pulse before excitation pulse.
Uses
 Improved cardiac and abdominal imaging
 Used in perfusion weighted imaging
 Useful in real time and interventional MR-guided procedures.

Echo planar imaging with STAR frequency - EPI STAR

Type of echo-planar imaging used for perfusion imaging and MRA.

Echo planner MR angiography - EP MRA

MR angiography method that uses EPI to acquired the image data. Can
be performed using either TOF MRA or PC MRA

Echo planar perfusion imaging - PS

Echo sharing
For double contrast sequences. Echoes that determine the image
resolution are used in both raw data matrices.

Echo planar spectroscopic imaging EPSI

Fastest available magnetic resonance spectroscopy technique. » EPI

Echo time / time delay between excitation and echo - TE

▪Echo delay time, Readout data
▪The time at which signal echoes are obtained.
▪The time interval between the excitation pulse and the peak of the
echo
▪The time frame from the 90o B1 RF pulse to the midpoint of the TE
echo.
▪The time between middle of 90o pulse and middle of spin echo
production.
▪The time between the 90o pulse and the maximum in the echo in a SE
PS
▪The time between the middle of the 90o pulse and the middle of the
resulting spin echo in a single slice
▪The time between the excitation pulse of a sequence and the resulting
echo used as the MR signal. Determines image contrast

Echo spacing - ES
Distance between two echoes; e.g., Turbo SE or EPI sequence. A short
echo space produces compact sequence timing and fewer image
artifacts / the time between the 180o refocusing pulses.
59
Echo train
Two or more echoes in sequence, each of which obtains a different
phase-encoding direction.

Echo train length - ETL

Number of echoes per excitation (More the ETL, less the scan time).

Edge spread function - ESF

Used to asses the spatial resolution of an imaging system.

Eddy currents
Relative to MRI it is the creation of small induced spurious electrical
current within the ROI. This situation produces artifactual images
created from and by metallic implants during an MRI examination.

Edema
A localized or generalized tissue area containing an excess
accumulation of water.

Edge acuity
Refers to the sharpness of an edge within an area of interest which is
controlled by pixel size and slice thickness.

Edge oscillation - Truncation artifacts, Gibbs artifact

Effective Echo time - Effective TE

Echo time of the central line in k-space

Effective echo time - TEeff

The contrast and SNR of an MR image are determined primarily by the
temporal position of the echo at which the phase-encoding gradient has
the smallest amplitude. The echo signal in this case undergoes minimal
dephasing and has the strongest signal. The time period between the
excitation pulse and this echo is the effective echo time.

Effective TR - TReff
During cardiac triggering, repetition time TR cannot be set as desired;
rather, it is determined by the time interval for the trigger. The effective
repetition time TReff established by the trigger interval fluctuates with the
physiological rhythm.

Effective transverse relaxation time >T2* / T2*

Refers to the situation in which the observed transverse relaxation time
is faster than the normal T2 time because of spatial inhomogeneity of
the magnetic field.
60
Effects of RF power
The RF pulses used in MR causes tissues to absorb power under
certain conditions. This may cause tissue heating. The amount of
heating depends on several factors such as patient size and pulse-
sequence timing. Before the patient is being scanned, the computer
estimates the level of heating and compares it to the predetermined
exposure limits. If the scan exceeds these limits, the system then
adjusts the scan parameters before starting the scan. The complete
estimate is based partially on patient weight. Therefore, take care to
enter the patient’s weight correctly to prevent excessive RF.

Einstein, Albert
German / American physicist, atomic theory pioneer, discovered the
theory of relatively and the energy conservation law, E = mc2

Electricity
Flow of electrons through or along a conductor. » Off-centre

Electrolysis
The creation of a chemical change by passage of a current through a
medium.

Electrocardiogram triggering - ECG triggering

Synchronize the measurement with the patient’s cardiac signal. The R
wave is used as the trigger. This method is particularly useful for
measurements of the heart or thorax, because images can blurred due
to cardiac contractions.

Electron » e- - Quantum/particle of negative charge

Electron - e-
A tiny negatively charged quantum/particle that orbits the nucleus of an
atom.

Electromagnetic
Having both electric and magnetic properties / Electromagnet, magnet
generates its field by means of passing current through coils of wire.

Electromagnetic absorption » Absorption

Electromagnetic spectrum
Electromagnetic waves are produced by electric charges that are
undergoing accelerations and can be categorized according to their
frequency and wavelength into a spectrum. The way in which the wave
interacts with matter depends on its frequency.
61
Electromagnetic radiation
The radiofrequency of the NMR signals are 9 orders of magnitude
smaller than the frequencies corresponding to the x-rays. Transmitted
x-rays have been used for years to generate images of the human
body. We will now show how NMR signals can be produce a very
exciting new type of image. While x-ray images stem from interactions
between the x-ray and the electron clouds of atoms, the NMR signals
stem from the interaction of radiowaves with the atomic nuclei
themselves.
Atoms consist of a nucleus surrounded by one or more electrons. The
nucleus consists of one or more “positively charged protons” and also
neutral particles called “neutrons”.
Fig. 2.2 Protons possess a positive charge; like the earth, they are
constantly turning around on an axis and have their own magnetic field

Electromagnetic wave - EM wave

Simultaneous periodic variations of electric and magnetic properties at
90o to each other.

Electromotive force - EMF

The maximum electric potential between the negative and positive
polarity (i.e., battery) measured in volts.

Electron
A negatively charged elementary particle that has mass, rotation, and
spin. It possesses 1/1837 of the proton’s mass.

Electron paramagnetic resonance - EPR

Magnetic resonance phenomenon primarily involving materials with
unpaired electrons » ESR

Electronegative
An element or a molecule with an excess negative charge, such as
oxygen in H2o.

Electronic - Relating to electron flow.

Electron microscope
An electronic optical instrument where a beam of electrons is focused
by electrostatic lenses to enlarge images of atoms onto a fluorescent /
photographic plate.

Electron spin resonance - ESR

A magnetic resonance phenomenon consisting of unpaired electrons
spin creating a frequency range much higher than a conventional ωO.
62
MRI & MRS rely on the resonant behaviour of the atomic nucleus in an
external magnetic field. » EPR

Electrostatics
A discipline of physics that investigates attraction and repulsion
phenomena of electrical charges.

Element
One of 100 fundamental submicroscopic identifiable substance in
nature and consisting of a single atom. Its number of protons and its
number of neutrons is its mass number (#A) reveals its physical and
chemical identity.

Elliptical - Very oblong in shape, similar to the shape of a football.

EM spectrum » Electromagnetic spectrum

Encoding - Decoding or deciphering coded signals for spatial location

Endo-oesophageal MRI - EE MRI

An Endo-oesophageal MR imaging coil delivers high-resolution, cross-
sectional image from within the body to help doctors make a better
diagnosis of a number of ailments and diseases.

Energy
Required performing work; kinetic energy is energy of motion, potential
energy is stored energy.

Energy level ground state

Stationary charged quantum energy at its equilibrium state.

Energy level, high energy state

Charged energetic particles that have absorbed an external applied
force elevating them to a higher energy position. When these MDMs are
at ground state they are positionally at a +z antiparallel longitudinal
equilibrium state.

Energy state
It is nature’s command that all objects naturally have a tendency to live
at ground or equilibrium (balance state). Relative to MRI, when the
MDMs have acquired excess energy they are torqued to a higher
energy antiparallel state or location. When these MDMs are at ground
state they are positionally at a +z antiparallel longitudinal equilibrium
state.

Entrance slice phenomena

63
Relative to MRI, an image portraying the contrast variance created
between flowing nuclei versus the stationary nuclei located in the slice
select.

Energy - The capacity of a system to do work » E

Equilibrium
A state in which opposing forces or influences are balanced / A state of
balance existing between two opposing forces or divergent forms of
influence.

Erg
A minute form of energy measurement embodied in Einstein’s formula
E = mc2. It requires about 70-100 ergs to softly phonate an Ah!

Ernst angle
The flip angle (<90o) of a GE sequence at which a tissue with a specific
T1 generates its maximum signal. Depending on TR. / Professor R.R.
Ernst perfected the RF pulse angle in conjunction with optimum signal
saturated (see fast scanning).

Erythrocytes
Bicave nonnucleated cells found in the blood, numbering 4.5 to 4.8
million per cm. Generally referred to as red blood cells, their primary
function is to transport oxygen bound to hemoglobin.

E short - E SHORT
Elscient brand name for a refocused gradient echo pulse sequence
Steady-state gradient echo with spin-echo sampling » E SHORT
Steady-state gradient echo with spin-echo sampling
Elscient brand name for a refocused GE-PS

Esophageal magnetic resonance angiography - EMRI

Ultra small, open design special imager for scanning of extremity.
The design of the E-scan XQ offers reduced anxiety and
claustrophobia, enhances comfort and allows attendance to be close
contact.

Even echo rephasing

Even echoes in an echo train of spin echoes are compensated for the
effects of flow.

Examination procedure
Identity
Prior to any examination being performed, the technologist must check
the identity of the patient.
64
Patients arriving into the department are often worried or apprehensive
and this may make it difficult for them to understand the instructions or
may produce an apparently aggressive attitude. In such cases, the
technologist should convince amicably and soft tones of voice often do
a great deal of comfort and give the patient confidence that he/she is in
an efficient hand.
The technologist should make every effort to obtain the willing
cooperation of the patient consent. Children and uncooperative patients
should be sedated before examination.
 Before entering the equipment room, the patient must wear a
hospital gown and should remove all personal possessions such as
watch, wallet, keys, hair pins, jewels, coils, removable dental bridge
work, etc. Even credit cards and cell phones must be secured, as the
scanner will erase the information on them.
 Wheelchair and trolleys (MR noncompatible) must always be kept
outside the magnet room.
The patient is made to lie down on a table. This table then passes
through a tunnel within the equipment. Inside the tunnel, it is quite noisy
when the scanning is going on. The region of interest is positioned at
the centre of the magnet. The patient can hear the voice of the
radiologist or the technologist and can respond. While the patient lies
within the tunnel, images of the interested regions are taken from
different angles. These images can be seen on a computer screen. The
entire procedure takes 15 to 20 minutes approximately depending upon
the strength of the magnetic field and the parameters set on.
It is most important that the patient should remain relaxed and
completely still during the scan. The patient can resume the routine
activities after getting the scan done.
 The patient should always be informed as to what is going to
happen and happen and what he/she is expected to do, so that he/she
can cooperate as much as possible.
 The patient should not wear makeup because some products may
contain metallic particles.
 The patient should be covered with a lightweight blanket.
 The patient must be made comfortable as far as possible because if
the patient is in pain or in distress, it is unlikely that he will be able to
remain still for long.
 Explanation: A detailed explanation of the exam to be performed (to
be informed to the patient) to give the patient, particularly as to how
long the procedure will take.
 The technologist from the start of examination/procedure should
make an effort to remember the name of the patient with whom he or
she is dealing and use it.
 Clear instruction regarding breathing or swallowing should be given
and rehearsed to ensure that the patient does hold his breath or
swallow when required to do so.
65
Due to high magnetic field strength used during MRI examination,
certain patients are unsuitable for imaging. These include patient who
have:
 Aneurysm clips (Older Ferromagnetic types)
 Cardiac pacemakers
 Patient with otologic implants and ocular implants
 Cochlear implants
 Metallic foreign bodies, especially within the eye.
Patient Screening
The following items can interfere with MR imaging and some can be
hazardous to your safety. Please check if you have any of the following
MR incompatible objects: (»Patient safety) Cardiac
pacemaker/pacemaker lead wires, Brain aneurysm clips, Aortic clips,
Implanted neurostimulators or lead wires, Artificial heart valve, Insulin
pump, Electrodes, Hearing aids, IUD (Intrauterine Device), Shunts,
Joint replacements, Fractured bones treated with metal rods, metal
plates, pins, screws, nails or clips, Harrington rod, Bone or joint pins,
Prosthesis, Metamesh, Wire sutures, Sharpnel, Dentures, Metal silvers
in the eyes, Cochlear implants, Tattoo eyeliner, Others
Screening Prior to Scanning
Glasses, Removable dental work, Hearing aid, Jewellery, Watch, Wallet
or money clip, Pens or pencils, Keys, Coins, Pocket knife, Metal zippers
or buttons, Belt buckle, Shoes, Magnetic strip cards, Credit cards, bank
cards, Hair pins or barrettes, Metal bra hooks, Bra and girdle underwear
support, Sanitary belt, Safety pins
Patient positioning, Precautions to be undertaken, Effect of RF power,
Hazards, Quenching, Magnet Quench Hazards

Examination/Image acquisition time » Technical factor

Excitation
Putting/adding energy into a/the spin system/given mass; if a net
transverse magnetization is produced, an NMR signal can be observed.

Excitation pulse
A brief RF pulse distorts the spin equilibrium in the magnetic field. The
higher the energy of the excitation RF pulses, the higher the expansion
of magnetization. The final expansion of the magnetic field after the RF
pulse is called flip angle. Pulse used to excite the spin system.

Exponential decay
Graphically depicting the relaxation decay process in an exponential
format.

Extracellular - Fluids located outside the cell, i.e., blood plasma.

Extremely low frequency fields - ELF fields

66
1to10 mA/m2. Currents induced by the application of strong time varying
magnetic fields from clinical MR units.

Extremity MRI - E MRI

Ultra small, open design special imager for extremities.

Extrinsic - Coming from or without.

►F◄
Face contrast MRA - FC MRA
This technique usually uses coherent GRE sequence. It provides
excellent background suppression. But the scan times with PC-MRA
are longer than the scan times of GE pulse sequence are flow sensitive
hence used for MRA.

Factor affecting the SNR » Technical factors

Faraday case
A six-sided cage constructed of a low resistance metal, such as copper
or aluminum, which is used to shield against RF that may interfere with
the production of MR signal.

Faraday shield
Electrical conductor designed so as to block out unwanted electric
fields.

Faraday, Michael
Founder of phenomenon electromagnetic induction.

Faraday’s Law
A changing magnetic field causes the induction of an electric potential;
the change can be either in amplitude or direction. The greater and/or
faster the change, the larger the induced potential (voltage).

Fast advanced spin echo - FASE, Fast spin echo, SuperFASE

Fast field echo - FFE

Philips brand name for Gradient echo pulse sequence

Fast imaging
Rapid imaging; check Acronyms used in Rapid Imaging

67
Fast low angled (single) shot - FLASH
A rapid partial saturation GRE technique using a low flip angle to
improve the SNR.

Fat suppression
▪The proton signal consists of water and fat (lipid) components. The fat
component can be removed using one of several techniques:
presaturation.
▪Pulsing an ROI usually with the frequency of fat or H2O to remove its
deleterious effect from the resultant image.

Fast acquisition double echo - FADE

A fast imaging technique, which observes both components of the
SSFP signal in separate acquisition periods during a signal interpulse
interval. Picker brand name for a refocused GE-PS

Fast inversion recovery - FIR, (IR), FEER

Magnetic resonance sequence used to demonstrate flowing blood

Fast imaging with steady procession - FISP / SSFP

Sequence in MRI which uses small flip angles and gradient echoes, but
in which phase encoding is reversed after data collection. » SSFP. True
FISP heavily T2W. Siemens brand name for a refocuses GE-PS 3D MPR + MIP

Fast multiplannar gradient echo - FMPGR

GE brand name for a fast multiplanar gradient echo pulse sequence.

Fast scan – FS Usually based on Gradient Echo Pulse Sequence » FI

Fast spin echo / turbo spin echo - FSE / TSE

FSE process characterized by rapidly applied 180o RF refocusing
pulses.
In this type of PS 90o excitation RF pulse will be delivered followed by
several 180o rephasing RF pulses. In CSE, only one line of K-space is
filled per TR. So the CSE takes longer scan time. But in FSE several
lines of K-space will be filled per TR. Because of this reason, the scan
times are reduced in FSE. The number of lines of K-space filled per TR
is referred to as TF (or) ETL. More the ETL less the scan time.
GE brand name for a RARE Pulse Seque.

Fast spoiled GRASS (Fast spoiled gradient-recalled) - FSPGR

GE brand name for a gradient echo pulse sequence

Fast short tau inversion recovery - FSTIR

MR sequence used to suppress the signal returned from fatty tissue.

68
Fast Fourier transform - FFT
An algorithm that greatly speeds up the computation of Fourier
transforms. (An Algorithm for high-speed reconstruction of MR images
from the raw data)

Fast gradient (-recalled) acquisition in steady state - FGR GRASS

GE brand name for a gradient echo pulse sequence, EPI GRASE pulse
sequence

Fast imaging - FI
Describe any type of MR imaging during which data acquisition is
relatively fast. » EPI GRASE PS

Fat saturation (Fat Sat)

To suppress the fat component in the MR signal, fat protons are
saturated by frequency-selective RF pulses. Magnet homogeneity
affects fat saturation. The chemical shift is 3.5 ppm. Magnetic
resonance sequence used to suppress the signal returned from fatty
tissues. IR-PS » STIR, FAT (fat/water separation)

Fat suppressed acquisition with TE & TR times shortened - FATS

Fat Suppression
The MR signal comprises the sum of water protons and fat protons.
Various techniques can be used to suppress the fat signal. In areas of
the body with abundant fat, T1W with fat suppression (STIR) provide
improved depiction of contrast enhancement. Fat suppression is
indicated in all fat rich areas like breast, retro-orbital and bone marrow,
etc.

Fat water discrimination - FWD, DTPM

MR pulse sequence which can discriminate between fat and water-
bound proton spins. » DTPM

Feridex
SPIO containing dextran, formulated for intravenous administration.
Cells of the reticuloendothelial system (RES) take up this contrast agent
and are sequestered by the RES, producing profund signal loss from
normal background tissue. On T2WI focal lesions like mets can be seen
well. Its principal use is as a liver agent. » Tesla scan

Ferromagnetic
The substances, such as iron, cobalt, and nickel that has a large
positive magnetic susceptibility

Ferromagnetic artefact
69
Artefact in magnetic resonance imaging due to materials exhibiting
ferromagnetism.

Ferromagnetism
Effect by which a material (such as iron) is drawn toward a magnetic
field. Relevant to safety for magnetic resonance imaging.

Feet first The patient is positioned feet first in the magnet bore.

FIDIF
Field echo with an echo time set so that water and fat spin are opposed
when the echo occurs. OPPOSED-PHASE IMAGE

FID SIGNAL
MR physics. Signal induced by the RF excitation of the nuclear spins,
and that decreases exponentially without external influence at a
characteristic time constant T2*.

Field acquired echoes » FACE

Field cycling relaxometry » Relaxometry

Field echo » Gradient echo

Field gradient » Gradient magnetic field

Field lock
A feedback control used to maintain the static magnetic field at a
constant strength, usually by monitoring the resonance frequency or a
line in the spectrum of a reference sample.

Field strength » Magnetic field strength

Filing factor
A measure of the geometrical relationship of the RF coil and the body. It
affects the efficiency of irradiating the body and detecting NMR signals,
thereby affecting the SNR ratio and, ultimately, image quality.

Filter
Any process or procedure to remove harmful (deleterious) frequencies
so as to avoid or reduce an alteration of the image quality. » Image data /
raw data / normalization filter

70
Filter back projection
Mathematical technique used in reconstruction from projections to
create images from a set of multiple projection profiles.

Field cycle MR imaging - FC MRI

PREPOLARIZED MR IMAGING

Field echo
FEDIF with TE set for water and fat signals in opposition
FESUM with TE set for water and fat signals in phase

Field echo - FE
GRE PS with an echo time set so that water and fat spin are opposed
when the echo occurs. OPPOSED-PHASE IMAGE
GE pulse sequence

Field echo with even echo re-phasing / field even-echo by reversal

- FEER
GRE PS used to demonstrate flowing blood » FIR, IR

Field echo with TE set for water and fat signals in opposition »
FEDIF

Field echo with TE set for water and fat signals in phase » FESUM

Field cycling relaxometry » Relaxometry

Field gradient - Gradient magnetic field

Field of view » FOV

Measurement parameter. The area that an imaging modality is set to
visualized. The smaller the field of view, the higher the resolution, since
the voxels are smaller for the same matrix size. » Technical factor

Field lock
A feedback control used to maintain the static magnetic
field at a constant strength, usually by monitoring the resonance
frequency or a line in the spectrum of a reference sample.

Field strength
The field strength is expressed in units of Tesla; (T:SI unit) or Gauss
(G:T=10,000G). Tesla is approximately 20.000 times stronger than the
earth’s magnetic field.

Field Strength and Frequency (MHz)

Field Strength Frequency (MHz)

71
 1 31
Tesla H P
0.1 4.3 1.7
0.3 12.8 5.1
0.5 21.3 8.6
1.0 42.6 17.2
1.5 63.9 25.9
2.0 85.2 34.5
3.0 127.8 51.8
4.7 200 81

Figure-8 Coil - A magnetic field gradient coil shaped like the number
eight.

Filling factor
A measure of the geometrical relationship of the RF coil and the body. It
affects the efficiency of irradiating the body and detecting NMR
signals, thereby affecting the signal-to-noise ratio and, ultimately, image
quality. Achieving a high filling factor requires fitting the coil closely to
the body, thus potentially decreasing patient comfort.

Filtered back projection

Mathematical technique used in reconstruction from projections to
create images from a set of multiple projection profiles

Fine needle aspiration - FNA

Method of tissue sampling by cellular aspiration through fine needle,
often positioned under CT and MRI. » FNAC, FNAB

Fine-needle aspiration biopsy / cytology - FNAC/B

MR guided procedures for biopsies and cytology.

Five gauss exclusion zone

An important limitation barrier for persons with electrically or
magnetically activated implants. Such as pacemakers, hearing aids,
and neuro-stimulators.

Five-gauss safety line

The 5-Gauss line defines the area at which the magnetic field becomes
dangerous to patients with cardiac pacemakers. 1.5T systems the 5-
Gauss line is located at the foot of each scan table as well as at the
same distance from the back of the magnet.

Fleming’s right-hand rule

Curl the fingers in direction of the electron flow and the thumb will point
in the direction of its magnetic north pole.

72
Flip angle - FA
Meas para. ▪The tilt of magnetization from the longitudinal direction at
the end of an RF pulse. Two flip angles frequently used are 90o and
180o. ▪The angle through which the bulk magnetization vector (M) has
been torqued or mutated by the resonant B1-RF pulse. ▪The flip angle is
determined by measuring the amplitude and duration of the excitation
pulse. A 90o FA is used in SE and FSE PS.

Flow - Blood volume per time: cm3/s.

Flow artefact - FA
Image qualityMotion artifact generated by local signal changes during a
measurement. For example, the inflow intensity of a vessel
perpendicular to the image plane changes periodically due to pulsatile
blood flow. In transverse body imaging, ghosting appears in the aorta.
Non-periodic inflow enhancement due to turbulent blood flow in the
heart results in smearing of the image. » CCF, GA, SMA, FE, IVIM

Flow compensation
The strategic application of reversal gradient pulses to compensate the
objectionable spin phase effects of flow motion. » GMRTechnique used to
minimize flow artefact in magnetic resonance imaging.

Flow dephasing
Measurement technique. Exclusion of the signal from flowing
substances such as blood, through the application of specifically
applied gradient fields. » Dephasing

Flow effect - FE
Image quality. Flow effects play two conflicting roles in MR imaging: a)
Source of undesired image artifacts (flow artifacts). b) In angiography,
displays blood vessels and provide quantitative information on the
velocity of blood flow. » Bright blood effect, Inflow amplification, Jet effect,
Signal elimination, Washout effect

Flow encoding
The use of phase encoding or spin tagging techniques to obtain
information on the direction and velocity of flowing material.

Flow imaging » PS

Flow quantification
Application. Quantitative flow measurements using phase contrast to
examine pathologies in large vessels or part of an extensive MR
cardiovascular examination. Flow measurements enable non-invasive
evaluation of blood flow.
73
Flow rephasing » Rephasing

Flow-related enhancement
The process by which enhanced signal intensity of flows is a result of
the unsaturated spin entering a saturated slice.
Increase in MR signal intensity of flowing blood or CSF relative to
stationary tissue owing to the replacement of saturated spins by fully
magnetized unsaturated spins. » Field-reversal echo

Flow sensitive alternating inversion recovery - FAIR

MR pulse sequence in which two-inversion recovery images are
acquired, one with a non-selective and the other with a slice selective
inversion pulse.

Flow sensitivity
PC angio. The flow sensitivity of a contrast sequence refers to the flow
velocity at which the phase difference between flow compensating and
flow encoding scans is 180o. » Venc: Velocity encoding

Fluid attenuated inversion recovery - FLAIR

It is another variation in the IR PS which uses a TI value around 2000
ms. usually; this sequence is used to suppress the signal from CSF
containing areas. FLAIR image (CSF appears more dark since it is
heavily T1WI). FFLAIR - Picker brand name for a RARE PS based on
IR-PS » PS

Fluorethyl tyrosine - FET

(O- (2-[F-18] fluorethyl) - L- tyrosine) - radioactive tagged amino acid for
PET scan

Flux
A flow of energy, i.e., magnetic field flowing from its north to south pole.

Flux, magnetic - Pattern of the magnetic lines of forces.

Focused nuclear resonance - FONAR

Early form of magnetic resonance imaging

Force
The ability to create work or create change (often measured in
horsepower) (A push or pull that one object exert on another)

74
Fourier acquired steady state technique - FAST
Fast gradient-recalled acquisition in the steady state technique.
T2*weighted rapid gradient echo technique with re-winder gradient
topromote steady state. » FADE Picker brand name for a GE-PS

Fourier space
Measurement. The raw data matrix axes are called kx and ky. They
divide the matrix into four squares. The plane spanned by the two axes
is called Fourier space or k space.

Fourier transform / Fallot’s tetralogy - FT

Imaging. Mathematical procedure for reconstructing images from raw
data. » FFT, 2DFT

Fourier transforms imaging

MRI technique in which at least one dimension is phase encoded by
applying variable gradient pulses along that dimension before 'reading
out' the NMR signal with a gradient magnetic field perpendicular to the
variable gradient. The FT is then used to reconstruct an image from the
set of encoded NMR signals. The spin warp-imaging version is the most
practical for this technique.

Frame of reference
There are two conventional frames of reference used in MRI for viewing
a spinning process: static and rotational.

Fractional Nex and Fractional Echo Image

An imaging technique that takes advantage of the symmetry in k-space
to reconstruct an image using only a fraction of k-space data.

Free induction decay / decay signal - FID

•Exponentially decaying electrical signal picked up by surface coils
following application of an electromagnetic pulse at resonant frequency
in MRI.
•A form of MR signal from the decay of transverse magnetization.
•The measurable MR signal that occurs as the transverse magnetism
(produced by the application of the 90o RF pulse) decays) toward zero.

Frequency - f/ƒ Hz,

Repetition rate of a regular event.
The number of repetitions of a periodic process per unit time,
measuring in Hertz, abbreviated Hz. For MRI in the EM spectrum, time
is measured in hertz or cycles per second.
» Technical factor, f, Fr.,n

Field Strength Frequency (MHz)

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 1 31
Tesla H P
0.1 4.3 1.7
0.3 12.8 5.1
0.5 21.3 8.6
1.0 42.6 17.2
1.5 63.9 25.9
2.0 85.2 34.5
3.0 127.8 51.8
4.7 200 81
(Greek: nu, sometimes also: f) - the number of repetitions of a periodic
process per unit time, measured in Hertz, abbreviated Hz. It is related to
angular frequency, omega, by nu = omega/2pi.

Frequency encoding
During data acquisition, a magnetic field gradient is applied in one
spatial direction, providing nuclear spins with linearity increasing
precessional frequencies. The readout MR signal is a mix of all these
frequencies. These various frequency must be filtered individually. In
the row direction, the location of the nuclear spin can be reconstructed
from the frequency. This axis is called the frequency-encoding axis. The
perpendicular axis is called the phase-encoding direction.

Frequency
The number of vibrations made each second by a wave of sound, light,
etc. •Repetition rate of a regular event. » Hz, f » Technical factor

Frequency encode » FR

Frequency encoding gradient (Gf)

A magnetic field gradient applied in an imaging sequence during the
acquisition of a signal which encodes spins with different frequencies
dependent on their position in the direction of this gradient.

Frequency tuning
Meas tech. Setting the RF system frequency to the resonant frequency
of tissue in the main magnetic field (Larmor frequency).

Fresh blood imaging - FBI

Protocol for cardiac imaging (MRA) » EPI SuperFASE

Fringe field
The intensity of a factor or source of energy characteristically indicated
by a series of isobar intensity curves.

Fringe magnetism

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The magnetic field strength measured on the outer borders of the
magnet

F short / F SHORT
Short repetition technique / steady-state gradient echo based on free
induction decay. Refocused GE PS (Elscient)

Fully relaxed ISIS FLAX-ISIS

Fully coupled spectroscopy FUCOUP

It is a dynamic MR imaging Technique that acquires images of the brain
during stimulus and also at rest. Then the two sets of images are
subtracted to demonstrate functional brain activity. This technique is
called BOLD. At the activated areas of brain, there will be increased
signal intensity. » fB MRI, fMRI

Functional brain MR spectroscopy - fB MRS

MRI is basically a spatial distribution map of signal intensity found in a
heterogeneous tissue sample. » Diffusion and Perfusion.

Functional brain MRI - fB MRI, fMRI

Latest technique for measuring electrical activity in the brain with
anatomical and functional images, the area of the brain called the
amygdala becomes increasingly hyper active when patients look at
threatening, angry, fearful, or disgusted faces.

Functional imaging – FI
General term used to describe the imaging of function as opposed to
morphology. / Broadly defined as the assessment of anatomy-specific
function. » BOLD imaging, fMRI

►G◄
Gadolinium - Gd
Gadolinium is a paramagnetic contrast enhancement agent generally
invasively applied in MRI. DTPA, Gadolinium-DTPA-BMA, Gadolinium-
DOTA, Gadolinium-DO3A, Gadolinium-BOPTA, and similar >
Paramagnetic; see also List of Contrast Agents in FAQ
Element used in chelate form as an intravenous contrast medium for
MRI owing to its paramagnetic properties.

Gadolinium-Diethylenetriamine pentacetic acid - Gd-DTPA

Gd binding reduces T1 and T2 of the tissue, depending on the
concentration. The effect is increased T1W and suppressed T2W. In
clinical routines, the T1 effect is relevant.
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Gamma ray ( )
An electromagnetic wavelength of energy emanating from an unstable
nucleus that has the power to penetrate lead.

Gastrointestinal contrast medium - GICM + MRCM

Enhanced signal from the gastrointestinal tract may be achieved with a
dilute solution of paramagnetic gadolinium containing contrast media or
intraluminal signal may be removed with orally ingested T2-shortening
contrast media such as SPIO.

Gated - G - Phase encoding gradient

Gated magnetic resonance imaging - Gated MRI

Magnetic resonance imaging with radio frequency synchronized with
the heartbeat or respiration to avoid motion artefact.

Gating
Cardiac Triggering, Respiratory Gating, Respiratory Triggering,
Peripheral Gating (Pegating), Breath Holding and Abdominal
Compression

Gauss - G
Physics. Old unit of magnetic field strength. Today the (SI) unit tesla is
used (1 tesla = 10.000G = 10 kG. 1 gauss = 10-4 tesla). The Earth’s
magnetic field is approximately one half gauss to one gauss, depending
on location.

Gaussometer
An instrument to measure gauss magnetic flux fields of force.

Gd-Benzyloxy propiomic tetraacetic acid Gd-BOPTA

Multihance (Gadobenate dimeglumine) is used both in CNS and body;
excrete by the kidneys and to a small extent by the liver. The latter
feature markedly improves the performance of this agent in the liver.
Delayed scans are particularly useful for the detection of small liver
mets. » Feridex

Ghosting artifact
An image artifact primarily associated with phase encoding direction
due to periodic movement like breathing. This quasi-periodic
misencoding results in a displaced false image of the body region.

Gibbs artifact / Truncation artifact

Gibbs or Truncation artifacts are bright and dark lines that are seen
parallel and adjacent to boarders of abrupt intensity changes, as may
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be seen at CSF, spinal cord, fat and muscle. These artifacts are
commonly seen in phase encoding direction.

Gigahertz – GHz - Unit of frequency = 100 Hz (cycles per second).

Global bolus plot – GBP - Global time-density curve

Global shim
Quality assurance. Some techniques such as fat saturation, EPI, or
spectroscopy require high magnetic field homogeneity. In this case,
shim coils can be used to optimize homogeneity.

Global time density curve

Perfusion imaging. Diagram for evaluating a successful bolus transport.

Golay coil
Term used for a particular kind of gradient coil, commonly used to
create gradient magnetic fields, perpendicular to the main magnetic
field. Bo

Gradient
Physics. A gradient defines the strength and direction of the change of
a quantity in space. A magnetic field gradient is the linear change in the
magnetic field in a specific direction. The magnetic gradient fields are
generated using gradient coils. They determine, for example, the spatial
resolution in the image. Parameters: rise time, duty cycle, gradient
linearity, gradient strength, slew rate.

Gradients (Gx, Gy, Gz)

Three orthogonal external magnetic fields designed to torque B o into a
predesignated gradient slope for spatial excitation.

Gradient accelerated spectroscopy GRASP

GRadient Acquisition in a Steady State - GRASS

GE brand name for GE-PS

Gradient amplifier channel

One of three channels that function to amplify gradient power.

Gradient and spin echo - GRASE pulse sequence

The GRASE seq is a cross between the RARE PS and an EPI seq.
GRASE PS RARE PS EPI Sequence
TSE
FSE
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 HASTE

Gradient coils
Components. Current-carrying coils designed to produce a desired
gradient magnetic field (so that the magnetic field will be stronger in
some locations than others). Proper design of the size and
configurations of the coils is necessary to produce a controlled and
uniform gradient.

Gradient echo - GE
Magnetic field gradient / Measured in milli-Tesla (mT) per meter
Echo created by switching a pair of dephasing and rephrasing
gradients, without a rephrasing 180o pulse as with spin echo technique.
 Echo produced in MR by reversing the direction of the frequency
encoding magnetic field gradient to cancel out phase shifts. » GRE
 Gradient echo pulsing creates a gradient echo image. It refocuses
spins by reversing the last gradient pulse.
 An echo signal generated from an FID by means of a bipolar switched
magnetic gradient. Does not refocus the effects of main field
inhomogeneity and therefore is generally used with a short echo time.
 A gradient magnetic field which changes in strength in a certain given
direction. Such fields are used in MRI with selective excitation to select
a region fimaging and also to encode the location of NMR signals
received from the object being imaged.
 A form of MR signals from the refocusing of transverse magnetization
caused by an application of a specific magnetic field gradient.

Gradient echo EPI - GRE EPI

Gradient magnetic field » GMF, Gradient field, GF

Gradient moment / motion nulling - GMN

A specialized gradient sequence to rapidly null or cancel out dephasing
spins to rephase them, thus a flow / phase compensator.
Pulse sequence employed to compensate for flow or motion artefact in
MRI by using gradient magnetic fields to correct for phase errors
introduced by motion in a specified direction.

Gradient motion rephrasing - GMR

Pulse sequence employed to compensate for flow artefacts in MRI.

Gradient motion » Flow compensation (GMR)

Gradient pulse - GP
Component of a measurement pulse sequence in MR which quickly
activate one or several of the three magnetic gradient fields.
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GRECO » Gradient-recalled echo

Gradient (recalled / refocused) acquisition in the steady state

GRASS (Gradient recalled echo in the steady state)
T2*weighted rapid GE technique with rewinder gradient to promote
steady state. » FAST >GE brand name for GE-PS, » Refocused FLASH

Gradient rephasing - GR
Brief magnetic gradient rephasing that occurs after the selective
excitation pulse. The result is the rephasing of the out-of-phase spins
along the direction of the selection gradients, thus forming a gradient
echo. This process is employed to improve the sensitive of the imaging
and follows the selective excitation.

Gradient reversal pulse - GRP

Use of gradient reversal pulses to reduce the effects of signal loss.

Gradient strength
Amplitude of the gradient field; measurement unit mT/m (millitesla per
meter).

Graduated fields - Magnetic fields that are produced by gradient coils.

GRASS » refocused FLASH

Gradient echo imaging - GE imaging

All MR imaging, which is done using a gradient echo pulse sequence.

Gradient echo pulse sequence » GE / GRE PS

One of the most frequent used Pulse Sequence in current day MR
imaging, often abbreviated GRE sequence.

Generic and brand names of various GE pulse sequence:

Sequence spoiled refocused CE GRE
GRE Magnetiza
tion
Manufactur T1- GRE T2- prepared
er weighted T1/T2*-w weighted GRE
Generic spoiled FLASH CE- snapshot
FLASH FLASH FLASH
DESS
Elscient SHORT F-SHORT E-SHORT V-SHORT
TurboSH
ORT

81
GE SPGR GRASS SSFP IR FGR
FSPGR FGR, DE FGR
FMPGR
HITACHI GE / FGE GFEC - RS
PHILIPS T1-FFE FFE T2-FFE Turbo (T)
FE
PICKER T1-FAST FAST-II CE-FAST RAM-
FAST
RF-FAST - FADE
SHIMADZ STAGE:T1- SSFP STERF SMASH
U w
SIEMENS FLASH FISP PSIF Turbo-
FLASH
ROAST MP-RAGE
True FISP
TOSHIBA FE/PF1 - - -

Gradient field - GF
Magnetic fields used to localize RF signal in MR Imaging and MR
Spectroscopy.

Gradient field echo (GRE) - GFE

Hitachi brand name for a GE PS

Gradient field echo compensation/with contrast » GFEC

Hitachi brand name for a GE-PS

Gradient magnetic field » GMF, GF > Gradient field

Gradient pulse - Briefly applied gradient magnetic field. » GRE

Gradient recalled echo sequence » GRE

Gradient recalled echo in the steady state - GRASS > GE-PS

Gradient rephasing » GR

Gradient reversal
Used in place of an 180o refocusing pulse to cause phase shift and
refocusing of the nuclei to produce an echo. The polarity of the gradient
is reversed but the strength of the gradient is the same as before the
reversal.

Gradient reversal pulse » GRP

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Gradient and spin echo » GRASE - GRASE pulse sequence

Gradient and spin echo pulse sequence - GRASE PS

Gradient (recalled / refocused) acquisition in the steady state »

GRASS, FAST

Gradient (refocused / recalled) echo pulse sequence » GRE, GE PS

GE PS, one of the favourite rapid imaging sequences of a refocusing
echo.
These sequences use variable FA and lesser TR. The gradients are
used to rephase the protons. We can apply the gradients quickly to
rephase the protons (unlike 180o rephasing pulses in SE which takes
some time to apply)
Because of the quicker application of gradients and reduced TR and
smaller FA, the scan times are greatly reduced in GRE PS. With this
sequence, we can get T1W, PD W and T2* WI.
Fig. 5.9 Image obtained with GRE PS where blood vessels appeared
bright.
Fig. 5.10 Schematic illustration of GRE PS
Since the gradient does not compensate for magnetic field
inhomogeneities, we will get T2* weighting.
Uses
Can be used to produce T1, PD and T2* weighting
Vary minimal scan times
Can used for single slice breath hold acquisitions and dynamic CE
Since these seq are flow sensitive, can be used for MRA / MRM
Less RF deposition into body, i.e. less Specific Absorption Rate
Disadvantages
Less signal-to-noise ratio when compared to SE PS
True T2 W is not possible (T2* contrast rather than true T2)
More work for the gradients
More noise to the patient

Gradient echo (GRE) » GREC

Gradient field echo with contrast » GREC, GRE

Gradient-recalled echo » GRECO, GRECHO, GRE

Gradient echo-echo planar imaging » GRE-EPI

Gradient reversal pulse » GRP

Gradient spectroscopy » GS

Gradient swap
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Meas para. Exchange of phase-encoding and readout directions in the
image. Flow and motion artifacts are rotated 90o prevents artifacts from
covering structures.

Gray meter
Nervous tissue of the brain, grayish in color due to its lack or reduction
of myelinated neuronal fibers.

Grid tagging » Tagging

Gyromagnetic ratio
A constant for a particular nucleus that relates its precessional
frequency to a field strength of 1.0 tesla. For hydrogen, it is 42.58
mHz/T.

Gyromagnetic ratio () of various nuclei

Nucleus Gyromagnetic ratio MHz/T
H1 42.58
C13 10.71
P31 17.12

Gyromagnetic ratio » 
▪Ratio of magnetic moment to associated angular moment of the
nucleus.
▪The ratio of the resonance frequency to the magnetic field strength for
a given nucleus. ▪The ratio of the magnetic moment to the angular
momentum of a particle. This is a constant for a given nucleus.

Gx, Gy, Gz
Conventional symbols for gradient magnetic field. x, y, z denote spatial
direction component of gradient, i.e. direction along which the field
changes.

►H◄
h - Planck's constant

H - Hydrogen > deuterium

Atom with a single proton, which carries a spin of ½ forming the basis of
MR imaging and proton MRS.

H - Magnetic field
The region surrounding a magnet (or current carrying conductor) is
endowed with certain properties.

84
Ho - Magnetic field
Obsolete symbol for contrast applied magnetic field in magnetic
resonance. » Bo, B, H

H1
Obsolete symbol historically used for the induced field in magnetic
resonance imaging/NMR system; it is physically more correct to use B 1
Conventional symbol historically used for the radiofrequency magnetic
field in an NMR system; it is physically more correct to use B1. > B1.

H0
Conventional symbol historically used for the constant magnetic field in
an NMR system; it is physically more correct to use B0. A magnet
provides field strength, H; however, at a point in an object, the spins
experience the magnetic induction, B.

Hahn, erwin Lewis

Founded the spin echo pulse sequence in 1949.

Hahn echo
An echo of the T2* FID created by a 90o RF torquing pulse followed by
an RF 180o refocusing pulse.

Half-Fourier matrix
Meas tech. The raw data matrix has a specific symmetry, which
theoretically makes sampling of only half the matrix sufficient. The other
half can be symmetrically reconstructed; mathematically, the matrices
are conjugated complexes.

Half-Fourier (acquisition) single shot turbo-spin echo - HASTE

Meas tech. Half acquisition single shot TurboSE technique and is used
for sequential acquisition of high-resolution T2WI. Siemens brand name
for RARE type pulse sequence.

Half FT imaging - HFI

A technique characterized by sampling the latter part of an echo for the
purpose of reducing the echo / sampling time.

Hanning filter - Type of raw data filter

Hardware
A generic term for the electrical and mechanical components of a
computer.

Hazards

85
Claustrophobia despite the fact that the patient lies in a confined space
is rarely a serious problem. MRI has not been probe to have any
adverse effects on foetuses. However, some teams avoid using during
the firs trimester of pregnancy. Till date, no harmful effects have been
obserbed from magnetic influences.

Headphones / Earplugs
All patients are required to wear ear protection. Earplugs &
Headphones, which hook into the stereo system so the patient may
enjoy music. The headphones are also part of the noise cancellation
system that helps drown out the knocking noise of the gradients.

Head first - The patient is positioned head first in the magnet bore.

Helium - Element with atomic mass number 2 » He

Helix - A looped coil of conductive wire.

Helmholtz coil
A pair of current-carrying coils specially designed to produce a uniform
magnetic field to the tissue sample located between them.

Hemodynamics - Moving fluids - the basis of the MRA

Hepatobiliary agents
Gd-Benzyloxy propiomic tetraacetic acid (Gd-BOPTA) Multihance
(Gadobenate dimeglumine) is used both in CNS and body. Multihance
is excreted principally by the kidneys and to a small extent by the liver.
The latter feature markedly improves the performance of this agent in
the liver. Multihance binds to protein improving its relativity regardless
of location in the body. Delayed scans are particularly useful for the
detection of small liver metastases. » Feridex

Hertz (Hz)
A measure of one complete frequency (360o), which passes a given
reference in one second. The standard (SI) unit of frequency; equal to
the old unit cycles per second 1 Hz = 1 s-1). » f, kHz, MHz, n

Heteronuclear correlation spectroscopy » HETCOR

Heteronuclear overhauster effect spectroscopy » HOESY

High and low MR signals » Tissue characteristic

High field MR imaging » HF MRI

MRI taking place at high field strengths in the range of 3-4 T
86
It has been shown that while imaging of the brain or knee at such high
fields can result in good images, the disadvantages of imaging the body
at these field strengths outweigh the advantages.
All MRI using Bo field below 0.1 T is ultralow-field
0.1 to 0.5 T is low field
0.5 to 1.0 T is medium field
1.0 to 2.0 T is high field
2.0 T > is ultrahigh

High resolution MRS - HR MRS

MRS of samples or systems which give rise to narrow spectral lines.
Pulse sequence which uses combination of a classical pulse sequence
such as a SE-PS or GE-PS and multilane data acquisition scheme. Use
of noble gases such as helium and xenon offers a dramatic new view of
body organs. » H3 MRI, HPG MRI

Homogeneity
Uniformity. A magnetic field is considered homogeneous when it has
the same field strength across the entire field. With MR, the
homogeneity of the static magnetic field is an important criterion for
magnet quality. Homogeneity is important for spectral fat saturation, a
large measurement field, EPI and MR spectroscopy.

Homogeneous
Similar in composition; in MR the homogeneous magnetic field is a field
that has very small-calculated variations in the magnetic field.

Homonuclear Hartmann-hahn spectroscopy » HOHAHA

Hybrid pulse sequence - HPS

PS that uses combination of a classical pulse sequence such as a SE-
PS or GE-PS and multilane data acquisition scheme.

Hybrid spectroscopy
Application. Combination of single volume spectroscopy (SVS) and CSI.
The CSI measurement is performed over a selectively excited volume
of interest. Through volume selection, area with strong distorting signals
(e.g., fat) are not stimulated and therefore do not contribute signal to the
spectra.

Hydrated
Characterized by possessing relatively large amounts of water.

87
Hydrogen
Colourless, odourless, highly flammable gas, the chemical element of
atomic number (H). H > deuterium

Hydrogen Atom
Hydrogen atoms are abundantly present in the body. The hydrogen
nucleus used in MRI, which contains a single proton. » Basic principle

Hydrogen density
The composition of a structure based on hydrogen content.

Hyperacute clots and oxyhaemoglobin - Appearance of blood

Hyperintense
Optimum signal intensity generally characterized by a bright T1 image.
Opposite of hypointense

Hyperbolic secant pulse

A selective inversion pulse which is insensitive to intensity variations in
the RF field.

Hyperpolarized xenon chemical exchange saturation transfer MRI

A ground breaking method for MRI allows detection of signals from
molecules present at 10,000 times lower concentration than traditional
MRI techniques. » Hyper CEST MRI

Hyperpolarized helium-3 MRI - H3 MRI

Use of noble gases such as helium and xenon offers a dramatic new
view of body organs.

Hyperpolarized Noble Gas Imaging

Magnetic resonance imaging of noble gasses whose spin distribution is
hyperpolarized.

Hyperpolarized xenon chemical exchange saturation » HYPER-

CEST

History of contrast media

Nearly all MR contrast agents constitute paramagnetic compounds. The
most commonly used paramagnetic ion is the gadolinium (Gd) ion. This
ion attaches with various ligands (Chemical compounds) such as
diethylenetriamine penta acetic acid (DTPA) that act as chelating
agents. The reaction of Gd ions with DTPA forms a stable chelate
complex. The presence of unpaired electrons in the paramagnetic ion is
a mandatory component to affect changes in the T1 and T2 relaxation
times of protons. The utilizing of a paramagnetic ion with highest spin
88
quantum number is desirable. The Gd ion of the lanthanide metal group
has a high spin quantum number (7/2), making this ion a desirable
contrast agent.
The first and foremost MRI contrast agent on the world market was
Schering Magnevist, the dimeglumine salt of gadolinium-
diethylenetriamine pentra acetic acid (Gd-DTPA).
US Food and Drug Administration (FDA) approve presently three
gadolinium based contrast agents. These are nonionic Gd-DTPA-BMA
(Gadodiamide or omniscan), ionic Gd-DTPA (gadopenetetate
dimeglumine or magnevist) and nonionic Gd-HP-DO3A (gadoteridol or
prohance). The osmolarity and viscosity of each of these three contrast
agents are given below:

The osmolarity & viscosity of commonly used MR CM

Trade name OsmolarityOsm/kg Viscosity (cp)
Gadodiamide 783 1.4
Gadopenetetate 1960 2.9
dimeglumine
Gadoteridol 630 1.3

►I◄
I - Number spin quantum number

I - Spin / Nuclear spin quantum number

Ideal contrast
The ideal contrast agent should have the following properties:
1) The contrast agent must be efficient at low concentrations
2) The contrast agent should possesses tissue specificity to enable
higher concentration in specific tissue
3) The contrast agent must be substantially chased from the targeted
tissue
4) It must have low viscosity
5) The contrast agent must possesses a suitable shelf life for storage
purposes
6) It should be non-toxic
There is no ideal contrast to date. However there are many MR contrast
agents that are safe, highly effective and widely used in routine clinical
practice.

Identity
Prior to any examination being performed, the Technologist must check
the identity of the patient.

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Image acquisition matrix
Maximum image matrix, e.g. 256-256 pixels.

Image acquisition time

The image or scan time for 2DFT is equal to the product of TR, number
of signal average or excitations (NEX), and phase encoding steps. »
Examination Time, TA, Technical factor

Image archiving and communications system » IMACS

Image artifacts » artifacts in MRI

Image contrast
Image quality. Difference in signal strength between two tissue. It
depends primarily on the existing tissue parameters (T1, T2, PD) and
flow for MRA. Contrast can be affected by the sequence used (SE, IR,
GE, TurboSE), the measurement parameters (TR, TE, flip angle), and
the use of contrast agent.

Image data acquisition time » Examination time » Technical factor, TA

Image data filter

Recon parameter. Filter of various strengths (strong, medium, soft) can
subsequently be applied to MR images to reduce noise. High pass and
low pass filters are used with different shapes to the characteristic
curves. Other filter types include, for example, smoothing filters.

Image guided spectroscopy » Localized spectroscopy

Image manipulation
MR images can be manipulated for evaluation in various ways. The
gray scale of the images (either in its entirely or in sections) can be
modified as desired (addition, subtraction, averaging, rotation, flip,
offset, inversion).

Image matrix
Image display. The MR image comprises a multitude of individual image
elements (pixels). Pixels are allocated to a matrix in a checkered
pattern. Every pixel in the image matrix displays a specific gray scale.
Viewed as a whole, this gray scale matrix provides the image. Do not
confused with measurement matrix. (Grid of columns and rows, usually
256·256, with a total number of 64,536 pixels).

Image noise
Noise. Noise in the image is a statistical fluctuation in signal intensity
that adds nothing to the image information. It appears in the image as a
90
granular, irregular pattern. In principle, the effect is unavoidable and it is
physically based.

Image orientation » Slice orientation

Image processor
Component. Part of the computer system that reconstructs images from
the measured MR signals (the raw data) using a Fourier transforms.

Image quality
The diagnostic quality of an MR image can be defined by artifacts,
contrast, noise (signal-to-noise ratio) and spatial resolution.

Image reconstruction
The mathematical process of converting the composite signals obtained
during the data acquisition phase into an image.

Image reconstruction time

The time required to assimilating all the data acquisition until the image
is visualized.

Image resolution
Quality. Is the ability to differentiate neighboring tissue structures. The
higher the image resolution, the better small pathologies may be
diagnosed. Resolution increases with a larger matrix, smaller FOV, and
smaller slice thickness. » Area resolution, Spatial resolution

Image selected in vivo spectroscopy - ISIS

▪Surface coil gradient method that uses frequency-selected inversion
pulses in the presence of magnetic field gradients to provide 3D
localization of an image volume. » OSIRIS
▪A localization scheme consisting of eight scans with different
combinations of three inversion pulses and receiver phase for each
scan. Summation in the correct manner causes all the signals outside of
the desired volume to cancel. Widely used for phosphorus
spectroscopy.

Image windowing » Windowing

Imager » Image processor

Imaginary
The complex number defining the y component of the vector that is 90o
out of phase with the reference vector.

Image review (Identifying image labels)

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 NIMS = Institution name Signa 1.5 T = Equipment name
= Patient name Se = Series number
= Gender, age and IP # Im = Image number
= Date OAX = Plane sequence
= Time ET = Echo train length
Mag = Magnification R/L = Side orientation mark
FL = Filter S/I = Top orientation mark
ROT = Rotation TR = Repetition time
W = Window width TE = Echo time
L = Window level 31.2 = Band width
v = Frequency encoding Head = Coil name
= Measurement in mm FOV = Field of view
Nex = Number of excitations = Thickness and spacing
FCf = Flow compensation = No. of slice and acquisition time
NP = No phase wrap = Frequency and FED
VB = Variable bandwidth

Imaginary - The component of a signal perpendicular to the real signal.

Imaging sequence (protocol)

Scanning parameters that are usually selected by the technologist,
which are based on the patient history, and should provide the most
useful information for diagnosis. (A specific set of RF pulses and
magnetic field gradients used to produce an image)

INADEQUATE - Incredible natural abundance double quantum

transfer exp

Incoherent (Spoiled) Gradient echo pulse sequences

These pulse sequences begin with a variable FA excitation pulse and
use frequency encoding gradient rephasing to give a gradient echo.
These sequences spoil (or) dephase the residual transverse
magnetization so that its effect on image contrast is minimal.
Uses
 Increased T1 weighting
 Spoils the transverse signal
 Only the longitudinal signal contributes to the next RF pulse
 Good SNR in volume acquisition
 Can be acquired in 2D (or) volume
 Breath holding is possible
Disadvantages
 Decreased SNR in 2D
 Loud gradient noise
Parameters
 To maintain the steady state
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  Flip angle: 30o-45o
 TR 20-50 ms
 To maximize T1
 TE 5-10 ms is used

Incredible natural abundance double quantum transfer exp

INADEQUATE

Indivisible
Unable to be divided by ordinary means (e.g., atoms are indivisible).

Induced field in MRI » H1 (obsolete) B1

Inductance
Measure of the magnetic coupling between two current carrying loops.
One of the principal determinants of the resonance frequency of an RF
circuit.

Induction
The act of causing or creating a specific action, i.e., magnetic induction,
as discovered by Michael Faraday in 1831.

Induction, electromagnetic
Physics. The electrical voltage in a receiver coil created by a temporal
change in the magnetic field.

Inertia
The property of a mass at rest tends to keep it at rest; and in motion
tends to keep it in motion.

Infarct - A tissue that is undergoing necrosis due to poor blood flow.

Inferior
The direction towards the feet in an anatomical coordinate system.

Inflow amplification
Quality. A blood volume slowly flowing perpendicular to the slice yields
a stronger signal than the surrounding tissue.

Inflow enhancement
A specialized MRA technique utilizing a GRE PS where the bolus is
excited, detected, and recorded in the same slice.

Inflow technique » TOF MRA

Inhomogeneity
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Degree of lack of homogeneity or uniformity, for example the fractional
deviation of the local magnetic field from the average value of the field.

In-plane resolution
The resolving power perpendicular to the slice, i.e., the pixel
dimensions.

Insensitive nuclei enhanced by polarization » INEPT

Insulator - Any medium that prevents the flow electrons.

Integer
Any of the natural numbers, the negative of these numbers, or zero. (A
whole number (e.g. 1, 2, 3); 1.23 is a real number).

Integrals
An essential volume or position necessary for completeness, i.e., to the
values of the electron spins in a given element which fulfils the innate
balance of force.

Integrated panorama array - IPA

Components. The concept of the integrated panorama array
significantly accelerates setup time and increases patient throughput.
Depending on the system, up to 4, 8, or 16 independent array coil
systems can be connected simultaneously. Up to 4 CP coil elements
can be combined for a measurement.

Integrated Parallel Acquisition Techniques - iPAT

Siemens - Breast imaging protocol for highest temporal and spatial
resolution.

Intensity - The measurable amount of a property.

Intensities of normal anatomical structures » Tissue characteristics

Interactive real time

Meas tech. Change in the measurement parameter in real time using
the 3D mouse.

Interactive shim
Quality assurance. Manual tuning of the shim coils to improve magnetic
field homogeneity. Shim currents can be set and optimized individually
for a selected pulse sequence.

Inter echo time » IET

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Interface / interfacing
Integration of images from various imaging modalities, i.e., PET, MRI,
CT.

Interleaved slices » Slice sequence

Interleaving
A pulsing technique that sequentially staggers the collection of data (1-
3, 2-4, etc.) so there is no interslice gap.

Intermediately weighted image - IWI

Image whose contrast is mainly influenced by proton density, but which
also has T1, T2, and bulk flow contributions. Synonym of spin density,
although this only applies for hydrogen. The terms IWI and PD WI are
essentially interchangeable.

Inter scan delay » ISD

Interventional radiology » IR

International system of units » SI

Internuclear double resonance » INDORE

Interventional (Intraoperative, intraprocedural) MRI » iMRI

IMR uses MR imaging to guide instruments for diagnostic or therapeutic
interventions. » MRF

Interpolation
Meas tech. Calculation of values that lie between known values in a
mathematical function; e.g., enlarging the image matrix from 256 x 256
to 512 x 512. The measurement time is not increased, but interpolated
images do require more storage space.

Inter polation algorithm » IPA

Interpulse time
Times between successive RF pulses used in pulse sequences.
Particularly important are the inversion time (TI) in inversion recovery,
and the time t between a 90° pulse and the subsequent 180° pulse to
produce a spin echo, which will be approximately one-half the spin echo
time (TE). The time between repetitions of pulse sequences is the
repetition time.

Intra venous contrast medium » IV CM

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Intra venous contrast medium standard volume technique IVCM-
SVT

Intravenous MR arthrography
MR arthrography has made arthrography of the knee joints nearly
obsolete, In MRI, even intravenous gadolinium-containing contrast
media results in some enhancement of the joint fluid: called intravenous
MR arthrography.

Intravoxel incoherent motion

▪Visible in standard MR images and give rise to flow related dephasing.
▪Diffusion and perfusion both act to reduce the signal observed in-vivo;
the two effects are difficult to separate and the term intra voxel
incoherent motion is used to describe their combined effect.

Intravoxel phase dispersion

Coherence loss suffered by phases within the imaging voxel. The
consequent reduction in signal intensity can usually be minimized by
using smaller voxel and/or less FA.

Intravenous magnetic resonance arthrography - IV MRA

Intravenous gadolinium-containing contrast media results in some
enhancement of the joint fluid to MR image: called IV MR arthrography.

Intravascular MR contrast medium - IV MR CM

Contrast agent, which has a long intravascular half-life.

Intravascular MR imaging
Procedure in which a local coil is used inside a vessel for HR MRI.

Intra-voxel incoherent motion

Diffusion and perfusion both act to reduce the signal observed in-vivo;
the two effects are difficult to separate and the term intra voxel
incoherent motion is used to describe their combined effect.
Inversion - a nonequilibrium state in which the macroscopic
magnetization vector is reversed so that its orientation is opposite to the
magnetic field; usually produced by adiabatic fast passage or 180° RF
pulses.

Intra Voxel Incoherent Motion » IVIM

Intravascular MRI IV MRI

Procedure in which a local coil is used inside a vessel for HR MRI.

Intrinsic - Within or originating from inside.

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Inverse Fourier transform » IFT

INVERSE - H, X correlation via 1H detection

Inversion
The macroscopic magnetization oriented opposite or 180o to the Bo
field. Inversion is generally related to the IR technique and is generally
used to produce a heavily weighted T1 image.

Inversion time / time following inversion pulse - TI

▪Interval between a 180o pulse and 90o excitation pulse in an IR
sequence
▪Time interval between the excitation pulse and the peak of the echo
Time between inversion (180o pulse) and the subsequent 90o pulse,
which elicits an NMR, signal in IR pulse sequences. » IR-PS
▪Time after middle of inverting RF pulse to middle of 90o pulse used to
monitor the amount of longitudinal magnetization.
▪Torque - the effectiveness of a force in setting a body into rotation. It is
a vector quantity given by the vector product of the force and the
position vector where the force is applied; for a rotating body, the torque
is the product of the moment of inertia and the resulting angular
acceleration

Inversion recovery » IR
A specialized pulsing technique where the bulks MDMs are inverted 90o
below the transverse x-y plane. This process usually produces a T1WI
but can produce T2-like images and contrast reversal images. » PS/
RF PS in MRI which can be incorporated into magnetic resonance
imaging, wherein the nuclear magnetization is inverted at a time on the
order of T1 before the regular imaging pulse-gradient sequences. The
resulting partial relaxation of the spins in the different structures being
imaged can be used to produce an image that depends strongly on T1.

Inversion recovery echo-planar imaging (MRM) » IR EPI

Inversion recovery fast GRASS » IR FGR

Inversion recovery fast gradient-recalled acquisition in the steady state.
GE brand name for IR-PS, GE-PS

Inversion recovery FSE

Inversion recovery magnitude » IRM

Inversion recovery magnetization preparation » IR prep

Inversion recovery pulse sequence » IR PS

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These pulse sequences use 180o inverting RF pulse followed by 90o
excitation RF pulse after certain time [Inversion Time (IT) or Time from
Inversion (TI)]. Depending on the value, we can classify the IR
sequence into: a) STIR, b) FLAIR. If we apply 180o inverting RF pulse,
the NMV (net magnetic vector) will be inverted through 180o into full
saturation. When we remove the inverting pulse, the NMV begins to
relax back to Bo (static external magnetic field) Fig. 5.5 Recovery from
inversion
A 90o excitation pulse is then applied at a time from the 180o inverting
pulse known as the TI time (Time from Inversion). The contrast of the
image depends on the TI value. These sequences are used to generate
heavily T1 weighted images bringing large difference between fat and
water.
AdvantagesProduces heavily T1 WI, Very good SNR, Disadvantage,
Long scan time

Inversion spin echo pulse sequence ISE

Form of inversion recovery in which an 180º inverting pulse is followed
by a 90º measuring pulse.

Inversion time » TI

Inversion transfer - Saturation transfer.

Ion
An atom or molecule with a net electric charge through loss or gain of
electrons, either positive (a cat ion) or negative (an anion).

Ionization
Atoms or molecules that have gained or Ionizing radiation
Radiation that removes an electron from an atom, resulting in a free
electron which is then available to participate in some physical or
chemical process. x-rays are a form of ionizing radiation.

Isocenter
A location in an imaging magnet assigned the coordinates (x,y,z)=0,0,0
o.

Isotope
Two atoms are isotopes if they have the same number of protons and
electrons, but a different number of neutrons in their nuclei.
▪Each of two or more forms of the same element that contain equal
numbers of protons but different numbers of neutrons in their nuclei.

Isotropic motion - A motion is uniform in all its dimensional directions.

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 ►J◄ ►K◄
Jet effect
Quality. Spin dephasing for complex flow patterns like turbulence. The
degree of signal loss and size of low-signal regions depend on the flow
patterns and pulse sequence used. This effect must be taken into
account when evaluating the extent of vascular stenosis.

Joint motion device JMD

Positioning device used to performed MRI examination of joint using the
active movement against resistance technique.

k - Boltzmann’s constant: appears in > Boltzmann distribution

k - Boltzmann constant / kilo (103) / proportionality constant

K - Kelvin temperature

Kelvin - Unit of temperature where absolute zero is at 0 k or - 273oc

Kilogauss - One thousand gauss

Kilohertz (kHz) - Unit of frequency; equal to one thousand Hertz.

Kinematics MRI - kMRI

Positioning device used to performed kMRI examination of the
pattellofemoral joint using the active movement against resistance
technique. A resistive band used to apply a load during the
examination.

k-space» Fourier space

Where raw MR data is stored before reconstruction. (A spatial
frequency domain where the raw MR signals are collected in the
computer system before being processed for reconstruction).

Kinematics scans
Scan procedure where a given joint is moving in a flexed / extended
position during the scanning process.

kynematics magnetic resonance imaging » kMRI

►L◄
Lanthanide induced shift » LIS

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Larmor equation - ωo
= y Bo, where ωo is the Larmor frequency, Bo is the strength of the static
magnetic field, y is the gyromagnetic ratio of a given element.

Larmor’s Equation
States that the frequency of precession of the nuclear magnetic
moment is proportional to the magnetic field.
ω =γ * Bo
Precessional Hydrogen (42.6 Magnetic field strength
freq. MH2T)
ω (omega) The precessional frequency in MHz
γ (gamma) The gyromagnetic ratio of hydrogen at 1Tesla
is 42.58 MHz
Bo The magnetic field strength of magnet (in T)

Larmor frequency » fo
Physics. Frequency at which the nuclear spins precess about the main
field. Depends on the nucleus type and strength of the magnetic field
applied. » Precession

Larmor’s frequency at various field strengths

Field strength Frequency F. Strength Freq (MHz)

1 31
0.5T 22.28 MHz Tesla H P
1.0T 42.58 MHz 0.1T 4.3 1.7
1.5T 63.9 MHz 0.3T 12.8 5.1
0.5T 21.3 8.6
1.0T 42.6 17.2
2.0T 85.2 34.5
3.0T 127.8 51.8
4.7T 200 81

Lattice
Magnetic and thermal environment in which the nuclei exchange energy
during/in longitudinal relaxation.

Law - A reproducible and predictable event.

Linear - straight-line

Line imaging > Sequential line imaging.

Linear polarization / linear prediction - LP

Line scanning (MRM) - LS - Sequential line imaging.

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Line width
Width of line in spectrum; related to the reciprocal of the transverse
relaxation time (T2* in practical systems). Measured in units of
frequency, generally at the half-maximum points.

Lipid - Any of the fatty acid fractions normally located in the body.

Lipoma - A tumour of fatty tissue

Local coil
Components. Special coils are used for each area of the body to be
examined (surface coils). They have a high SNR and small
measurement field.

Localized MIP
Localized MIPs improve image quality and significantly reduce
reconstruction time. Only a partial data volume containing the vessels of
interest is used.

Localized magnetic resonance LMR

Technique for obtaining magnetic resonance spectra from region of
interest.

Localized spectroscopy
The acquisition of spectra from a region within a sample. The region is
usually defined using selective RF pulses and field gradients.

Localizer - Basic image

Local shim
QA. The shim is limited to a previously selected local volume.

Location encoding
Meas tech. Definition of the position and orientation of a slice using the
frequency and phase-encoding gradients. The location where the signal
originates is encrypted in the MR signal and reconstructed with the
image.

Lodestone - A piece of magnetic iron or containing natural magnetism.

Logical gradients
Meas tech. For orthogonal slices, each of the 3 physical gradients has
exactly one “logical” task: slice selection, frequency encoding, and
phase encoding. For oblique slices, the logical gradients are a mix of
the physical gradients.

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Longitudinal magnetization » Mz / Z (longitudinal) component of
magnetization
Component parallel to the axis of the main magnetic field usually
termed Mz. In standard cylindrical magnets Mz is thus parallel to the
bore of the magnet.
Portion of the macroscopic magnetization aligned along the Z-axis; that
is, along the outer magnetic field. After excitation by an RF pulse, M z
returns to equilibrium Mo with a characteristic time constant T1. Mz (t) =
Mo (1-exp(-t/T1))

Longitudinal relaxation
Return of longitudinal magnetization to its equilibrium value after
excitation; requires exchange of energy between the nuclear spins and
the lattice. » T1
T1 relaxation (longitudinal) in which some of the energy absorbed by
the nuclei during RF excitation is dissipated to the chemical
environment in which the nuclei are located. » T1

Long term averaging technique - LOTA technique

Data averaging for reducing motion artifacts.

Longitudinal plane (Z)

The axis of the magnet in which the patient lies, that is oriented with the
magnetic field.

Longitudinal relaxation time » T1 / T1 constant

Long scale - Large gray scale latitude.

Look-Up Table » LUT

A table (or function) used to relate intensity of a screen pixel to the data
value of that pixel in the image.

Lorentzian line
The conventional shape of the graphic lines comprising the MR
spectrum. Usual shape of the lines in an NMR spectrum, characterized
by a central peak with long tails; proportional to 1/[(1/T2) 2 + (n-n0)2],
where n is frequency and n0 is the frequency of the peak (i.e. central
resonance frequency).

Lorentzian Lineshape
A function obtained from the Fourier transform of an exponential signal.

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Loud noise during MR procedure
The continuous movement of the gradient coils during the examination
is very loud. Patient could use earplugs during MR examination to make
it tolerable.

Low contrast resolution

The ability of an imaging system to detect of low contrast. » CD-CURVE

Low field MRI LF MRI

All MR imaging using Bo field, Below 0.1 T is ultralow-field, 0.1 to 0.5 T
is low field, 0.5 to 1.0 T is medium field, 1.0 to 2.0 is high field, 2.0 T > is
ultrahigh

Low threshold visualization SR/VR - L threshold

Luminar - Related to blood flow patterns

►M◄
M - Magnetization vector, three spatial components Mx, My &

M - milli (10-3)

M - Mega, one million, 106.

M - Net macroscopic magnetization vector,

Usually shown as a positional vector arrow. (Magnetization vector,
which has the three spatial components Mx, My & Mz /
Conventional symbol for macroscopic magnetization vector).

Mxy - Transverse magnetization

Components of macroscopic magnetization vector at right angles to the
static magnetic field in MRI. Magnetic dipole moments in the transverse
x-y plane.

Mz - Longitudinal magnetization / Z (longitudinal) component of

magnetization
Component parallel to the axis of the main magnetic field usually
termed Mz. In standard cylindrical magnets Mz is thus parallel to the
bore of the magnet.

Mx - X component of magnetization

Mx,y - Transverse component of magnetization

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My’ - Y' component of magnetization

Mo - The magnetization vector, Bo / Equilibrium magnetization

Mo - The magnetization vector Mo

Equilibrium value of magnetization; directed along the direction of the
static magnetic field. Proportional to gyromagnetic ratio (g), spin density
(N) and static magnetic field (o)

Macromolecules
Very large molecules some of which may be seen under powerful
microscopes. A macromolecule can be several thousand times larger
than unbound water molecules.

Macroscopic magnetic moment - Macroscopic magnetization vector.

Macroscopic magnetization vector

Net magnetic moment per unit volume (a vector quantity) of a sample in
a given region, considered as the integrated effect of all the individual
microscopic nuclear magnetic moments. Most NMR experiments
actually deal with this.

Magic angle - MA
Angle of 55º to the magnetic field in a magnetic resonance imager.

Magic angle artifact - MAA

Seen mostly in tendons and ligaments of knee-joint that is oriented at a
magic angle, i.e. 55o to the main magnetic field. This artifact is seen
commonly in the rotator cuff and occasionally in the patellar tendon
region and elsewhere.

Magnet
▪A substance whose magnetic properties have been induced naturally
by the earth's magnetic field. ▪A material in which electrons spin in one
direction, creating a magnetic field. Similar ends of magnets will push
away (repel) each other; different ends will attract each other. Which is
available in three types - viz., the permanent magnets, electromagnets
and superconducting magnets.
Permanent magnets, Resistive systems, Superconductive magnets.

Magnetic cloud
The orbiting electrons create a magnetic shielding which modestly
impedes the proton MDMs as they exit from the nucleus. Extreme
cases will cause image misregistration called chemical shift.

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Magnetic dipole
North and south magnetic poles separated by a finite distance. An
electric current loop, including the effective current of a spinning
nucleon or nucleus, can create an equivalent dipole. (Magnetic domains
exist in pairs known as dipoles).

Magnetic dipole moment » MDM

Magnetic field
A region around a magnetic material where a magnetic force is present
or the constant applied magnetic field in magnetic resonance. » Ho, Bo,
B, H

Magnetic field, energy levels in

Each spin exists in a distinct energy state and has an identifiable spin
quantum number.

Magnetic field gradient » MFG

Magnetic field strength

The strength of the magnetic field force on magnetizable parts. In
physics, the effect is called magnetic induction. In MR, it is referred to
as magnetic field strength. Unit: tesla (T).

Magnetic gradients Gradients

Magnetic homogeneity » Homogeneity

Magnetic induction (B)

Also called 'magnetic flux density' (magnetic field strength). The net
magnetic effect from an externally applied magnetic field and the
resulting magnetization. B is proportional to H (B = mH), with the SI unit
being the Tesla (T).

Magnetic iron oxide particles » MIOP

Magnetic moment
The net strength and orientation of a magnetic field. » Basic principle

Magnetic lines of force

The magnetic lines of force forming a given magnetic domain or field of
force.

Magnetic resonance » MR + Basic principle

Imaging technique in which images are formed by absorption or
emission of electromagnetic energy by atomic nuclei in static magnetic
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field, after excitation by electromagnetic RF radiation at resonant
frequency. » NMR, ESR

Magnetic resonance active nuclei » Basic principle

Magnetic resonance angiography - MRA

An imaging technique for demonstrating vessels and blood flow using
specific MR sequences, which allows us to acquire the images with high
signal from flowing nuclei and low signal from stationary nuclei. This
technique will allow us to see the blood vessels more clearly than
surrounding.

Magnetic resonance arthrography / MR Arthrography

Technique in which diluted MR contrast media is injected into a joint
space to improve its delineation.
HIP/: This test is chosen to show parts of the hip that are not as clearly
seen on the usual MR exam of hip and not well seen on x-ray / CT.
The reasons that doctor may have requested this test include:
a) An unstable hip which may have resulted from a prior dislocation.
b) Suspected cartilage abnormalities.
c) Abnormalities of the socket part of the joint.
The test is done in two parts:
a) An injection procedure done using x-ray fluoroscopy, which allows
the selection of an injection site.
b) An MR exam of your hip
Prior to the test, you should tell the radiologist if you have any allergies.
For the injection procedure, you will be asked to undress, put on a gown
and lie on x-ray table.
A site for injection of a needle into your hip will be chosen using x-ray
fluoroscopy, a procedure which allows the radiologist to see your hip
and to choose the best site for the injection.
Your skin will then be cleaned, and a local anaesthetic injected.
a) You will feel a burning sensation when the anaesthetic is injected.
A needle will then be placed into your hip joint.
a) You may feel pressure during this part of the exam. If you feel pain,
you should tell the radiologist doing the procedure.
Once the needle has been successfully placed into your hip, the
radiologist will then inject some diluted MRCM which will distend your
joint. For shoulder you may asked to exercise.
After the injection, you will asked to move to MRI room.
During the MR portion of the exam, a large number of images of your
hip will be obtained, and these will be carefully studied by the
radiologist.
After the procedure, you should have no lasting effects, and you can
return to work or go home. You should avoid strenuous exercise activity
for about 24 hrs.
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a) There may be mild discomfort or soreness.
b) You may lake a mild pain reliever such as ibuproten.
Risk for the procedure:
a) Pain, bleeding, infection, joint stiffness.
b) Allergic reaction to injected materials.
c) Temporary numbness or weakness.

Magnetic resonance applications using oxygen as resonating

nucleus O2-17 MR

Magnetic resonance cardiology - MR cardiology

The advantage of cardiac MR include
 Free selection of image planes and FOVs
 Higher tissue contrast
 Temporal and spatial resolution
Image planes projections can be compared in angiocardiography,
scientigraphy, or 2-D echocardiography. Multiple cardiac slices can be
acquired along the respective slice plane, providing complete
anatomical display of the heart in all 3D. Data records acquired across
cardiac phases enables cine display of heartbeat.
Subsequent quantitative evaluation of cardiac studies enables the
following:
 Manual or semi-automatic segmentation of the inner and outer
cardiac walls of
the LV, and the inner wall of the right ventricle: ED ES images or the
complete cardiac cycle.
 Calculation of ventricular volume, myocardial mass, and functional
parameters.
 Evaluation of myocardial wall thickness: changes in wall thickness
(between the
ED and ES phase or during the cardiac cycle) are evaluated for each
sector.
 Viability, perfusion, coronary angiography.

Magnetic resonance cholengio-pancreatography » MRCP

3D imaging of the biliary system and pancreatic duct with MR imaging.
MRU and MR mylography are commonly performed rapidly without use
of contrast.

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Magnetic resonance contrast medium - MRCM
A chemical substance, which is introduced into an organism to change
the contrast between two tissues. Normally paramagnetic contrast
agents like Gadolinium-DTPA or other Gadolinium compounds are
used. In contrast to x-ray techniques, where contrast agent is directly
visible, in MR, contrast agent has an indirect effect; it reduces the
relaxation times for water in tissue.

Magnetic resonance diffusion DWI

Magnetic resonance digital subtraction angiography MR DSA

Magnetic resonance elastography MRE

An imaging technique for using MRI to effectively gauge the hardness
or elasticity of the liver, to detecting liver fibrosis. (Technique, which
images the share modulus of tissues).

Magnetic resonance fluoroscopy - MRf

MRf uses MR imaging to guide instruments for diagnostic or therapeutic
interventions. » iMR, tMR, MRGI

Magnetic Resonance guided intervention - MR GI

Uses MR imaging to guide instruments for diagnostic or therapeutic
interventions » iMR, MRf, tMRI

Magnetic Resonance image - MR image

The MR image comprises a multitude of individual image elements
called pixels. Pixels are allocated to a matrix in a checked pattern.
Every pixel in the image matrix displays a specific grey scale matrix
provides the image. The grey scale of a pixel mirrors the measured
signal intensity of the corresponding volume element (voxel). The signal
intensity of a voxel depends on the respective transverse
magnetization.

Magnetic resonance imager MRi

Imaging system used in MRI. » MRi, MR scanner

Magnetic resonance imaging - MRI, fMRI, NMR imaging

Images of objects (like the human body) from magnetic resonance
using magnetic gradient fields. In practical application, the distribution of
protons in the body is displayed. The clinically relevant objective of MR
imaging is the differentiation between pathological and healthy tissue.

Magnetic resonance imaging MRI (NMR Imaging)

An imaging technique based on the principles of NMR.
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▪Technique for producing images of bodily organs by measuring the
response of atomic nuclei to radio waves when placed in a strong
magnetic field.
▪The MRI machine creates a magnetic field, sends radio waves through
body, and then measures the response of atomic nuclei with a
computer. This creates an image of the inside of human body.
▪Scanner applies the magnetic field to a patient to align the nuclei within
the atoms of the patient’s body. RF pulses are applied; the nuclei
release some of the RF energy and the computer detects these
emissions and generates image of tissue.
▪The integration of the minute magnetic properties of the tissue atoms
with the static magnetic field (Bo), to be in a resonant state with an
applied external RF pulse, and will in turn produce MR signals that are
converted into an exquisite tissue image.

▪When a patient is placed in the strong magnetic field in the MRI

scanner, the hydrogen nucleus in the body, align with the applied
external magnetic field when exposed to short burst of electromagnetic
energy in the form of RF pulses. The hydrogen nuclei in the patient’s
body absorb its energy and then generate MR signal. This process of
absorbing energy is known as “magnetic resonance”. It forms the basics
of MR imaging.

▪Creation of images of the human body by use of the nuclear magnetic

resonance phenomenon usually by the application of magnetic field
gradients. The immediate practical application involves imaging the
distribution of hydrogen nuclei (proton) in the body. The image contrast
in a given region is usually dependent jointly on the spin density and the
relaxation times, with their relative importance determined by the
particular imaging technique employed.

▪The hydrogen protons present in the body act like tiny magnets. When
the body is exposed to magnetic field the hydrogen protons align and
precess. The precession frequency is proportional to the strength of the
magnetic field. External energy in the form of Radiofrequency is applied
to the precessing protons. There is disturbance in the magnetic
equilibrium of the protons. Discontinuation of RF pulse causes the
magnetic equilibrium of body to return to normal. While magnetic
equilibrium is returning to normal it emits energy which is recorded as
signal. It is the detected signal which forms the MR image.

Magnetic resonance imager MR imager/scanner

Magnetic Resonance Imaging scans MRI scans

Image or set of images obtained with a magnetic resonance imaging
scanner. » MRI scanner
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Magnetic Resonance Imaging scanner
Magnetic resonance imaging machine.

Magnetic resonance imaging scanner

MRI machine » MRi, MR scanner

Magnetic resonance mammography - Breast imaging using MRI

Magnetic resonance microscopy

The production of images of microscopic details using the magnetic
resonance phenomenon.

Magnetic resonance mylography » MR Mylo, MRU

Sequence to provide high contrast between the “dark” spinal cord and
its nerves and the surrounding “bright” CSF.

Magnetic Resonance perfusion MR perfusio

Perfusion describes blood delivery to tissue; usually flow on the
capillary level

Magnetic resonance relaxometry » MRR

Magnetic resonance scans

Image or set of images obtained with an MRI scanner. » MRI scanner

Magnetic Resonance scanner - MR scanner/imager/machine » MRi

Magnetic resonance pulse sequence » MR PS

Magnetic resonance pylography / urography » MRP, MRU

Heavily T2-WI coronal section through the genitourinary system is
acquired, only the urine fields structures are thus visualized, resulting in
a pylogram and/or a urogram.

Magnetic resonance relaxometry MRR

Magnetic Resonance sensitivity MR sensitivity

Atomic nuclei for MR examinations must be “MR sensitive”; that is, they
must have a nuclear spin. This condition excludes all atomic nuclei with
an even number of protons and neutrons. Because the hydrogen
isotope 1H is the most sensitive, it is set as a reference to all other
atomic nuclei and has the relative MR sensitivity of 1 (or 100%).

Magnetic resonance signal MR signal

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In MR imaging, the MR signal is encoded using varying gradient fields
so that the position of the spins yielding the signal can be
reconstructed.
Electromagnetic signal in the RF range. Caused by the precession of
transverse magnetization created by a variable voltage in a receiver coil
(dynamo principle). The temporal progression of this voltage is the MR
signal. (An electromagnetic signal in the RF resonant range, generally
between 1-100 meters in length).

Magnetic resonance spectroscopy » MRS

MRS provides non-invasive measurement of cellular metabolic
relationships. An MR spectrum shows the dependence of signal
intensity on chemical shift for a measurement volume (Voxel). The
concentration of metabolites contributing to the spectrum can then be
inferred. In MRS, the MR signal in measured as a function over time: a
rapidly increasing high-frequency oscillation. Using a Fourier transform,
the oscillation is converted into a display of its frequency component,
the spectrum. In the area of intermediately metabolism, MRS is an
important method for in-vitro and in-vivo examination of tissue and
organs. (To obtain spectral information from specific chemical entities. »
PS) - Atomic nuclei with an odd number of neutrons and protons have
what is called nuclear spin. For MRI, only hydrogen protons are used.
For MRS, other nuclei are used, such as phosphorous, fluorine, and
carbon.

Magnetic resonance spectroscopy imaging » MRSI, CSI, SMRI

Magnetic retentivity
The innate ability of a magnetized substance to resist demagnetisation.

Magnetic shielding - In space. Shielding

Magnetic source imaging

The combination of biomagnetic field detection and MRI into a merged
data set.

Magnetic susceptibility
The measurement of a given substance in becoming magnetized
through the process of magnetic induction. (chi) - measure of the ability
of a substance to become magnetized).

Magnetism
The power or force created by a substance having the property of
creating or inducing magnetic dipoles

Magnetizability » Susceptibility
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Magnetization
(Macroscopic magnetization vector) The magnetic polarization of a
material produced by a magnetic field (magnetic moment per unit
volume).

Magnetization preparation RAGE

Magnetization prepared rapid GRE

Magnetization preparation rapid acquisition gradient echo

MPRAGE
3D extension of the TurboFLASH technique with prepared inversion
pulses. Only one segment or partition of a 3D data record is obtained
per preparatory pulse. After the acquisition, all rows within a 3D partition
use delay time TD. The delay time is necessary to prevent saturation
effects. » GE-PS, IR-PS, 3D MP RAGE, turbo FLASH

Magnetization protocol gradient sequence » MPGRE

Magnetization transfer » MTC

Magnetization transfer contrast » MT, MTC

Magnetization transfer ratio

Ratio quantifying magnetization transfer (MT).

Magnetization vector M / Mo
Equilibrium value of magnetization directed along the static magnetic
field. Proportional to gyromagnetic ratio (g), spin density (N) and static
magnetic field (Bo), which has the three spatial components Mx, My &
Mz.

Magnetogyric ratio - Gyromagnetic ratio.

Magneto encephalography MEG

The measurement of magnetic fields generate by electric current in the
brain. » MSI

Magnetohemodynamic effect
An artifactual effect produced when blood crosses a magnetic field.

Magneto hydrodynamic effect

Additional electrical charges generated by loaded particles (ions in
blood) moving perpendicular to the magnetic field.

Magnetometer
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An instrument for measuring magnetic force.

Magnitude
Quantity or amount; often exhibited by an MRI spectral peak.The length
of a magnetization vector. In MRI the square root of the sum of the
squares of Mx and My components of transverse magnetization. » MEG

Magnitude contrast angiography

Used to display slow flow with good resolution across a large volume.
Two data volumes are measured: the flow-rephased image shows
bright flow, and the flow dephased image shows dark flow. Stationary
tissue looks the same in both data volumes. The data volumes are
subtracted from one another pixel-by-pixel. What remains is the signal
intensity of the flowing blood.

Magnitude image
In a magnitude image, the grey scale of a pixel corresponds to the
magnitude of the MR signal at that location. Alternative: phase image

Main magnetic field - B/Bo/Bo field

▪Symbol representation of the static magnetic field strength generated
by the electromagnetic coils within the gantry.
▪Also called magnetic flux density or induction: main magnetic field used
in an MR imager. In current MR systems it has a constant value over
time varying from 0.2 to 4T. Field strengths of 0.5 T and above are
generated with super conductive magnets. High field strength has a
better SNR. The optimal imaging field strength for clinical imaging is
between 0.5 and 2.0 tesla. » Ho, (obsolete)

MAP shim
MAP shim globally tunes the shim currents. Correction functions are
calculated using a fixed algorithm and applied to the corresponding
shim currents. The shim is also applied to the entire measurement field.
In modern systems, MAP shim is not required.

Mass - A quantity of matter without a definite shape.

Mass number (A)

Total number of proton and neutrons within the nucleus of an Atom. » Z

Matrix
The x and y dimension of the image region of interest defined by phase
encode steps and frequency or readout steps. Image matrix; grid of
columns and rows, usually 256·256, with a total number of 64,536
pixels. » Technical factor

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Matrix size » Technical factor

Matter, brain
Approximately 1350 - 1500 g of nerve-related soft tissue divided into
cerebrum, cerebellum, pons, medulla oblongata, and midbrain.

Maximum entropy method MEM

Maximum intensity projection » MIP

Maxwell coils
A special type of gradient coil, commonly used to create gradient
magnetic fields along the direction of the main magnetic field.

Megahertz » MHz

Magic angle in the rotating frame MARF

Magnet
A material in which electrons spin in one direction, creating a magnetic
field. Similar ends of magnets will push away (repel) each other;
different ends will attract each other.

Magnet quench hazards

Magnetic quench is indicated by a loud noise, warning message, dense
white vapor (with vent failure), helium mete dropping considerably or
the tilting of an image on image screen. If the patient needs medical
attention, press an emergency stop button on the console or magnet
and remove the patient from the scan room.

Magnetic field
A region around a magnetic material where a magnetic force is present.

Magnetism
The power of force created by a substance having the property of
creating or inducing magnetic dipoles.

Magnetization protocol/prepared gradient echo sequence MPGRE

Any GE-PS where data are acquired after an initial preparation pulse for
contrast enhancement such as in the turbo GRE sequence.

Mass - A quantity of matter without a definite shape.

Matrix » Image matrix, Raw data matrix

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Matrix size
Size of the raw data matrix; influences not only the measurement time,
but also the resolution and SNR. With a square raw matrix data, the
number of rows equals the number of columns.

Maximum intensity projection » MIP

Maximum value of phase encoding gradient » Gmax

Measurement field
1) Spherical volume in the centre of the magnetic field where the field
has a defined homogeneity. For MR examinations, objects to be
measured must always be positioned in the measurement field (to
prevent signal distortions). 2) FOV

Measurement matrix
Raw data matrix, not to be confused with the image matrix.

Measurement sequence - Pulse sequence

Measurement time
The measurement time for 2D measurement is as follows:
measurement time = no. of scans x TR x no. of acquisitions.

Mechanism of action of contrast media

MR contrast agents alter tissue contrast. Signal will increase when
hydrogen proton increases, T1 decreases and T2 increases. Signal will
be decrease when hydrogen protons decrease, T1 increases or T2
decreases. CO2, perfluorocarbons and deuterated water decrease
protons, as they possess no hydrogen nuclei. Paramagnetic materials
like Gd, Fe and Mn decrease both T1 and T2 thereby altering the
signal. Super paramagnetic particles produce T2 thereby decreasing
the signal. Diamagnetic substances have negative induced
magnetization and are used in situations where they can displace or
mix with normal tissue. Water, fat, perfluorocarbon and CO2 are used as
gastrointestinal contrast agents by the displacement of normal bowel
contrast. » T1 & T2 contrast agent

Mega » M One million, 106.

Mega bytes MB

Megahertz
MHz or a million wavelengths traversing a given reference in one
second of time. The hydrogen proton has a precessional rate of 42.58
or 42,584,000 Hz/sec.
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Magic angle spinning / Milli ampere second MAS

Magic angle sample spinning MASS

Magnetic dipole moment MDM

The strength and orientation of a magnetic dipole, an object possessing
magnetic north and south poles. The MDM is the composite of three
magnetic properties: nucleus, electron orbits, and electron spin.

Magnetic field gradient MFG

Super imposing a weaker magnetization on Bo to create a linear slope
for spatial excitation. (Gradient magnetic field).

Magnetic GF in MilliTesla per metre and millisecond mT/m/ms

Measurement of the magnetic GF in milliTesla per metre and
milliseconds

Magnetization transfer MT
MRI technique based on cross relaxation between “bound” and “free”
bulk water protons. Provides high lesion-white matter contrast in brain
imaging.
The application of MT in SE imaging can improve the enhancement
effect produced by a gadolinium chelate in the brain. MT pulses
preferentially suppress the signal from background tissue, usually
improving the conspicuity of gadolinium-enhanced regions. This can
lead to improvement in the visualization of CE at standard dose. Hence
MT is advisable in all post contrast sequences in brain. » MRCM + PS

Magnetization transfer contrast MTC

Contrast in an MR image due to MT between protons in water and
those in macromolecules. This is a technique used to suppress the
background tissue thereby increasing the conspicuity of vessels and
certain disease processes. MTC is useful in diagnosing haemorrhage,
AIDS, MS and also to improve contrast in TOF-MRA images by
suppressing background tissue.

Magneto optical disc MOD

Maximum intensity projection MIP

A 3D rendering technique, which is extremely effective for visualization
of 3D angiographic image data. » CM MRA, MRP, MRPC, MPR

MBEST sequence
An EPI pulse sequence (FID-based MBEST sequence)

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Mean transit time MTT
maps generated via perfusion imaging techniques.

MEDIC technique
Multiple echoes acquired in a scan are combined into an image.
Advantage: higher SNR per time period, fewer artifacts. Application:
spine, joints.

MEDUSA - Technique for determination of dynamic structure

Megahertz -Unit of frequency, equal to one million Hertz MHz

Mega heat units MHU

Magnetic iron oxide particles MOIP

Magnetic resonance contrast agent, which diminishes the signal from
normal tissue.

Magnetization transfer ratio MTR

Ratio quantifying magnetization transfer (MT).

Meiboom-Gill sequence - Carr-Purcell-Meiboom-Gill sequence.

Melanin
The pigment giving color to certain parts of the body, skin, eyes, brain.

Micron (μ) - 1 μ = 10 –1 m = 1/1,000,000m.

Microsecond (μsec) 10 –6 = 1/1,000,000sec

Midfield MRI MF MRI

MR imaging using Bo field more than 0.5T to 1.0T. All MR imaging
using Bo field: <0.1 T is ultralow-field, 0.1 to 0.5 T is low field, 0.5 to 1.0
T is medium field, 1.0 T to 2.0 T is high field, 2.0 T > is ultrahigh

Milli (m) - Divided by one thousand, 10 –3, or 1/1000

Mirrored FISP mFISP

M0
Equilibrium value of the magnetization, directed along the direction of
the static magnetic field. Proportional to spin density, r or N.

Minimum basis set magnetic resonance angiography MBS MRA

m.Levitt’s sequence MLEV-n

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Mobile MRI unit - An MRI system that may be moved at random.

Modality performed procedure step MPPS

Modification of the ISIS method for localized spectroscopy OSIRIS

Modulations - Radio frequency variation

Modulus - Magnitude.

Modulation transfer function

Used to assess the overall spatial resolution of an imaging system.

Molecule
A group of two or more atoms bonded to each other. (Any atom
(element) or group elements that cannot be broken down any further by
ordinary means without losing their identity.

Moment
A magnetic field created by the positively charged particle within the
nucleus, which has an angular momentum or spin. A current loop
therefore exists which results in a moment.

Morphology - Cellular structure interest versus functional interest

Mosaic images
16 to 64 EPI images are compiled into a mosaic image. This increases
the clarity of BOLD display.

Motion artefact
Results from random or involuntary movement: breathing, heartbeat,
blood flow, eye movement, swallowing, and peristalsis. The effect
appears as ghosting, smearing, in the images in phase-encoding
direction only. The various types of motion artifacts are as follows:
Patient Motion, Cardiac Motion, Respiratory Motion, and Blood Flow
Motion, CSF Pulsation, Aperiodic motion.

Motion artefact suppression technique - MAST

Technique in which measure are taken to suppress motion artefacts. »
Motion compensation

Motion compensation
Modifying the field gradients used in a pulse sequence such that flow
and acceleration do not induce any additional phase effects

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Multi angle reconstruction plan MARP

Multi-contrast turbo spin echo MCTSE

MCTSE-T1, T2 & PD, DC TSE-T2 & PD, SCTSE-T1, T2 or PD.

Multi-echo multi-planar » MEMP

Multi-echo pulse sequence ME-PS

PS that excites multiple echoes with different degree of T2w. Signal
height reduces with transverse relaxation. This drop in signal can be
used to calculate a pure T2 image. (Sequence where the acquisition
module (PS) contains multiple SE-PS or GE-PS during each of which
an image line is read).

Multi-echo single shot » MESS / RSE

Multiplanar inversion recovery MPIR

Multiplanar reconstruction MPR

Enables new images or any orientation to be reconstructed based on a
3-D or gap-less multislice measurement. (Production of 3D images from
data acquired in a series of 2D planes).

Multiple line scan imaging MLSI

Variation of sequential line imaging technique that can be used if
selective excitation methods, which do not affect adjacent lines, are
employed.
Adjacent lines are imaged while waiting for relaxation of the first line
toward equilibrium, which may result in decreased imaging time. A
different type of MLSI uses simultaneous excitation of two or more lines
with different phase encoding followed by suitable decoding. This can
be extended to planar sequences.

Multiplanar inversion recovery

Multiplanar reconstruction
Production of 3D images from data acquired in a series of 2D planes.

Multiple echo imaging

A fast spin echo technique utilizing many spin echoes. This pulse
sequence is characterized by a series of 180o refocusing pulses.

Multiple line-scan imaging » MLSI

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Multiple overlapping thin slab angiography / acquisitions MOTSA
Angiography Technique where several overlapping 3D acquisitions are
performed and displayed as a single data set.
MOTSA artifacts
It also occurs on 3D TOF and multiple overlapping thin slab acquisitions
images of the neck. Patient motion and vascular pulsations during
acquisition resulted in a stair-step pattern in the 3D TOF of MIP. The
MOTSA images have higher SNR but greater background signal.

Multiple planar GR (ASS) - MPGR

Pulse sequence used in fast-scanning technique that allow the
acquisition of more than one slice per repetition time.

Multiple planar gradients recalled - Multiplanar gradient GE-PS

Multi planer recon-coronal MPR-Cor

Multi planer recon-oblique MPR-Obl

Multi planer recon-sag MPR-Sag

Multiple quantum coherence MQC

Multiple quantum filter MQF

Multiple quantum spectroscopy MQS

Multiple sensitive point

Sequential line imaging technique utilizing two orthogonal oscillating
magnetic field gradients, an SSFP pulse sequence, and signal
averaging to isolate the sensitivity to a desired line in the body.

Multi-planer volume rendering recons MPVR

Multiquantum heternonuclear polarization transfer MQHPT

Multi shot echo planar imaging MS EPI

Multi-slice imaging
Variant of sequential imaging. The recovery period of the first excited
slice is used to measured additional slices (saves time). The slices are
interleaved. (The process of incorporating multiple slice acquisition
during “dead” time of a TR).

Multiple thin slab acquisition MTSA

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Multiple slice imaging
Variation of sequential plane imaging technique that can be used with
selective excitation techniques that do not affect adjacent planes.
Adjacent planes are imaged while waiting for relaxation of the first plane
towards equilibrium. resulting in decreased imaging time. (An imaging
technique involving the formation of multiple images from a single
volumetric acquisition).

Multi-slice multi-echo sequence

MR imaging pulse sequence in which signals for multiple slices at
multiple echoes are collected.

Multi-slice off resonance fat separation technique

Multivenc sequence
A sequence that is equally sensitive to various flow velocities. Used to
acquire wide variations in flow velocity, e.g., in the peripheral arteries.

Multi-volume spectroscopy MVS

Myocardial perfusion imaging » MPI

maging technique with which myocardial perfusion is assessed at rest
or under stress conditions.

►N◄
N/2 ghost
Ghost artefact in MR imaging in the phase encoding direction stemming
from an original structure in the image.

#N
Symbol for the number of neutrons in the nucleus: # N = # A - # Z

N (= rho) > spin density.

N (H) weighted - Hydrogen density » N (H) W PD

Native image
MR image without the use of contrast agent, for example as a pre-
contrast study. BOLD imaging: Non-activated image (baseline).

Navigator echo
▪A quick MR pulse sequence which measures the position of e.g. the
diaphragm before collecting imaging data. ▪Additional spin or gradient
echoes used to monitor changes in the position of the sample during
the scan time. See also retrospective gating.
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Navigator echoes
NMR signal - Electromagnetic signal in the radiofrequency range
produced by the precession of the transverse magnetization of the
spins. The rotation of the transverse magnetization induces a voltage in
a coil, which is amplified and demodulated by the receiver.

Necrosis - Dead tissue or bone primarily due to deficient blood flow.

Negative relaxation agents

The contrast agent that affects T2 relaxation is referred to as negative
contrast agent. These contrast agents reduce T2 relaxation times
resulting in decreased signal intensity on T2WI. Examples of these
contrast agents are ferromagnetic and supermagnetic metals. Gd
chelates in high concentration can also be used as negative relaxation
agents, provided fast imaging sequences are used. Perfusion imaging
with high dose of contrast and associated EPI pulse technique reduces
T2 with relative loss of signal.
Negative relaxation agents have a limited role in clinical practice.

Negative Relaxation Agents: Parenteral (systemic):

SPIO-Superparamagnetic iron oxide/USPIO - Ultrasmall
superparamagnetic iron oxide/MION-Monocrystalline iron oxide
Gastrointestinal (oral):
OMP-Oral magnetic particles/PFOB-Perfluoro octyl bromide
In post contrast images, the contrast enhancement is increased by
various imaging parameters other than contrast media. Such
parameters include MT, Fat suppression techniques, etc.

Net macroscopic magnetization vector - M

Usually shown as a positional vector arrow. (Magnetization vector,
which has the three spatial components Mx, My & Mz /
Conventional symbol for macroscopic magnetization vector).

Net Magnetization Vector

A vector representing the sum of the magnetization from a spin system.
An uncharged neutral component located in the nucleus which serves
as a stabilizer. This neutron mass is slightly greater than the proton
mass and has an enormous effect on the quantum spin value of an
element.

Neuro imaging
General term for brain and nervous system applications, such as BOLD
imaging.

Neutron
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A basic particle found in the nucleus of an atom, which has electrical
charge.

Noise
An undesirable background interference or disturbance that affects
image quality. » Image noise

Non-selective pulse
Non-selective pulse affect all of the tissue within the transmitting coil.
May only be used if another method is selected to define slices (3D) or
at a frequency removed from the resonant frequency (MTC)

Normalization filter
Equalizes signal intensity when using surface coils. Using the filter, the
signal intensity of areas close to the coil is reduced; the signal intensity
is increased in areas further from the coil. Used primarily with array
coils.

Nuclear energy
Energy released when the nuclei of atoms collide.

Nuclear magnetic moment - NMN

Nuclear magnetic resonance - NMR

Technique in which images are formed by absorption or emission of
electromagnetic energy by nuclei in a static magnetic field, after
excitation by a suitable RF magnetic field.

Nuclear magnetic resonance imaging - Synonym for MR imaging.

Nuclear magnetic resonance signal NMR signal

Electromagnetic signal in the radiofrequency range produced by the
precession of the transverse magnetization of the spins. » MR signal

Nuclear magnetic resonance spectroscopy

Use of magnetic resonance to obtain spectral information from specific
chemical entities in compounds or tissues in the form of peaks analyzed
according to their frequency, amplitude and area under the peak. » MRS

Nuclear overhauster effect spectroscopy NOESY

Nuclear overhauster enhancement NOE

Nuclear quadrupole coupling constant NQCC

Nuclear spin
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An intrinsic property of certain nuclei that gives them an associated
characteristic angular momentum and magnetic moment.

Nuclear spin quantum number

(I) - property of all nuclei related to the largest measurable component
of the nuclear angular momentum. Non-zero values of nuclear angular
momentum are quantized (fixed) as integral or half-integral multiples of
(h/2pi), where h is Planck’s constant. The number of possible energy
states for a given nucleus in a fixed magnetic field is equal to 2I +1.
- Atomic nuclei with an odd number of neutrons and protons have what
is called nuclear spin. For MRI, only hydrogen protons are used. For
MRS, other nuclei are used, such as phosphorous, fluorine, and carbon.

Nucleon - A generic term for the neutron and proton in the nucleus

Nuclear species - An atomic structure.

Nuclear spin number (I) - A quantized property relating to spin quality.

Nucleus
The centre of an atom, it contains the positive (+) protons and neutrons,
and occupies one hundred million billionth of the 3D atom, yet consists
of more than 99.99percent of the total atomic mass in nature.
I. The central part of an atom.
II. The central centre of a cell, which contains the DNA.

Number of acquisitions Nacq / NA

Number of times an individual slice or volume is sampled in MRI,
typically 2-4. The higher the Nacq, the better the SNR.

Number of excitation
How frequently each k-space line is scanned » NEX, NSA

Number of frequency encoding rows Nƒ

Number of frequency encoding steps Nx

Number of partitions » Partitions

Number of phase encoding steps on the matrix Ny

Number of phase encoding views Np

Number of signal averaged » NSA, Signal average, Technical factor

Numbers of slices
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Multiple slices are usually acquired in an MR measurement. The
maximum number of slices of a pulse sequence or measurement
protocol depends on the TR. » Multi-slice imaging

Nutation
A displacement of the axis of a spinning body away from the simple
cone shaped figure which would be traced by the axis during
precession. In the rotating frame of reference, the nutation caused by
an RF pulse appears as a simple precession, although the motion is
more complex in the stationary frame of reference.

Nyquist limit - The optimum frequency where aliasing will not occur.

►O◄►P◄
Oblique imaging
An imaging technique which produces images along oblique planes
between the conventional X, Y, and Z axes.

Oblique slice
Obtained by rotating an orthogonal slice (sagittal, coronal, or
transverse) about a coordinate axis in the slice plane.

Oersted, Hans - Discover in 1819 that electricity produce magnetism

Off-centre (Eccentricity)
Shifting of the centre of a slice group from the centre of the magnetic
field within the slice plane.

Ohm’s law - E = IR, where E = volts, I = amperage, and R = ohms.

Oil-filled phantom
QA is performed initially on oil-filled phantoms which vield the most
homogeneous signal intensity for evaluation.

Online display
Immediately display of reconstructed images. Used for CARE Bolus and
BOLD imaging.

Oral contrast agents

Complete bowel opacification is difficult and side effects are high due to
the rapid transit of the agent through the bowel. The majority of the
agents are eliminated rectally within the first few hours’ administration
and are not absorbed by the bowel.
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Oral positive or negative relaxation agents
Either positive or negative relaxation agents can be used in bowel
imaging. Positive contrast agents, increasing the signal intensity of the
bowel are Gd-DTPA with a volume expander of ferric ammonium citrate
(Geritol).

Oral negative or positive relaxation agents

Examples of negative contrast agents, causing a reduction in signal
intensity of the intestinal lumen, are small particles of iron oxide (SPIO-
AMI-25) and ultrasmall particles of iron oxide (USPIO-AMI-227).

Orientation
A conventional positional standard, i.e., Mo is oriented to +z at
equilibrium, which is coincident with the north pole of the magnet.

Orthogonal - Coordinates that are 90o to each other.

Orthogonal slices
Slices oriented perpendicular to one another. The basic orientations are
available: sagittal, coronal, and transverse (axial). » Slice orientation

Ortho graphic external rendering OGER

Oscillation - Rhythmic periodic motion

OSIRIS
A modified form of the ISIS sequence in which the signal from the outer
volume is suppressed with a noise pulse; suitable for proton
spectroscopy

Osmolarity of contrast media » MRCM

Overlap » Aliasing artifact

Oversampling
Method for preventing aliasing artifacts. 1) Readout Oversampling:
Doubling the sampling points in FED without extending the
measurement time. The additional part is discarded after reconstruction.
Phase Oversampling: Measurement data acquisition beyond the FOV in
PED. Increases SNR. The measurement time is appropriately longer.
100% phase Oversampling has the same effect as double the number
of acquisitions.

Oxygen - O

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Element with eight protons and second most important constituent of
the atmosphere.

Oxygen / suction / room air supplies

Some MRI facilities are equipped with oxygen, suction, and room air
channels. These may be mounted on a wall or hung from a ceiling to
the left of the scanner. Oxygen is marked by the green hose or
regulator, suction is white, and room air is yellow.

O2-17 MR - MR applications using oxygen as resonating nucleus.

P/N - Proton / neutron ratio

Paradigm
BOLD imaging. Planned sequence of the functional measurement. For
example, 10 non-activated images (baseline), 10 active images, 2
ignored images.

Paradoxical enhancement
The unpredicted change of signal intensity of vessels with flowing blood
in multislice imaging.

Parallel alignment
Alignment of the net magnetic vector with the magnetic field
(longitudinal plane or z axis)

Parallel v antiparallel energy state

An energy state where the parallel is at the power equilibrium state and
the antiparallel is positionally at 180o and in a higher energy states.

Parallel imaging
An imaging technique which utilizes signals phased array coils to
reconstruct an image in less time than conventional imaging.

Parallel saturation
By saturating areas parallel to the slice plane but outside the slice of
interest, blood flowing to the measurement area produces almost no
signal at the beginning of the measurements the vascular intraluminal
signal, and prevents ghosting. This presaturation can be performed on
both sides of the slice. Parallel saturation slices shift with the slices of
interest, simplifying planning.

Paramagnetic
A substance with a small but positive magnetic susceptibility
(magnetizability). The addition of a small amount of paramagnetic
substance may greatly reduce the relaxation times of water. Typical
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paramagnetic substances usually possess an unpaired electron and
include atoms or ions of transition elements, rare earth elements, some
metals, and some molecules including molecular oxygen and free
radicals. Paramagnetic gadolinium chelate complexes are used as T1
contrast agents in MRI.

Paramagnetic metals
Those materials in which some of the electrons are unpaired so that
there is a net spin magnetism. When an EMF is applied, alignment of
the atom with the MF occurs thereby increasing the field strength. Para-
magnetism has a small effect compared to that of ferromagnetism.
Examples are titanium, platinum, and gadolinium.

Paramagnetism
Substance with weak magnetic properties due to its unpaired electrons.
Researchers have developed certain paramagnetic materials as MRI
invasive contrast media.

Parenchyma - The essential and distinctive tissue of an organ.

Parenteral (systemic): » MRCM

Partial flip (gradient reversal)

PS that uses less than the conventional 90o RF flip to resonate the
spins to the transverse plane; flip less number of spins therefore
longitudinal relaxation is decreased requiring decreased TR; scan time
is diminished.

Partial flip angle

Flip angle of less than 90º used in an MR imaging experiment. » FA

Partial flip imaging

(reduced flip angle) Toshiba brand name for a GE-PS

Partial Fourier
Reduction of the number of PES so that the raw data matrix is filled with
fewer rows. Enables shorter echo times. Special case: Half Fourier.

Partial saturation - SP
▪Images where the 90o RF excitation pulse are rapidly reapplied. A
series of repeated RF pulses following the initial torquing pulse.
▪Technique of applying repeated RF pulses with TR less than or equal
to T1. Generates images with increased contrast between regions of
different T1.

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Partial Saturation Pulse Sequence - PSPS
The early days of MRI one plain RF pulse sequence was used to create
images:

Partial saturation sequence - PS sequence

Saturation recovery pulse sequence (SR-PS)

Partial saturation spin echo - PSSE

Partial saturation technique with TR less than T1, in which the signal is
detected as a spin echo.

Partial volumning - A loss of resolution due to excessive large voxels.

Partitions
In 3D imaging, whole volumes (instead of individual slices) are excided.
A 3D slab comprises multiple partitions in sequence without gaps. The
number of partitions corresponds to the number of slices for a 2D
measurement.

Partition thickness
The effective slice thickness of individual partitions in a 3D slab is the
slab thickness divided by the number of partitions.

parts per million

Term used in MR imaging to define the quality of the magnetic field
homogeneity or the chemical shift of a substance investigated.

Passive shimming
(Irons is placed on the magnet itself, in order to shape field flux lines in
the desired configuration) Previously, the magnet was covered with soft
iron that worked as flux return and significantly reduces the stray field.
The system weight increased dramatically. Today, active shielding is
preferred. »Shimming

Patency - Lumen opening integrity

Pathological changes influencing image appearance » High and low

MR signal

Pathological changes and effect of relaxation time » Tissue

characteristics

Patient motion artifacts

Since all the images in one sequence are taken at the same time, it is
important not to use excessively long sequences, as movement for a
brief period spoils all the images. Remedy: Make patient lie comfortably,
stabilize, with straps and cushions.
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Patient screening » Examination procedure, Safety

Patient positioning
Positioning of the patient can affect the safety of the scan procedure.
Improper positioning can result in sunburn – like burns. » Precaution to
be undertaken

Peak
Theoretically, the frequency of a pure sine wave displays sharp spectral
lines at the point of resonant frequency. In reality, the spectral lines
spread into a blurred peak. Caused by the spin-spin effect and field
inhomogeneity (magnet and patient). Peak characteristics: resonance
frequency (vo), peak height (h), peak width at half height (b) (Full Width
Half Maximum FWHM), area.

Pegating (peripheral gating) » Gating

Percentage of Baseline at Peak - PBP map

Perfusion. A percentage of baseline at peak image can be
reconstructed for the slice. The grey scale displays the signal change
relative to a basic image prior to contrast agent administration.

Percutaneous fine needle biopsy » FNAB, FNAC

Perfusion
Brain hemodynamic assessment to evaluate CBV, CBF & MTT.

Perfusion and Diffusion » Diffusion and Perfusion

Perfusion imaging - PI
Methods providing regionalized maps of tissue perfusion.
Technique for evaluating organs and organ areas, frequently using
contrast agent. Areas poorly supplied with blood display a signal
change over time.
e.g., T1-sensitive perfusion of liver, heart, or sella lesions, T2*-sensitive
perfusion for stroke. EPI sequences are used most frequently.
For perfusion imaging, the contrast medium is injected as a bolus using
MRI compatible power injector. Images are acquired very rapidly during
and immediately post injection. This helps to study the first pass of the
contrast agent through the brain. In brain perfusion imaging studies
T2W scans are used. These scans provide the required high temporal
resolution and are also quite sensitive to the vascular bed. On T2W
scans, the gadolinium chelate causes a reduction in signal intensity as
opposed to the increased in signal intensity seen on T1W scans. After
acquisitions with the help of software rCBV and rMTT of a given area is
130
calculated. Perfusion imaging can detect brain ischemia far sooner than
standard T2W scans. It also detects the tissue at risk.

Perfusion measurement
Any procedure used to measure perfusion in an end organ.

Perfusion weighted imaging - PWI

This is a type of dynamic MR imaging by using GRE (or) EPI
sequences with contrast enhancement to study the uptake of contrast
medium by the lesion. This technique can be used in abnormalities of
brain, pancreas, liver and prostate.

Peripheral angiography
MR angiography of the peripheral vascular system has special
requirements ▪ Arterial flow is often pulsating ▪ Large volumes must be
measured ▪ Images must clearly distinguish between arteries and veins.
3D GRE protocols with contrast agent are used most frequently.
Measurements are performed with tabletop movement in several
stages. Requires an optimized timing sequence.

Periodic table
A categorical listing of the elements corresponding to their physical and
chemical properties.

Periodically rotated overlapping parallel lines with enhanced

reconstruction - PROPELLER
▪Acquire data in a unique way that allows one to monitor the motion of
the patient during the MRI scan, allowing for the motion to be later
removed.
▪Freezes patient movement and corrects for motion artefacts without
compromising image resolution or prolonging scan time. (GE)

Peripheral Gating (Pegating)

Pegating uses a photo sensor attached to either finger or toe. Gating
and respiratory compensation are commonly used to examine the chest
and abdomen, and also used in imaging of brain (CSF flow, spinal cord
and in cine).

Permanent magnet
A magnet whose magnetic field originates from permanently
magnetized material. Though simple and cheap to run, they are still
extremely heavy and do not generate high fields. » Comparison

(Coprises large blocks of magnetic material, usually horseshoe-shaped.

It has a permanent magnetic field. Requires no power supply or cooling,
maximum field strength 0.3T.
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Permeability
Tendency of a substance to concentrate magnetic field mu = B/H.
How readily a substance can become magnetized. The lower the
permeability, the greater the retentivity, and vise versa.

Phantom
A simulated synthetic item with known dimensions, properties and
measurement characteristics. Usually a fluid-field container with a built-
in plastic structure of various sizes and shapes. Phantoms are used to
test the system and quality features of imaging-systems.

Phase
A position relative to a periodic function such as a cyclical movement.
An in-phase situation relates the relative positions as being consistently
uniform; an out-of-phase situation relates the relative position as
varying from one movement to another. » Technical factor

Phase FOV - PFOV

FFOV shortens scan time by scaling down the FOV size in the phase
direction.
Select 0.75 or 0.5 to reduce phase steps and thus
▼ (less) Scan time
▼ (less) FOV in the phase direction
▼ (decreases) SNR slightly
Freq DIR: S/I (superior to inferior), A/P (anterior to posterior), R/L (right
to left).
The scanning direction associated with the frequency gradient.
The direction displayed is the default frequency direction which is
typically the long axis of the image. To swap phase and frequency,
select the other direction.

Phase contrast - PC
Technique used in MRA in which contrast between various structures is
obtained by differences in signal phase rather than in signal amplitude.»
PS

Phase contrast angiography - PCA

Method for displaying vascular flow. In PCA, the phase change of the
spins in flowing blood induced by velocity is used to distinguish the
blood from stationary tissue. Only flowing spins contribute to the signal.
The blood contrast in the image is proportional to the local flow velocity.
2D & 3D PCA protocols have established flow sensitivity for all three
spatial directions. This allows various flow velocities to be displayed.
Applications: slow flow, “bent” vessels with variable flow direction,

132
overview projection images. This technique is also the basis for flow
measurements.

Phase contrast MRA - PC MRA

MRA technique that provides vascular contrast by making use of spin-
phase effect (flow effect) » PS, TOF MRA, CE MRA

Phase correction » Technical factor

Phase direction
Coil Plane Frequency Phase Slice Select
Head coil Axial A/P R/L S/I
Sagittal S/I A/P R/L
Coronal S/I R/L A/P
Body Axial R/L A/P S/I
extremity, NV Sagittal S/I A/P R/L
Array coil, Coronal S/I R/L A/P
Surface coil, Receive only
Frequency can be swapped with phase direction by changing the entry
in (Frequency Direction).

Phase elimination (Chemical shift)

Fat and water protons have only slightly different resonant frequencies,
resulting in phase cycling. For example, at 1T, fat and water spins
switch in and out of phase every 3.4 ms after application of an RF
pulse. For this reason, the signal intensity of a voxel containing fat and
water oscillates with an increasing echo time. The strength of the
oscillation depends on the relative proportion of fat and water protons in
the tissue. This effect occurs primarily with gradient echo sequences.

Phase encoding
The application of a gradient prior to recording an NMR signal encodes
the signal with a phase which depends on the strength of the gradient,
the duration of the gradient and the position of the spins. Acquiring a
series of signals with different amounts of phase encoding, followed by
a FT allows the positional information to be decoded.

Phase encoding
Sequentially encoding MR signals by their phase values; it
conventionally occurs along the Gy (view) axis. As each component in
their respective vertical view position has experienced a different phase
encoding pulse, its exact spatial reconstruction can be specifically and
precisely located by the FT analysis.

Phase encoding
Method for defining the rows in the measurement matrix.
133
Between the RF excitation pulse and the MR read out signal, a
magnetic field gradient is switched briefly, applying a phase shift to the
spins from row to row. Phase-encoding steps are required to fully scan
the slice depending on the matrix (256 or 512). The subsequent FT can
allocate the various phasings to the respective rows.

Phase encoding artefact reduction

Phase encoding gradient

Magnetic field gradient switched in the phase-encoding direction whose
function is to identify phase relationships of rows of data accumulated in
the y direction of the matrix. It is applied in a precise manner during the
acquisition of a scan. » PS

Phase-encoding step
Phase-encoding of an MR image requires that there are as many
excitations and signal acquisitions as there are image matrix rows (e.g.,
256 or 512). The amplitude of the phase-encoding gradient changes
incrementally from excitation to excitation. For this reason, each row of
raw data has different phase information.

Phase image - PI
Recon. In addition to regular magnitude images, phase images can also
be reconstructed from the raw data measured. In the magnitude image,
the grey scale of the pixel corresponds to the MR signal magnitude at
that location. In the phase image, each pixel grey scale represents the
respective phasing between - 180o and + 180o. Spin ensembles can be
distinguished from stationary tissue in phase images. Stationary spins
have the same phasing, moving spins have differing phasing on the
velocity.

Phase reversed pulse

RF pulses designated to reverse the Mxy magnetization.

Phase rewinder gradient

A gradient which is applied after data collection and has equal
amplitude but opposite polarity to the normal phase encoding gradient.
Ensures that each interpulse interval produces the same net phase,
allowing transverse coherences to develop uniformly across the whole
field of view.

Phase-offset multi-planar - POMP

PS in MRI that doubles the number of slices per repetition time.

Phase Oversampling » Oversampling

134
Phase sensitive detection
Method for balancing real and imaging channels in MR to eliminate any
hardware-induced artifacts.

Phase sensitive detection - PSD

Method for balancing real and imaging channels in MR to eliminate any
hardware-induced artifacts.

Phase shift
Loss of phase coherence in precessing spins (signal reduction). In most
physiological situations, vascular spines move at variable velocities.
Faster flowing spins undergo a stronger phase shift than slower flowing
spins.

Phosphorus (31P)
A natural element of cellular protoplasm that plays a significant role in
ATP-ADP cellular energy transformation.

Physical gradients » Gradient coils

Physiologically-control images
Physiological movements like heart beat, breathing, blood flow, or fluids
generally cause artifacts that can make clear interpretation of an MR
image difficult, if not impossible. Physiologically controlled imaging
enables these artifacts to be suppressed. » Triggering

Picture archiving and communication system PACS

Used to communicate and archive medical imaging data. » IMACS,
DICOM

Pixel
The smallest discrete 2D picture element of a digital image. To display
the MR image, every pixel in the image matrix contains a specific grey
scale. Pixel size = FOV / matrix size.

Planar - The imaging process of a selected plane.

Planar imaging
Imaging technique in which the image of a plane is built up from signals
received from the whole plane. See also Sequential plane imaging.

Planar spin imaging

One particular technique of planar imaging that creates an NMR image
of a plane from one excitation sequence by selectively exciting a grid of
points within the plane and then applying a gradient magnetic field so
that each point has a different Larmor frequency. Fourier transformation
135
of the FID can then be used to separate the signals from each selected
point and create the image.

Point Artifact
Point artifact is seen as a bright spot of increased signal intensity in the
centre of the image. This is caused due to constant offset of the DC
voltage in the receiver coil, which after FT appear as a bright spot in the
centre of the image. Fig.7.20

Point imaging » Sequential point imaging.

Polar coordinate system

Polarisation transfer
A technique for transferring magnetization from proton to strongly
coupled nuclei and hence improving the S/N ratio of the other (less
sensitive) nuclei.

Polarity
An intrinsic separation of charges, i.e., magnetic north and south pole;
the gradient negative and positive polarity. Negative electricity is where
it is stored, and positive where it is going.

Poles - Either of two opposed forces, as at the end of a magnet.

Population
The number of sampled nuclei; image brightness is directly proportional
to population size.

Positive relaxation agents

The contrast agent that affects T1 relaxation is referred as positive
relaxation agent. These contrast agents reduce T1 relaxation times and
shows increased signal intensity on T1WI. The gadolinium chelates,
namely paramagnetic agents, are examples of positive relaxation
agents and have wide clinical application.

Positive contrast media

In MRI, all CM having an effect on T1 relaxation are positive contrast
media, while T2 effects (T2 relaxation) result in a decrease in the signal
intensity measured.

Positive relaxation agents

Parenteral (systemic): ▪Gd-DTPA: Gadopenetetate dimeglumine
(Magnevist) ▪Gd-DTPA-BMA Gadodiamide (Omniscan) ▪Gd-HPDO3A-
Gadoterodole (Prohance)

136
▪Gd-BOPTA-Gadobenate dimeglumine. Gastrointestinal (Oral): ▪Gd-
DTPA Ferric ammonium citrate (Geritol) Vegetable oils, Fats, etc

Positron - e+,
Quantum with the energy of an electron but positively charged.

Positron emission mammography - PEM

A high resolution PEM system capable to detecting tumor with diameter
less than 2 mm. PEM systems has 3 main components. The first one is
the scanner. The scanner is mainly constituted by two planes of
scintillant crystals. A radioactive liquid, (radioactive tag) is injected into
the patient. The tag reads with the human cells. However, cancerous
cells have a metabolism superior to the normal ones and therefore,
more protons are emitted by cancerous cells.

Positron emission tomography - PET

Radioactive tracer emit positively charge electron, “called positron”.
This positron and counter electron align each other to produce two
gamma particles, gamma particle detection from several angle in
conjunction with computer produces images.

Post processing image

Image measured for post processing; i.e. MIP or MPR.

Posterior
The direction towards the back in an anatomical coordinate system.

Potential - Stored energy

Precaution to be undertaken in MRI

In order to maintain a safer scan environment, the following precautions
are to be taken: ▪MRI systems are equipped with laser alignment lights.
▪Exposing eyes to the laser alignment lights may result in eye injury.
▪Do not stare directly into the laser beam. ▪Instruct the patient to close
their eyes during land marking in order to avoid eye exposure to the
alignment light while the laser light is “On”. ▪Do not leave the laser
beam “On” after you position the patient. ▪Place foams between the
patient and the bore wherever a portion of the body comes in contact
with the bore. ▪Ensure that the patient does not touch the magnet bore.
▪Orient the patient (head first or feet first) to minimize the length of the
cable in the bore. ▪For larger patients, use wide patient straps to secure
the arms, preventing them from touching the bore.

Precess
A rotational motion about an axis of a vector whose origin is fixed at the
origin of the coordinate system.
137
Precession
The phenomenon of a magnetic field (or any object) spinning or
gyrating around an imaginary axis of its own creation, describe a cone.
Comparatively slow gyration of the axis of a spinning body so as to
trace out a cone; caused by the application of a torque tending to
change the direction of the rotation axis, and continuously directed at
right angles to the plane of the torque. The magnetic moment of a
nucleus with spin will experience such a torque when inclined at an
angle to the magnetic field, resulting in precession at the Larmor
frequency. A familiar example is the effect of gravity on the motion of a
spinning top or gyroscope.

Precessional angle
Often referred to as angular momentum; it is the angle created by an
object precessing around its unwavering vertical axis.

Precessional frequency
The frequency of precession of the hydrogen nucleus determined by the
Larmor equation. » Synonym Larmor frequency

Presaturation (pre-sat)
An excitation pulse followed by a spoiler gradient which is used to
remove the signal from a particular part of a spectrum or imaging
volume).
Regional presaturation, frequency-selective presaturation (fat
saturation, water saturation), presaturation with inversion pulses (e.g.,
dark blood techniques). Regional presaturation can be used to reduce
the signal from undesired tissue; for example, to minimize artifacts
caused by movement of the chest. An additional saturation pulse is
applied at the beginning of the PS to saturate the spins within the
saturation slice. The saturated region produces almost no signal and
appears black in the image.

PRESS
A technique for localized spectroscopy using a spin echo sequence.

Principle » Basic principle

Prescan » Technical factor

Probe
The portion of an NMR spectrometer comprising the RF coils and some
associated electronics. The RF coils may consist of separate receiver
and transmitter coils in a crossed-coil configuration, or, alternatively, a
single coil to perform both functions.
138
PROBE
PROSE is a non-invasive imaging technique to assist in the evaluation
of the location, size and aggressiveness of prostate cancer.
3D CSI Software enables 3D Multi-Voxel Proton Spectroscopy (GE)

Processed data
Reconstructed time domain data using FT.

Production if image » Tissue characteristics

Program - Software.

Progressive saturation - Saturation recovery » SR

Projection profile
An NMR spectrum that is varied by the gradients and viewed on the
monitor. Spectrum of NMR signal whose frequency components are
broadened by a gradient magnetic field. In the simplest case (negligible
line width, no relaxation effects, and no effects of prior gradients), it
corresponds to a one-dimensional projection of the spin density along
the direction of the gradient.

Projection reconstruction imaging - PRI

Technique in MR in which projection profiles of the body are obtained
by observing signals using a set of magnetic gradient aligned at
different angles with respect to the imaged object.

Proportionality constant
A constant used to convert one set of units to another.

Protein
A large molecule of hydrogen, oxygen, nitrogen, phosphorous, sulfur,
and iron, and found throughout the plant and animal kingdoms.
Essential for growth, repair, and energy.

Protocol (imaging sequence)

Scanning parameters that are usually selected by the technologist,
which are based on the patient history, and should provide the most
useful information for diagnosis. (A specific set of RF pulses and
magnetic field gradients used to produce an image)

139
 Protocol for MRI examination of: -
► Brain
Indication
● Evaluation of infarction, AIDS
● Multiple sclerosis, Primary tumour assessment and metastatic
disease
● Unexplained neurological symptoms or deficit
Sequences

PS Axial AxialT1 Axial Sag T2 Cor T2 Axial

T2 FSE FSE T1 SE FSE FSE FLAIR
TR 4900 525 600 3650 4000 9000
TE/IR 85 Min. Min. 85 85 120/20
00
ETL 16 2 - 15 15 -
Bandwi 20.83 20.83 20.83 20.83 20.83 15.63
dth
Nex 2 1 2 2 2 1
Slice 5 5 5 5 5 5
thk
Gap 1.5 1.5 1.5 1.5 1.5 1.5
# Of 20 20 20 20 20 20
Slice
Matrix 256/25 256/25 512/25 256/25 256/25 256/19
Freq/P 6 6 6 6 6 2
hase
FOV 24 24 24 24 24 24
SNR 100 100 100 100 100 100
ScanTi 2.02 1.44 3.54 2.18 2.00 4.12
me
Freq A/P A/P A/P S/I S/I A/P
Dir
A.C. Water Water Water Water Water Water
Freq
F C Dir Slice - - Freq Freq Slice
Saturati I I I I I I
on
Cont. Gadolinium (10 ml), T1 WI in all 3 planes, if pathology seen.

140
►Temporal lobes
Indication
● Diagnosis and evaluation of a lesion specifically in the temporal lobes
(tumours, vascular malformation, leukodystrophies and atrophic
processes)
● Evaluation of signal changes in the hippocampus and the temporal
lobe.
● Measurements of the hippocampal volume (hippocampal atrophy is
presently considered the most sensitive indicator of hippocampal
disease).
Sequences

Pulse Axial T2 Oblique Oblique Oblique Cor

Sequenc Cor T1 Cor T2 Cor 3DSPGR
e FLAIR
TR 4900 400 4000 4200 30
TE/IR 85 Min 85 50/350 Min
ETL 16 2 16 12 FA-45
deg
BW 20.83 20.83 15.63 20.83 15.63
Nex 2 4 4 2 2
Slice thk 5 4 4 4 1.5
Gap 1.5 1 1 1 # of scan
locs 28
# Of slice 20 16 16 16 Slab 1
Matrix 256/256 256/192 320/256 320/192 256/192
Freq/Pha
se
FOV 24 16 16 16 20
SNR 100 65 100 94 100
Scan 2.02 5.12 4.24 4.37 6.12
Time
Freq Dir A/P S/I S/I S/I S/I
A C Freq Water Water Water Water Water
F C Dir Slice - Freq Freq -
Saturatio I I I I I
n

141
►Posterior Fossa and IAM
Indication
● Symptoms that require the exclusion of an acoustic neuroma (vertigo,
unilateral sensory hearing loss, tinnitus)
● Diagnostic of posterior fossa lesion ● Facial palsy / numbness
● Hemifacial spasm
● Trigeminal neuralgia
Sequence

PS Axial Axial *Axial Cor T1 Axial AX-T1

T2 T1 T1+C- 3DT2 FS-FSE
FS
TR 4000 450 600 650 4000 450
TE/IR 85 Min Min Min 130 Min
ETL 20 - - 2 64 2
Bandwi 15.63 15.63 15.63 20.83 15.63 20.83
dth
Nex 5 3 2 4 1 4
Slice 3 3 3 3 0.8 3
Gap 0 0 0 0 LOCS 0
per
slab;
30
# of 12 12 12 11 slab 1 12
slices
MFPha 320/25 256/25 256/22 320/25 256/25 320/25
se 6 6 4 6 6 6
FOV 18 18 18 18 18 18
SNR 100 100 100 100 100 100
Scan 4.37 5.45 4.32 5.30 8.01 7.34
time
Freq R/L R/L A/P S/I R/L R/L
Dir
A C Water Water Water Water Water Water
Freq
F C Dir Slice - - - Slice Slice
Saturati A,P,S,I S,I S,I,FAT S,I A,P,S,I S,I FAT
on
Contrast Gadolinium (10 ml), T1 W Image in all 3 planes, if pathology
seen

142
►Pituitar
Indication
● Investigation of diseases related to pituitary function
(hyperprolectinaemia, Cushing’s disease, acromegaly, hypopituitarism,
diabetes insipidus, amenorrhea)
● Hypothalamic disorders
● Visual field defect,
● Pre-and postoperative assessment of pituitary adenomas
Sequence

PS AxialT CorT1 CorT2 Sag T1 Sag T1 C-T1+C-

2 +C-fs dyn-FSE
TR 4900 450 4000 450 650 400
TE/IR 85 Min 85 Min Min-full Min
ETL 16 - 24 - - 4
BW 20.83 10.42 20.83 10.42 12.50 20.83
Nex 2 3 4 3 3 1
Slice 5 3 3 3 3 3
Gap 1.5 0.3 0.3 0.3 0.3 0
Slices 20 11 12 11 12 6
MFPha 256/25 256/19 256/25 256/19 256/19 256/160
se 6 2 6 2 2
FOV/P 24/ .75 18 18 18 18 20/ .75
FOV
SNR 100 100 100 100 100 100
Scan 2.02 4.20 3.20 4.20 6.17 0.14
Time
Freq A/P S/I S/I s/I S/I S/I
Dir
A C Water Water Water Water Water Water
Freq
F C Dir Slice - Freq - - -
Saturat I I I I I,FAT S,I
ion
Contrast: - Gadolinium (10 ml), if pathological condition seen.
Dynamic scans should be taken after IV cont/Cor image should be
taken first/Acquire postcontrast T1W images in all 3 planes

143
►Orbits
Indication
● Visual disturbance ● Proptosis ● Evaluation of orbital or ocular mass
lesions
Sequence
PS Ax T2 Ax T1 Cor T2 Sag T1 Sag Sag T1
T2-fs FATSAT
TR 4000 450 4000 400 4050 400
TE/IR 85 Min full 85 Min 85 Min
ETL 16 - 16 - 24 -
BW 20.83 15.63 12.50 15.63 20.83 15.63
Nex 2 2 4.00 2.00 3 2
Slice 5 3 3 3 3 3
Gap 1.5 0 0 0 0 0
Slices 20 12 1 12 12 12
MF/Ph 256/25 256/22 256/22 256/22 256/19 256/224
ase 6 4 4 4 2
FOV 24 16 16 16 16 16
SNR 115 100 55 100 100 100
Scan 2.16 3.20 3.52 3.02 1.41 6.04
time
Freq A/P A/P S/I R/L S/I S/I
Dir
A C Water Water Water Water Water Water
Freq
F C Dir Slice - Freq - Freq -
Saturat I S.I - S.I S.I S.I FAT
ion FAT
Contrast Gadolinium (10 ml), T1 W Image in all 3 planes, if pathology
seen

144
►Temporomandibular joint
Indication
● Suspected internal meniscal derangement
Sequence

PS Sag Sag Sag Cor Cor T1 Sag 3D T2*

T1 T2 T2* T2* SE GRE
FSE FSE GRE GRE
TR 450 2600 300 350 400 29.0
TE/IR Min 8.5 15.0 15 Min 12.0
ETL 3 16 FA 20˚ FA 20˚ - FA 20˚
BW 20.83 20.83 8.93 8.93 8.93 8.93
Nex 4 4 3 3 3 2
Slice 2 2 2 2 2 1.2
Gap 0 0 0 0 0 o locs;2
# of 9 9 11 11 12 Locs per
slices slab;24
MF/Ph 256/22 256/22 256/19 256/19 256/19 256/128
ase 4 4 2 2 2
FOV 12 12 12 16 16 12
SNR 100 100 100 100 100 100
Scan 2.13 2.31 2.56 3.19 3.56 3.01
time
Freq S/I S/I S/I S/I S/I S/I
Dir
A C Water Water Water Water Water Water
Freq
F C - - - - - -
Dir
Satura - - - - - -
tion
Contrast Gadolinium (10 ml), T1 W Image in all 3 planes, if pathology
seen

145
►Diffusion
Indication
● Early detection of cerebral infarction
● Differentiating between arachnoid cysts versus epidermoid
● To differentiate cerebral abscess from necrotic tumour
● In the evaluation of patients with multiple sclerosis.
Sequence

Pulse Sequence O-Axial T2 O-Axial FLAIR

DW-EPI DW-EPI
TR 10,000 10,000
TE/IR Minimum Minimum
ETL - Inv. Time:2500
Bandwidth - -
Nex 1 1.00
Slice 5 5
Gap 0 0
No. of Slice 25 25
Matrix Freq/Phase 96/128 128/128
FOV/Phase FOV 36/0.60 36/0.60
SNR 100 100
Scane Time 0.40 2.00
Frequency Direction A/P R/L
Auto Centre Water Water
Frequency
Flow Compensation - -
Dir
Saturation I -
Remarks: B-Value 1000, Diffusion direction: ALL

146
►Perfusion
Indication
● For the evaluation of hyper acute stroke
● For the evaluation of brain tumours (for grading, sterotactic biopsy
guidance, distinguishing radiation necrosis from recurrent glioma and
determining prognosis and response to treatment)
● For the evaluation of epilepsy and Alzheimer’s type dementia
Sequence

Pulse Sequence No. of Shots O-Axial dynamic

EPI SE EPI
TR 2000
TE/IR 60
ETL FA 90°
Bandwidth 62.50
Nex 1
Slice 10
Gap 0
No. of Slice 12
Matrix Freq/Phase 96/64
FOV 30
SNR 100
Scan Time 1.20
Frequency Direction R/L
Auto Centre Frequency Water
Flow Compensation Direction -
Saturation -
Contrast 20 ml, all image data has to be transferred to the
workstation for further evaluation.

147
►Seizure protocol:
Common Abnormality Recommended MR sequences
Developmental Dual echo T2W axial, T1WI
malformations, conventional, & GRE coronal
Neurocutaneous syndromes, long TR FRFSE HR, 3D
Inherited metabolic SPGR, IR or FSE DWI
abnormalities, GD+/-
Hippocampal sclerosis Routine & coronal SPGR coronal
FLAI, coronal IR T2W, coronal T2W
FRFSE HR, T2W sagittal through
temporal lobe. Additional:-Volumetry,
Relaxometry, MRS.
Tumour & other Routine coronal FLAIR, DWI & GD
for? Tumor.

►Routine protocol for brain: Axial T2WI, T1WI and FLAIR

Sagittal T1WI
Coronal T2WI

Point-resolved spectroscopy - PRESS

Technique for localized spectroscopy using a spin echo pulse
sequence. (GE)

Positron » e+
Quantum with the energy of an electron but positively charged.

Positron emission tomography and MR - PET/MR

Positron emission tomography and MR spectroscopy PET/MRS

Combined use of PET and MRS by injecting a radioactively tagged
amino acid (FET) into patients with suspected brain tumours.

Projection reconstruction imaging enhancement - PR imaging

Technique in MR in which projection profiles of the body are obtained
by observing signals using a set of magnetic gradient aligned at
different angles with respect to the imaged object

Protons
The nucleus of the hydrogen atom has just one proton and no neutron.
It has the highest sensitivity to magnetic resonance.

Proton
One of the basic particles found in the nucleus of an atom, which has a
positive electric charge; like the earth, they are constantly turning
around on an axis and have their own magnetic field. The nucleus of
148
the hydrogen atom has just one proton and no neutron. It has the
highest sensitivity to magnetic resonance.

Proton density - PD
T1, T2 generated image. (rho). The spin density of hydrogen-1 (1H)
spins; represents to a certain extent the water content of a sample or a
tissue in proton MRI. (Number of hydrogen protons per unit of volume).
(Generally: spin density).
▪The amount (number) of protons contained in the tissue sample
▪The concentration of spins. ▪(rho or N) - the density of resonating spins
in a given region; one of the principal determinants of the strength of the
NMR signal from the region. Strictly defined to be the amount of
hydrogen per unit volume; the SI units would be moles/m3. For water,
there are about 1.1 x 105 moles of hydrogen per m3, or 0.11 moles of
hydrogen/cm3. Spin density changes very little between many biological
tissues and pathologies leading to images with poor contrast.

Proton (Spin) density, T1W AND T2W » PD, T1W & T2W

Proton density weighted » PD

Proton density weighted image - PD WI

(rho-weighted) T1/T2 generated image
In a PDWI (spin density), contrast is affected primarily by the proton
density of the tissue to be displayed, but which also has T1, T2, and
bulk flow contributions, although this only applies for hydrogen. Better
term: IWI (between T1 & T2)

Photon energy The capacity of a system to do work. » E

Proton, mobile
Protons that have a tendency to move when exposed to the static
magnetic field.

Proton relaxation enhancement

Enhancement of the signal intensity of hydrogen spectra or images
using contrast agents.

Pseudo - A false image or process.

Pseudo-gating
Pseudo-gating is obtained with a TR corresponding to the RR interval in
the cardiac cycle. This application is used to prevent flow artifacts
(assuming a stable heart rate), not for cardiac imaging.

Pulse
149
A single vibration or short burst of sound, electric current, light, rhythm,
wave etc.

Pulse, 90°
(pi/2 pulse) - RF pulse designed to rotate the macroscopic
magnetization vector 90° in space as referred to the rotating frame of
reference, usually about an axis at right angles to the main magnetic
field. If the spins are initially aligned with the magnetic field, this pulse
will produce transverse magnetization and hence an FID.

Pulse, 180°
RF pulse designed to rotate the macroscopic magnetization vector 180°
in space as referred to the rotating frame of reference, usually about an
axis at right angles to the main magnetic field. If the spins are initially
aligned with the magnetic field, this pulse will produce inversion, for
transverse magnetization causes a phase change which leads to the
generation of a spin echo.

Pulse oximeter (Blood oxygen saturation monitor)

The pulse oximeter displays the heart rate of the patient and
percentage of oxygen in the blood. The pulse oximeter may be placed
on any finger of the subject; however, the index or middle finger has
been found to work the best.

Pulsed gradients - Gradient pulse.

Pulsed NMR/MR
NMR/MR techniques that use RF pulses and Fourier transformation of
the NMR signal; have largely replaced the older continuous wave
techniques.

Pulse length (width)

Time duration of a pulse. For an RF pulse near the Larmor frequency,
the longer the pulse length, the greater the angle of rotation of the
macroscopic magnetization vector will be (greater than 180° can bring it
back toward its original orientation).

Pulse MR
MR technique that applies RF pulses in contrast to continuous wave
(CW) NMR.

Pulse NMR/MR
NMR/MR technique that use RF pulses and Fourier transformation of
the NMR/MR signal; have largely replaced the older continuous wave
techniques. » CW NMR.

150
Pulse programmer
The component of a computer system that controls the pulse features
such as time, amplitude, phase, and frequency.

Pulse sequence - PS
•Set of RF (and/or gradient magnetic field pulses and time spacing
between these pulses; used in conjunction with gradient magnetic fields
and NMR signal reception to produce NMR images. » Interpulse times.
•A series of RF pulses and/or magnetic field gradients applied to a spin
system to produce a signal representative of some property of the spin
system.
•The complex sequence of events occurring during MR data acquisition
by switching on RF pulse and magnetic gradient fields.
Introduction: SE, IR and GRE PS are routinely used in MRI. But there
are many different PS available, and each is designed for a specific
purpose. The image weighting, the type of PS we use determines
contrast and quality.
1. Spin echo (SE) pulse sequence
a. Conventional spin echo (CSE) pulse sequence
b. Fast spin echo (FSE) pulse sequence
2. Inversion recovery (IR) pulse sequence
a. STIR (short tau/time inversion recovery)
b. FLAIR (fluid attenuated inversion recovery)
3. Gradient echo (GE) pulse sequence
a. Coherent gradient echo pulse sequence
b. Incoherent gradient echo pulse sequence
4. Steady state free precession (SSFP)
5. Ultrafast imaging
6. Echoplanar imaging
7. Saturated recovery pulse sequence (SR)
Particular type of partial saturation in which the preceding pulses
leave the spins in a state of saturation, so that recovery at the time
of the next pulse has taken place.
8. Partial saturation recovery pulse sequence (PS)
MR technique of applying repeated RF pulses with TR less than or
equal to T1. Generates images with increased contrast between
regions of different T1.
Recent Development in Pulse Sequences
MRI has created a new era in diagnostic and management of various
diseases. Contrast in MRI is dependent on T1 relaxation, T2 relaxation
and PD. Depending on the predominant component; the image is called
T1WI, T2WI or PDWI. The contrast is achieved by the basic PS namely,
SE, GRE and IR. All the new PS have their origin in them.
The hydrogen protons present in the body act like tiny magnets. When
the body is exposed to magnetic field the hydrogen protons align and
precess. The precession frequency is proportional to the strength of the
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magnetic field. External energy in the form of RF is applied to the
precessing protons. There is disturbance in the magnetic equilibrium of
the protons. Discontinuation of RF pulse causes the magnetic
equilibrium of body to return to normal. While magnetic equilibrium is
return to normal it emits energy which recorded as signal. It is the
detected signal which forms the MR image.
Spin Echo imaging
A spin echo sequence is the most commonly used technique in MRI.
A slice selection 90o RF pulse is applied in conjunction with a slice
selection gradient. After a time of TE/2 an 180o slice selection gradient
is applied. A phase encoding gradient is applied between the 90o and
180o pulses. The frequency-encoding gradient is applied after the 180o
pulse, during the time the signal is collected. The recorded signal is the
echo.
TR is time between successive excitation pulses for a given slice. TE is
the time from the excitation pulse to the maximum echo. (Fig.10.1SE
PS diagram)
The contrast between white matter and oedema is maximized in two
distinct situations. A short TR and TE situation where white matter is
brighter than oedema and a long TR and TE situation where oedema is
brighter than white matter.
Gradients
The Imaging plane or point is determined by applying magnetic field
gradients. There are basically three types of gradients coils. One
gradient is required in each of the x, y, and z direction. A gradient is
simply a magnetic field that changes from point to point. Depending on
their orientation axis they are called Gx, Gy, Gz and used for slice
select, frequency (read out) or phase encoding.
Slice selection gradient: It is turned on only during application of RF pulse.
If we make the magnetic field change from point to point, then each
position will have its own resonance frequency. We can make the
magnetic field slightly weaker in strength at the feet and gradually
increase in strength at the head. This effect is achieved by using slice
selecting gradient coil. It helps to select the point of the slice.
Phase encoding gradient: The gradient is applied in one direction of the
slice. Protons precess at slightly different speeds (according to the
intensity of the gradient) and thus have different phase angles which
make it possible to differentiate them. This operation is called phase
encoding. Phase encoding gradient is usually applied between the 90o
and the 180o RF pulses or between the 180o pulse and the echo. For
every slice, Each TR interval contains one phase encoding step. This
process completes one line in K-space corresponding to the selected
gradient strength. This process is repeated to fill K-space.
Frequency encoding gradient (read out gradient): This is applied
perpendicular to the phase encoding. Its give rise to phase angle
differences in each band of protons which previously had the same
phase angle. The new phase angle provides spatial information. this
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operation is called frequency encoding. The frequency encoding
gradient is applied during the time the echo is received, i.e. during read
out. Each TR interval contains one read out per slice.
T1 and T2
T1 and T2 refer to physical properties of tissues after exposure to a
series of pulses at predetermined time intervals. Different tissues have
different T1 and T2 properties based on the response of their hydrogen
nuclei to RF pulses imposed by the magnetic field. MRI exploits these
different tissue properties by selecting equipment parameters (TE and
TR) producing images based on either the T1 or T2 properties of the
tissues. TE is the time interval between applying the pulse and
receiving the signal. TR is interval between two RF pulses. TE and TR
are both expressed in milliseconds (ms). A relatively low TE is about 20
ms, and high TE is above 100 ms. Low TR is about 50 ms and long TR
is above 1500 ms. T1WI have a low TE and low TR. (Fig. 10.2
convetional SE T1WI). Whereas both are high for T2WIs. PD images
have a low TE and high TR. (Fig. 10.3 convetional SE T2WI)
Contrast
Contrast agents currently in use are paramagnetic substances.
Molecules of paramagnetic contrast material create varying magnetic
field in tissues depending on their vibration/tumbling velocities and
concentration. These movements accelerate the relaxation process of
the hydrogen nuclei in the tissues, shortening both T1 and T2. At
certain tissue concentrations these substances produce a much shorter
T1 effect and if image acquisition is T1W certain tissues demonstrate
contrast enhancement.
The most promising contrast material developed to date is Gd-DTPA. It
has a similar effect in MR as that of iodine in CT. However the action of
Gd-DTPA is to shorten T1 relaxation time and the area appears brighter
on T1WI. (Fig.10.4). In contrary the action of iodine in CT is to increase
the density of area of the tissue and hence appears brighter.
Inversion Recovery (IR)
The RF pulses are 180o-90o-180o. A slice selection 180o RF pulse is
applied in conjunction with a slice selection gradient. A period of time
equal to inversion time (TI) elapses and a spin echo sequence is
applied. The remainder of the sequence is equivalent to a spin echo
sequence.
Inversion time (TI) is between the initial 180o pulses and 90o pulse. The
inversion recovery sequence is generally used in a high T1 dependent
medium. Inversion recovery images are strongly T1 dependent
providing excellent image contrast and anatomical details when the
correct pulse parameters are used. Area of short T1 appear bright
(white) and areas of long T1 appear dark (black). Areas of low PD such
as cortical bone and air appear dark in IR sequence. Hence lesion
adjacent to bone, e.g. Acoustic neuroma, chordoma, etc. cannot be
easily distinguished (Fig. 10.5)
Short Inversion Time Inversion Recovery
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The T1 relaxation time of fat is 150 ms. By selecting of inversion time
equal to 150 ms, the fat in the images gets suppressed and it is termed
as fat suppression images. This is useful technique in fatty tissues like
retro-orbital, musculoskeletal system and to differentiate between
lipoma and subacute hematoma (methemoglobin stage) as both are
hyperintense on T1WIs. Lipoma is a fatty lesion and is therefore
suppressed on STIR sequences. The inversion time of 2000 ms
suppresses CSF and it is known as FLAIR.
FLAIR
Hajnal et al first described FLAIR MR imaging techniques.
In an IR sequence if the inversion time (TI) is increased to 1500-2000
ms the longitudinal magnetization of the brain is all most fully
recovered. The signal from CSF can be nulled.
The FLAIR sequence has been used in the brain in cases of infarction
and multiple sclerosis. The FLAIR sequence is used in heavily T2W
form in the brain where most lesions are highlighted. It also can be used
to improve the accuracy of detecting T2 prolongation in the
hippocampus in mesial temporal sclerosis. The CSF signal is
decreased and this helps in detecting acute subarachnoid hemorrhage
(Fig. 10.6)
One of the main disadvantages of FLAIR was long acquisition time,
however newer techniques combining FLAIR like sequences with FSE
techniques have greatly shortened acquisition times.
FLAIR technique is currently used in a variety of brain diseases
including ischaemic stroke, demyelinating disorders, SAH, meningitis,
trauma (diffuse anoxal injury), cystic lesions, tumours (pilocystic
astrocytoma and glioblastoma multiforme) and vascular malformation.
Gradient Recalled Echo (GRE) Technique
Gradient echoes achieve their speed by using a low FA and gradient
reversal resulting in a short TR. In GRE imaging sequence a slice
selection RF pulse is applied to the imaged object. This RF pulse
typically produces a rotation angle between 10 and 90 called FA. A
refocusing gradient (read out direction) is employed that eliminates the
original 180o pulse of SE and later recalls it at the TE (hence the name
gradient recalled echo or GRE (Fig. 10.7).
Fast low angle shot (FLASH) and gradient recalled acquisition study
state (GRASS) are examples of GRE technique. The shortening of TR
values from seconds in conventional SE or IR sequences to tens of
milliseconds in gradient sequences greatly reduces scan times.
The table below contains important acronyms used by major
manufacturers.
Important acronyms
HITACHI GE SIEMENS PHILIPS
FSE GRASS FISP FE
GE SPGR FLASH MFE
FE SSFP PSIF TFE
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 GRE FSPGR turbo-FLASH
▪GRASS : Gradient recalled acquisition in the steady state
▪SPGR : Spoiled GRASS
▪SSFP : Steady state free precession
▪FSPGR : Fast SPGR
▪FISP : Fast imaging with steady state precession
▪FLASH : Fast low angle shot
▪PSIF : Fast imaging with steady state precession (opposite to
FISP)
▪Turbo-FLASH : Turbo-FLASH
▪GRASS yields more T2*WIs
In SPGR, a long TR and a large a yield T1WI. The disadvantages of
SPGR include increased rephasing caused by inhomogeneity,
increased magnetic susceptibility and chemical shift artifacts.
▪SSFP images yield heavily T2 (not T2*) WIs with increased scan speed
without the use of dedicated excitation and rephasing pulses. The
advantages include decreased dephasing caused by inhomogeneity,
decreased magnetic susceptibility and chemical shift artifacts. The
disadvantages are decreased SNR and increased sensitivity to
nonstationary tissue.
Multiplanar Techniques: The GRASS and SPGR sequences can be
performed using a multiplannar technique by selecting a long TR.
These are called MPGR (multiplannar gradient recalled, MPSPGR. A
small  yields PDW while a large  yields T1 weighting. Advantages of
multiplanar technique including increased SNR, multiplannar scanning,
multiecho imaging and reduces saturation effects.
Fast Gradient Echo Technique: The GRE techniques are generally
faster than SE techniques. There additional methods to increase the
speed of scanning. These methods are called Fast GRASS, Fast SPGR
Fast multiplannar GRASS, Fast multiplannar spoiled GRASS, etc.
Ultrafast TRs and TEs are employed to reduce the sequence time. This
is achieved by fractional echo, fractional RF, fractional NEX, and
reduction in the sampling time (increasing the band with).
Advantages of Fast GRE Techniques:
1. Single breath hold techniques in the abdomen
2. Imaging a joint in motion
3. Cine imaging of the heart
4. Temporal scanning of the same slices after contrast admin
5. Perfusion imaging
Disadvantages of Fast GRE
1. Decreased SNR
2. Increased chemical shift artifacts
Flow Imaging
GRE scanning performs one slice at a time except in multiplannar
imaging. Each slice is an entry slice. Consequently, flow related
enhancement (FRE) applies to every single slice, and vessels appeare
bright on GRE images. No saturated flowing protons enter the slice, so
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that flipping these protons yieds maximum signal. This is the basic
concept behind 2D or 3D TOF MRA.
Rapid Scan Techniques
As a result of ongoing technical developments rapid scan techniques
have established themselves as indispensable for state of the art
clinical MRI. A ten minutes scan protocol is becoming popular for most
of the routine imaging. Rapid MR techniques are based on either
gradient recalled or RF refocusing.
Radiofrequency Refocussed Technique
This achieves speed by sampling multiple lines of K-space per TR.
FSE, TSE and HASTE are the examples of this technique.
Fast Spin Echo
In FSE long train of RF focusing pulses can be applied to create
multiple SE’s after an initial RF excitation pulse, then the individual
echoes may be differently phase encoded to produce a data set for
image reconstruction. This principle underlines the RARE imaging
technique.
FSE is one of the most important recent advances in MRI. It was
originally called RARE. The primary advantages of FSE is speed
without the usual concomitant loss of SNR (Fig.10.8)
The essential difference between conventional CSE and FSE is that in
CSE all echoes in a train are preceded by a single value of phase
encoding gradient whereas in FSE each echo in a train is preceded by
different value of the phase encoding gradient (Fig. 10.9)
For an eight-echo train length the scan time is reduced by a factor of 8.
FSE can use a higher TR, larger matrix and is more advantageous than
CSE and still do it in much reduced times (Fig. 10.10)
FSE advantages include acquisition of true T2WIs and the possibility of
thin section T2W 3D imaging. FSE is relatively insensitive to magnetic
susceptibility effects hence artifacts produced by metallic objects are
reduced. However, small hemorrhagic or calcified lesions may be
missed. Fat is bright on PD and T2WI on FSE compared to CSE.
Subtle differences between FSE and CSEI include failure to detect
small objects with T2 values close to background, minor changes in the
size of small objects, and decreased signal in some stationary tissues
related to increased magnetization transfer and saturation effects in
FSE images. The protein bound water is relatively suppressed on FSE
images compared with CSE images. (Fig. 10.10) This effect is most
noticeable in the spine where normally hydrated disks are bright on
T2W CSE images but somewhat darker on FSE images.
In general FSE sequences have replaced CSE sequences for many
clinical applications because they provide a comparable SNR and
image contrast at significantly shorter scan times.
Half Fourier imaging uses only about half the number of phase
encoding steps of conventional image matrix. For example, a K-space
consists of 256 horizontal lines with 256 data samples wit a spatial
resolution of 256 * 256 pixels. Imaging times may be cut by a factor of 2
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if only half of the data in K-space is acquired saving 50% in imaging
time.
Echoplanar Imaging
Echoplanar Imaging fills K-space after a single RF pulse in a single
measurement or shot.
An MR image is referred to as image space. Its FT is referred to as K-
space. In MRI K-space is equivalent to the space defined by the
frequency and phase encoding directions. Conventional imaging
sequences record one line of K-space in each encoding step. Since one
phase encoding steps occurs with each TR time, the product of TR and
the number of phase encoding steps determines the time required to
produce an image. EPI measure all lines of K-space in all single TR
period.
There is a 90o slice selection RF pulse that is applied in conjunction with
a slice selection gradient. There is an initial phase encoding gradient
pulse. Next time there is 180o pulse. There are 128 or 256 phase and
frequency-encoding gradient when the echo is recorded. The rate at
which K-space is reversed is rapid (Fig 10.11).
The greatest application of EPI appears to be in the area of functional
MRI of the brain. During brain activity there is a rapid momentary
increase in the blood flow to the specific thought centre in the brain.
Similarly, movement of index finger causes rapid momentary increase
in the circulation of the specific part of the brain controlling the
movement of the finger. The increase in oxygen (which is
paramagnetic) affects the T1 and T2 of the local brain tissues. The
difference in T1 and T2 relative to surrounding tissue causes a contrast
between the tissues. This is known as BOLD technique (Fig 10.12 GRE
EPI PS diagram)
Echoplanar Diffusion Imaging
Diffusion Imaging is accomplished by adding diffusion sensitising
gradient pulses on either side of 180o of a SE sequence either CSE or
SE-EPI.
Diffusion is the process of random thermal motion of molecules
(Brownian motion). These motions occur at microscopic scale (i.e. on
the order of tenths or hundredths of millimetre per second). To enable
MR acquisition to detect these small motions, gradients applied across
the imaging field gradients, experience a phase change. These phase
changes either combine to retain signal, or combine to reduce signal.
Signal loss is related to the product of the ADC of the tissue and b value
of the sequence, which is determined by the amplitude, duration and
spacing of the additional gradient pulses (Fig 10.13 SE EPI diffusion).
In echoplanar diffusion imaging of the brain two or more acquisitions
must be made. First a base line SE-EPI image is made with the
diffusion sensitising gradient off (b=0) establishing a reference image.
Next a diffusion-sensitised image is taken using a b value in the range
of 1000 sec/mm2. Typically the following four sequences are required:
b=0 baseline image and then b=1000 images sensitising along each of
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the three (x, y and z) axes. In each diffusion image white matter tracts
running parallel to the gradients appear dark and white matter tracts
running perpendicular to the gradients appear bright reflecting the
preferred diffusion direction of water along the axons (Fig. 10.14)
Because this bright signal can potentially simulate pathology (i.e.
ischaemic lesion), lesions must be assessed in all three diffusion
images to accurately diagnose pathology. Alternatively a trace image
can be acquired showing the average diffusion changes along the three
axes. (Fig 10.14 diffusion image)
Echoplanar Perfusion Imaging
Perfusion or blood flow of the brain can be assessed with EPI
monitoring the first pass effect of gadolinium contrast. T2W EPI
sequence can be used to measure susceptibility changes caused by the
passage of the paramagnetic contrast agent. Large macromolecules of
gadolinium do not cross the blood brain barrier. As this bolus traverses
vascular bed it changes the intravascular signal and dephases spines
outside the lumen in the nearby tissues. This long-range intravascular
phenomenon has the beneficial effect of increasing the potential volume
of tissue signal changes. The transient drop in the signal intensity
caused by the passage of the gadolinium bolus provides indirect
evidence of the state of perfusion of the tissue. From these data, rCBV
and MTT maps can be generated. The sensitivity to perfusion is vessels
of a particular site depend on the specific EPI sequence used.
Performing echoplanar perfusion imaging with a SE-EPI provides
sensitivity to the microcirculation alone and a GRE-EPI sequence
provides sensitivity to both the microcirculation and the capillary
circulation (Fig. 10.15).
Magnetization Transfer Contrast
The main use of MTC is to extract more information from relaxation of
biological tissues. In most biological tissue, there is cross relaxation
between the free proton pool in protons in moving water (Hf) and the
restricted proton pool in protons in stationary water or tissues such as
macromolecues (Hr). Only protons that have a sufficiently long T2 time
(Hf) can be imaged. Typically, these protons are found in moving water.
Other protons (Hr) lose their transverse magnetization decay before
their signal is collected. (Fig. 10.15 Echoplanar perfusion graph)
Magnetization is constantly being transferred between Hf and Hr and
this will result in a change to the T1 values of Hf. If the Hr pool is
saturated by off resonance irradiation this will reduce its magnetization
to zero. This causes loss of signal intensity from the Hf pool at the
interface between the two pools. Due to the very short T2 value of the
Hr pool, the behaviour of the magnetization during the RF pulse is
dominated by relaxation. Hr makes up only around 10 percent of the
total proton pool in muscle tissue and therefore continuous or repeated
saturation is needed to create sufficient MTC in the Hf pool. MTC is
particularly good at increasing the T1 contrast between normal and
diseased tissue and is noted as being particularly useful in MRA.
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Most MRI manufacturers propose MTC as a standard push button
technique. It has been widely applied in clinical routines. Main
applications are the suppression of background tissue in MRA, and
synergetic enhancement of contrast in the T2W or contrast agent
enhanced scans.
However, only recently has the value of MTC for assessing tissues
diseases by quantitative indexes started to emerge.
Magnetic Resonance of Angiography
MRA is a non-invasive method of study of blood vessels. Fast imaging
technique like GE is used for MRA. There are two major ways of
performing MRA (1) TOF (2) PC.
Time of Flight
In TOF angiography low FA is used and 180o pulse is eliminated.
Stationary tissue is exposed to multiple RF pulses and is fully saturated.
Unsaturated blood entering this slice gives high signal. Obviously,
maximum enhancement will be obtained when the imaging plane is at
right angles to the direction of blood flow (Fig.10.16 and 17).
Phase Contrast
PC MRA is based on the principle that flow of blood along a magnetic
field gradient causes a phase shift in the MR signal. Pairs of image are
obtained using different gradient polarities. One image of a pair will be
obtained with a gradient of positive polarity to induce positive flow
related phase shift, whilst for the other image a gradient of negative
polarity is used to induce a negative flow related phase shift. These
images are subtracted to delete stationary tissue so that only blood
vessels are seen. Phase contrast sequences have to be encoded for
specific peak velocities. Unlike multiple projection images on TOF MRA,
in PC MRA a single collapsed image available from the subtracted
phase, forms the source image (Fig 10.18 MRV PC technique dual
sinuses)
TOF versus PC
TOF PC
Images Multiple projection Usually single collapsed
Bright Met Hb Simulates flow Image subtracted
Slice thickness 1-2 mm 3-5 mm
Resolution Good Fair
Flow sensitive Fair Good
Time 3-4 min 7-8 min

Clinical Application of MRA

Method Anatomy
2D TOF Conventional carotid artery overview, venous flow
gradient echo
3D TOF with Carotid artery overview with optimal visualization of
MOTSA stenosis. Combined with contrast for intracranial
aneurysm
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 3D TOF ê Cerebral arteries
MOTSA dural sinus (<20cm/s)
and MTC
2D PCA Vertebral basilar system (30 cm/s)
3D PCA Carotid arteries (30-60 cm/s)

MRS relies of information provided by chemical shifts. The magnetic

field around nuclei in a chemically complex environment is altered due
to shielding currents that are associated with the electron distribution
around adjacent atoms. These alterations in the magnetic field cause
small changes in the resonance frequencies, which are known as
chemical shifts, and these allow a distinction to be made between the
small nuclei in different chemical environment.
MRS may be obtained with many clinical 1.5 T MR units. Adequate MR
spectra may be obtained in periods of time as short as 10 to 15
minutes. Therefore, they may be added to routine MR imaging studies.
MR spectroscopy provides greater information concerning tissue
characteristic than what is possible with MR imaging studies alone.
31P MRS can be utilized to measure the concentration of ATP,
phosphocreatine and inorganic phosphate as well as the intracelular pH
in muscles. The metabolites of interest in brain include N-acetyle
aspartate (NAA), choline containing compounds (CHO) as well as
creatine and phosphocreatine (Cr). The NAA serves as a marker of
neurons. In a variety of disorders it may be decreased where there is
little or no change on the MR image (Fig 10.19).
Proton spectroscopy appears complementary to MR imaging which
generally of value in acute and subacute disease. Proton MRS readily
distinguished normal brain from tissues from astrocytoma. However,
proton MRS may not be able to distinguish between different histologic
grades of malignancy in astrocytoma. MRS may be useful in difficult
cases to differentiate tumours. Proton MRS shows elevation of lactate
in patients who have received 40 Gy or more to the brain. It also
demonstrates marked metabolic alterations in patients with mild AIDS
related dementia. Spectroscopy is also helpful in degenerative
disorders like Alzheimer and Parkinson disease, hepatic
encephalopathy, cerebral ischemia, etc. some innovative applications
include measurement of psychoactive drugs, neurofibromatosis type 1,
cerebral heterotopias, multiple sclerosis, etc.
Conclusions
Rapid scanning techniques have established themselves as
indispensable for state-of-art clinical MRI. A major breakthrough came
with introduction of low FA GRE imaging which is the basis for most
recent advances. Now we have magnets with high fields (1.5-3T) high
gradient strength 25-40 mt/m, which enables far better contrast
functional imaging. MRS is a new development and its application in
metabolic and functional imaging is rapidly evolving. Recent advances
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in MRI include new pulse sequences, rapid scanning, functional
imaging, angiography and spectroscopy.

Pulse sequences - PS
A pre-selected set of parameters, usually consisting of RF, gradient
magnetic field pulses, and time spacing of TR/TE. » PS

Pulse triggering
Pulse triggering suppresses motion and flow artifacts, as a result of
pulsating blood and fluid. The pulse wave obtained with a finger sensor
is used as the trigger. Pulse sensors are easier to use than ECG
electrodes, but less precise. They are therefore not recommended for
cardiac imaging.

Purcell Edward
Invented spectroscopy independently of and concurrently with Felix
Bloch.

►Q◄
Q factor
In radiology the term relates to the efficiency of an MR RF coil.

Quadrature coil
Analogous to quadrature detection in that the in phase and 90° out of
phase components are used to improve the efficiency of the RF pulse
and the S/N ratio.

Quadrature Detection
Detection of Mx and My simultaneously as a function of time.

Quadrature detector
A phase sensitive detector or demodulator that detects the components
of the signal in phase with a reference oscillator and 90° out of phase
with the reference oscillator.

Quality assurance - QA
Method for tuning the components and parameters of an MR system,
for determining spatial resolution, contrast resolution, SNR, and other
quality-relevant parameters to
ensure that the result of the imaging or working procedure meets some
predefined quality standard.

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Quality assurance in MRI
In order to get optimum image quality from a MRI system, a set of tests
at regular interval alongwith the preventive maintenance measures are
mandatory. The report of acceptance testing of the system (e.g.
physical inventory, radiofrequency shielding verification, cryogenic fluid
consumption, magnetic field in homogeneity, signal to noise ratio or
different coils, gradient coils, gradient strength linearity, provisions of
image acquisition and image processing software, acoustic noise
measurements and functioning of hard copy camera should be taken
into account. All QA measures should be directed to get better image
quality parameters. » Daily quality assurance - DQA
The daily test ensures the smooth functioning of the system avoiding
inconvenience to the patient. Daily tests take only 20 minutes and are
carried out by the technologist every morning before the patient
examination is resumed

Quality control - QC
Quality control comprises the qualitative or quantitative measurements
or test of performance of an instrument or program and the
determination of adequacy and acceptability of performance. This
includes the set of operation) programming, coordinating) intend to
maintain or to improve quality (ISO definition). In other words, as
applied to diagnostic procedures, it covers monitoring, of all
characteristics of performance that can be defined, measured and
controlled.
 Fig. 3.10A Phantom placed in the head coil
 Fig. 3.10B Image of DQA phantom coronal view
 Fig. 3.10C Image of DQA phantom axial view
 Fig. 3.10D System performance test (SPT) scan image for head
 Fig. 3.10E Noise scan

Quality factor » Q

Quantum - An indivisible unit of energy on a submicroscopic level.

Quantum physicist
One who views mass by its energy levels or subatomic parts.

Quench
Sudden loss of superconductivity of a magnet coil due to a local
temperature increase in the magnet. The cryogen used for
superconductivity evaporates rapidly, quickly reducing the magnetic
field strength.

Quenching
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Sudden loss of superconductivity of the current carrying coil that may
occur unexpectedly in a superconducting magnet. As the magnet
becomes resistive, heat will be released that can result in rapid
evaporation of liquid helium in the cryostat. When a system has a
malfunction of its electronics and/or there is a significant loss of
cryogenic coolants, the magnetic field becomes excessively incoherent
causing it to malfunction or go inoperative - thus a quench.

Quenching
A magnet quench will result in several days of down time. So, do not
press or push button except in a real emergency. Do not test that
button. Only qualified services personnel should test it. Quench button
is located near the magnet. » Magnet quench hazards

QUEST - Quick echo-split imaging technique

►R◄
R1
Longitudinal relaxivity or efficiency
Measured per unit concentration of salute of an agent that alters T 1
relaxation rates. Used in MR techniques.

R2 - Transverse relaxivity or efficiency

Measured per unit concentration of salute of an agent that alters T2
relaxation rates. Used in MR techniques.

-Weighted Image
A magnetic resonance image where the contrast is predominantly
dependent on spin density.

Radian - dimensionless unit of angular measure; 360° = 2pi radians.

Radiofrequency
The number of oscillations or cycles per unit time generated by radio
waves. » RF

Radiofrequency coil – RF coil

Antennas, called coils, are used to transmit RF pulses and/or receive
MR signals. As a transmitter coil, it should excite the nuclei in the
volume of interest as homogeneously as possible; al nuclei should
receive the same excitation. As a receiver coil, it should receive the MR
signal with as little noise as possible; the signal strength depends on

163
the excited volume measured in the coil and the distance to the
measurement object. Noise depends primarily on the coil size.
(Tuned circuit that is used to transmit the irradiating B 1 RF field and
receive the MR signal in an NMR experiment and MR imaging).

Radiofrequency echo - RF echo

NMR signal formed by the action of two or more radiofrequency pulses.

Radiofrequency or Excitation
If radiofrequency pulse having the same frequency as that of the
precessing nuclei is applied, the precessing path of the nuclei will be at
right angles and thus it spirals away which resembles like the wobbling
of a spinning top.

Radiofrequency interference (EFI)

Radiofrequency - RF
Frequency required to excite nuclei to resonate. Radiofrequency lies
between the acoustical and infrared frequencies. For MR frequencies in
the Megahertz range (MHz) are used. The primary effect of RF
magnetic fields on the human body is energy dissipation in the form of
heat, usually on the surface of the body. Energy absorption is an
important value for establishing safety thresholds. » SAR
∙A frequency band in the electromagnetic spectrum with frequencies in
the millons of cycles per second. ∙Transmission in the frequency of
radio waves. The raw signal in MR is in the RF range. ∙Wave frequency
intermediates between auditory and infrared. The RF used in NMR
studies is commonly in the megahertz (MHz) range. The principle effect
of RF magnetic fields on the body is power deposition in the form of
heating; this is a principal area of concern for safety limits.

Radiofrequency Quality factor - Q

Applies to any electrical circuit component; most often the coil Q is
limiting. Inversely related to the fraction of the energy in an oscillating
system lost in one oscillation cycle. Q is inversely related to the range of
frequency over which the system will exhibit resonance. It affects the
SNR, because the detected signal increases proportionally to Q while
the noise is proportional to the square root of Q. The Q of a coil will
depend on whether it is unloaded (no patient) or loaded (patient).

Radio-frequency pulse - RF pulse

•Transmission in the frequency of radiowaves used to alter the
orientation of procession of nuclei in MR. a major constituent of an MR
pulse sequence.
•Brief burst of RF magnetic field delivered to object by RF transmitter.
For RF frequency near the Larmor frequency, it will result in rotation of
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the macroscopic magnetization vector in the rotating frame of reference
(or a more complicated nutational motion in the stationary frame of
reference). The amount of rotation will depend on the strength and
duration of the RF pulse; commonly used examples are 90° (pi/2) and
180° (pi) pulses.

Radiofrequency refocused technique » PS

Radiofrequency screen
Shield placed around a MR imaging or MR spectroscopy instrument to
prevent airborne electrical noise from interfering with the MR signals.

Radio frequency spoiled

Refers to a spoiled gradient echo pulse sequence

Radio frequency spoiled fast acquisition in the steady state - RF

spoiled FAST
Picker brand name for a spoiled GE-PS » RF FAST

Radiofrequency spoiler pulse

Strategically applied reverse RF pulses to reduce the effects of residual
pulses in the ROI.

Radiofrequency - RF Shielding
The radiofrequency pulse used in MR is in the radiofrequency range. It
must be shielded for two reasons:
a) External electromagnetic waves (e.g., radios, electrical machines)
would distort the measurement and generate image artifacts.
b) The system RF signals should not extend beyond the system so as
to avoid interference with other receivers. RF shielding is provided by
installing the magnet and receiver coils in a Faraday case (a space that
cannot be penetrated by high-frequency waves). The magnet room, for
example, is shielded with copper and windows are covered by
electrically conductive screens.
The MR signal is relatively weak. Hence, small external RF
interferences can significantly degrade the image quality. As a result,
MRI systems generally require that the imaging room be shielded from
external sources of RF energy. For most of the systems, this involves
building RF shielding into the side walls, floor and ceiling of the MR site.
RF shielding also prevents the RF signal generated during MR
measurements from being disturbed by radio signals outside of the
room.
 Shimming
 Gradient

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Radio frequency spoiled fast acquisition in the steady state
Picker brand name for a spoiled GE-PS » RF spoiled FAST

Radiofrequency transmitter and receiver coils

Near field antenna designed to pick up or send out radio frequency
signal.

Rapid acquisition matrix FAST

Rapidly acquired magnetization prepared Fourier acquired steady state

Rapid/reduce acquisition matrix/magnetization RAM FAST

Rapidly acquired magnetization prepared Fourier acquired steady state
Reduced acquisition matrix Fourier acquired steady state
Picker brand name for a magnetization prepared GE-PS.
Fast imaging technique in magnetic resonance imaging.

Rapid acquisition with relaxation enhancement

Multiple spin echo sequence with echo encoding, multiple phase steps.

Rapid acquisition with relaxation enhancement - RARE

∙Multiple FSE imaging method using a single excitation followed by a
train of echoes.∙Faster TurboSE technique, for which a complete echo
train of 256 or more echoes is read after a single excitation pulse
(Single Shot TurboSE). Each echo is individually phase encoded.

Rapid acquisition with relaxation enhancement PS – RARE PS

MR imaging PS of the multi-echo SE-PS type. Other names for or
variations of the RARE sequence are: Turbo spin echo (TSE), Fast spin
echo (FSE) HASTE

Rapid acquisition spin echo

A short repetition time, short echo time, half Fourier spin echo
sequence.

RARE pulse sequence

An MRI PS of the multi-echo SE-PS type. Other names for or variations
of the RARE sequence are turbo SE (TSE), fast spin echo (FSE) and
HASTE.

Rapid imaging
All fast and ultrafast MRI technique and including rapid sequences
based on the SE-PS, the fast and ultrafast magnetization-prepared GE-
PS and all type of EPI.

Rapid scan
Hitachi brand name for a magnetization prepared GE-PS
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Rapid scan technique » PS

Rapid spin echo - RSE

RSE, RARE, FSE, TSE, MESS, RISE are rapid imaging pulse
sequence based upon multiple-echo spin-echo sequence, can be
implemented as different lines in k-space in a single image.

Rapid Spin-Echo Pulse Sequence Parameters

Echo Train Length (ETL) number of echoes per excitation
Effective Echo Time (eff.TE) echo time of the central line in k-
space
Echo Spacing (ES) time between the 180 refocusing
pulses
Repetition Time (TR) repetition between the 90 pulses

Rapid scan techniques » PS

Rapid scan specific absorption rate GE.

Raw data
The Mx and My data as a function of phase and time from an imaging
sequence. The MR measurement does not directly obtain the image.
Raw data are generated that are subsequently reconstructed into an
image. (K-space data).

Raw data filter

Raw data can be filtered prior to the image calculation. The Hanning
filter is provided with various weightings, enabling, for example, the
reduction of edge oscillation.

Raw data matrix

As with a hologram, every point in the raw data matrix contains part of
the information for the complete image. A point in the raw data matrix
does not correspond to a point in the image matrix.
The rows arranged about the centre of the raw data matrix determine
the basic structure and contrast in the image. The outer rows of the raw
data matrix provide information regarding the borders and contours of
the image, detailed structures, and also determine the resolution. Using
the 2DFT, the raw data matrix is converted into the image matrix. For
this reason, raw data rows are also referred to as Fourier rows.

Read out bandwidth

A pulse sequence’s received bandwidth in read out direction.

Readout delay » TE.

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Readout gradient
Conventionally refers to the frequency-encoding gradient activated
during the echo pulse.

Readout direction
The image direction corresponding to the MR signal readout. Also
called the frequency encoding direction.

Real
The component of a signal perpendicular to the imaginary signal. x

Received bandwidth » Readout bandwidth

Receiver
Portion of the NMR apparatus that detects and amplifies RF signals
picked up by the receiving coil. Includes a preamplifier, amplifier, and
demodulator.

Receiver dead time

A segment of time after the excited RF pulse where the FID cannot be
detected due to saturation of the RF receiver circuitry.

Recent development of pulse sequences » PS

Receiver coil - Coil of the RF receiver; 'picks up' the NMR signal.

Receiver tuning
Receiver dynamic setting for the ADC. This is unnecessary for many
modern systems with large receiver dynamic ranges.

RectangularFOV - RecFOV
If the object of interest is oval, a rectangular FOV can be selected. This
applies in particular to examinations of the abdominal and spinal
regions. The rectangular FOV is acquired with fewer measurement
lines. The full resolution raw data space is sampled less densely, so
resolution is not lost. Because there are fewer rows than columns, a
rectangular image is obtained. Measurement time is reduced, but so is
the SNR.

Reconstruction
A mathematical process utilizing FT and filtering for converting k-space
data into a permanent image.

Reconstruction from projections imaging

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MRI technique in which a set of projection profiles of the body is
obtained by observing NMR signals in the presence of a suitable
corresponding set of gradient magnetic fields. Images can then be
reconstructed using techniques analog to those used in conventional
CT, such as filtered back projection. It can be used for volume imaging
or, with plane selection techniques, for sequential plane imaging. See
also zeugmatography.

Reduced matrix
Measurement time may be saved by not acquiring raw data lines c
corresponding to high spatial frequencies (high resolution). Rows that
are not measured are filled with zeroes prior to the image calculation
(zero filling). This corresponds to an interpolation in phase-encoding
direction; therefore, a square image is still displayed on screen.

Reference image
Selected template for defining reconstruction methods, like MIP or
MPR.

Refocusing » Rephasing, Spin echo

Refocused FLASH a type of gradient echo pulse sequence

Refocused gradient echo - R-GRE

FAST, FFE, FISP, F-SHORT, GFEC, GRASS, ROAST, and SSFP

Refocusing pulse
RF pulse used to reverse the sense of precession of a signal and hence
produce a spin echo.

Region of interest
Region defined on a computer image for measurement purposes. (A
ROI is the area in the MR image singled out for evaluation).

Registration
Prior to the MR examination, the patient must be registered. The patient
data are entered, enabling a unique correspondence between the
patient and MR image. Interventional imaging: link between the “real”
position and the measured data record. : Matching of data from various
modalities.

Relaxation
Dynamic physical process in which a system returns from a state of
imbalance to equilibrium. » Longitudinal relaxation, Transverse relaxation

Relaxation rates
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The measured relaxation values of specific tissues.
R1 and R2; reciprocals of the relaxation times: 1/T1, 1/T2 measured in
1/s.

Relaxation times
▪After the initial RF torquing pulse the nuclear spins will
characteristically relax back to their original +z longitudinal equilibrium
in the form of T1 & T2 signals. The rate of the relaxation process is the
reciprocal of the relaxation time, as one increases the other decreases
proportionally.
▪After excitation, the spins will tend to return to their equilibrium
distribution, in which there is no transverse magnetization and the
longitudinal magnetization is at its maximum value and oriented in the
direction of the static magnetic field. It is observed that in the absence
of applied RF, the transverse magnetization decays toward zero with a
characteristic time constant T2, and the longitudinal magnetization
returns towards the equilibrium value M0 with a characteristic time
constant T1. T1 and T2 are measured in ms.

Relaxivity
r1 and r2; enhancing effect of an MR contrast agent. Measured under
standard conditions (37° C + 2° C; at physiological pH in water or
saline) expressed per paramagnetic center as r1,2 s-1 · mM-1. L.

Relaxometry
▪The measurement and study of spin-lattice and spin-spin relaxation
times. ▪The measurement of relaxation times. This can be performed
with a regular analytical magnetic resonance spectrometer in vitro or ex
vivo at defined field strength, with a magnetic resonance imager in vivo
at defined field strength, or with a field cycling magnetic resonance
relaxometer in vitro or ex vivo at different fields.

Relief artifact
Structures along the transitions between tissue with significant
differences in fat and water content (e.g., spleen, kidney, eye sockets,
spine, and spinal disks). The cause is chemical shift: during readout, fat
protons precess slower than water protons in the same slice because of
their magnetic shielding. The signal from the fat protons is incorrectly
encoded.

Remote control MRI (cardiac scanning) - RC MRI

Remote control software that enables an off-site imaging specialist to
operate an MRI unit via the Internet.

Removing patients from the scanner

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If a patient requests to be removed from the magnet, the technologist
should do so promptly. Whether due to pain, illness, or claustrophobia,
never keep the patient in the scanner. If a patient asks to be brought
out, communicate to determine the problem. If can’t continue, remove
the immediately.

Repetition time, time of repetition, repeat time - TR

The period of time between the beginning of one pulse sequence and
the next.
▪In general, the time between two excitation pulses. Within the TR
interval, signals may be acquired with one or more echo times, or one
or more phase-encodings (depending on the measurement technique).
TR is one of the measurement parameters that determine contrast.
▪The period of time between the beginning of a PS and the beginning of
the succeeding (essentially identical) PS.
▪The period of time between the beginning of a PS and the next in MRI.
▪The time that a pulse sequence is repeated for a given slice.
▪The time frame between two corresponding 90o B1-RF pulses.
▪Repetition between the 90o pulses

Rephased-Dephased » Magnetude contrast angiography

Rephasing
Reversal from dephasing; the spins go back into phase. Achieved
through a 180o pulse that creates a SE or GE pulse in the opposite
direction.
(The regrouping of the dephasing spins following a reversal refocusing
pulse. » GRM

Rephasing gradient
Specialized gradient sequence designed to speedily refocus dephasing
spins.

Respiratory ordered phase encoding - ROPE

Process of varying the strength of phase encoding gradients in a non-
sequential sequence in MRI. Diminishes respiratory motion artfacts.

Retrospective gating
Simultaneous acquisition of untriggered data and the ECG signal. The
ECG signal is used during subsequent post-processing to assign the
images to the correct phase in the cardiac cycle. Can also be used for
pulsatile flow.

Resistive electromagnets

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A magnet whose magnetic field is generated using a normally
conductive coil system. When used with cooper or aluminum
conductors, creates maximum field strength of 0.3 Tesla. Disadvantage:
high electric costs. (Magnetic fields that are generated by applying
current to a loop of wire. A continuous power source is necessary to
maintain electromagnetism).

Resistive magnet
A magnet whose magnetic field originates from current flowing through
an ordinary (nonsuperconducting) conductor. » Comparison
Resistive systems: These are electromagnets wherein the magnetic field
is generated by an electric current flowing through a coil. They have two
major drawbacks. High electric and water consumption (cooling) and
generate fields that are difficult to raise above 1.5 T

Resolution = contrast » Image resolution, Contrast.

Resolution
Spatial - although generally referring to the ability of the imaging
process to distinguish adjacent structures in the object (an important
measure of image quality), the specific criterion of resolution to be used
depends on the type of test used (e.g. bar pattern of contrast-detailed
phantom). As the ability to separate or detect objects depends on their
contrast, and the different MRI parameters of objects will affect image
contrast differently for different imaging techniques, care must be taken
in comparing the results of resolution phantom tests of different
machines, and no single simple measure of resolution can be specified.

Resolution, time - imaging time.

Resonance
▪An exchange of energy between two systems at a specific frequency.
▪The transition of nuclei from low energy state to high energy state
following the application of an RF pulse at the same frequency as the
precessing nuclei.
▪A large amplitude vibration in a mechanical or electrical system caused
by a relatively small periodic stimulus with a frequency at or close to a
natural frequency of the system; in an MRI machine, resonance can
refer to the NMR itself or to the tuning of the RF circuitry.

Resonance frequency
The frequency at which (resonance occurs) protons process within an
applied magnetic field. For MR, this frequency is used for the RF pulse
that affects the spin equilibrium (matches the Larmor frequency).

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▪Frequency at which the resonance phenomenon occurs; given by the
Larmor equation for NMR; determined by inductance and capacitance
for RF circuits.
▪The f required to cause resonance of the same f as the precessing
nuclei. It may be determined using the Larmor equation.

Resonant frequency - RF
Frequency at which protons process within an applied magnetic field

Resonant offset averaging in the steady state - ROAST

GE-PS, where the readout gradient is left on after signal readout to
assure that a full 360o range of magnetization Vector orientations exists
in each voxel.

Respiratory compensation

Respiratory Gating
It is used to suppress the breathing motion. Acquisition takes place only
during the “gate” when the respiration movement are minimal. It is
relatively effective at minimizing the effects of thoracic motion, but
results in substantial increase in imaging time and hence, is not
commonly employed. (Synchronization of the measurement with the
patient’s breathing. Diaphragm movement is detected with the navigator
echo).

Respiratory Motion artifact

This type of artifacts is caused by respiration during the scanning.
Respiratory gating and respiratory compensation can avoid this. It can
be avoided by placing bellows (pressure transducers) around the
patient’s chest or abdomen.

Respiratory ordered phase encoding

Process of varying the strength of phase encoding gradients in a non-
sequential sequence in MRI. Diminishes respiratory motion artfacts

Respiratory Triggering
Data acquisition is synchronized to breathing. A respiratory signal
acquired with suitable sensor or MR methods (navigator echo) is used
as the trigger signal.
In analogy to cardiac triggering, respiratory triggering can also be used
to generate an electric signal upon expiration to start data acquisition.

Retrospective gating
Used in cardiac imaging. Involves collecting non-gated data while
simultaneously recording the ECG signal; the latter is then used with a
post-processing routine to assign the images to the correct stage in the
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cardiac cycle. The ECG can be replaced by additional echoes which
monitor the position (navigator echoes).

Reverse fast imaging with steady procession - PSIF

GE PSIF sequence, Siemens a refocused GE-PS » Reverse FISP
Time-inverted FISP technique. Produces strong T2-weighted contrast in
a short measurement time. Siemens brand name for a refocused GE-
PS, CE FLASH

Reversed FISP (PSIF) Reverse fast imaging with steady procession

Siemens brand name for a refocused gradient echo pulse sequence

Rewinder gradient >Phase rewinder gradient.

Rewinding pulse
The strategic employment of reversal gradients used to remove or
reduce flashband artifacts.

RF field
Rotating magnetic field B1 used in nuclear magnetic resonance (NMR).

RF spoiled FAST -Radio frequency spoiled FAST

RF-spoiled Fourier acquired

rho > Spin density.

Rise rate » Slew rate

Rise time
The time required for the gradient field to rise from zero to the maximum
value.

Role of MRI in diseases » Tissue characteristics

Respiratory ordered phase encoding - ROPE

Rotating delivery of excitation off-resonance - RODEO

New 1.5T Dedicated MRI system for breast imaging developed by
Aurora Imaging Technology.

Rotating frame of reference

A frame of reference (with corresponding coordinate systems) that is
rotating about the axis of the static magnetic field B0 (with respect to a
stationary frame of reference) at a frequency equal to that of the applied
RF magnetic field, B1. Although B1 is a rotating vector, it appears
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stationary in the rotating frame, leading to simpler mathematical
formulations. Rotating frame zeugmatography - technique of MRI that
uses a gradient of the RF excitation field (to give a corresponding
variation of the flip angle along the gradient as a means of encoding the
spatial location of spins in the direction of the RF field gradient) in
conjunction with stepping the duration of the RF pulse to give one-
dimensional spatial encoding. It can be considered as a form of FTI.

Rotating-frame spectroscopy
MR spectroscopy technique using surface coils taking advantage of
spins nears the surface. » SCRF

Rotation Matrix
A matrix used to describe the rotation of a vector.

Routine Sequences used in MRI

There are essentially 3 pulse sequences, which are routinely used in
MRI. a) Spin echo (SE) b) Inversion recovery (IR) c) Gradient recalled
echo (GRE) technique

Rows
The phase encoded portion of the measurement matrix. Often also a
row in the displayed image. » Columns

►S◄
Saddle coils - Helmholtz coils
▪RF coil configuration design commonly used when the static magnetic
field is coaxial with the axis of the coil along the long axis of the body
(e.g. superconducting magnets and most resistive magnets) as
opposed to solenoid or surface coil. ▪A coil geometry which has two
loops of a conductor wrapped around opposite sides of a cylinder.

Sagittal
A tomographic imaging plane bisecting the body into left & right parts. »
Orthogonal slices

Sagittal slice
Cross-sectional images parallel to the long axis of the patient’s body
(left to right direction).

Sampling
Conversion of analog signals to discrete digital values through a
preselected measurement process.

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Saturate  soak, hold, a saturated fat.

Screening patients » Safety

Screening prior to scanning » Examination procedure, Safety

Saturation
The state in which spins have no net longitudinal or transverse
magnetization. It is not possible to obtain an MR signal from saturated
tissue.
▪A nonequilibrium state in NMR, in which equal numbers of spins are
aligned against and with the magnetic field, so that there is no net
magnetization. Can be produced by repeatedly supplying RF pulses at
the Larmor frequency with interpulse times short compared to T1.
▪Reduction or suppression of segments of the longitudinal
magnetization by selectively saturating adjacent spins in the ROI, thus
effectively removing/reducing their superimposing deleterious influence.
This process is also effectively used to enhance image contrast.

Saturation pulse
RF pulse which saturates the spin system (saturation). » SP

Saturation recovery - SR
Technique for generating primarily T1 dependent contrast through a
series of 90o excitation pulses. Immediately after the first pulse,
longitudinal magnetization is zero because the tissue is saturated. The
next 90o pulse is not applied until longitudinal magnetization has
recovered somewhat. The TR depends on the T1 constant of the tissue.
▪PS in MRI characterized by two sequential 90º pulse; a saturation and
a detection pulse. This result in short TR spin echo sequences. » SR-PS
▪A specialized pulse sequence where saturated spins are allowed to be
restored to equilibrium before the next pulse is activated.

Saturation transfer
(or Inversion transfer) - Nuclei can retain their magnetic orientation
through a chemical reaction. Thus, if RF radiation is supplied to the
spins at a frequency corresponding to the chemical shift of the nuclei in
one chemical state so as to produce saturation or inversion, chemical
reactions transform the nuclei into another chemical state with a
different chemical shift in a time short compared to the relaxation time.
The NMR spectrum may show the effects of the saturation or inversion
on the corresponding, unirradiated, line in the spectrum. This technique
can be used to study reaction kinetics of suitable molecules.

Saturation slice

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Regional presaturation to suppress undesired signals for specific areas,
either within the slice or parallel to it. » Parallel saturation, Presaturation,
Travelling saturation slice.

Scan
i) Acquisition of one or more MR signals from a single excitation pulse.
ii) Acquisition of a complete raw data set.

Scan time
Total time required for the acquisition of all the patient data to produce
the programmed image. MATRIX Size » Measurement time, Technical
factor

Scout - Basic image

Screening patients » Examination procedure, Safety

Sech pulse » Hyperbolic secant pulse.

Segmented TurboFLASH
Siemens brand name for an ultrafast segmented (segmented data
acquisition), magnetization-prepared gradient echo PS

Segmented HASTE
Variant of the standard HASTE technique. With segmented HASTE,
half the image information is acquired after the first excitation pulse, and
half after the second excitation pulse. The acquired raw data are then
interleaved into the raw matrix. Along repetition time TR is selected to
allow the spin system to recover between excitation pulses. Any dead
time may be used to excite additional slices. Advantage: the length of
the multiecho pulse train is cut in half. HASTE sequences may also be
divided into more than 2 segments.

Seizure protocol » Protocols

Selective excitation
Limits excitation to the region desired. Magnetic field gradients are
combined with a narrow band RF pulse. Selective excitation is also
used with fat and water suppression. Low band RF pulses excite the
protons bound in fat or water.
Controlling the frequency spectrum of an irradiating RF pulse (via
tailoring) while imposing a gradient magnetic field on the spins, such
that only a desired region will have a suitable resonance frequency for
excitation. Originally used to excite all but a desired region, now more
commonly used to select only a desired region, such as a plane, for
excitation.

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Selective irradiation - Selective excitation.

Self refocusing pulse

A category of RF pulses which can be used without a slice refocusing
gradient.

Semiconductor
A substance, usually metallic, that will only allow electrons to flow in
one direction only.

Sensitive plane
Technique of selecting a plane for sequential plane imaging by using an
oscillating gradient magnetic field and filtering out the corresponding
time dependent part of the NMR signal. The gradient used is at right
angles to the desired plane and the magnitude of the oscillating
gradient magnetic field is equal to zero only in the desired plane.

Sensitive point
Technique of selecting out a point for sequential point imaging by
applying three orthogonal oscillating gradient magnetic fields such that
the local magnetic field is time dependent everywhere except at the
desired point, and then filtering out the corresponding time dependent
portion of the NMR signal.

Sensitive volume
Region of the object from which NMR signal will preferentially be
acquired because of strong magnetic field inhomogeneity elsewhere.
Effect can be enhanced by use of a shaped RF field that is strongest in
the sensitive region.

Sensitivity » MR sensitivity

Sequence
Particular order in which related events, movements, etc., follow each
other. » Pulse sequence

Sequence and Finding

Diffusion Hge/Ischemic stroke, Edematous/Hge infarct
FLAIR I, MS, SAH, Ischaemia, DD, M, T, DAI, CL, T, PA, GM, VM
Perfusion Brain Ischemia
STIR Differentiate Lipoma / Subacute hematoma

Sequence controller
Computer hardware that controls the output of waveforms.

Sequence time » TR
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Sequential line imaging
(Line scanning, Line imaging) - MRI techniques in which the image is
built up from successive lines through the object. In various schemes,
the lines are isolated by oscillating gradient magnetic fields or selective
excitation, and then the NMR signals from the selected line are
encoded for position by detecting the FID or spin echo in the presence
of a gradient magnetic field along the line; the Fourier transform of the
detected signal then yields the distribution of emitted NMR signal along
the line.

Sequential multislice imaging

The slice in the area under examination are measured sequentially. The
slices desired are selected using suitable gradients (selective
excitation).

Sequential plane imaging (Plane imaging)

MRI technique in which the image of an object is built up from
successive planes in the object. In various schemes, the planes are
selected by oscillating gradient magnetic fields or selective excitation.

Sequential plane imaging

Successive images of an object are collectively sandwiched together by
computerization to form a volumetric image.

Sequential point imaging

(Point scanning) - MRI techniques in which the image is built from
successive point positions in the object. In various schemes, the points
are isolated by oscillating gradient magnetic fields (sensitive points) or
shaped magnetic fields. Now obsolete for imaging (due to poor S/N
ratio) but used in localized spectroscopy.

Shaped pulse - SP
RF pulse whose amplitude varies during the pulse.

Shielding
Magnetic shielding is required to protect the surrounding environment
from the effects of fringe field, which surround a magnet. To maintain
magnetic field homogeneity, shielding is necessary for the field to be
protected from being distorted by the external environment: » Active
shielding, Magnetic shielding, Passive shielding, RF Shielding
(Shimming (Active and Passive)

Shielded gradients
A modified gradient system, which eliminates eddy current problems.

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Shim
Correction of magnetic field inhomogeneity caused by the magnet itself,
ferromagnetic objects, or the patient’s body. The basic shim usually
involves the introduction of small iron pieces in the magnet. The patient
related fine shim is software-controlled and performed using a shim coil.
(Metal object used to shape the magnetic field flux lines into a desired
configuration). » Active shim, Global shim, Interactive shim, Local shim,
3D shim.

Shim coils
Coils that create weak additional magnetic fields in various spatial
directions. Used to correct inhomogeneity in the main magnetic field.
Coils carrying a relatively small current that are used to provide auxiliary
magnetic fields in order to compensate for inhomogeneities in the main
magnetic field of an NMR system.

Shimming
Better homogeneity can be achieved by electrical and mechanical
adjustment by a process known as “shimming”. Correction of
inhomogeneity of the magnetic field produced by the main magnet of an
MRI system is necessary due to imperfections in the magnet or the
presence of external ferromagnetic objects. The important quality for a
magnet is “homogeneity” of its main magnetic field. Inhomogeneities
distort the spatial encoding which in turn adversity affects the slice
geometry. The MR image will show distortions in the slice plane. In
order to prevent this type of image errors, the magnet system has to be
adjusted during system installation to local conditions or deviations in
unit spread prevailing in the unit. a process called shimming is used.
We differentiate between Active and Passive shimming. Generally
carried out by adjusting the current in the shim coils while observing an
FID (or the Fourier transformed signal).

Short absorption rate gradient echo - SARGE

Rate at which energy is deposited in MRI, usually in W kg-1 » SAR

Short inversion time inversion recovery » PS

Short minimum angle shot - SMASH

Shimadzu brand name for a magnetization prepared GE-PS

Short repetition technique - SHORT

Elscient brand name for various gradient echo pulse sequence

Short scale - Short grey scale latitude.

Short tau / time inversion recovery » STIR

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Short tau / time inversion recovery PS » STIR PS

Short tau inversion recovery / Short TI inversion recovery » STIR

Short T1 weighted sequences

Chosen scanning parameters that produce images that exaggerate the
contrast of short T1 tissues.

SI units - International System of Units

Signal » MR signal

Signal averaging
The repeated scanning of a given k-space line of the matrix for the sole
purpose of enhancing S/N.

Signal elimination
Areas in the image that do not generate a signal (are black). Various
caused: metal artifacts, susceptibility artifacts, flow effects, and
saturation effects. Flow voids may occur with fast flow when using spin
echo sequences if the bolus flows out of the slice between the 90o and
180o pulses. No spin echo is produced, and blood appears black in the
image.

Signal intensity
Strength of the signal from a voxel of tissue as detected by a MR
scanner. » High and low MR signal

Signal-to-noise ratio - SNR / S/N

The measurement of true signal to random signal.
Relationship between the intensity of signal and noise. Ways to improve
SNR include:
a) Increasing the number of averagings
b) Increasing the measurement volume (spatial resolution degrades)
c) Using special coils and local coils
d) Smaller bandwidth
e) Shorter echo time
f) Thicker slices
Ratio of signal from an imaged object to random signal fluctuations as
recorded by an imaging system. The higher the SNR, the better the
images contrast.

Signal size
Strength of a signal (commonly number of protons) recorded per pixel
by an imaging system.
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Single slice acquisition - SSA
Any MRI acquisition where a single rather than multiple slices is
acquired.

Single contrast turbo spin echo - SCTSE

T1, T2 or PD, DC TSE - T2 & PD, MC TSE - T1, T2 & PD

Single shot fast spin echo - SS FSE

MRCP, MRU and MR mylography are commonly performed rapidly
without use of contrast. GE

Single volume spectroscopy - SVS

SVS methods map the metabolic information from the VOI in a
spectrum. Single volume techniques are advantageous in case of
pathological changes that cannot spatially be limited to a few VOIs:
local inhomogeneity in the magnetic field can be compensated to a
large extent using “local volume-sensitive shim”. Clinical 1H
spectroscopy currently uses single volume techniques based on spin
echoes or stimulated echoes (STEAM).

Simultaneous acquisition of spatial harmonics - SMASH

Simultaneous multislice imaging - SMI

Simultaneous volume imaging - Volume imaging.

sinc - sin(x)/x

Sinc Pulse - A radiofrequency pulse shaped like Sin (x)/x.

Sine wave
The propagation of a wave is in a sinosoidal shape mapped on the y
axis and characterized by amplitude vs. frequency of the wave.

Single point MRI

A class of MR imaging pulse sequence which are insensitive to even
high degrees of magnetic field inhomogeneity.

Single shot EPI

EPI technique where the data of an entire image are acquired after a
single preparation phase in the pulse sequence.

Single shot fast spin echo » SS FSE

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Single shot MRI
Any imaging pulse sequence which generate an image using a single
preparation phase pulse and a scheme to read out all lines of the image
after the single pulse.

Single-shot technique
All image information is acquired in a single excitation pulse. The
magnetization of a fully relaxed spin system is used. Each of the
subsequent echoes is given a different phase encoding. Only slightly
more than half the raw data are acquired. The image is obtained
through Half Fourier reconstruction. Single shot techniques include EPI,
RARE, and HASTE.

Single voxel MRS

Technique for obtaining MR spectra from a single volume of tissue.

Single Turn Solenoid

A transmits and receives radiofrequency imaging coil, which, in general,
has a cylindrical shape.

Skin depth
Time dependent electromagnetic fields are significantly attenuated by
conducting media (including the human body); the skin depth gives a
measure of the average depth of penetration of the RF field. It may be a
limiting factor in magnetic resonance imaging at very high frequency
(high magnetic fields). The skin depth also affects the Q of the coils.

Slab » 3D slab

Slab thickness - The slice thickness of a 3D slab.

Slew Rate
▪Identifies how fast a magnetic gradient field can be ramped to different
field strength. » SR-PS
▪The rate at which a gradient may be turned on or off. The faster the
slew rate the more possible it is for an MRI system to do EPI or fMRI,
and the shorter the TE value that can be achieved in a SE sequence.

Slice
Thin, 3D cuboids uniquely defined by slice position, FOV, and slice
thickness. The centre plane or the slice is the image plane.
(Synonymous with the planar region or the image slice select region).

Slice distance
The separation between the centre planes of two sequential slices or
three-dimensional slabs.
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Slice encoding
Relates to the addition of phase encoding steps for 3D volumetric
imaging.

Slice gaps
The gap between the nearest edges of two adjacent slices. Not to be
confused with the slice distance.

Slice orientation
Orthogonal planes are available for use as the basic slice orientation.
▪Sagittal ▪Coronal ▪Transverse. An oblique or double-oblique slice is
obtained by rotating the slice out of the basic orientation.
Superior ↔ Inferior (Axial), Right ↔ Left (Sagittal), Anterior ↔ Posterior
(Coronal)

A recommended standard orientation for the presentation of MR images

is: (1) transverse: patient's right on the left side of the image, anterior or
ventral on top; (2) coronal: patient's right to left side of image, superior
or head to the top; (3) sagittal: patient's head to the top, anterior to the
left side of image. R (right), L (left), P (posterior), A (anterior), and if
necessary S (superior) should be shown on the screen and the
hardcopies, as appropriate. In displaying sagittal images, it is helpful to
indicate whether a slice is to the left or right of the midline.
 Superior <> Inferior (Axial plane)
 Right <> Left (Sagittal plane)
 Anterior <> Posterior (Coronal plane)

Slice overlap artifact

This slice overlap artifact is a name given to the loss of signal seen in
an image from a multislice acquisition, as is obtained commonly in the
lumber spine. If the slices obtained at different disk spaces are not
parallel, then the slices may overlap. If two levels are not done at the
same time, e.g. L4/L5 and L5/S1 then the level acquired second will
include spins that have already been saturated. This causes a band of
signal loss crossing horizontally in our image, usually prominent
posteriorly. Fig. 7.21,22A+B

Slice position
The position of the slice to be measured within the area under
examination.

Slice positioning
Graphical positioning of the slices/saturation slices to be measured in a
basic image.

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Slice rephasing gradient
Gradient magnetic field applied for a brief period after a selective
excitation pulse, in the opposite direction to the gradient used for the
selective excitation. The result of the gradient reversal is a rephasing of
the spins (which are out of phase with each other along the direction of
the selection gradient) leading to a greatly improved S/N ratio.

Slice-selection
Process by which gradient are applied and a radiofrequency pulse is
transmitted to a unique volume of tissue. » Technical factors
Displaying an MR image of the human body requires that the slice
desired be selectively excited. For orthogonal slices, a magnetic
gradient is applied perpendicular to the desired slice plane (slice-
selection gradient). Oblique and double-oblique slices are excited by
simultaneously applying 2 or 3 gradient fields.

Slice selection gradient

That gradient whose function is to identify specific slices in an imaging
volume. It is applied at the time of RF pulse application during an image
acquisition.

Slice selection gradient Gs

Slice selective off resonance since pulse saturation transfer

contrast - SORSSTC

Slice sequence
For multislice measurements, the excitation sequence can be selected
as desired: ▪Ascending (1, 2, 3, …, n) ▪Descending (n, n-1, …, 3, 2, 1)
▪Interleaved (1, 3, 5, …, 2, 4, 6, …) ▪Freely defined

Slice shift
Distance between the centre of a slice group and the centre of the
magnetic field in slice-selection direction.

Slice thickness
The thickness set for the slice to be measured. The thicker the slice, the
stronger the signal and the better the signal-to-noise ratio. However,
spatial resolution drops. The thickness of the preselected image slice,
usually measured in mm. » Technical factors

Small tip angle gradient echo T1 W » STAGE T1W

Shimadzu brand name for a spoiled GE-PS

Small tip angle gradient echo » STAGE

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SmartPrep
MRA program automatically begins pulse sequence when the signal
intensity of the vessel exceeds a preset threshold value. (GE)

Smearing artifacts
In the case of non-periodic movement (such as eye movement), the
excited spins may be at a different location in the gradient field at the
echo time, resulting in incorrect phase-encoding. This smears the object
in the phase-encoding direction. These artifacts are more discrete for
periodic movements.

Snapshot FLASH
A magnetization prepared rapid GE-PS
A very rapid FLASH sequence (scan time 200-500 ms) using a low flip
angle (~5°) to produce proton density-weighted scans. Contrast can be
manipulated by suitable preparation of the magnetization prior to the
scan.

Snapshot sequence - Magnetization prepared GE-PS

Sodium (32Na)
A natural element within the body, found particularly in extracellular salt.

Soft shareholding and depth cueing of unspecified technique »

STANDOUT
Post-processing technique used for 3D reconstructions in MRI.

Software
The entire set of instructions, programs, procedure and related
documentation that controls the activities of the computer system.

Solenoid coil
A coil of wire wound in the form of a long cylinder. When a current is
passed through the coil, the magnetic field within the coil is relatively
uniform. Solenoid RF coils are commonly used when the static
magnetic field is perpendicular to the long axis of the body. The Greek
solenoid means “channeled.”

Spacing » Technical factors

Spatial encoding
Selective identification of the signal within the imaging volume.

Spatial resolution
The ability to define minute adjacent objects / points in an image,
generally measured in line pairs / mm (1p/mm) » Technical factors
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SPAtial Modulation of Magnetization SPAMM
A technique in which spin tagging is accomplished by multiple RF
pulses separated by magnetic GF pulses.

Spatial resolution
The full spatial resolution in the image is based on the FOV,
measurement matrix, and slice thickness. It is characterized by the
voxel size. The smaller the voxel, the higher the special resolution, but
the smaller the measured signal.

Special coil - Local coil

Specific absorption rate - SAR

▪The number of Watts of radiofrequency energy per kilogram of body
weight in an imaging sequence.
▪Rate at which energy is deposited in MRI, usually in W/kg-1 » SARGE
The RF energy absorbed per unit time unit and per kilogram. Absorption
of RF energy can result in warming of the body. It is an important value
for establishing safety thresholds. Unauthorized high local
concentrations of RF energy can result in burns (local SAR). When the
RF energy is uniformly distributed, safety thresholds must be observed
to avoid thermoregulation or cardiac stress (whole-body SAR).
Remedies: other RF pulses, smaller flip angles, lower TR, fewer slices

Specific gravity
The weight of a substance compared to another as a standard.

Specificity - The quality or condition of being specific.

Spectral width
The selected frequency or bandwidth range being imaged. A form of
frequency window. The primary trade-offs in the BW are imaging time,
S/N, and resolution.

Specific Absorption Rate

Not to exposed more than 0.4 W/g3, average whole body. » SAR

Spectral maps
Mapping of a CSI spectral matrix to an anatomical image. It shows the
regional changes in metabolites as superimposed contours.

Spectral presaturation/selective IR - SPIR

Spectral presaturation with inversion recovery is a technique which
utilizes the differences in resonance frequencies between water and fat
(about 3.4 ppm). » Spectrally selective inversion recovery
187
Spectrometer
Computer-controlled pert of an MR system which generates the MRI
phenomenon.

Spectroscopic MRI
Technique for producing spatially resolved MR spectra in a manner
analogous to MR imaging.

Spectroscopy
The study of the electromagnetic radiation frequencies absorbed by
matter. » MR spectroscopy (MRS)

Spectrometer
The portions of the NMR apparatus that actually produce the NMR
phenomenon and acquire the signals, including the magnet, the probe,
the RF circuitry, etc. The spectrometer is controlled by the computer via
the interface under the direction of the software.

Spectrum
The frequency plot of the MR signal. The signal intensity is displayed as
a function of the chemical shift. Nuclei with different resonant
frequencies appear as separate peaks in the spectrum.
▪An array of the frequency components of the NMR signal according to
frequency. Nuclei with different resonance frequencies will show up as
peaks at different corresponding frequencies in the spectrum, or 'lines'.
▪Bonds of colors of different wavelengths like those seen in a rainbow.
▪A categorical arrangement of components in the order of their specific
properties, i.e., the electromagnetic spectrum.

Spin
Protons, neutrons, electrons and other particles possess a remarkable
characteristic known as ‘Spin’. » Nuclear spin
▪A fundamental property of matter responsible for MRI and NMR.
▪The intrinsic angular momentum behavioral pattern that creates the
precessing MDMs. The spin of a given nucleus has characteristic fixed
gyromagnetic ratio () values that are directly proportional to Bo.

Spin density » PD
The amount of protons contained in the tissue sample.

Spin density (proton) – DS - Number of protons in the tissue sample.

Spin density N (=rho) / (H) W

Hydrogen density (H weighted) / signal size / spin population in high
energy state /
188
MR image in which differences in hydrogen (proton) density are the
major source of image contrast. » PD

Spin echo
The delayed echo of T2 FID made possible by refocusing dephasing
protons.

Spin echo - SE
▪Sequence of RF pulse in MRI whereby the signal reappears after
reversal of the dephasing proton spins.
▪Echo of a MR signal generated by 180º RF pulse.
▪An MRI pulse sequence whose signal is an echo resulting from the
refocusing of magnetization after the application of a 90o and 180o RF
pulses. In Imaging.
▪Reappearance of an NMR signal after the FID has died away, as a
result of the effective reversal of the dephasing of the spins
(‘refocusing’) by the application of a refocusing RF pulse (applied in a
time shorter than or in the order of T2). Multiple spin echoes or a series
of spin echoes at different times can be used to determine T2 without
contamination by effects of the inhomogeneity or diffusion.
▪The reappearance of an MR signal after the decay of the FID signal.
Dephasing of the spins (decay in transeverse magnetization) is offset
through the application of an 180o inversion pulse. The spins rephase,
producing the spin echo at time TE (echo time). T 2* effects (field
inhomogeneity, susceptibility) are reversed but not T2 effects.

Spin-echo echo-planar imaging

EPI PS, which has a spin-echo preparation module (SE-PS) and an
echo-planar readout module.

Spin echo chemical shift imaging - SE CSI technique

Hybrid procedure based on the spin echo SVS technique.

Spin echo imaging

▪A generic term for many MRI techniques where the echo of the FID is
primarily used to create the image rather than the T2* FID. The spin
echo technique is characteristically more tissue oriented vs. the FID.
▪Any of many MRI techniques in which the spin echoes NMR signal
rather than the FID is used. Can be used to create images that depend
strongly on T2. Note that spin echoes do not directly produce an image
of T2, but rather (with long echo times) a T2W image. » PS

Spin echo pulse sequence - SE PS

Standard pulse sequence used in MRI. » PS The ME PS using single or
multislice acquisition.

189
 The RARE, EPI & GRASE PS are all basically SE sequence
Manufacturer RARE type PS GRASE type PS
ELscient FSE GRASE
GE - -
HITACHI FSE GE/GR
PHILIPS Turbo (TSE) GRASE
PICKER - FAST
SIEMENS Turbo SE (TSE) Turbo GSE
- HASTE -
- DEFSE -
TOSHIBA Fast se HEPI

Spin echo pulse sequence imaging - SE imaging

MR imaging methods using a spin echo pulse sequence

Spin isochromat
A collection of precessing spins at a constant frequency and retaining a
balanced coherent state; it can only occur when the magnetic field is
completely homogeneous.

Spin lag
A given nucleus spin having been altered through motion, resulting in a
lagging effect that often serves as a tagging method to trace the motion
factor.

Spin-lattice relaxation (time) » Longitudinal relaxation

Spin locking
If one applies a long lasting B1 magnetic field immediately after a 90°
pulse, the dephasing of the spins in the x-y plane is stopped while the
B1 field is on. This is called spin locking and the B1 field is called a
spin-locking pulse even though it may last hundreds of milliseconds.

Spin number - Nuclear spin number.

Spin population in low energy state N+

Spin-spin coupling
Interaction between nuclei in a molecule, resulting in additional splitting
of peaks in the spectrum,

Spin-spin relaxation time

T2.Nuclei will retain their magnetic orientation for a time in the order of
T1 even in the presence of motion. Thus, if the nuclei in a given region
have their spin orientation changed, the altered spins will serve as a
190
'tag' to trace the motion of any fluid that may have been in the tagged
region for a time on the order of T1. » Transverse relaxation time

Spin warp imaging

A form of FT imaging in which phase encoding gradient pulses are
applied for constant duration but with varying amplitude. This is a
distinct form of the original FT imaging methods in which phase
encoding is performed by applying gradient pulses of constant
amplitude but varying duration. The spin warp method is relatively
tolerant of non-uniformities (inhomogeneities) in the static or gradient
magnetic fields.

Spin-Lattice Relaxation
The return of the longitudinal magnitization to its equilibrium value along
the +Z axis.

Spin-Lattice Relaxation Time (T1)

The time to reduce the difference between the longitudinal
magnitization and its equilibrium magnetization by a factor of e.

Spin Packet
A group of spins experiencing the same magnetic field.

Spin relaxation
Formation of T1 signal from one radiofrequency pulse.

Spin-spin relaxation
▪Formation of T2 signal indicating that the RF resonant pulse was
activated at least twice (90o and 180o) during a given TR.
▪The return of the transverse magnitization to its equilibrium value, zero.

Spin-spin relaxation time

The time to reduce the transverse magnetization by a factor of e.

Spin tagging
A brief time (equal to T1) where nuclei retain their magnetic orientation,
allowing them to be tagged in fluid flow imaging.

Spiral MR imaging
Spiral scanning, a way of sampling image data for MR imaging in k-
space

Spoiled FLASH
Name for a Spoiled gradient echo pulse sequence
A FLASH sequence with a short TR in which the transverse coherences
are removed by the application of one or more spoiler gradients.
191
Spoiler gradient - a gradient of sufficient amplitude and/or duration to
fully dephase a signal. Often placed symmetrically about refocusing
pulses so that they have no effect on the refocused signal but eliminate
any signal originating at the refocusing pulse.

Spoiled gradient refocused acquisition in the steady state

(GRASS) SGGR
Heavily T1 weighted RF spoiled GE technique.

Spoiled gradient echo - S GRE

Synonym: FLASH, RFS FAST, SPGR, STAGET1W, T1-FFE

Spoiled GE imaging
MR imaging method, which makes uses of spoiled GE-PS

Spoiled GE imaging / spoiled GEI

A FLASH sequence with a short TR in which the transverse coherences
are removed by the application of one or more spoiler gradients. »
Spoiled GRE

Spoiled GE sequence - Gradient echo pulse sequence » SP-GRE

Spoiled GRASS - SPGR GE - Brand name for a spoiled GE-PS

Spoiled GRASS - SPGR

Spoiled gradient recalled
Spoiled gradient refocused acquisition in the steady state
Heavily T1-W RF spoiled GE-PS technique in GE brand. » GRASS

Spoiled gradient refocused acquisition in the steady state

(GRASS).
Heavily T1 weighted RF spoiled GE technique.

Spoiler gradient
Gradient pulse with sufficient amplitude and/or duration to completely
dephase the transverse magnetization. The spoiler gradient is applied
after the echo so that transverse magnetization is destroyed prior to the
next excitation pulse. Used for presaturation and FLASH sequences.
Applied gradients used to electronically destroy residual M xy before
energizing the subsequent radiofrequency torquing pulse.

Square pulse
RF pulse that has constant amplitude for a predefined duration.

192
Starting / Stopping a Scan
To start a scan, simply click on the “measurement” (or its equivalent)
button on the control screen. To stop a scan, click on the “stop” (or its
equivalent) button on the control screen.

Static
Stationary or nonmoving, i.e., Bo.
Lacking movement, action, or change. Ph concerned with bodies at rest
or forces in equilibrium. Often contrasted with dynamic.

Static magnetic field » Bo

Created whenever an electron is ejected from a neutron in unstable
nuclei.

Static frame of reference

Depicted by a magnetization vector, M, which relates to the location of
its net (bulk) relaxation state at a given time.

Steady State
In this state, the selected TR will be shorter than the T1 and T2 times of
the tissues. In this state, there will be coexistence of both longitudinal
and transverse magnetization. Most GRE sequence uses the steady
state. Generally, FA of 30o to 45o with TR of 20 to 50 ms favours the
steady state.
Depending on the residual transverse magnetization in phase (or) out of
phase GRE PS are classified into:
a) Coherent (in phase) GRE PS. b) Incoherent (out of phase GRE PS

Steady state free precession (GE) SSPF; steady state - SEFP

Method of MR excitation in which strings of RF pulses are applied
rapidly and repeatedly with interpulse intervals short compared to T2.
This allows transverse coherences to develop which act to reinforce the
fresh transverse magnetization generated at each RF pulse. Fourier
SSFP imaging sequences require the use of a phase rewinder gradient.

Steady State Free Precession (SSFP)

These sequences are used to attain more T2 weighting. In this
sequence the steady state is maintained.
Parameters
 Flip angle: 30o-45o
 TR 20-50 ms
Advantages
 True T2 weighting is achieved
 Can be acquired in volume or 2D
Disadvantages
193
  Loud gradient noise
 Poor image quality
Ultrafast Sequences
 These sequences use coherent (or) incoherent gradient echo
pulse sequences
 Only a portion of the RF pulse is used
 Only a portion of the echo is read
Because of the above reasons, the scan time is drastically
reduced.

Steady state gradient echo imaging GE-PS > SSGE imaging

Steady state gradient echo sequence GE-PS > SS GRE

Steady state technique with refocused free induction decay »

STERF

Steady state technique with refocused FID

Shimadzu brand name for GE-PS

Stimulated echo – SE Echo generated by three radiofrequency pulses.

Stimulated Echo Acquisition Mode » STEAM

Stejskal - Tanner sequence ST sequence » Diffusion imaging

Stimulated echo
Echo generated by three RF pulses. One of five echoes generated by a
sequence of three RF pulses. The signal is stored as longitudinal
magnetization between the second and third RF pulse and hence has a
signal intensity which depends both on T1 and T2. The maximum
intensity of a stimulated echo is only half that of an equivalent spin
echo.

Stimulation
Application of a high-powered gradient rapidly changes the magnetic
field. If the electrical fields generated exceed a specific threshold,
electrical currents can be induced in the patient’s body. The currents
can result in peripheral nerves stimulation that may be uncomfortable to
the patient. An important value for establishing safety thresholds.

Stimulated echo, steady state technique with refocused - STE

Stimulated echo acquisition method technique - STEAM

Single volume method: with the STEAM pulse sequence, 3 slice
selective 90o pulses generate a stimulated echo.
194
▪A single-voxel localizer MR spectroscopy technique, particularly suited
to proton spectroscopy. ▪MR fast imaging technique using two 90º RF
pulses followed by a third pulse of 90º or less. Subsequently spin
echoes are produced as “stimulated echoes”

Stimulated echo progressive imaging » STEP

STIR sequence - Short TR/T/tau/ TI inversion recovery PS

IR PS with a short TI, used for fat suppression. TI selection depends on
field strength.
MR sequence used to suppress the signal returned from fatty tissues.
This sequence is used to suppress the fat signal from the anatomy of
interest. Here we use a TI value that corresponds to the time it takes fat
to recover from full inversion to the transverse plane so that there is no
longitudinal magnetization corresponding to fat. When the 90o RF
excitation pulse is applied, the fat is flipped 90o to 180o, so there will not
be any fat signal. It will suppress the fat in STIR. Generally, a TI value
of around 100-200 ms is used. This TI value may slightly vary
depending on the field strength. Fig. 5.7 T1 determination of STIR
Optimal inversion times for a given field strength (for STIR)

Field strength (T) TI (ms)

1.5 120-150
1.0 100-130
0.5 90-115
0.2 75-90

Uses
Used to suppress the fat signal in T1 WI
Disadvantage
Should not be used with contrast enhancement
Parameters
TE = 10-30, TR = 2000, TI = 150-200ms, Scan time = 3-5 min
Stochastic - Probability in the sampling process, random or statistically
chosen.

Stopping / Starting a Scan

To start a scan, simply click on the “measurement” (or its equivalent)
button on the control screen. To stop a scan, click on the “stop” (or its
equivalent) button on the control screen.

Stray field
Magnetic field outside the magnet that does not contribute to imaging. A
specific distance must be kept between the field and various devices
and patients with cardiac pacemakers (e.g., 0.5mT line). The stray field
is low with permanent magnets because the system is largely self-
shielding.
195
Stripe tagging - Tagging

Substance - Any mass that has a definite composition.

Susceptibility artifacts » Artifact in MR

Superconduct
To have no resistance. A perfect superconductor can carry an electrical
current without losses.

Super-conducting magnets
▪Electromagnets whose circuitry is super cooled to near absolute zero
thereby decreasing electrical resistance within the system. Once current
is applied and the desired field strength is reached, no further power is
required.
▪A magnet whose magnetic field originates from current flowing through
a superconductor. Such a magnet must be enclosed in a cryostat.

Superconductive magnets
These are also electromagnets, made of materials with no electric
resistance when placed at a temperature close to absolute zero (-
273oC) They consume no power and allow stable and very high fields to
be generated. Their major drawback is running costs of cryogens
(helium and nitrogen). However, they are more and more commonly
used.
An electromagnet whose strong magnetic field (typically at least 0.5T) is
generated using superconductive coils. The conductive wires of the
coils are made of a cryogenically cooled Niobium Titanium alloy. Liquid
helium is used as the cryogen. Liquid nitrogen may be used for
precooling.

Superconduction
Material characteristic of various alloys, which at very low temperatures
(close to absolute zero) results in a complete loss of electrical
resistance. Electrical current can then flow without loss.

Superior
The direction towards the head in an anatomical coordinate system.

Superconducting quantum interference device » SQUID » MEG

Superconductive magnets
These are also electromagnets, made of materials with no electric
resistance when placed at a temperature close to absolute zero (-
273oC) They consume no power and allow stable and very high fields to
196
be generated. Their major drawback is running costs of cryogens
(helium and nitrogen). However, they are more and more commonly
used.

Super-conductivity
Flow of electrons free of any molecular resistance.

Superconductor
A substance whose electrical resistance essentially disappears at
temperatures near absolute zero. A commonly used superconductor in
MRI system magnets is niobiumtitanium, embedded in a copper matrix
to help protect the superconductor from quenching.

Superior vena cavography » SVC

MRA examination of superior vena cava

Suppression
Forcibly put an end to, prevent from being expressed or published

Superparamagnetic
T2 or T2* contrast agents; originally ferromagnetic substances which
have a very small size and thus have lost their permanent magnetism.
Also known as bulk susceptibility agents.

Super paramagnetic iron oxides / small particle iron oxide SPIO

>MR contrast media

Suppression
A specialized pulsing technique used to minimize or cancel out the
adverse effects from adjacent dephasing protons by RF bombardment
onto the ROI.

Surface coil
Special RF receiver coil positioned close to the body to acquire signal
from nearby regions. Compared to the body coil, the RF receiver coil
has a better SNR and higher spatial resolution. Surface coils can also
be used to simple localization in MR spectroscopy.
▪A circular coil is placed directly on or over the ROI for increased
magnetic sensitivity. The imaging depth is r/2 from the midpoint of the
coil’s diameter. ▪An receive only RF imaging coil which, in general, fits
against the surface of the object being imaged

Surface coil rotating frame

MR spectroscopy technique using surface coils taking advantage of
spins nears the surface. » RFS

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Susceptibility
Measure for the ability of a material or tissue to be magnetized in an
external magnetic field. » Magnetic susceptibility » Magnetization

Susceptibility artifact
Local magnetic field gradients are produced in all transitions between
tissues of differing magnetic susceptibility. In transitions between tissue
and air-field spaces (e.g., temporal bone), there may be areas present
that show reduced signal or no signal at all. The effect is stronger with
GE, in particular EPI.
The susceptibility of a tissue fells us how easily it can be magnetized.
Normally most of the tissues have susceptibility values which fall in a
fairly narrow range. However, presence of paramagnetic material like
haemoglobin degradation products or tissue-air interphases lead to
local variations in the susceptibility. This is turn result in reduction in the
quality of the local field. Fig. 7.23A-C. Tissue air interphases related
artifacts are commonly seen around the paranasal sinuses and the
lungs. These susceptibility artifacts can be removed by using SE PS.

Susceptibility contrast - T2* contrast

Symbols for gradient magnetic field » Gx, Gy, Gz

x, y, z denote the spatial direction component of the gradient, i.e.
direction along which the field changes.

Symbol for the number of neutrons in the nucleus: # N = # A - # Z

Syngo TimCT MRI

Get ready for T-class, the next generation of MRI. With syngo®
TimCT™-Continuous Table move-the new MAGNETOM® T-class shifts
the paradigm to CT-like scanning. Non-stops, just continuous scanning.

Syringomyelia
Chronic progressive disease of the spinal cord resulting in cavities.

Système internationale – SI (International System of Units)

The international accepted unit of weight and measurement. The
international standard system of physical units and measures.

Swap » Gradient swap

►T◄
T - Tesla

198
The SI unit for magnetic field strength (flux density). Approximately
20,000 times as strong as the earth’s magnetic field (1 Tesla = 10, 000
gauss, the older (CGS) unit) » G

T-one - Spin relaxation and/or longitudinal relaxation. » T1

 - (tau) = time delay, Designated time segment in the pulse sequence

T 1 constant (longitudinal relaxation time)

P. Tissue-specific time constant that describes the return of longitudinal
magnetization to equilibrium. After time T1, longitudinal relaxation has
returned to 63% of its final value. A tissue parameter that determines
contrast.

T 1 / T1 - T1 relaxation/longitudinal relaxation time

Characteristic time (time constant) of spin-lattice relaxation time

T 1 contrast - Q.
The contrast of a T1WI depends primarily on the various T1 time
constants of the different tissue types.

T1 relaxation
Process by which the longitudinal magnetization Mz attains its
equilibrium value Mzo

T 1 relaxation
The time constant for a given tissue’s MDM Bo vector components t
repolirize to +z longitudinal equilibrium; solely governed by the thermal
energy content within the tissue lattice structure.

T 1 / T1 (‘T-one’) - Spin-lattice or longitudinal relaxation time

▪The relaxation process of the T1 MDMs to recover 63% of its original
signal value. T1 relaxation is exponentially expressed and often referred
to as spin relaxation and/or longitudinal relaxation.
▪Time that it takes for longitudinal magnetization vector to recover in
MRI.
▪Spin-lattice or longitudinal relaxation time; the characteristic time
constant for spins to tend to align themselves with the external
magnetic field. ▪ Starting from zero magnetization in the z direction, the
z magnetization will grow to 63% of its final maximum value in a time
T1.

T 1 - rho ‘T-one rho’

Spin-lattice relaxation time in the rotating frame the characteristic time
constant for loss of magnetization of spins under the influence of a spin-

199
locking B1 field. Despite its name T1-r relaxation is more closely related
to T2 relaxation than T1.

T 1 FAST – T1W Fourier acquired steady state technique

Fourier acquired steady state, Picker brand name for a spoiled GE-PS
T1 FFE Contrast enhance fast field echo, Philips brand name for a
spoiled GE-PS

T1 / T2 » PS

T1 Fourier acquired steady state » T1 FAST

T1 FFE Contrast enhance fast field echo » T1 FFE

Philips brand name for a spoiled GE-PS

T1 FLAIR
Sequence that provides T1 contrast between gray and white matter and
CSF.

T-one rho » T1-rho

T1 prolonged » Pathological changes...

T1 shorten » Pathological changes...

T 1 / T 1W / T 1WI / T1WI - T1 Weighted image

▪Denotes a MR sequence, demonstrating anatomy, timed to emphasize
the T1 tissue characteristics.
▪An image created by predominantly T1 signals and associated with
decreased TR/TE.

T1 & T2 contrast agent

Positive relaxation agents (T1) and negative relaxation agents (T2).
Signal will increase when hydrogen proton increases, T1 decreases and
T2 increases. Signal will be decrease when hydrogen protons
decrease, T1 increases or T2 decreases

T-two » T2

T-two-star » T2*

T2 prolonged » Pathological changes...

T2 shorten » Pathological changes...

T 2 / T2 weighted image » T2WI / T2WI

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T 2 constant (transverse relaxation time)
P. Tissue specific time constant that describes the decay of transverse
magnetization in an ideal homogeneous magnetic field. After time T2,
transverse magnetization has not lost 63% of its original value. A tissue
parameter that determines contrast.

T 2 contrast - Q.
The contrast of a T2 T2WIdepends primarily on the various T2 time
constants of the different tissue types.

T 2* constant - P.
Characteristic time constant that describe the decay of transverse
magnetization, taking into account the inhomogeneity in static magnetic
fields and the human body. T2* is always less than T2.

T 2 / T2 (T-two) - Spin-spin or transverse relaxation time

▪Time that it takes for transverse magnetization vector to recover in
MRI.
▪Spin-spin or transverse relaxation time; the characteristic time constant
for loss of phase coherence among spins oriented at an angle to the
static magnetic field. Arises from interactions between the spins, with a
resulting loss of transverse magnetization. The x-y magnetization will
decay so that it loses 69% of its initial value in a time T2. ▪Signal
occurring immediately following an 180o refocusing B1-RF resonant
pulse and consisting of vary rapid dephasing T2 components and
magnetic inhomogenities created by the Bo magnetic field.

T 2* / T2* (‘T-two-star’) - Effective transverse relaxation time

T2 star signal, rapidly dephasing components consisting of T2+ inherent
(inborn / natural) inhomogeneities.

2-T2
A second spin echo characterized by less image contrast. Its spin
density significantly affects 2-T2 and its amplitude will be less than the
previous 1-T2. System software governs how many multiple SE can be
imaged within a given TR.

T2 - PRE - T2 proton relaxation enhancement

T 2 / T 2W / T2WI - T2 weighted image

▪Denotes a magnetic resonance sequence, sensitive to pathology,
timed to emphasize the T2 tissue characteristics. ▪An MRI, sensitive to
pathology, produced using a sequence timed to emphasize the T2
tissue characteristics. ▪Image whose contrast is mainly influenced by
T2, but which also has T1, proton density, and bulk flow contributions. ▪
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An image consisting of more T2 relaxation data and conventionally
obtained by using a long TR/TE.

T2 FFE - Contrast enhance fast field echo (T2W)

T2 PEDD - T2 proton electron dipole dipole interjection

T2 PRE - T2 proton relaxation enhancement

T2 signals
After M is torqued to Mxy, those components undergoing the 180o RF
refocusing pulse will subsequently produce T2 signals during the
dephasing / rephasing process.

Tagging
Grid tagging: Grid of saturation lines across cardiac MR images. Used
to view myocardial motion. Stripe tagging: parallel stripes in the MR
image; used to view myocardial motion in primary axis view or four-
chamber view. Spin tagging.

Tailored excitation - Selective excitation.

Tailored pulse
Shaped pulse whose magnitude is varied with time in a predetermined
manner. Affects the frequency components of an RF pulse in a manner
approximately determined by the FT of the pulse for simpler pulse
shapes.

Tau ()
Time delay, Designated time segment in the pulse sequence

Technical factors influencing the image quality

Number of MR signals averaged together to determine each distinct
position. Encoded signal to be used in image construction. There are
many factors available to the technologist when setting up a sequence.
The appropriate selection of the parameters determines the weighting,
improved quality of images and sensitivity to pathology. Therefore, the
technologist should be aware of these factors and their interrelation so
that optimal quality of the images can be obtained. The following are the
factors discussed below which affect the quality of the image.
Performing an MR examination demands multiple choices:
I. The acquisition parameters
II. The imaging plane orientation
Type of coil, slice thickness, matrix size, number of excitations, etc.
FACTORS AFFECTING THE SNR
Field of view
FOV is one of the important factors affecting the SNR.
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An image consists of a FOV that relates to the region of interest
(anatomy) covered.
The field of view ranges from 10 to 50 cm for most of the equipment.
Therefore, if the entire spinal cord is to be imaged in the sagittal plane,
its upper and lower parts need complementary series of pulse
sequences. Fig. 8.1, 8.2AB
FOV controls spatial resolution and SNR.
Small FOV produces ↑ (high) resolution ↓ (low) SNR and increases the
minimum TE value =SAT pulses decreases the number of slices in an
acquisition.
At a given matrix size (i.e. number of pixels on the two image
coordinates), The FOV determines pixel size, e.g. at a FOV of 24 cm
and a matrix size of 256x256pixels, the size is 0.9mm x 0.9mm (240
mm/256).
FOV = 175 mm FOV 325 mm
High resolution Low resolution
SNR = 100 percent SNR = 345 percent
It is critical that the technologist should understand the relationship
between SNR and FOV. SNR is proportional to square of the FOV. Fig.
8.2A & B
For example, having a FOV reduced from 24 to 12 cm results in, a
signal-to-noise reduction of 75%.
In practice, the reduction in FOV requires some changes that results in
increased SNR.
Spatial Resolution
Spatial resolution is defined as the ability to separate closely spaced
anatomical details.
Slice Thickness
To give each slice a thickness, a band of nuclei must be excited by the
excitation pulse.
Increased of slice thickness, increases SNR, coverage of anatomy and
partial volume whereas spatial resolution is decreased.
As slice thickness ↑ (increases), resolution ↓ (decreases and SNR
(increases). Fig. 8.3AB
Decrease of slice thickness, reduces SNR, coverage of anatomy and
partial volume whereas spatial resolution is increased. Fig 8.3A&B
The basic values of slice thickness ranges from 3 to 15 mm.
Slice thickness controls resolution and SNR.
The technologist should be aware that as the slice thickness is
increased or decreased, there would be a corresponding change in the
S/N ratio for the image.
If one slice is acquired at a 6 mm thickness, and another slice is
acquired at a 3 mm thickness (with all other factors equal), the second
slice will have one-half the signal of the first slice. Since the noise is
essentially unchanged, the effect is that the S/N ratio will be cut in half
for the second slice.
SNR-Slice Thickness
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 Fig. 8.4A Fig. 8.4B
Thickness = 3 mm Thickness = 10 mm
SNR = 50 percent SNR = 167 percent
Scan time = 1.28 sec Scan time = 1.28 sec
Ideally, we would like to obtain images from, infinitely thin sections. The
thicker the slice, the more partial volume, which implies that certain
structures may be hidden by overlying tissues. Fig. 8.4AB
On the other hand, SNR and CNR are improved larger slice thickness.
Spacing
Spacing is the gap between two slices. When acquiring a multiplanar,
single acquisition, spacing controls cross-talk.
As spacing ↑ (increases), cross-talt ↓ (decreases)
Typically, a spacing that is 20 percent of the slice thickness is sufficient
to minimize cross-talk. Fig. 8.5A & B
As number of slices ↑ (increases), scan time also ↑ (increases) Ideally,
we would like to obtain our images from completely contiguous slices.
In practice, there is always some excitation outside the slice
boundaries. This means that when excitation a particular slice with a RF
pulse, partial excitation of neighboring slices will cause an alteration in
images contrast, or the effective TR for every slice is less than
determined by TR.
Matrix Size
The matrix size is represented by two figures. The first figure usually
related to the number of frequency samples taken, whereas the second
related to the number of phase encoding performed. For example 256 x
128 indicates that 256 frequency samples are taken during readout and
128 phase encoding are performed. A course matrix corresponds to
less number of pixels and fine matrix corresponds to more number of
pixels.
In all digital imaging methods, and therefore in MR too, the image is
divided into small picture elements called pixels. Each individual pixel
corresponds to the intensity and amplitude of MR signal represented on
gray scale. The dimensions of the matrix can be changed. The most
commonly used matrix is 256x256. Some systems offer low resolution
(128x128) and or/high-resolution (512x512) matrixes.
At a given FOV, matrix size determines pixel size and thus spatial
resolution. Fig. 8.6, 7, 8, & 9
Therefore, an image obtained with 128x256 pixels is typically less well
resolved in the Y dimension than one obtained with 256x256 pixels.
However, all other parameters being equal, the 256x256 image has a
factor of 2 less SNR, while it requires twice the scan time.
Pixel: Acronym for a picture element, the smallest discrete part of a
digital image displays.
Voxel: Volume element, the element of the three-dimensional space
(3D-space) corresponding to a pixel, for a given slice thickness.
Scan Time~MATRIX Size
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 Fig. 8.10 Fig. 8.11
Matrix size = 256mm Matrix size = 512mm
Good resolution High resolution
SNR = 100% SNR = 25%
Scan time: 2 min Scan time: 4 min
Prescan
Prescan is a method of calibration to be performed prior to every data
acquisition. The following are the three main tasks involved in
prescanning viz.
I. Finding out the center frequency at which RF is to be transmitted.
II. Finding the exact magnitude of radiofrequency ought to be
transmitted in order to generate maximum signal in the coil.
III. Adjustment of the magnitude of the received signal.
Prescan allows for the adjustment of the transmit and receive gain and
the setting of the center frequency for a specific body part to be imaged.
NEX / NSA
Every individual signal, which contributes to form an MR image, can be
received once or collected several times, using repeated excitations.
Hence, the average signal value is used to generate the image. When
the number of excitation are increased, the error (the noise) doubt and
the measurements are more precise.
Fig. 8.12 Fig. 8.13
Nex = 2 Nex = 4
Scan time = 1.28 min Scan time = 2.48 min
SNR = 100% SNR = 141%
In practice, the number of excitation ranges from 1 to 6.
The number of excitations implies the number of times a particular line
in sampled in K space. K space refers to the raw data of an image.
A line in K space corresponds to the spin echo obtained at a particular
setting of the phase encoding gradient. Scan time is proportional to
Nex.
By increasing the number of excitations, the SNR is improved and vice
versa.
Image Acquisition Time (Examination Time)
The acquisition time (T) of a sequence is given by the following formula:
Acquisition Time (T) = TR x N x Nex
Where, TR is the repetition time,
N is the number of phase encoding in the matrix
Nex is the number of excitations
Acquisition Time = TR x N x Nex
= 400 x 160 x 2 = 128000 ÷ 1000 = 128sec
= 128 sec ÷ 60 = 2.1333333
= 2. 14 minutes
Image (Data) acquisition time (Examination time)
The time required to gather a complete set of image data, including
image reconstruction time.
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Increase of TR increases the scan time and similarly increasing N
increasing the scan time and vice versa.
Improving the SNR by increasing Nex also increases the imaging time
and vice versa.
Frequency
Frequency axis of the acquisition matrix.
The number of cycles or separations of a periodic process per unit time.
In electromagnetic radiation, it is usually expressed in units of Hertz
(Hz), where 1 Hz = 1 cycle.
Increase the frequency matrix to produce (high) resolution, ▼ (low)
SNR and ▼less number of slices.
Phase
In a periodic function (such as rotational or sinusoidal motion), the
position relative to a particular part of the cycle.
Phase controls scan time for most pulse sequence database and may
control resolution.
Nex: Select a Nex value that produces sufficient SNR.
Phase FOV
PFOV shortens scan time by scaling down the FOV size in the phase
direction.
Select 0.75 or 0.5 to reduce phase steps and thus
↓ (less) scan time
↓ (less) FOV inthe phase direction
↓ (decreases) SNR slightly.
Freq DIR: S/I (Superior to inferior), A/P (Anterior to posterior, R/L (right
to left).
The scanning direction associated with the frequency gradient.
The direction displayed is the default frequency direction which is
typically the long axis of the image.
To swap phase and frequency, select the other direction.
Auto Shim
Auto shim is typically selected when the FOV centre is not at isocentre.
A preparation phase is performed in which small gradient amplitudes
are determined which optimise the main magnetic field homogeneity.
The small gradients remain present during the scan.
Contrast
Select only contrast if contrast is injected. Enter amount of contrast
injected and the type of contrast used in the designated fields.
Phase Correction
A process that mathematically corrects for phase errors in FSE and (E)
sequences. Phase correction is selected for EPI and FSE, FSE-IR and
FLAIR protocols.
I. Corrective processing of the spectrum so that spectral lines at
different frequencies all have the decorption-mode phase.
II. In imaging, adjustment of the signal in different parts of the image
to have a consistent phase.
Auto Centre Frequency
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Select the CF peak that should be set during prescan.
A prescan procedure to fine-tune the system’s RF transmit/receive
frequency to the precessional frequency of the protons under study,
providing optimal sampling of a patient’s anatomy.
Unlike other imaging modalities, MRI requires a multitude of operating
parameter decisions. Improper choices can result in impaired image
quality, cause artefacts and reduce a study’s diagnostic efficacy.
Therefore, it is important that the technologist should understand both
intrinsic tissue parameters, extrinsic equipment parameters as well as
how they interact.
Noise is always superimposed on the images. This noise causes a
fluctuation of pixel values.
Signal-to-noise Ratio (SNR)
It is defined as the ratio of the amplitude of the signal generated to the
average amplitude of the noise. Quality of image is mainly
characterized by its SNR. Increase of signal increases the SNR and
vice versa. The following are the factors that affect the SNR:
 Coil type
 Volume of the voxel
Fig. 8.14
 PD of the ROI under examination
 TR, TE and Flip angle
 Nex
 Receive bandwidth
 FOV
Scan time, spatial resolution, SNR are mathematically related.
Contrast-to-noise ratio (CNR)
It is defined as the difference in the SNR of two adjacent areas. The
factors that affect CNR are the same as that of SNR.
Measure for assessing the ability of imaging or procedure to generate
clinically useful image contrast.
Bandwidth (BW)
A general term referring to a range of frequencies (e.g. contained in a
signal or passed by a signal processing system).
This is the range of frequencies that are acquired by the readout
gradient. As bandwidth is decreased, noise is reduced thereby
increasing the SNR. If the bandwidth is reduced to half, SNR is
increased by 40% but increases the sampling time. Fig.8.15AB
Bandwidth defines the number of frequencies. We can change the
bandwidth with RF pulses.
Frequency can be swapped with phase direction by champing the entry
in (Freq DIR), following the table sum.
The default directions of phase freq. and slice select by coil selection.
Two-Dimensional Fourier Transform 2DFT
In order to reconstruct the image, each gradient cycle (slice-selection,
phase-encoding, readout) must be repeated for each level of the phase-
encoding axis. For example, a matrix of 256x256 would require 256
207
cycles. Each of the 256 resulting signals (K-space data) is then
converted from its time domain into its frequency domain by a FT. Each
signal produced along the horizontal axis is the sum of all the
magnetization vectors for level of the phase encoding gradient. After all
256 signal have been transformed into their frequency domain (shown
in fig 8.16A&B), a FT is performed at each frequency utilizing the data
at all phase encoding levels to decode the spatial information along the
vertical axis. The second FT is performed on each corresponding point
along x and y, where y = the sum of all 256 signals collected at each
level of the y-axis.
» The default dir for phase, freq, & slice, select by a coil selection
Frequency can be swapped with phase direction by changing the entry
in (Frequency Direction). Fig 8.16AB
Image Reconstruction
The mathematical process of converting the composite signals obtained
during the data acquisition phase into an image.
Gradients
In order to spatially encode the NMR signal, a gradient magnetic field is
superimposed on the static magnetic field. The gradients place the
nuclei in a slightly different magnetic field depending on their location.
Slice-Select
In order to confine excitation to a single slice only, an RF pulse
containing a narrow band of frequencies is applied, in conjunction with
the gradient located in the plane perpendicular to the imaging plane. In
an axial image in the x-y plane, for example, the slice-selection gradient
is Gz. The gradient is applied only during the RF excitation pulse. Only
that plane of nuclei located with its z position such that its Larmor
Frequency matches that of applied RF will be excited to produce a
signal.
Slice Orientation
 Superior > Inferior (Axial plane)
 Right > Left (Sagittal plane)
 Anterior > Posterior (Coronal plane)
Fig. 8.17+ 8.18A,B

Tesla
Unit of magnetic field measurement 1T = 10,000 gauss. » T

Tesla scan
(Mn DPDP, Nycomed) agent designed to incorporate into hepatocytes.
Post contrast moderate enhancement of normal liver parenchyma is
seen improving lesion conspicuity.

The magnetization vector, Bo / Mo Equilibrium magnetization

Equilibrium value of magnetization; directed along the direction of the
static magnetic field. Proportional to gyromagnetic ratio (g), spin density
(N) and static magnetic field (o)
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Therapeutic MRI - tMR
MR imaging to guide instruments for diagnostic or therapeutic
interventions. » iMR

Thermal - Relating to heat energy

Thermal equilibrium
A state in which all parts of a system are at the same effective
temperature. In particular it is where the relative alignment of the spins
with the magnetic field is determined solely by the thermal energy of the
system. In MRI, thermal equilibrium means relative alignment of spins
with Bo.

Thermal motion
The movement of molecules and atoms of an object determined the
amount of kinetic energy of that object.

Three-dimensional - 3D
Refers to imaging modalities and images in radiology in which data are
acquired and/or viewed in three orthogonal axes.
3D CE MRA, 3D DESS, 3D FLASH, FISP, 3D FSE, 3D GE (FLASH, FISP,
FSIF, DESS, CISS), 3D MARP, 3D MIP, 3D MPR, 3D MPRAGE (3D
magnetization-prepared rapid gradient echo)
3D-Oblique sagittal volume rendering image, 3D PC MR, 3D-SA, 3D SSD
3D SVA MIP, 3D SVC MIP, Multi-criterion 3D segmentation algorithm

Three-dimensional FASTER

Three-dimensional Fourier transforms - 3DFT

A specialized imaging technique that uses a computer to sandwich
together slice acquisitions for an image reconstruction of L, W, & H.
3DFT = Np x Nf x Gz x NEX.
Mathematical analysis applied along all 3 orthogonal directions of a
volume of signal data, thereby creating a high-resolution image in any
plane.

Three-dimensional gradient echo » 3D GRE

Three-dimensional imaging - 3-D imaging

An entire measurement volume, the 3-D slab, is excited instead of
single slices. Additional phase encoding in the slice-selection direction
provides information in this direction.

Three-dimensional magnetization prepared RAGE » 3D MP RAGE

Three-dimensional slab - 3-D slab

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Excited measurement volume for 3D imaging. The 3-D slab is divided
into partitions.

Three-dimensional shim - 3D shim

3D shim enable the shim volume to be limited (local shim). A 3-D
volume is defined. The local magnetic field distribution is determined in
this volume, resulting in the calculation of the shim currents. 3D shim
provides a more precise results compared to map shim and therefore
better fat saturation. For spectroscopy, it provides a better starting value
for interactive shim.

Three-dimensional turbo SE - 3D TSE

Turbo SE as a 3D sequence allows for the acquisition of T2W images
with thin slices and almost isotropic voxels.

Three dimensional Fourier transforms » 3DFT

Three-dimensional imaging - Volume imaging

Tilted optimised nonsaturation excitation - TONE

TONE is used for TOF angiography to minimize saturation effects as
blood flows through a 3D volume. An RF pulse with a tilted slab profile
compensates for the velocity and direction of blood flow. This generates
a FA that varies from partition to partition. GE-PS in which the FA is
increased gradually from small to larger values. » MTC

Time domain data - TD

Unprocessed time domain data obtained during acquisition (frequency
and phase information).

Time of flight - TOF

Technique used for magnetic resonance angiography. » PS, MRA

Time of flight MRA - TOF MRA

The flow of non-saturated, fully relaxed blood into the slice generates a
high signal, and makes time-of-flight angio possible. By comparison,
stationary spines are partially saturated and generate a relatively low
signal intensity.
3D imaging technique for MRA, which is based on inflow effects.
An MRA technique relying solely on the flow of unsaturated blood into a
magnetized presaturated slice. The difference between unsaturated and
presaturated spins creates a bright vascular image without the invasive
use of contrast media. This technique commonly uses incoherent GRE
pulse sequences in conjunction with TR and FA combinations that
saturate background tissue but allowing moving spins to show high
signal intensity. This technique is used in demonstrating arterial and
210
venous flow in head, neck and peripheral vessels. Fig. 5.11 3D TOF
MRA showing intracranial vessels

Time resolved imaging of contrast kinetics - TRICKS

A GE-exclusive Signa HD imaging technique eliminates the trade-off
between spatial and temporal resolution that’s typical of conventional
MR angiography.

Time series - TS
The obtained T2* images are labelled with number and time position in
the series. They maybe used in Cine and for statistical evaluation.

Time to peak map - TTP

A TTP map shows the regional distribution of the time needed to the
minimum perfusion signal, either grey scale or color-coded. It is
generated for every slice measured.

Time varying magnetic fields - TVMF

▪The magnetic field strength is varied linearly over time by the
application current to the gradient coils.
▪Magnetic fields that change with time. They are necessary for image
formation in MRI.

Timing Diagram
A multiaxis plot of some aspects of a pulse sequence as a function of
time.

Tissue Classification
The classification of tissues in a magnetic resonance image using
computer algorithms and some property of the imaged tissue.

Tissue characteristics
MRI is diagnostic modality providing cross-sectional imaging of the
entire body in any plane with no radiation risk to the patient. There are
no known adverse effects.
Role of MRI in diseases
MRI has unique properties. It is a complex yet interesting imaging
technique utilized for the diagnosis of various diseases in all parts of the
body. MRI is a very sensitive to certain pathologies, demonstrating
disorders not shown on other imaging modalities, i.e. CT. The rapid
advances in MRI have resulted in many new pulse sequences providing
details about tissue characterization.
Production of image
When the patient is placed in the scanner, the applied EMF induces a
NNM in the longitudinal axis of the patient. This NNM is rotate through
90o by the RF pulse. When the RF pulse is discontinued, relaxation
back to the original state occurs, i.e. recovery of the magnetization in
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the longitudinal plane and decay of magnetization in the transverse
plane. The recovery of the longitudinal magnetization is known as spin
lattice or T1 recovery. The decay of transverse magnetization is known
as spin spin relaxation or T@ decay. T1 is determined by how quickly
the nuclei can transfer energy to their surrounding environment (lattice)
and return to a lower energy state. T2 is determined by how quickly the
nuclei can exchange energy with neighboring nuclei to produce random
distribution of the precessing nuclei about the magnetic field.
The sensitivity of MRI to certain substance, i.e. water and iron
copmpounds, is of particular importance in clinical imaging. For
example, the high sensitivity of MRI to tissue water allows the effective
demonstration of brain edema. All type of edema namely vasogenic,
cytotoxic and interstitial, result in altered signal and are best seen on T2
weighted images as a bright signal.
The marked differences in the relaxation times of water and brain tissue
enable the differentiation of tissue. For example, smaller structures
such as cranial nerves that are bathed in cerebrospinal fluid are well
demonstrated on MRI. MRI is superior in the demonstration of tumors
and othe abnormalities of nerves, i.e. acoustic neuromas and lesions
involving the optic chiasma
The sensitivity of MRI to paramagnetic substances such as iron is of
great clinical importance, as lesions of increased iron in pallidues,
substantia nigra, red nucleus and dentate nucleus demonstrate a low
signal on T2WI.
MRI is sensitive for the detection of cerebral ischeamia, plus has the
advantage of evaluating subacute and chronic trauma cases.
(See advantages and disadvantage of MRI)
MRI image
The image represents a display of the MR signal. The signal intensity
depends on both the tissue and the equipment (operator) parameters. It
is important to understand that the gray scale on a MR image in not
readily predictable and can be dramatically altered by machine-
dependent parameters such as choice of PS, time between pulses (TE),
TR, TI, etc.
There are four main tissue MR parameters contributing to the signal
intensity of an image. The MR image depends on the following four
main factors; a) PD b) T1, c) T2 and d) Blood flow
The MRI image depends on the following four main factors:
a) T1 relaxation time b) T2 decay time c) Proton density d) Blood flow
Proton density, T1 weighted and T2 weighted
MR imaging is related to the density of mobile protons. Proton density is
represented by the symbol (PD). The PD image is obtained using a spin
echo sequence with long TR and short TE or a gradient echo sequence
with a long FA. As the PD of various tissue obtained differs only by a
few percent, this pulse sequence is not widely used.
Air contains a low density of protons; therefore sinuses show no proton
image. Trabecular bone, on the other hand, contains many protons but
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still generate no signal. This is because the protons are tightly bound
and have a T2 decay time so small that the signals vanish before
conventional MR imaging is able to detect them.
Relaxation times are affected by the chemical composition of the tissue
being studied. Each normal tissue in the body has a specific relaxation
time, which is either shortened or prolonged by certain pathological
changes.
The choice of a short TR enhances the T1 contrast between fats and
liquids. On the T2 decay curve, each tissue starts at a different level.
Fats are characterized by a short T2 and liquids by a long T2: There is
a crossing point between the two curves where the two substances
show an isointense signal.
Intensities of normal anatomical structures
Normal anatomical structures are listed below according to their signal
intensity on T1 weighted images.
1. High intensity
 Fat
- Orbital
- Scalp
 Mucus
Typical values for normal and some abnormal tissues at 1.0 T
Tissue type Relative PD T1 (ms) T2 (ms)
Lipids 0.6 250 50
White matter 0.75 670 85
Gray matter 0.85 920 95
Peripheral muscle 0.8 620 45
Liver 0.70 570 45
Cerebrospinal fluid 1 2000 1000
Oedema 0.90 1060 150
Brain tumour 0.90 1410 200
MS plaque 0.90 1100 150

 Marrow
- Cranium
- Spenoid, clivus
- Vertebra
 Cartilage of nasal septum
2. Low intensity
 Venous sinuses
 Veins
- Internal jugular
- Superior ophthalmic
- Internal cerebral
- Vein of Galen
 Cortical veins
 Arteries
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 - Carotid
- Opthalmic
- Anterior, middle and posterior cerebral
- Anterior inferior cerebral artery (AICA)
- Posterior inferior cerebral artery (PICA)
- Vertebral-basilar
 Paranasal sinuses
 Choroid plexus
 Cortical bone
 Falx cerebri
 Tentorium
 Calcified cartilage
 Calcified structures, e.g. pineal gland
When excited protons return to equilibrium, they relax inducing a signal.
The combined signal generates the MR image.
High MR signals (White) Low MR signal (Black)
PD High Low
T1 relaxation Short Long
T2 relaxation Long Short
Blood flow Slow/stationary Fast/turbulent

If the emitted signal is low, it is termed hypointense and represent in

black. If the emitted signal is high, it is termed hyperintense and
represented in white
 T1 weighted images
Hypointense: tissue with a long T1
Hyperintense: tissue with a short T2
Fig. 6.1 T1 characteristic of body tissues
 T2 weighted images
Hypointense: tissue with a short T2
Hyperintense: tissue with a long T2
Liquid produces a hypointense signal on a T1W PS and a hyperintense
signal on a T2W PS. Fat, on the contrary, has an opposite signal, i.e.
hyperintense on a T1 PS and hypointense on a T2 PS. Both fat and
water have the same signal (isointense) in a mixed PS.
Fig. 6.2 T2 characteristic of body tissues
Cause of hypointensity (on short FA, long TE gradient echo images):
 Haemorrhage
 Deoxyhaemoglobin
 Ferritin/hemosiderin
 Other iron forms
 Calcification
 Diamagnetic calcium salts
 Associated paramagnetic irons
 Air containing paranasal sinuses
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  Normal brain iron
 Paramagnetic contrast agent
 Ferromagnetic devices, foreign bodies
 Intravascular deoxygenated blood
Pathological changes influencing image appearance:
Oedema: Both cytotoxic oedema and vasogenic oedema are
hypointense on T1 and hyperintense on T2W PS. Necrosis also
appears hypointense on T1 and hyperintense on T2W PS.
Fig. 6.3 Mixed sequence with short TR
Fig. 6.4 Mixed sequence with three echoes
Gliosis: On T2W PS, gliosis appears as distinct areas of high signal
intesity.
Radiation effects: Radiation may cause a decrease in signal intensity on
T2W PS.
Cysts: Cyst are hypointense on T1 and hyperintense on T2W PS and
are similar to CSF in intensity.
Demyelination: Areas of demyelination are visualized as hyperintense
signal of T2W PS.
Fatty changes: increased fat or lipid content as in epidermoid tumours,
results in a characteristic high intensity lesion on T1W PS.
Fibrosis: Fibrosis, seen in postoperative disk surgery, appears
hypointense on both T1 and T2W PS
Gray-white matter: The T2 of white matter is less than the graymatter
and the T1 of WM is less than the GM. As WM has a shorter T1 and T2,
it appears brighter on T1WI while the short T2 makes it appear less
bright on T2WI. The brightness of WM on T1WI is attributed to the
membrane lipid myelin in the brain.
Vascular structure: If hydrogen passes through the image volume faster
than the time taken to perform an imaging sequence, there will be no
detectable signal. The signal intensity of flowing blood is a function of
the percentage of moving hydrogen nuclei, their velocity and the
temporal parameters of the imaging technique. The normal carotid
artery, basilar artery and venous sinuses have no detectable signal,
appearing black on MR images.
Intravascular blood appears either white or black on MR images
depending on its velocity of flow or turbulence: fast flowing blood
appears black, whilst slow flowing blood appears white.

215
Pathological changes and Effect of Relaxation Time
Both the T1 and T2 recovery times either be shortened or prolonged by
the following:
T1 Shortened T2 Shortened
Lipid Air
Paramagnetic substance: Calcium
-Cooper, -Iron, -Manganese Cortical bone
Mucus Paramagnetic substances
Cholesterol Fat
Postradiation changes (2W)
Haemorrhage-methemoglobin
Increased protein content
Melanin
T1 Prolonged T2 Prolonged
Air Demyelination
Calcium Infection
Cortical bone CSF
Oedema Ischemia
Demyelination Neoplasia
Neoplasia Oedema
Infection
Ischemia
Infarction
CSF
» Appearance of blood on MR images Utilizing Various Imaging Technique
Tissue Characteristic of Brain
Relaxation Image
Time Contrast
T1 T2 PD T1 T2
CSF Long Long Grey Dark Bright
Gray M Intermediate Intermediate Isointense Grey Grey
White Short Short Bright Bright Grey
M
Fat Short Intermediate Bright Bright Grey
C. Long Short Dark Dark Dark
Bone
Air Long Short Dark Dark Dark
Blood F Long Short Dark Dark Dark
Edema Long Long Bright / G Grey/D Bright
Protein Short Long B / Grey Bright Bright

216
Tissue contrast » Contrast

Tissue heating » Effects of RF power

Tomographic > A slice with some thickness

Topical MR - TMR
Spectroscopic technique that uses special shim coils to produce a small
region of high field homogeneity.

Torque
The application of an external resonantB1-RF pulse that will mutate or
create a sufficient force to increase its angular momentum () from +z
longitudinal orientation.

Total imaging matrix - TIM

MR technology for a seamless whole body surface coil. For whole body
imaging in one examination (by 328 independent RF channels and has
been expanded to 128 independent RF channels and coil elements

Trace image
In trace images, contrast is generated by the direction of the diffusion
tensor. This corresponds to the sum of diagonal elements (trace) of the
diffusion tensors: Trace = Dxx + Dyy + Dzz

Train - Echo train.

Transaxial - A plane 90o to the long axis of the human body.

Transformer
A device or induction process which steps electromotive force (voltage)
either up or down.

Translate - Move from side to side.

Transmission bandwidth
The frequency range of an excitation pulse in a sequence.

Transmitter
Portion of the NMR apparatus that produces RF current and delivers it
to the transmitting coil.

Transmitter coil
Coil which delivers RF from the transmitter to the sample being
examined.

217
Transmitter tuning
Setting the transmission power of RF pulse (flip angle).

Transreceiver coil
An MRI surface coil that serves as both a transmitter and a receiver.

Transverse » Orthogonal slices

Transverse coherences
If RF pulses are repeated at intervals which are less than T2 then they
can act both as excitation and refocusing pulses since in addition to
generating fresh transverse magnetization they can refocus all or part of
the signal from preceding RF pulses. This can lead to the formation of
spin echoes centred on the RF pulses which supplement the newly
created transverse magnetization.

Transverse component of magnetization » Mxy

▪Component of the macroscopic magnetization vector at right angles to
the static magnetic field (B0). Precession of the transverse
magnetization at the Larmor frequency is responsible for the detectable
MR signal. In the absence of externally applied RF energy, the
transverse magnetization will decay to zero with a characteristic time
constant of T2*.
▪Components of macroscopic magnetization vector at right angles to the
static magnetic field in MRI. Magnetic dipole moments in the transverse
x-y plane.
▪The XY component of the net magnetization.
Transverse magnetization Mxy is the component of the macroscopic
magnetization vector in the xy plane; that is, oriented perpendicular to
the applied magnetic field. The precession of transverse magnetization
induces electrical voltage in a receiver coil that changes over time. The
temporal or time course of this voltage is the MR signal. After RF
excitation, Mxy decays to zero at time constant T2 (ideal) or T2* (real).

Transverse (XY) plane

The plane that orients perpendicular to the magnetic field (which is in
the longitudinal plane); the net magnetic vector is transferred to the
transverse plane following excitation by an RF pulse.

Transverse relaxation
Decay of transverse magnetization through the loss of phase coherence
between precessing spisn (due to spin exchange); also referred to as
spin-spin relaxation.

Transverse relaxation time T2 / T2

218
Time that it takes for the transverse magnetization vector to recover in
MRI. » T2 constant
T2.Nuclei will retain their magnetic orientation for a time in the order of
T1 even in the presence of motion. Thus, if the nuclei in a given region
have their spin orientation changed, the altered spins will serve as a
'tag' to trace the motion of any fluid that may have been in the tagged
region for a time on the order of T1.

Traveling saturation slice

A presaturation pulse can be applied to one side of the slice to reduce
the signal intensity of spins (typically blood) that are about to flow into
the side of the slice. This enables arteries or veins to be displayed
selectively, since the flow is often in the opposite direction (e.g., carotid
artery and jugular vein). The slices are measured sequentially (slice by
slice). The presaturation pulse retains its position relative to the slice.

Trigger
Reference point in the physiological signal that releases the scan (e.g.,
R-wave in the ECG signal.

Trigger delay - TD
ECG triggering. Interval between the trigger and release of the
measurement.

Trigger signal
Physiological control imaging. Physiological signal (ECG signal, finger
pulse, or respiratory curve) time starts or restarts data acquisition.

Truncation artifact / Gibbs artifact

An image artifact characterized by a multiple ring-like effect caused by
adjacent high and low signal intensity areas.
In MR images, periodic oscillations frequency occur parallel to
transitions in tissue. The artifacts are bands of alternating high and low
signal intensity. All abrupt transitions in tissue are subject to this effect.
The finite sampling of the analogue signal causes the artifact.
Theoretically, an infinite number of points must be sampled. In reality,
sampling is finite; the data are truncated.

TrueFISP
Fast imaging with steady procession heavily T2 weighted
Siemens brand name for a refocuses GE-PS 3D MPR + MIP
GE PS that provides the highest signal of all steady state sequences.
Contrast is a function of T1/T2. With short TR and short TE, the T 1
portion remains contrast and the images are primarily T 2 weighted.
FISP and PSIF signals are generated simultaneously. Because the
signals are superimposed, trueFISP is sensitive to inhomogeneity in the
219
magnetic field. The images may contain interference stripes. For this
reason, TR should be as short as possible, and a shim must be
performed.

t-Test » Z score

Tuning
▪ Setting components prior to measurement, usually automatic process
of adjusting the resonance frequency, e.g. of the RF circuit, to a desired
value, e.g. the Larmor frequency. More generally, the process of
adjusting the components of the spectrometer for optimal signal
strength.
▪ Adjustment process of the B1-RF resonant pulse; it must equal Wo for
the tissue sample. » Frequency tuning, Receiver tuning, Transmitter tuning

Turbo factor
Measurement time saved using a TurboSE sequence compared to a
conventional SE. Example: At turbo factor 7, the TurboSE sequence
measures 7 times as fast as a SE sequence with comparable
parameters.

Turbo field echo

Philips brand name for a magnetization-prepared ultrafast GE-PS » TFE

Turbo gradient spin echo - TurboGSE

With Turbo GSE, additional gradient echoes are generated before and
after each spin echo. The spin echoes are allocated to the centre of the
raw data matrix to give pure T2 contrast. The gradient echoes primarily
determine the image resolution. Advantages compared to TurboSE:
faster, fat is darker, more sensitive to susceptibility effects (e.g.,
bleeding with hemosiderin).

Turbo inversion recovery magnitude » TIRM

TurboIR /TIR
TurboSE sequence with long TI for fluid suppression. The TurboIR
sequence allows for a true inversion recovery display that shows the
arithmetic sign of the signal.

Turbo MRA - Ultra fast MRA technique.

Fast 3D angio techniques; increases speed by a factor of 2 using zero
filling (interpolation techniques in slice-selection direction) short TR and
TE.

Turbo inversion recovery sequence » TurboIR/TIR sequence

220
Turbo inversion recovery magnitude - TIRM
Just as TurboIR, but with a magnitude display.

Turbo spin echo - RARE pulse sequence » TSE

Turbo fast low angle shot - TurboFLASH

Siemens brand name for an ultrafast gradient echo pulse sequence
The entire raw data matrix is measured in one acquisition with an ultra-
fast GE sequence. A preparation pulse modifies the image contrast.

Turbo fast low angle shot - Turbo FLASH

Siemens brand name for an ultrafast gradient echo pulse sequence

Turbo MRA
Ultrafast MR angiography technique. » TurboMR angiography

Turbo Short
Turbo short repetition technique, Elscient brand name for an ultrafast
GE-PS

TurboSE / TSE - Turbo spin echo GE PS

Philips Elscient and Siemens brand name for a RARE pulse sequence
A fast multiecho sequence. Every echo of the pulse train has different
phase-encoding. Within one TR, raw data rows equal to the number of
pulse train echoes are acquired (segmented raw data). The Turbo
factor increases speed, and is usually used to improve resolution.

Two-dimensional » 2D
Refers to imaging modalities and images in radiology in which data are
acquired and/or viewed in two orthogonal axes.

Two-dimensional Fourier transforms 2DFT

A FT mathematical analysis applied along two directions of a slice of
signal data, thereby creating an anatomical image. » Technical factor

Two-dimensional (Fourier transform) imaging

A form of sequential plane imaging using Fourier transform imaging.»
2DFT

Type of pulse sequences » PS

►U◄►V◄►W◄
Ultrafast gradient echo pulse sequence –

221
GE-PS where the TR chosen is so short that image acquisition lasts
less than 1s. » U GE-PS, U MRI

Ultrafast magnetic resonance imaging

MRI technique using rapid data acquisition. All forms of EPI including
the GRASE PS, GE-PS RARE PS.

Ultrafast sequences » PS

Ultrasmall particle iron oxide or ultrasmall superparamagnetic iron oxide »

USPIO

Ultrasonic frequency
Frequency that is above the range of sound audible to the human ear
(approximately 3 kHz).

Unidentified bright objects - UBOs

High focal signals from subcortical cerebral white matter seen on MR
brain images. Incidence increase with age. Diverse aetiology. » WMHs

Valence
The combining power of a given element/molecule based upon the
number of its outer electrons. The valence governs the ability of
elements / compounds to bond, as indicated in the Mendeleev periodic
table.

Variable bandwidth imaging

Imaging with different bandwidths (digitization rates) in order to control
the noise and chemical shift artifact.

Variable echo multiplannar » VEMP

Vascular magnetic resonance imaging - VMRI

Vector
▪A quantity having both magnitude and direction, frequently represented
by an arrow whose length is proportional to the magnitude.
▪A mathematical entity characterized by magnitude and direction.
Vector quantities can be added or subtracted from one another.

Velocity - (blood) flow per area: cm3 · s-1 · cm-2.

Velocity encoding - Speed in a particular direction. » VENC

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Velocity encoding / velocity encoding value - Venc
Specialized technique for encoding flow velocity.

Vertex flow
Area within a blood vessel where the blood is suddenly accelerated
then rapidly decelerated, i.e., blood passing through a vascular
stenosis.

Vibration - The shaking movement of an object.

Viscosity
A property of a fluid or semi-fluid that affects its mobility, thus its image
intensity.

Viscosity of contrast media » MRCM

Volt - Unit of electrical pressure; 1kilovolt (kv) = 1000 volts

Volume of interest - VOI

MRS. A VOI is the volume selected for measurement or evaluation. For
SVS or hybrid CSI procedures, VOI means the signal generating the
measurement volume. For SVS, VOI and voxel are identical, but for
hybrid CSI the VOI is divided into voxels.

Volume imaging
Signals are gathered from the whole object volume to be imaged at
once, with appropriate encoding sequences. Many sequential plane-
imaging techniques can be generalized to volume imaging, at least in
principle. Advantages include potential improvement in SNR by
including signal from the whole volume at once, form 3D; disadvantages
include a bigger computational task for image reconstruction and longer
image acquisition times. Also called 'simultaneous volume imaging'.

CYCLPOT- VOSING Volume selective single scan heteronuclear

Volumetric imaging
A specialized technique where all the MR signals are collected from the
entire tissue samples and imaged as a whole entity. Compare with slice
select.

VOSY - volume spectroscopy, see localized spectroscopy.

Voxel
Volume element of the sample to be examined. Voxel size = slice
thickness x pixel size. » Spatial resolution

223
▪Volume element; the element of 3-D space corresponding to a pixel,
for a given slice thickness.
▪A 3D volumetric portion of an image where viewing face is the pixel
and whose depth is the third dimension.

Voxel bleeding
MRS. Indicates cross talk of signal intensity from one voxel to an
adjacent voxel. Up to 10% of a signal can appear in an adjacent voxel.
These localization artifacts primarily appear in the image during
intensity tests.

Washout effect
The washout effect can appear perpendicular to the image plane during
fast flow. It occurs during spin echo imaging and similar procedures.
Using a 90o pulse, a bolus is excited within the slice to be measured. If
blood flows out of the slice before the subsequent 180 o pulse, some or
the entire signal is lost. This results in a low signal or no signal at all.

Watt - Unit of electrical power, the product of volts and ampères.

Water saturation
Frequency-selective excitation of water, with subsequent dephasing, is
used to suppress water signals. This technique is used for MR imaging
and spectroscopy.

Water suppression
Pulse sequences in MR imaging or MR spectroscopy image can be
formed only fat or water respectively. » Dark fluid imaging, Water saturation
▪In proton spectroscopy the water signal is usually several orders of
magnitude greater than the next strongest signal. To avoid the resulting
dynamic range problem the water signal is suppressed, typically with
presaturation or by using binomial pulses. Similar techniques can be
applied to imaging so as to remove the water component from images.

Wave
▪The way in which sound, light, heat and electricity travel.
▪The propagation of a wavelength of energy that has the dimensions of
period, frequency, and amplitude.

Wavelength
▪The distance between two peaks on a wave.
▪The distance measured in the direction of propagation of a wave, from
one points to another in the same phase.

224
Weight bearing MRI - WB MRI
MR imaging is perform under weight bearing on patient body in a
special MR unit

Weighting
Allowance or adjustment made to take account of special
circumstances or compensate for a distorting factor.

Whisper sequence - Sequence with low noise gradient pulses.

White matter hyperintensities - WMH

High focal signals from subcortical cerebral white matter seen on MR
brain images. Incidence increase with age. Diverse aetiology. » UBOs

Window
Setting of brightness (centre) and contrast (width) in the MR image.
▪A range of values considered together (looked at).
▪Relationship between signal intensity and shade of the display gray
scale. Window width: number of digital levels between pure black and
pure white; window center: digital level on which the window is
centered.

Window centre - WC
Centering point for grey scale when viewing digitally produced images

Work
Moving mass through space by overcoming the resting inertia. W =
force (F) x distance (d)

Work image » Basic image

Wraparound / Aliasing artifacts

Wrap around or aliasing appears when the diameter of the scanned
area is greater than the dimensions of the field of view used a part of
the image is ‘folded’ on it self. Fold over artifacts also known as: Back
folding, Aliasing, Wrap around
Phase of the signal just out of the field of view, increase FOV; changes
preparation direction increased phase encoding. Fig. 7.1-5
Remedies: Increase FOV, Filtering the frequency encoding direction,
Oversampling in the phase encoding direction

►X◄►Y◄►Z◄
X - axis in laboratory coordinate system
225
X’ - rotating frame X axis

Xe - xenon, element with 54 protons.

Xe 129 MRI - hyperpolarized gas magnetic resonance imaging

Xenon MRI - MR imaging of lung using xenon gas as a MR CM

x
Dimension in the stationary (laboratory) frame of reference in the plane
orthogonal (at right angles) to the direction of the static magnetic field
(B0), z and orthogonal to y.

X'
Dimension in the rotating frame of reference in the plane orthogonal to
the direction of the static magnetic field (B0) z.

X axis
The axis in the magnet that corresponds to the width of the magnet or
from patient’s shoulder to shoulder.

X – gradient / X component of magnetization

X-component of the magnetic gradient field, which is defined as
horizontal and perpendicular to the axis of a cylindrical MRI system and
thus perpendicular to the main magnetic field.

Xenon - Xe
Element with 54 protons. Xe 127 and Xe 133 are both used as
ventilation agents, while stable hyperpolarized Xe has been used for
MR imaging ventilation studies.

Xenon 129 MR imaging » Hyperpolarized gas MRI

x-y-z
Cartesian axes at 90o to each other
y - dimension in the stationary (laboratory) frame of reference in the
plane orthogonal to the direction of the static magnetic field (Bo), z, and
orthogonal to the other dimension in this plane, x.

 (gamma)
Y – gradient y-component of the magnetic gradient field

Y axis in laboratory coordinate system

Y’rotating frame Y axis

226
y
Dimension in the stationary (laboratory) frame of reference in the plane
orthogonal to the direction of the static magnetic field (B0), z, and
orthogonal to the other dimension in this plane, x.

y'
Dimension in the rotating frame of reference in the plane orthogonal to
the direction of the static magnetic field (B0), z, and orthogonal to the
other dimension in this plane, x'.

Y axis
The axis in the magnet that corresponds to the vertical direction of the
magnet or anterior/posterior orientation of the patient.

Y' component of magnetization - My

Y – gradient
Y-component of the magnetic gradient field, which is defined as vertical
and perpendicular to the axis of a cylindrical MRI system and thus
perpendicular to the main magnetic field.

#Z
Atomic number, the number of protons in a given nucleus. It is the
subscript in 168O, for example.

Z
Dimension in the direction of the static magnetic field (B0 and H0), in
both the stationary and rotating frames of reference.

Z axis
The longitudinal axis of the magnetic field. Corresponds to the
craniocaudal / caudocranial direction of the patient.

Z - gradient
Z-component of the magnetic gradient field, which is taken to be parallel
to the axis of a cylindrical MRI system and thus the main magnetic field.

Zero filling
Meas. Interpolation technique for expanding a raw data matrix with
zeroes.

Zero temperature
Water freezes at 0o Celsius = 32o Fahrenheit. Absolute zero, when all
molecular motion ceases, is equivalent to 0 k or –273oC

Zeugmatography
227
Term for MRI coined by Paul C. Lauterbur suggesting the role of the
gradient magnetic field in joining the RF magnetic field to a desired local
spatial region through NMR

Zipper artifacts
This artifact is caused by external RF entering the room at a certain
frequency and interfering with inherently weak signal coming from the
patient. There are various causes for zipper artifacts in images. Most of
them are related to hardware or software problems. The zipper artifacts
that can be controlled easily are those due to RF entering the scanning
room when the door is open during acquisition of images. RF from radio
transmitters will cause zipper artifacts that are oriented perpendicular to
the frequency axis of the image. Frequently there is more than one
artifact line on an image from this cause. Fig. 7.24A+B
Remedy: System generated artifacts should be reported service
engineer.

ZIP technique
Recon. Zero filling. Interpolation technique in slice-selective direction for
3D measurements. Enables reconstruction of intermediate 3D partitions
between those normally reconstructed

Zonal EPI - ZEPI

Rapid acquisition magnetic resonance sequence used to demonstrate
flowing blood.

Z score
BOLD imaging. Statistical evaluation procedure similar to t-test. Z score
is used to calculate a differential image from the activated and non
activated images. Significance weighting is used on the difference.

228
 Acronyms used for rapid imaging technique:
Acronym Spelled-out Name
Balanced FFE Balanced fast field echo
CE-FAST Contrast-enhanced Fourier-acquired steady state
CE-FFE T1 Contrast-enhanced fast field echo (T1-weighted)
CE-FFE T2 Contrast-enhanced fast field echo (T2-weighted)
CSFSE Contiguous-slice fast-acquisition spin echo
DE FGR Driven-equilibrium fast gradient-recalled acquisition in
the steady state
DEFAISE Dual-echo fast-acquisition interleaved spin echo
DESS Double-echo steady state (combination FISP and PSIF
DFSE Double-fast spin echo
E-SHORT Steady state gradient echo with spin-echo sampling
FADE FASE acquisition double echo
FAME Fast-acquisition multi-echo
FASE Fast spin echo
FAST Fourier-acquired steady state
FATE Fast turbo echo (=FADE)
FE Field echo
FEDIF Field echo with echo time set for water and fat signals
in opposition
FEER Field even-echo by reversal
FESUM Field echo with echo time set for water and fat signals
in phase
FFE Fast field echo
FGR Fast gradient-recalled acquisition in the steady state
FISP Fast imaging with steady precession
FLARE Fast low-angle recalled echo
FLASH Fast low-angle shot
FRE Field-reversal echo
FS Fast scans
229
FSE Fast spin echo
F-SHORT Steady-state gradient echo based on FID
FSPGR Fast spoiled gradient-recalled
GE Gradient echo
GFE Gradient field echo
GFEC Gradient field echo with contrast
GRASE Gradient and spin echo
GRASS Gradient-recalled acquisition in the steady state
GRE Gradient echo (‘generic’ name); gradient-recalled echo
GREC Gradient field echo with contrast
GRECO Gradient-recalled echo
GRECHO Gradient-recalled echo
IR FGR Inversion recovery fast gradient-recalled acquisition in
the steady state
MESS Multi-echo single shot
MPGR Multiplanar gradient-recalled
MP-RAGE Magnetization-prepared rapid gradient echo
PFI Partial flip imaging
PS Partial saturation
PSIF Reverse fast imaging with steady precession
QUEST Quick-echo-split imaging technique
RAM-FAST Rapidly acquired magnetization-prepared Fourier-
acquired steady state
RARE Rapid acquisition with relaxation enhancement
RF-FAST RF-spoiled Fourier-acquired steady state
RF spoiled RF-spoiled Fourier-acquired
RISE Rapid imaging spin echo
ROAST Resonant offset averaging in the steady state
RS Rapid scans
RSE Rapid spin echo
SHORT Short repetition technique

230
SMASH Short minimum-angle shot
SPGR Spoiled gradient-recalled
SSFP Steady-state free precession
STAGE Small tip angle gradient echo
STAGE: T1W Small tip angle gradient echo: T1-weighted
STEP Stimulated echo progressive imaging
STERF Steady-state technique with refocused free FID
TFE ‘Turbo’-field echo 3D-MPRAGE3D magnetization-
prepared rapid gradient echo
T1 FAST Fourier-acquired steady state (T1-weighted)
T1 FFE Contrast-enhanced fast field echo (T1-W)
T2 FFE Contrast-enhanced fast field echo (T2-W)
TRUE FISP Fast imaging with steady precession (heavily T2-W)
TSE ‘Turbo’ spin echo
Turbo-FE ‘Turbo’ field echo
TurboFLASH ‘Turbo’-fast low angle shot
Turbo SE ‘Turbo’ spin echo
Turbo-SHORT ‘Turbo’ short repetition technique

231
Different terms for the gradient-echo pulse sequences:
*In this context, ‘contrast-enhanced’ refers to the radiofrequency pulse
sequence; it does not mean enhancement with a contrast agent.
S-GRE (spoiled gradient-echo)
Acronym Spelled-out Name
GFE Gradient field-echo
CE*-FFE-T1 Contrast-enhanced* fast field echo with T1-W
FLASH Fast low angle single shot
PS Partial saturation
RFS FAST RF spoiled Fourier-acquired steady-state technique
SHORT Short repetition technique
SPGR Spoiled gradient recalled (spoiled GRASS)
STAGE: T1WT1-weighted small tip angle gradient-echo
T1-FAST T1-weighted Fourier-acquired steady-state technique
T1-FFE T1-weighted fast field echo
R-GRE (refocused gradient-echo)
FAST Fourier-acquired steady-state technique
FFE Fast field echo
FISP Fast imaging with steady-state precession
F-SHORT Short repetition technique based on FID
GFEC Gradient field echo with contrast
GRASS Gradient-recalled acquisition in the steady state
ROAST Resonant offset averaging in the steady state
SSFP Steady-state free precession
CE-GRE (contrast-enhanced gradient-echo)
CE-FFE F Contrast-enhanced*fast field echo / FAST
PSIF Reverse fast imaging with steady-state precession
SSFP Steady-state free precession

232
 ABBREVIATION USED IN MRI
A▼
A Anterior, Amphère, Mass number
Å Angstrom (10-10 meters)
AA arch aortography
A/D analogue-to-digital converter
ADC analogue-to-digital converter
apparent diffusion coefficient
ADP adenosine diphosphate
AE asymmetric echo
A Echo asymmetric echo
AFP adiabatic fast passage
AI amplitude image
ALFMA abnormal low-frequency magnetic activity
AP alpha pulse / anterior-posterior
ASE asymmetric echo, advance/asymmetric spin echo
AST arterial spin trapping
ATEC automated tissue excision and collection
ATP adenosine triphosphate
B / Bo static magnetic field
Bo field constant magnetic field of a MR scanner
B1 radio frequency magnetic field the induced field in MRI
B1R Receive B1 magnetic field
B1T Transmit B1 magnetic field
BA backfolding artefact, blurring artefact
BBA black blood angiography
BEST blood vessel enhancement by selective suppr tech
BFFE balanced fast field echo
BOLD blood oxygen level dependent (contrast)
BPM beats per minutes
BSIR British Society of Interventional Radiology
233
BW bandwidth / receiver bandwidth
C▼
C contrast
CA carrier wave
CAD computer aided diagnosis
CARS computer assisted radiology surgery
CBF cerebral blood flow
CBFI cerebral blood flow imaging
CBV cerebral blood volume
CCF countercurrent flow
CD curve contrast detail curve
CE comb echo, contrast enhancement
CE-FAST contrast-enhanced Fourier-acquired steady state
CE-FFET1 contrast-enhanced Fast field echo
CE-FFET2 contrast-enhanced Fast field echo T2 W
CE FLASH contrast-enhanced fast low angle shot
CFOV central field of view
CHESS chemical shift selective
CI correlation Imaging
CM contrast medium
CMA cardiac motion artefact
C MRI cine magnetic resonance imaging
CM MRA contrast medium MR angiography
CNR contrast to noise ratio
CO2 carbon dioxide
CP Sequence Carr-Purcell sequence
CP MG seq Carr-Purcell Meiboom-Gill sequence
CPU central processing unit
CSA chemical shift artefact

234
CSE conventional spin echo
CS FSE contiguous-slice fast-acquisition spin echo
CSI chemical shift imaging
CV MRI cardiovascular magnetic resonance imaging
CW continuous wave, contrast weighting
D▼
2-D two-dimensional
2-DFT two-dimensional Fourier transforms
3-D three-dimensional
3-DFT three-dimensional Fourier transforms
DAT digital audiotape
dB Decibels
dB/dt rate of change magnetic flux density with time
DBM doubly balanced mixer
DSC MRI dynamic susceptibility contrast MR imaging
DC TSE double contrast turbo spin echo
DE FGR driven equilibrium fast gradient-recalled acquisition in
the steady state
DE FAISE dual echo fast-acquisition interleaved SE
DEFT driven equilibrium Fourier transform
DE prep driven equilibrium magnetization preparation
DESS dual echo in steady state
DFSE dual (echo) fast spin echo
DI diffusion imaging
DC TSE double contrast turbo spin echo
DM dorsal mylography
DMAP diffusion apparent diffusion coefficient mapping
DMRI deuterium magnetic resonance imaging
DMRS diffusion magnetic resonance spectroscopy
deuterium magnetic resonance spectroscopy

235
DRESS depth-resolved surface spectroscopy
DT MRI diffusion tensor magnetic resonance imaging
DTPA diethylenetriamine-pentacetic acid
DTPM dixon two-point method
DW diffusion weighted MR imaging
DWI diffusion weighted imaging / image
DW MRI diffusion weighted MR imaging
DW SE-EPI diffusion-weighted spin echo-EPI
E▼
e charge of an electron
E energy, the capacity of a system to do work.
EEMRI endo-esophageal MR imaging
EEMR coil endo-esophageal MR imaging coil
ELF fields extremely low frequency fields
EM electromagnetic
EMI/RFI electromagnetic and radio frequency interference
EMRF European magnetic resonance forum
EMRI esophageal magnetic resonance angiography
EPI echo-planar imaging
EP MRA echo planner MR angiography
EPISTAR echo-planar imaging with signal targeting & alternating
radio frequency
EPR electron paramagnetic resonance
EPS echo-planar spectroscopy
EPSI echo-planar spectroscopic imaging
ES echo shift
ESF edge spread function

236
E short Elscient brand name for a refocused GE-PS
ESR electron spin resonance
E SHORT steady-state gradient echo with spin-echo sampling
ETL echo train length
F▼
F frequency; Fr.; n
fo Larmor frequency
FA flip angle, flow artefact, ferromagnetic artefact
FADE FASE acquisition double echo Picker -GE-PS
FAIR flow sensitive alternating inversion recoveries
FAME fast acquisition multi-echo
FASE fast advanced spin echo, fast spin echo
FAST Fourier acquired steady state
FATE fast turbo-echo
Fat. Sat. fat saturation
FB MRI functional brain magnetic resonance imaging
FB MRS functional brain MR spectroscopy
FBSE flip back spin echo
FC flow compensation
FC MRI field cycle magnetic resonance imaging
FE flow effect, field echo, fractional echo
FEER field echo with even echo re-phasing
FEDIF field echo with TE set for water and fat signals in .
FESUM field echo with TE set for water and fat signals in phase
FFE fast field echo
FFLAIR fast fluid attenuated inversion recovery
FFT fast Fourier transform
FGR fast GRASS-Gradients recalled acquisition in the
steady state

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FI fast imaging, functional imaging
FID free induction decay, free induction decay signal
FIDIF field echo with an echo time set so that water and fat
spin are opposed when the echo occurs. OPPOSED-
PHASE IMAGE
FIR fast inversion recovery
FISP fast imaging with steady state procession
FLAG flow adjusted gradients
FLAIR fluid attenuated inversion recovery
FLARE fast low-angle recalled echo
FLASH fast low angled shot
FMPGR fast multiplannar gradient echo
fMRI functional magnetic resonance imaging
FONAR focused nuclear resonance
FOV field of view
FRE flow related enhancement, field reversal echo
FRFSE fast recovery fast spin echo
FS fast scans
F short Elscient brand name for a refocused GE-PS
FSE fast spin echo
FSE-IR fast spin echo-inversion recovery
F short short repetition technique based on FID
FSIP fast imaging with steady state procession
F SHORT steady-state gradient echo based on FID
FSPGR fast spoiled GRASS (Gradients recalled acquisition in
the steady state)
FSTIR fast short tau inversion recovery
FT fourier transform
F/W discri fat and water discrimination
G▼
G/g gated, gauss, non-SI unit of magnetic flux density

238
GBP bipolar magnetic field gradient
Gd gadolinium
GE gradient echo
GE imaging gradient echo imaging
GEPS gradient echo pulse sequence
GF gradient field
GFR glomerular filtration rate
Gf frequency encoding gradient
GFE gradient field echo
GFEC gradient field echo with contrast / compensation
GHz gigahertz
Gi Field gradient in the i direction
G Phase encoding gradient
Gmax Maximum value of phase encoding gradient.
GICM gastrointestinal contrast medium
GIT gated imaging technique
GMF gradient magnetic field
GMN gradient moment nulling
GMR gradient motion/moment rephrasing
GMRI gated magnetic resonance imaging
GP gradient pulse
GR gradient rephasing
GRASE gradient and spin echo, gradient and SE PS
GRASS gradients recalled echo/acquisition in the steady state
 gyromagnetic ratio
GRASE PS gradient and spin echo pulse sequence
GRE gradient echo
GREC gradient echo, gradient field echo with contrast
GRECO gradient-recalled echo
GREg radient recalled echo, gradient refocused echo
GRE Seq gradient echo pulse sequence

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GRECHO short for gradient echo, gradient recalled echo
GRE-EPI gradient echo – echo planar imaging
Gs Slice selection gradient
Gx, Gy, Gz symbols for magnetic field gradients
H▼
h Planck's constant
H hydrogen, deuterium
Ho magnetic field
H1 obsolete symbol for the induced field in MRI
H3 MRI hyperpolarized helium-3 MR imaging
HASTE half –Fourier/acquisition single shot turbo spin echo
He helium Element with atomic mass number 2
HFI half Fourier imaging
HF MRI high field magnetic resonance imaging
HPG MRI hyperpolarized helium-3 MR imaging
HPH3 MR hyperpolarized helium-3 MR imaging
HPS hybrid pulse sequence
HR MRS high-resolution MR spectroscopy
Hz hertz, SI unit of frequency (e.g. kHz, MHz)
I▼
I inferior
IET inter echo time
IFT Inverse Fourier transform
IM Imaginary part of a complex number
IMACS image archiving and communications system
IMR imaging interventional / intraoperative / intraprocedural MRI
IR inversion recovery
IR FGR inversion recovery fast GRASS
IR FSE inversion recovery fast spin echo
IR prep inversion recovery magnetization preparation
IR PS inversion recovery pulse sequence
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ISCE inclined slab for contrast enhancement
ISE inversion spin echo pulse sequence
ISIS image selected in vivo spectroscopy
IVIM intravoxel incoherent motion
IV MR CM intravascular MR contrast medium
IV MRI intravascular magnetic resonance imaging
IWI intermediately weighted image
J▼
J Joule
JMD joint motion device
K▼
k boltzmann constant, kilo (103)
k proportionality constant
K kelvin temperature
kHz kilohertz 1000hertz (Hz)
kMRI kinematics’ magnetic resonance imaging
L▼
L left
LCR low contrast resolution. CD-CURVE
LF MRI low field magnetic resonance imaging
LMR localized magnetic resonance
LUT look-up table
M▼
m milli (10-3)
Mo the magnetization vector, Bo
Mo Equilibrium magnetization
M molar; magnetization vector, three spatial components
Mx, My & Mz.
MA magic angle
MARP multi angle reconstruction plan

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MAST motion artefact suppression technique
MDM magnetic dipole moment
MCTSE multi-contrast turbo spin echo
MEG magneto encephalography
MEMP multi-echo multiplanar
ME-PS multi-echo pulse sequence
MERGE …
MESS multi-echo single shot
Mhz megahertz
MIOP magnetic iron oxide particles
MIP maximum intensity projection
MLSI multiple line scan imaging
MPGR multiple planar gradient recalled (ASS)
MPGRE magnetization protocol gradient sequence
magnetization prepared gradient echo sequence
MPI myocardial perfusion imaging
MPIR multiplanar inversion recovery
MPR multiplanar reconstruction
MP-RAGE magnetization prepared rapid gradient echo
MR magnetic resonance
MRA MR angiography / arthrography
MRC MR cholengio-pancreatography
MR DSA MR digital subtraction angiography
MRCM magnetic resonance contrast medium
MRCP MR cholangio-pancreatography
MRF magnetic resonance fluoroscopy
MR GI magnetic resonance guided intervention
MRi magnetic resonance imager
MRI magnetic resonance imaging
MRI scans magnetic resonance imaging scans
MRI scanner magnetic resonance imaging scanner

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MRI machine magnetic resonance imaging machine
MRM magnetic resonance mammography / mylography /
MRPS magnetic resonance pulse sequence
MRP/U magnetic resonance pylography / urography
MRV magnetic resonance venogram
MR scanner magnetic resonance imager
ms millisecond
MRS magnetic resonance signal / spectroscopy
MRSI magnetic resonance spectroscopy imaging
MSI magnetic source imaging
MSME seq multislice multiecho sequence
MSOFT multi slice off resonance fat separation technique
MT magnetization transfer
MTC magnetization transfer contrast
MTF modulation transfer function
MTR magnetization transfer ratio
mT/m/ms magnetic GF in milliTesla per metre and milliseconds
Mx X component of magnetization
My Y component of magnetization
Mz Z component of magnetization
Mx,y transverse component of magnetization
Mz longitudinal component of magnetization
N▼
N+ spin population in low energy state
N- spin population in high energy state
n frequency
N signal size, hydrogen density, H weighted
N/2 ghost ghost artefact in MRI in the phase encoding direction
Nacq number of acquisitions
NE navigator echo
Nex / NEX number of excitations (number of averages)
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NMM nuclear magnetic moment.
NMR nuclear magnetic resonance
NMR imaging nuclear magnetic resonance imaging
NMR signal nuclear magnetic resonance signal
NMR spec nuclear magnetic resonance spectroscopy
NMV net magnetization vector
NPW no phase wrap
NSA number of signal averaged
NSF nephrogenic systemic fibrosis
O▼
O oxygen
O2-17 MR MR applications using oxygen as resonating nucleus.
OSIRIS A modification of the ISIS method for localized
spectroscopy
P▼
P posterior / power / Phase angle
PACS picture archiving and communication system
PC phase contrast
PCE paramagnetic contrast enhancement
PC MRA phase contrast MR angiography
PCM positive contrast media
PD proton density T1, T2 generated image
PDW proton density weighting
PD WI proton density weighted image
PEAR phase encoding artefact reduction
PFA partial flip angle
PFI partial flip imaging
PFNB percutaneous fine needle biopsy
PI perfusion imaging
PM perfusion measurement

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POMP phase-offset multi-planar
ppm parts per million
PRE proton relaxation enhancement
PRESS technique for localized spectroscopy using a SE PS
PR imaging projection reconstruction imaging
PRO PELLER periodically rotated overlapping parallel lines with
enhanced reconstruction
PS partial saturation / pulse sequence
PS sequence saturation recovery pulse sequence SR-PS
PSD phase sensitive detection
PSIF reverse fast imaging with steady procession
PSSE partial saturation spin echo
Pulse MR MR technique that applies RF pulses in contrast cont.
wave
PWI perfusion weighted imaging
PRI projection reconstruction imaging
Q▼
Q RF coil quality factor
QA quality assurance
QD coil quadrature detection coil
Q factor efficiency of a MR RF coil.
QUEST quick echo-split imaging technique
R▼
R right
R1 longitudinal relaxivity or efficiency
R2 transverse relaxivity or efficiency
RAGE rapid gradient echo
RAM FAST rapid/reduced acquisition matrix FAST
rapidly acquired magnetization prepared FAST
RARE rapid acquisition with relaxation enhancement
RARE PS rapid acquisition with relaxation enhancement PS
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RASE rapid acquisition spin echo
RC respiratory compensation
Refoc FLASH a type of gradient echo pulse sequence
RE real part of a complex number
RECT FOV rectangular field of view
REST regional saturation technique
Rev FISP reverse fast imaging with steady procession
RF resonant frequency / radio frequency
RFA reduced flip angle
RF coil radiofrequency coil
RF echo NMR signal formed by the action of two or more RF
pulses.
RF field rotating magnetic field B1 used in NMR
RF FAST radio frequency spoiled fast acquisition in the steady
state
RFspoiledFAST radio frequency spoiled Fourier acquired steady state
RFI radio frequency interference
RF pulse radio-frequency pulse
RF screen radiofrequency screen
RF spoiled RF-spoiled Fourier acquired
RFS rotating-frame spectroscopy
RF spoiled radiofrequency spoiled
RI rapid imaging
R/O rule out
ROAST resonant offset averaging in the steady state
ROI region of interest
ROPE respiratory ordered phase encoding
RISE rapid imaging spin echo
RSE rapid spin echo
RS rapid scan
RS SARGE rapid scan specific absorption rate gradient echo

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S▼
S superior
s second
SAR specific absorption rate
SARGE short absorption rate gradient echo
SAT saturation
SCRF surface coil rotating frame
SCTSE single contrast turbo spin echo
SE spin echo / stimulated echo
SE EPI spin-echo echo-planar imaging
SE imaging spin echo pulse sequence imaging
SENSE sensitivity encoding for MRI
SE PS spin echo pulse sequence
SGGR spoiled gradient refocused acquisition in the steady
state
SHORT short repetition technique
SI signal intensity, spectroscopic imaging
Sinc Sin(x)/x
SLT slice thickness
SMART Shimadzu motion artefact reduction technique
SMASH short minimum angle shot
simultaneous acquisition of spatial harmonics
S/N short for signal to noise ratio
SNR signal to noise ratio
SORSSTC slice selective off resonance since pulse saturation
transfer contrast
SP saturation pulse, shaped pulse/ square pulse
SPACE-RIP sensitivity profiles from an array of coils for encoding
and reconstruction in parallel
SPAMM SPAtial Modulation of Magnetization

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SPGR spoiled GRASS, (gradients recalled acquisition in the
steady state
SPIO super paramagnetic iron oxides
small particle iron oxide MR contrast media
SPIR spectrally selective inversion recovery
Spiral MRI spiral scanning
Spoiled FLASH Name for a spoiled gradient echo PS
Spoiled GEI spoiled gradient echo imaging
Spoiled GES spoiled gradient echo pulse sequence
Spoiled GRASS GE brand name for a spoiled GRASS
SPRITE single-point ramped imaging with T1 enhancement
SQUID superconducting quantum interference device
SR saturation recovery, slew rate
SR-PS saturation recovery pulse sequence
SSA single slice acquisition
SSFP steady state free precession
SSPF steady state procession in FID
SS FSE single shot fast spin echo
SSGE Imaging steady state gradient echo imaging
SS GRE steady state gradient echo sequence
STAGE small tip angle gradient echo
STAGE T1 w small tip angle gradient echo T1 weighted
STANDOUT soft shresholding and depth cueing of unspecified
technique
STEAM stimulated echo acquisition mode
STEP stimulated echo progressive imaging
STERF steady state technique with refocused FID
STIR short tau inversion recovery, short TI recovery, short T1
inversion recovery

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STS Single-turn solenoid
ST sequence Stejskal-Tanner sequence
SVC superior vena cavography
T▼
T tesla SI unit of magnetic flux density / teperature
T1 / T1 longitudinal relaxation time; T1 relaxation time, spin-
lattice relaxation time
T1 FAST fourier acquired steady state
T1 FFE contrast enhance fast field echo
T1 FLAIR sequence forT1 contrast between G & W matter and
CSF
T1 relaxation process by which the longitudinal magnetization Mz
attains its equilibrium value Mzo
T1W / T1W T1 weighted
T1WI / T1WI T1 weighted image
T2 spin-spin relaxation time
T2inhomo Inhomogeneous T2
T2 / T2 transverse relaxation time
T2* T2 star; effective transverse relaxation time
T2W / T2W T2 weighted
T2WI / T2WI T2 weighted image
T2 FFE contrast enhance fast field echo
TE echo time
TFE turbo field echo
Thk slice thickness
TI inversion time
TIM total imaging matrix
TMR therapeutic magnetic resonance imaging
topical magnetic resonance
TOF time of flight
TOF MRA time of flight MR angiography
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TONE tilted optimized nonsaturation excitation
True FISP fast imaging with steady procession heavily T2 W
Siemens brand name for a refocuses GE-PS 3D
MPR+MIP
TR repetition time, repeat time, time of repetition
TSE turbo spin echo RARE pulse sequence
Turbo FE Philips brand name for an ultrafast GE-PS
Turbo FLASH turbo fast low angle shot (Siemens ultrafast GE-PS)
Turbo MRA ultrafast MR angiography technique
Turbo Short turbo short repetition technique
Elscient brand name for an ultrafast GE-PS
Turbo SE Philips/Siemens brand name for a RARE PS
TVMF time varying magnetic fields
U▼
UBOs unidentified bright objects
U GE-PS ultrafast gradient echo pulse sequence
U MRI ultrafast magnetic resonance imaging
USPIO ultrasmall particle iron oxide
ultrasmall superparamagnetic iron oxide
V▼
VEMP variable echo multiplanar
VENC velocity encoding
VEST volume excitation using stimulated echoes
W▼
W weighted
w/Kg watts per kilogram
WMH white matter hyperintensities
WS water suppression
X▼
X axis in laboratory coordinate system

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X’ rotating frame X axis
X - gradient x-component of the magnetic gradient field
Xe xenon, element with 54 protons.
Xenon MRI MR imaging of lung using xe gas as a CM
Xe 129 MRI hyperpolarized gas MR imaging
Y▼
Y Axis in laboratory coordinate system
Y’ rotating frame Y axis
Y – gradient y-component of the magnetic gradient field
Z▼
Z axis in laboratory coordinate system
Z – gradient z-component of the magnetic gradient field

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 FREQUENTLY ASKED QUESTIONS ON MRI

What are Absolute contraindications?

Electronically, magnetically, and mechanically activated implants:
cardiac pacemakers ferromagnetic or electronically operated stapedial
implants, hemostatic clips (CNS) metallic splinters in the orbit.

What is the Acceptable amount of acoustic noise?

The FDA regulates the peak unweighted sound pressure level to be not
more than 140 dB or the A-weighted r.m.s. sound pressure level to be
not more than 99 dBA with hearing protection in place.

What is the Acceptable amount of deposited heat by SAR?

If the field strength is not >4 Tesla or if SAR is less than or equal to: 4
W/kg averaged over the whole body for any period of 15 min; or 3 W/kg
averaged over the head for any period of 10 min; or 8 W/kg in any gram
of tissue in the head or torso, or 12 W/kg in any gram of tissue in the
extremities, for any period of 5 min.

What is the Accident in cooling gases?

In superconductive magnet systems, helium and nitrogen are used as
cooling gases. In the case of a quench, gases are released to the
outside. Under normal circumstances, the gases should escape through
a pipe system and not reach the magnet-room. Accidentally some gas
could be released into the magnet room.

What is the Acquisition time in MRA?

Once the transit time is determined, the other inputs for this formula are
readily available. The injection time is calculated by dividing the volume
of contrast media by the injection rate. The software provides the
acquisition time.

Cause of Acute Hazards in MRI?

Acute hazards are created by the static magnetic field usually
covering an ellipsoid region around the isocenter of the MR imager.
The range of this fringe or stray field depends on the field strength of
the system, the type of magnet, and the kind of shielding used.

What are Additional hazards?

The possibility of the patient falling from the examination couch and
hypotonic syndrome (due to heat, motionless horizontal lying for a
certain time, and psychological agitation) are additional hazards.

What are the Advantages of CT?

Usually faster scanning times. Usable in patients with pacemakers and
non-removable implants. Better visualization of chest and abdomen
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areas.

What are the Advantages of MRI?

No X-rays. Best for imaging Spine, Joints, Pituitary Tumors, and
Multiple Sclerosis

What are the Advantages of open MRI?

Open MRI has larger-bore or c-shaped magnets rather than the closed
narrow tunnel; it can be used for claustrophobic patients to reduce
anxiety, guidance for interventional procedures, able to scan large
patients.

What are the Advantages & disadvantages of MRA?

Advantages
MRA is less invasive than conventional angiography. Reduce ionising
radiation exposure to patients and health care personnel. Attractive for
patients with impaired renal function. MRA also obviates some of the
ancillary costs associated with conv angio. MRA can provide high-
quality diagnostic images of arteries and veins.
Disadvantages
Disadvantage of MRA is limited spatial resolution compared with that
achieved by conventional angiography. However, the resolution gap
between MRA and conventional angio is expected to narrow with further
advances in MR gradient systems and imaging software.

What are the Advantages and Disadvantages of MRI?

Advantages
1. Blood flow imaging
2. Nonionising radiation
3. No known biological hazards
4. Non-invasive imaging technique
5. Multiplanar imaging: image can be obtained in any planes
6. High soft tissue resolution in T1, T2 and other sequences
Disadvantages
1. High cost
2. Claustrophobia
3. Longer imaging time
4. High degree of technical expertise is required
5. Cortical bone and calcific lesion are poorly visualized
6. Patient with pacemaker and other surgical clips are unable to
undergo an MRI

What is the Advice for Pregnant Staff?

It is the policy of the MRI department that all pregnant staff members be
restricted from the magnet room when radiofrequency pulses are on.

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Any pregnant ancillary staff member who does not need to be in the
magnet room should stay out of the room unless there is an emergency.

Does the patient need Advice for MRI?

In order to perform the study we need a referral from your physician.
Your doctor will provide the necessary information to perform the most
accurate study.

What should be the Ambient temperature in MR room?

In superconducting systems the examination room should have an
ambient temperature of 21°C ± 3°C with a relative humidity of 50% to
70%.

What is Array processor?

The array processor is involved in the signal averaging process during
data acquisition and reconstruction.

What is Artifact in MRI?

Any irregularity false features noted in an MR image related to imaging
process rather than an anatomical or physiological abnormality is called
Artifacts.

What is Atom?
The smallest particle of an element, made up of a tiny central nucleus
(One or more “positively charged protons” and also contains neutral
particles called “neutrons”) surrounded by a cloud of fast moving
electrons.

How do the Atoms behave in magnetic field?

They behave like small bar magnets and align with an outside magnetic
field like the needle of a compass.

What is Auto sequence in MRA?

When the contrast material arrives in the vessel, the pulse sequence is
automatically started when the signal intensity exceeds the preset
threshold value.

What is o / Mo?
This results in a net magnetic moment within the body that is aligned
with the external magnetic field. The strength of this net magnetization
(Mo) is directly proportional to the strength of the external magnetic field,
o.

Who first demonstrated Backprojection technique?

Paul Lauterbur

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What is the Based of MRI?
Clinical magnetic resonance imaging is based on the hydrogen nucleus.

Is MRI only Based on hydrogen?

No MRI is also based on the observation that certain nuclei in the
periodic system such as hydrogen, phosphorus, and sodium possess
magnetic properties.

What is the Basic MR reconstruction?

'NMR Fourier Zeugmatography' by Anil Kumar, Dieter Welti, and
Richard Ernst, and to the basic reconstruction method for MR imaging
today.

What are the Basic pulse sequences?

1. The spin-echo pulse sequence (SE PS)
2. The inversion-recovery pulse sequence (IR PS)
3. The gradient-echo pulse sequence (GRE PS)

What is the Beginning of CT?

In roentgenology, the times of conventional imaging ended in
September 1971, when the world's first axial x-ray computed
tomography was installed in England.

What is the Beginning of MR?

Like any history, the history of MR imaging has no real beginning.
"Everything flows and nothing stays," as Heraklitos pointed out. One
major contribution to the technique can be found in Napoleon's realm.

a) In 1946, two scientists in the US, independently of each other,

described a physicochemical phenomenon which was based upon the
magnetic properties of certain nuclei in the periodic system. This was
'nuclear magnetic resonance', for short 'NMR'

b) Purcell was born in Illinois in the United States of America. He

worked at the Massachusetts Institute of Technology, MIT, and later
joined the faculty of Harvard University.

c) Bloch was born in Zurich in 1905 and taught at the University of

Leipzig until 1933; he then immigrated to the US and was naturalized in
1939. He joined the faculty of Stanford University at Palo Alto in 1934
and became the first director of CERN in Geneva in 1962. In 1983 he
died in Zurich.

d) The 1920s had been roaring and inflationary, but also extremely
fruitful in science.

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e) In 1924, Wolfgang Pauli suggested the possibility of an intrinsic
nuclear spin. The year after, George Eugene Uhlenbeck and Samuel A.
Goudsmit introduced the concept of the spinning electron.

f) Two years later Pauli and Charles Galton Darwin developed a

theoretical framework for grafting the concept of electron spin into the
new quantum mechanics developed the year before by Edwin
Schrödinger and Werner Heisenberg.

g) Pauli, Uhlenbeck, and Goudsmit went to the United States to work.

The British stayed in Britain - at that time.

h) This development continued in the 1930s. After their initial

pacemaking work, in 1933, Otto Stern and Walther Gerlach were able
to measure the effect of the nuclear spin by deflection of a beam of
hydrogen molecules.

i) During the early 1930s, Isidor Isaac Rabi's laboratory at Columbia

University in New York became a major center for related studies.

j) Rabi's research was successful, but only the visit by Cornelis

Jacobus Gorter from the Netherlands in September 1937 finally showed
how to measure the NMM. Gorter had tried similar experiments and
failed. Rabi accepted and realized Gorter's suggestions concerning his
experiments, changed them, and was able to observe resonance
experimentally. This led to the publication of 'A New Method of
Measuring NMM' in 1938

k) Gorter first used the term 'nuclear magnetic resonance' in a

publication which appeared in the war-torn Netherlands in 1942,
attributing the coining of the phrase to Rabi

l) The SWW had a major influence upon research - and its

interruption. Germany, for instance, the leading country in science and
medicine at the time, quit the race in the 1930s.

m) But there was another country in which major contributions to NMR

were made. They originated in Kazan in Tatarstan, which was part of
the Soviet Union at that time and is now an independent republic within
Russia. Until recently, Russian contributions to NMR and radiology
were frowned upon or not even discussed in the West.

n) Electron spin resonance was discovered at Kazan's university by

Yevgeni K. Zavoisky towards the end of the war. Zavoisky had first
attempted to detect NMR in 1941, but like Gorter he had failed.

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o) The final breakthrough came with Bloch and Purcell in 1946.

p) During the next few decades NMR developed in a wide range of

applications. Hardly any of them were medical, although in vivo NMR
already had been performed since the early 1950s.

q) In 1955/1956, Erik Odeblad and Gunnar Lindström from Stockholm

published their first NMR studies, including relaxation time
measurements, of living cells and excised animal tissue. Odeblad
continued working on tissues throughout the 1950s and 1960s. He is
the major early contributor to NMR in medicine.

r) Oleg Jardetzky and coll. performed sodium NMR studies in blood,

plasma and red blood cells in 1956. T1 & T2-measurements of living
frog skeletal muscle were published by Bratton and coll. in 1965.

s) In the 1960s and 1970s a very large amount of work was published
on relaxation, diffusion, and chemical exchange of water in cells and
tissues of all sorts. In 1967, Ligon reported the measurement of NMR
relaxation of water in the arms of living human subjects.

t) In 1968, Jackson and Langham published the first NMR signals

from a living animal.

u) In the late 1960s, Jim Hutchison at the University of Aberdeen in

Scotland began working with magnetic resonance on in vivo electron
spin resonance studies in mice.

v) Hazlewood added to the work on relaxation time measurements by

studying developing muscle tissue. Cooke and Wien worked on similar
topics. Hansen added NMR studies of brain tissue.

w) Others joined in this kind of research, among the better known

being the research groups of Raymond Damadian at Downstate
Medical Center in Brooklyn and Donald P. Hollis at Johns Hopkins
University in Baltimore.

x) Damadian's group measured T1 and T2 relaxation times of excised

normal and cancerous rat tissue and stated that tumorous tissue had
longer relaxation times than normal tissue. Hollis and his collaborators
achieved similar results, but were more balanced and scientifically
critical in their postulations and deductions.

y) Damadian thought that he had discovered the ultimate technology

to detect cancer and, in 1972, filed a patent claim for an 'Apparatus and
Method for Detecting Cancer in Tissue'. The patent included the idea
257
but no description of a method or technique of using NMR to scan the
human body.

z) 1973 Abe and his colleagues applied for a patent on a targeted

NMR scanner. They published this technique in 1974. Damadian
reported a similar technique in a publication two years later, dubbed
'field-focusing NMR (Fonar)' which contained an image of scanned
volume elements through a mouse.

What is the Basis of MRI?

Hydrogen nuclei aligned with the EMF. RF pulse applied the hydrogen
nucleus absorbed this energy and then generate signal, which form the
basis of MRI.

What is the Beginning of flow measurement?

By 1959, Jay Singer had studied blood flow by NMR relaxation time
measurements of blood in living humans. Such measurements were not
introduced into common medical practice until the mid-1980s, although
Alexander Ganssen already filed a patent for a whole-body NMR
machine to measure blood flow in the human body in early 1967

What is the Beginning of MR spectroscopy?

Actual in vivo NMR spectroscopy took off in Oxford from 1974, with the
group of Rex E. Richards and George K. Radda. Among others, David
Hoult and David G. Gadian belonged to this group.

Why Better image on high field strength?

Because the image is form by the response of protons in an external
magnetic field, so in high field strength more protons are active, which
gives a better image.HF strength systems have a better spatial
resolution and are used for spectroscopy.

What is Black blood?

Blood flowing at normal velocities usually produces little or no signal or
no SE or FSE images, resulting in a natural contrast between flowing
blood and vessel walls. This is sometimes referred to as BBI, or BB
MRA.

What is the Blood oxygen level dependent contrast?

A magnetic resonance gradient echo technique using blood as an
endogenous contrast medium. The best sequence for observing the
BOLD effect is T2W-GE EPI sequence. However, other MR PS, such
as spoiled GE PS is also used

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What is the Bright blood angio / Bright blood imaging?
In this technique the flowing blood appears dark.

What is Bright Blood cine?

BB cine sequence is used to assess ventricular function and valvular
patency, assessment of cardiac morphology in applications ranging
from congenital heart disease to right ventricular dysplasia.

What is the use of Bright blood imaging?

BBI is primarily used for assessment of cardiac morphology in
applications ranging from congenital heart disease to right ventricular
dysplaysia. BB cine sequence is used to assess ventricular function and
valvular patency.

When Bright blood imaging can perform?

Black blood imaging of vascular structures is usually performed either
as an adjunct to bright blood MRA or incidentally during imaging
performed for other reasons.

What is the Bright blood cine sequence?

Bright blood cine sequence is used to assess ventricular function and
valvular patency

What is the Brightest tissue on T1

The fat is the brightest tissue on unenhanced T1 weighted image.

Is there any Cardiac changes after scan?

A field-strength-dependent increase in the amplitude of the ECG in rats
has been observed during exposure to homogeneous stationary
magnetic fields. The minimum level at which augmentation could be
observed was 0.3 T; at 2.0 T, the increase was by an average of 400%.

Does CE-MRA require power injector?

CE-MRA examinations are greatly facilitated by the use of a power
injector. Ideally an IV line should be inserted before the patient is placed
on the table and should be connected both to a syringe containing the
contrast agent and to a saline flush.

What is the Character of hydrogen nucleus?

The hydrogen nucleus is a positively charged proton, which spins on its
axis much like a spinning top.

What is the Cardiovascular MRI?

Technique to produce images of heart to diagnose disease.

Can patient bring CD to listen during MRI?

259
You are also welcome to bring your own CD or cassette! There is a two-
way intercom system providing communication between you and the
technologist.

Is there any Change in enzyme kinetics?

Up to 45 Tesla, no important effects on enzyme systems have been
observed.

How to Change T1 and T2 value?

T1 and T2 values are unaffected by the technologist’s choice of
different imaging parameters or PS. The only way to change a tissue’s
T1 or T2 relaxation time is to administer an MR contrast agent.

How to Change tissue’s relaxation time?

The only way to change a tissue’s T1 or T2 relaxation time is to
administer an MR contrast agent.

Can Children have an MRI?

Yes, child can have an MRI. Children under 5 years old are generally
given a mild sedative during the scan to keep the child from moving.

What should be the Choice of an MR system?

The choice of an MR system might be quite agonizing. Field strength is
one, but not the only and most important, parameter; higher field
strength does not necessarily guarantee a better quality system or
better diagnostic outcome. The quality of the component parts, both in
terms of hardware and software, makes a considerable impact. Service,
maintenance, and knowledge of how to run the system are of essential.

What is the Classification of CM?

Contrast agents have been broadly classified as positive relaxation
agents (T1 contrast agents) and negative relaxation agents (T2 contrast
agents)

Is any Claustrophobia during scan?

This is a very common occurrence and real psychological danger for
some patients with the "tunnel" style MRI. Claustrophobia and other
psychological stress situations have been reported severe enough to
interrupt the examination in about 1-4% of cases. In this respect Open
MRI systems are spacious.

Why not Claustrophobia in open MRI?

Open MRI system is open on all sides making it airy, bright, and open.
Patients should not have that "closed-in" feeling. The openness allows
a friend or family member to sit with, even hold hand.

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When Clinical MR was started?
Clinical magnetic resonance imaging was introduced in the early 1980s.

What is the Comb echo?

Gradient echo & spin echo

What are the Components of the MRI system?

An MR imager consists of several principal components
1. A magnet to align the spins
2. Magnetic gradient fields to localized the signals
3. A radiofrequency generator
4. A radiofrequency receiver
5. Documentation system
6. Computer system
7. Cooling system
8. Shielding sys
9. Power supply
10. Camera

Is it Comfortable bed on MRI?

Patients are made comfortable with the help of cushioned pads, pillows
and specially formed sponges.

What is the Common PS in MRA?

Generally, GRE PS are used to show flowing vessels as bright. There
are two types of MRA techniques available. TOF, PC, CE MRA

What should be the Conditions of MR room?

In superconducting systems the examination room should have an
ambient temperature of 21°C ± 3°C with a relative humidity of 50% to
70%.

Does it require a Consent forms?

Every patient will need to sign a consent form. The patient may need a
contrast agent and therefore consent must be given prior the exam. The
research patient must sign a new consent form every time.

What are the Contraindications for MRI?

Never forget that the magnetic memory of credit and similar cards, as
well as magnetic devices such as tapes, will be erased by MR magnets.
Leave home without them or leave them outside the magnet room.

What is the Contrast medium?

An agent (gadolinium chelate) used in imaging to enhance visualization
of anatomical structures.

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Is Contrast can be used during pregnancy?
During pregnancy use of contrast is not recommended as it crosses the
placental barrier. Lactating mothers should stop breastfeeding their
babies, as contrast is excreted in breast milk.

For which patient Contrast media is high risk?

Patient with asthma, multiple allergies, or known drug sensitivity
(including to iodinated contrast media) are at increased risk.

Is Contrast media safe for children?

Yes, Gd contrast media are safe to be administered in children.

What is the Incidence of Contrast reaction?

The incidence of patients with adverse effects after IV injection of Gd-
DTPA was found to be approximately 1 to 2%. In a post marketing
survey of 5 million applications of Gd-DTPA, possible drug related
death was reported in one patient.

What is the Contrast detail curve?

Tools used to quantify the ability of an imaging system to visualize low-
contrast objects.

What & how many Crash Carts are there?

The crash cart is equipped with an ambu bag that may be used to
breathe the patient if trained to do so. There is usually one crash cart
located in any MRI area.

What are the Criteria for SAR limits?

According to the specific FDA criteria the SAR must not be greater than:
• 4 W/kg averaged over the whole body for any 15-minute period;
• 3 W/kg averaged over the head for any 10-minute period; or
• 8 W/kg in any gram of tissue in the extremities for any period of 5
minutes.
Some European countries have issued SAR restriction too. No common
denominator has been found.

What are the Dangers in MRI?

The most imminent danger for both patients and personnel in the
magnetic field of an imaging system may result from ferromagnetic
objects such as scalpels, scissors, pens, and even sand bags (not filled
with sand but with iron shot) and gas dewars, which can be attracted by
the magnet and thus behave like projectiles.

What is Data store in MRI?

The tasks involved, computed data and reconstructed images are
stored either in:
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A fixed storage medium – Magnetic Hard Disks
A removable storage medium Magneto Optical Disks

What is Delay time in MRA?

Delay time” which is used by the technologist performing the study. The
delay time is the time interval between the beginning of the contrast
injection and the initiation of data acquisition.

What is Delay time formula in MRA?

The delay time is the time interval between the beginning of the contrast
and the initiation of data acquisition. This “delay time formula” is
calculated using the following formula: Delay time = (½ x injection time)
+ (transit time) – (1/2 x image acquisition time)

Who Developed the MR machine first?

After MR imaging had first been described, several individuals and
companies claimed that they had achieved imaging earlier, but their
machines were not conceived of as imagers.

Who & when Developed the 3D magnetic field gradients?

September 1971, Paul Lauterbur of the State University of New York at
Stony Brook had the idea of applying magnetic field gradients in all
three dimensions and the CAT scan back-projection (= projection-
reconstruction) technique to create NMR images.

What is Difference between BBI & BB MRA?

MR PS where flowing blood appear black called BBI and when it is on
MRA resulting in a natural contrast between flowing blood and vessel
walls called BB MRA

What is the Difference between CNR and SNR?

The factors that affect CNR are the same as that of SNR.

What is the Difference between CT & MRI?

One of the most basic differences between the two tests is that CT uses
x-rays and MRI does not. In most situations, MRI is superior to CT in
the demonstration of soft tissue pathology.

What is the Difference between CT & MRI?

a) The NMR signals stem from the interaction of radiowaves with the
atomic nuclei themselves and generate image with a set of signals, by
acquiring numerical value of the pixel as a level of grey using a digital
to analogue converter process.
b) CT images stem from interactions between the x-ray and the
electron clouds of atoms and the signal solitarily depends on one
parameter, x-ray beam attenuation coefficient.
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What is the Difference between high and low field strength?
Magnetic field strengths clinically are .3, .5, 1.0, 1.5 and 3T. Magnets of
1T or higher are treated high-field strength which generate higher
signals and usually more appealing images. Therefore, the HF strength
units generally offer more aesthetic and diagnostic images than the
open units. HF strength systems have a better spatial resolution and
are used for spectroscopy.

What is the Difference between PD and IWI?

Image whose contrast is mainly influenced by proton density is called
PD. The terms PD and IWI are essentially interchangeable.

What is the Difference between the SE-PS and RSE-PS?

RSE is rapid imaging sequence where TE is multiple of ES is used for
one single slice.

What is the Diffusion imaging?

The use of a proper PS permits the acquisition of diffusion-weighted
imaging. MRI is sensitive to diffusion.

What are the Disadvantages of CT?

Uses x-ray. Chance of allergic reaction to intravenously administered
dye.

What are the Disadvantages of MRI?

Longer scanning times. Patients with pacemakers, intra-
cerebral aneurysm clips, cannot be scanned.

What is the Disadvantage of open MRI?

These magnets are weaker (0.1-0.3T) limitation in anatomic and spatial
resolution.

What is the Dose for CE-MRA?

System with advances in gradient coils and imaging software, most
examinations are now performed using a standard clinical dose of 0.1
mmol/kg.

What is the Effect of static magnetic field?

Many results presented in publications about effects of static magnetic
fields are contradictory and cannot be explained by biophysical or
biochemical mechanisms. In some cases, the effects observed must be
attributed to other causes which had not been considered by the
researchers in the setup of the experimental protocol. However, the
data available are not comprehensive enough to assume MRI&S are
absolutely safe.
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Any Higher dose can be used in MRA?
Yes, for studying large anatomic areas for example, imaging the
abdominal aorta and distal run-off vessels requires multi-station imaging
and a double or triple dose of contrast material.

What is the Dynamic susceptibility contrast MRI?

Differentiate between tumours and abscess to distinguish malignant
brain tumour and cerebral abscess without surgery.

What is the Deuterium MR imaging?

Magnetic resonance imaging (MRI) using the nuclear spins of
deuterium.

What is the Double-inversion ECG gated pulse sequence?

………………………………………………………………………………

Why the Door should keep closed?

The doors leading to the magnet room should be closed at all times
except when entering or exiting the room. This will prevent people who
do not belong in the room from wandering into the room.

What are the Drugs should be available during contrast?

All emergency drugs, oxygen and suction should be made available
while injecting contrast media.

What is the Earth’s magnetic field?

The earth’s magnetic field is approximately one half gauss (0.5G) to
one gauss, depending on location.

What is Echo time?

Echo time is the time between pulses

What does the Eddy currents do?

Eddy currents may heat up implants and thus may cause local heating.
In vitro worst-case experiments performed with a large and very thin
thermally insulated aluminium sheet at 1.5 T after 15 minutes of
exposure showed a temperature rise of only .08°C.

How the Emitted radio waves create a picture?

Radio waves contain information about their physical and chemical
environment, a second low gradient magnetic field, determine the
position of nuclei within a sample and thus create a picture of their
distribution.

What is Equilibrium?
A state in which opposing forces or influences are balanced.
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What are the Factors that affect the MR appearance?
The five main time factors affect the MR appearance is spin density
(PD) T1, T2, flow and chemical shift. Additional tissues parameter that
change with physiological condition or pathological state: diffusion &
perfusion

What is Fat / Water suppression?

Pulse sequences in MRI or MRS image can be formed only fat or water

What is the use of Fat suppression?

In areas of the body with abundant fat, T1W with fat suppression (STIR)
provide improved depiction of contrast enhancement. Fat suppression
is indicated in all fat rich areas like breast, retro-orbital and bone
marrow, etc.

What is the Fast imaging in MRI?

Describe any type of MR imaging during which data acquisition is
relatively fast, is called fast imaging.

What is Fast spin echo?

This is a commercial name of RARE (rapid acquisition with relaxation
enhancement) this technique is probably better known under the
commercial names of fast or turbo spin-echo.

What is the Field strength expressed in MRI?

The field strength is expressed in units of Tesla; (T: SI unit) or Gauss
(G: T=10,000G). Tesla is apprx 20.000 times stronger than the earth’s
magnetic field.

What was the First MRA protocol?

The first bright blood technique widespread clinical use was TOF MRA.
Early TOF protocols were limited by poor spatial resolution.

What is the First MR scanner?

This machine was meant to measure the NMR signal of flowing blood at
different locations of a vessel with a series of small coils, allowing
calculating the blood flow within that vessel. It could be described as the
first MR scanner. However, it is not an MRI machine.

What was the First term of NMR imaging?

1974 picture of a living animal, a clam, and by the image of the thoracic
cavity of a mouse. Lauterbur called his imaging method
zeugmatography, which was later replaced by (N)MR imaging.

Who is the First Novel Prizewinner in MRI?

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In 1952 Dr Bloch Stanford University and Dr Purcell from Harvard
University were awarded the Novel Prize for their work on what was
then known as NMR.
An American scientist Lauterbur, and a British scientist Peter Mansfield
were honoured with Novel Prize on 10th Dec. in 2003.

What is Five gauss exclusion zone?

Limitation barrier for persons with electrically or magnetically activated
implants. Such as pacemakers, hearing aids, and neuro-stimulators.

What is Five-gauss safety line?

The 5-Gauss safety line defines the area at which the magnetic field
becomes dangerous to patients with cardiac pacemakers, hearing aids,
and neuro-stimulators.

What is FLAIR?
The inversion time of 2000 ms suppresses CSF and it is known as
FLAIR (Fluid Attenuation Inversion Recovery)

What is the Form of SE-PS?

It exists in many forms: The multi-echo pulse sequence using single or
multislice acquisition, The RARE PS, EPI PS & GRASE PS are all
basically SE sequence

What is called Fourrier Transform?

The MR raw data are collected in k-space (a map of the digital phase
and frequency data) and converted into an image using a mathematical
process called the Fourrier transform.

Who Developed Fourrier Transform?

Jean-Baptiste-Joseph Fourier, and without his Fourier transform we
would not be able to create MR images.

What is the Functional brain MRI?

All method used to image brain function with magnetic resonance
imaging.

What is the Functional MRI?

Latest technique for measuring electrical activity in the brain with
anatomical and functional images,

Why Gating are needed?

Gating allow imaging in areas of the body where there is considerable
motion. Cardiac gating is used to instruct the computer to image all of
the slices at the same point in the heart cycle every time the heart

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beats. This gives the appearance that the heart motion is frozen
resulting little or no motion artifact.

What is the Gauss in MRI?

Unit of magnetic flux density in the older (CGS) system. 1 gauss = 10 -4
Tesla. The earth’s magnetic field is approximately one half gauss to one
gauss, depending on location. The current preferred (SI) unit is the
Tesla (T) (1T = 10.000 G = 10kG).

Is there any Genetic effects after scan?

Static magnetic fields may provoke genetic mutations, changes in
growth rate and leukocyte count and other effects. No reports have
been published that persons exposed to magnetic fields, including
personnel at MR departments, have a higher incidence of genetic
damage to their children than found in the average population.

What is the Gradient echo?

One of the favourite rapid imaging sequence in MR

What is the Gradient system?

………………………………………………………………………………

What is the Gradient echo pulse sequence?

One of the most frequent used pulse sequence in current day magnetic
resonance imaging often abbreviated GRE sequence.

What is the Half-life of contrast agents?

……………………………………………………….

Is any Hazard on static magnetic fields?

In MRI, a large static magnetic field is applied. Field strengths for
clinical equipment can vary between; experimental imaging units have
field strength of up to 17.5 T, depending on the equipment used. In
MRS, field strengths up to 12 T are currently used. No permanent
hazardous effects of static magnetic fields upon human beings have yet
been demonstrated.

What is High and low TE?

A relatively low TE is about 20 ms, and high TE is above 100 ms

What is the High field in MRI?

MRI taking place at high field strength in the range of 3 - 4 tesla is
called high field MRI.

What is meant by High and low field strength MRI?

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The most common magnetic field strengths clinically are 0.3, 0.5, 1.0,
1.5 and 3 Tesla. Magnets of 1.0 Tesla or higher are treated high-field
strength which generate higher signals and usually more appealing
images than lower-field strength units.

How the High field generate, benefit and need for clinical imaging?
Field strengths of 0.5 T and above are generated with super conductive
magnets. High field strength has a better SNR. The optimal imaging
field strength for clinical imaging is between 0.5 and 2.0 tesla.

What are the High and low TR and TE?

A relatively low TE is about 20 ms, and high TE is above 100 ms. Low
TR is about 50 ms and long TR is above 1500 ms. T1WI have a low TE
and low TR. Whereas both are high for T2WIs. PD images have a low
TE and high TR

What is the High TR & TE?

A relatively high TR is above 1500ms and low TR is about 50ms. High
TE is above 100ms and low TE is about 20ms.

Does the Higher field strength guarantee a better image?

Field strength is one, but not the only and most important, parameter.
Higher field strength does not necessarily guarantee a better quality
system or better diagnostic outcome. The quality of the component
parts, both in terms of hardware and software, makes a considerable
impact. Service, maintenance, and knowledge of how to run the system
are of essential.

What is High resolution (HR) MRI?

Procedure in which a local coil is used inside a vessel called high
resolution MRI.

If a patient has a History of working with metal?

Any person who has a history of working with metal as an occupation or
hobby should have X-rays of their orbits to rule out any metallic foreign
body before they enter the magnet room.

What is Homogenous magnetic field?

A magnetic field of uniform field strength is known as a “homogenous
magnetic field”

What are Hot spots after MRI?

Hot spots may occur in the exposed tissue. At present, it seems unlikely
that such hot spots in the body exist, but to avoid or at least minimize
effects of such theoretical complications, the frequency and the power
of the RF irradiation should be kept at the lowest possible level.
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How the Hydrogen emits radio waves?
If radio waves of a certain frequency, equal to the resonance frequency
of the nucleus in question, are transmitted into a sample, they will be
lifted to a higher state of energy. Once the radio transmitter is switched
off, the nuclei will start to return to the equilibrium state of energy and
re-emit radio waves.

What is the Hydrogen nucleus?

Hydrogen nucleus is the most common and basic element found on
earth. It is also the most abundant element in the human body and most
of the hydrogen atoms in the body are found in water and/or fat.

What is the Character of hydrogen nucleus?

……………………………………………..

What is the Pole in hydrogen nucleus?

…………………………………………..
How does the Hydrogen nucleus arranged? How does the Hydrogen
nucleus align?
………………………………………………..
How to tell, whether it is a T1, T2 or PDWI?
In T1 CSF fluid is dark, the grey substance is more grey than the white.
In a normal pulse sequence if you see white fluid, you are dealing with a
T2WI. In PD, CSF fluid is darker than the solid; signal intensity of GM is
higher than WM.

How does the Hydrogen protons act like?

The hydrogen protons present in the body act like tiny magnets. When
the body is exposed to magnetic field the hydrogen protons align and
precess.

What is the Hyper & hypointensity?

When the emitted signal is low, it is termed hypointense and represent
in black. If the emitted signal is high, it is termed hyperintense and
represented in white

How the Images are formed?

External energy in the form of RF is applied to the precessing protons.
There is disturbance in the magnetic equilibrium of the protons.
Discontinuation of RF pulse causes the magnetic equilibrium of body to
return to normal. While magnetic equilibrium is return to normal it emits
energy which recorded as signal and forms the image.

270
How the Images are formed?
The scanner applies the magnetic field to a patient to align the nuclei
within the atoms of the patient’s body. RF pulses are applied; the nuclei
release some of the radiofrequency energy and the equipment detects
these emissions and generates image.

What is Image quality?

Image quality can be defined by contrast, spatial resolution, and signal
to noise ratio.

Is the Image quality same in open system?

Yes, using state-of-the-art technology, and aggressively pursuing the
latest protocol developments have dramatically improved the quality of
scans generated by Open Advanced MRI.

What is Image reconstruction time?

The time required to assimilating all the data acquisition until the image
is visualized.

What is the Incidence of patients with adverse effects after IV

injection?
The incidence of patients with adverse effects after IV injection of Gd-
DTPA was found to be approximately 1 to 2%.

Is any threat from Increase body temperature?

In several in vitro and in vivo experiments, no threatening increase in
temperature could be shown. Even in high magnetic fields, no local
temperature increase greater than 1°C occurred. The highest skin
temperature increase described reached 2.1°C.

How to Insulate the patient?

If the patient’s arms and legs are not completely covered with clothing,
insulating material must be placed between the legs and between legs
and magnet. Leg-to-leg and leg-to-arm skin contact must be prevented
in order to avoid the risk of burning due to the generation of high current
loops if the legs or arms are allowed to touch.

What is the Intermediately weighted image?

MR imaging, which does not exhibit predominantly T1 or T2
characteristics. The terms IWI and PD WI are essentially
interchangeable.

Who Interprets the MRI Scan?

A certified radiologist is a medical doctor specifically trained to read
diagnostic images including X-rays, CT Scans, USG and MRI's.

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How the Interpretation done?
Image reading and interpretation is basically done as (a) analysis of
morphology, and (b) analysis of signal behavior. In general, MRI is a
qualitative and subjective examination with a high level of uncertainty.

What is the Inversion recovery pulse sequence?

…………………………………………………………………………………
What is the Inversion spin echo pulse sequence?
Form of inversion recovery in which an 180º inverting pulse is followed
by a 90º measuring pulse.

If there is an Intra-uteri device (IUD)?

Most of the commonly used intrauterine contraceptive devices do not
move under the influence of the magnetic field, do not heat up during
sequences usually applied for pelvic imaging, and do not produce major
artifacts in vitro or in vivo. Thus, patients with either all-plastic or copper
IUDs can be safely imaged with magnetic resonance.

If there is a Joint and limb prostheses?

Generally, such prostheses present no risk. However, they can
introduce image artifacts. If possible, they should be removed prior to
the MR examination.

What is the Kinematics MRI?

Positioning device used to performed kMRI examination of the
pattellofemoral joint using the active movement against resistance
technique. A resistive band used to apply a load during the
examination.

What was the Lack of spatial information?

All the experiments up to now had been one-dimensional and lacked
spatial information. Nobody could determine exactly where the NMR
signal originated within the sample.

Larmor frequency - The frequency at which the nuclei precess within

unique field strength.

Frequency at which the nuclear spins precess about the main field.
Depends on the nucleus type and strength of the magnetic field applied.
The frequency depends on the nucleus type and strength of the
magnetic field applied.

What are the Legal requirements?

In the early 1980s, a number of national health and radiation protection
boards first established recommendations concerning MR imagers and
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spectroscopic units. All limits set by them were recommended levels,
not mandatory ones. Legal requirements in some European and Asian
countries exist; some of them are without any scientific background,
imposed by economic lobbies rather than learned societies.

What is the Limitation of specific absorption rat?

2 / 4 W/kg averaged over the whole body for any period of 6 min; or 3.2
W/kg averaged over the head for any period of 6 min; or 10 W/kg in any
gram of tissue in the head or trunk, or 20 W/kg in any gram of tissue in
the extremities, for any period of 6 min; or three times the appropriate
long-term SAR level for any period of 10 sec.

Is there any Locker in the MR suite?

Yes, the departments have lockers and locking dressing rooms for the
personal belongings, clothing, jewelry and other metallic items.

What is the Low contrast resolution?

The ability of an imaging system to detect of low contrast, which
therefore must be fairly large in size and clear to be seen.

What are the Low and high TE?

A relatively low TE is about 20 ms, and high TE is above 100 ms

What are the Low and high TE and TR?

A relatively low TE is about 20 ms, and high TE is above 100 ms. Low
TR is about 50 ms and high TR is above 1500 ms.

What is Mo / o?
This results in a net magnetic moment within the body that is aligned
with the external magnetic field. The strength of this net magnetization
(Mo) is directly proportional to the strength of the external magnetic field,
o.

What is Manually start sequence?

The images are reconstructed in real time and displayed on the
console, allowing the technologist to give the breath-hold instructions
and start the CE-MRA PS as soon as the contrast material is seen
entering the vessel.

What is Manual sequence in MRA?

Another approach, referred to as CARE Bolus or Bolus Track, is to have
the technologist monitor the vessel-of-interest in real time, where series
of 2D gradient-echo images is acquired at a rate of 1 to 2 images per
second.

Why Many Images?

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Because several series of images with different parameter weighting
(PD, T1 & T2, pre & post-contrast) of the same region of the body have
to be acquired. This leads to several dozen images per examination
which have to be read by the radiologist.

Is the Magnetic field always on?

The magnetic field is always on. Under normal working conditions, the
field is never turned off. Therefore, it is important to be aware of safety
issues regarding ferrous objects that can act as projectiles and
watching out for patients who may have contraindicated devices
implanted in their bodies.

What is Magnetic resonance?

When a patient is placed in a strong magnetic field the hydrogen nuclei
aligned with the field. When RF pulse applied the hydrogen nucleus
absorbed this energy and then generate signal. This process of
absorbing energy is called magnetic resonance, which form the basis of
MR imaging.

What is Magnetic resonance angiography?

Technique for demonstrating vessels and blood flow using specific
magnetic resonance sequence. This is a way to look at the blood
vessels and evaluate the characteristics of blood flow.

What is Magnetic resonance angiography protocols?

An MRA protocol is usually used to describe an imaging technique in
which blood flow appears bright.

What is the Magnetic resonance arthrography?

Diluted contrast media such as gadopentetate dimeglumine is injected
into a joint space to improve its delineation then imaging is performed.

What is Magnetic resonance imaging?

When a patient is placed in the strong magnetic field, the hydrogen
nucleus in the body, align with the applied external magnetic field when
exposed to short burst of electromagnetic energy in the form of RF
pulses, the nuclei release some energy and the equipment detects
these emissions and generates image is called MR imaging.

How the MR images formed?

External energy in the form of RF is applied to the precessing protons.
There is disturbance in the magnetic equilibrium of the protons.
Discontinuation of RF pulse causes the magnetic equilibrium of body to
return to normal. While magnetic equilibrium is return to normal it emits
energy which recorded as signal and forms the image.

274
How the MR images formed?
The scanner applies the magnetic field to a patient to align the nuclei
within the atoms of the patient’s body. RF pulses are applied; the nuclei
release some of the radiofrequency energy and the equipment detects
these emissions and generates image.

On what the MR images depend on?

There are four main tissue MR parameters contributing to the signal
intensity of an image. The MR image depends on the following four
main factors; a) PD b) T1, c) T2 and d) Blood flow

How many MR-scanners are there?

Worldwide, there are approximately 22,500 MR machines. The biggest
markets are the USA with some 46% followed by Europe, which has
approximately one quarter of all units, and Japan with 15%.

Is MRI used in industries?

The applications in industry are widespread. Analysis of chemicals,
measure the water/fat ratio in foods, monitor the flow of corrosive fluids
in pipes, or to study the structure of catalysts. It can be divided into
chemical, biological, paramedical, data processing, and non-destructive
testing.

What does the MR image represents?

The MR image represents a display of the MR signal. Which depends
on the parameters such as choice of PS, time between pulses (TE), TR,
TI, etc.

On what the MR signal depend on?

The signal intensity depends on both the tissue and the equipment
(operator) parameters, such as choice of PS, time between pulses (TE),
TR, TI, etc.

Why MRI is major break-through?

Because regions of the body such as the brain and the spinal cord, but
also the musculo-skeletal system, the pelvis, the heart, and the blood
vessels can be depicted for the first time without any invasive
manipulation.

What is the use of Magnetization transfer?

MT in SE imaging can improve the enhancement effect produced by a
gadolinium chelate in the brain. MT pulses preferentially suppress the
signal from background tissue, usually improving the conspicuity of Gd-
enhanced regions. This can lead to improvement in the visualization of

275
CE at standard dose. Hence MT is advisable in all post contrast
sequences in brain.

How many MR-scanners are there?

In the USA 46%, Europe 25% and Japan 15%, worldwide there are
approximately 22,500 MR machines.

What is the Magneto encephalography?

The measurement of magnetic fields generate by electric current in the
brain, used to map cortical brain function.

What is the Magnetic moment?

The nucleus of the hydrogen proton depicting its motion is shown in Fig.
2.6. Positive charge, i.e. Proton-it spins at a very high speed. This
combination of spin and charge generates tiny magnetic field. The
strength and direction of this field is represented by a vector called
“magnetic moment”.

What is the Maximum gradient field MR system?

12Tesla MRI magnet with a magnetic field 1 20.000 times stronger than
that of the Earth is now being utilized at OHSU/AIRC-USA.

How many Magnetic Fields are there in MRI?

There are two magnetic fields, one is gradient magnetic field and
another one is artificial magnetic field.

When Magnetic resonance occurs?

If radiofrequency equals the precessional frequency, then the
phenomenon of resonance occurs.

What is the Magnetic resonance spectroscopy?

Magnetic resonance spectroscopy is the basic analytic application of
the technique, for studying the composition of chemical compounds in
vitro

Is there any Magneto hydrodynamic effect?

A blood pressure increase of 28% is predicted theoretically for a field of
10 T. This is claimed to be caused by interaction of induced electrical
potentials and currents within a solution, e.g. blood, and an electrical
volume force causing a retardation in the direction opposite to the fluid
flow. This decrease in flow velocity must be compensated for by an
elevation in pressure. At 1.5 T, no significant changes are expected; at
6.0 T a 10% pressure change is expected.

What is the Matrix & Matrix Size?

276
The two figures are usually related to the number of frequency samples
taken, and number of phase encoding performed. 256 x 128 indicates
that 256 frequency samples are taken during readout and 128 phase
encoding are performed. A course matrix corresponds to less number of
pixels and fine matrix corresponds to more number of pixels.

What is Maximum intensity projection?

This is post-processing technique for generating three-dimensional (3D)
reconstruction in MR and CT.

Is any Membrane transportation & blood sedimentation?

Other potential hazards from static fields include, for instance,
membrane transportation and blood sedimentation induced by the field.
As Mansfield and Morris pointed out, static magnetic field gradients of
0.01 T/cm (100 G/cm) make no significant difference in the membrane
transport processes. The influence of a static magnetic field upon
erythrocytes is not sufficient to provoke sedimentation, as long as there
is a normal blood circulation.

If any Metallic foreign bodies from an accident?

People, who have been involved in wartime activity, grind sand or cut
metal may have pieces of shrapnel or other metal fragments in their
body, must be investigated.

If there is a Metallic surgical implants in brain?

A particular danger is presented by small metallic surgical implants.
Haemostatic or other clips in the CNS can move in their position.
Dislocation by magnetic attraction or torque presents a risk of
hemorrhage.

If there is a Metallic surgical implants in body?

In other parts of the body, we consider this to be a minimal risk,
because after the healing phase of six to eight weeks, fibrosis and
encasement of the clip help to keep it in a stable position. The label
stainless steel is not a guarantee for non-ferromagnetic steel.

If there is a Metallic dental implants?

Implants that involve magnets such as magnetic sphincters, stoma
plugs, dental implants, etc., can be demagnetized by the MR imager.
They should be removed prior to the examination.

If there is Metallic foreign body?

Occult ferromagnetic foreign bodies incorporated in accidents are
dangerous, in particular those close to the eyes. The patient's history
may help to rule out such foreign bodies. Many patients, however, do

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not remember such accidents. In case of doubt, x-rays should be taken
prior to MR imaging.

If there is a Metallic makeup?

Ferromagnetic makeup and tattoos cannot only distort MR images, but
also can be irritated and makeup can even be pulled into the eye by
magnetic forces. Makeup should be removed before the examination, if
possible.

If there is a Metallic pacemakers?

RF radiation might disturb the function of demand pacemakers by
closing the reed relay and switching to the asynchronous mode; varying
magnetic fields may mimic cardiac activity. Magnetic attraction can
provoke motion of the pacemaker in its pocket and thus move the
conducting lead. Therefore, persons bearing pacemakers should not
come close to an MRI.

If there is a Metallic prosthetic heart valves?

Prosthetic heart valves are not considered to be dangerous in low
fields. Patients should not undergo MR imaging in high fields if valve
dehiscence is clinically suspected.

If there is a Metallic objects, and skin contact?

Wire configurations such as pacemaker lead wires, ECG and
plethysmographic cables, and surface-coil connections can act as
antennae. Gradient and RF fields may induce current into these wires
and thus cause fibrillations and burns. This presents a risk to the patient
and must be eliminated prior to the examination.

If there is a Metallic threads or components?

Clothing containing metallic threads or components, as well as all
metallic objects such as eye glasses, jewelry, hairpins, buttons,
watches, bracelets, prostheses, etc. All of these objects must be
removed prior to the examination.

If there is a Metallic prosthetic heart valves?

Large-radius wire loops should not be formed by leads or wires that are
used in the magnet bore during imaging procedures. The patient’s skin
should not be in contact with the inner bore of the magnet.

What is the Minimum scan time in MRI?

Techniques using 3D CE MRA can now be performed within a single
breath-hold on most current imaging systems. This is particularly
important for abdominal applications, such as assessment of the renal
arteries.

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Which Molecules are responsible for the signal in MRI?
Water and fat molecules.

What is Multiple line scan imaging?

Sequential line imaging technique that can be used with selective
excitation methods in magnetic resonance imaging.

What is Multiplanar gradient recalled?

Pulse sequence used in fast-scanning technique that allow the
acquisition of more than one slice per repetition time.

What is the Multiecho pulse sequence?

MR pulse sequence where the acquisition module (PS) contains
multiple SE-PS or GE-PS during each of which an image line is read. In
this sense, an EPI sequence is also a ME PS.

How the MRI superior to other modalities?

An MRI offers a safe and efficient method for medical diagnosis of
many conditions, without the use of harmful x-rays. In many cases, MRI
can lead to early detection and treatment of disease without surgery or
biopsy. It is a noninvasive method of examining the soft tissue of the
body including organs, muscles and tendons.

Does the MRI department need a doctor?

When a patient is scanned, or contrast is administered, a physician
must be available to cover in the event of a medical emergency. The
technologist knows how to reach a doctor in case of an emergency.

Most MRI looks at NMR signals from which nuclei?

Hydrogen

What is MRI?
Magnetic resonance imaging: Technique for producing images of bodily
organs by measuring the response of atomic nuclei to radio wave when
placed in a strong magnetic field.

How does the MRI works?

The MRI machine apply magnetic field, send radio waves to align the
nuclei within the atoms of the patient’s body. The nuclei release some
of the RF energy and the computer measures/detects these
emissions/response and generates image.

Is MRI safe?
The strength of the magnetic field and the frequency of the radio waves
have no known harmful effects. However there are some patients who

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cannot have an MRI test due to certain medical conditions such as
pregnancy and metallic or electronically implanted devices.

How the MRI systems livelong?

That will largely depend on how well imaging professionals understand
even its most advanced capabilities and how to use them with skill and
fitness.

Who demonstrated MRI using the Fourier technique?

Richard Ernst

What is the Magnetic source imaging?

The combination of biomagnetic field detection and MR imaging into a
merged data set.

What is the use of Magnetization transfer contrast?

MTC is commonly used to enhance the quality of TOF-MRA
examination of the intracerebral arteries.

What Magnetization transfer contrast Involves?

MTC involves the use of an off-resonance RF pulse to saturate protons
that are normally undetected by owing to their very short T2 relaxation
times.

What is the use of Magnetization transfer contrast in MRA?

In intracranial MRA, MTC reduces the signal from brain parenchyma,
thereby increasing the contrast between the blood vessels and the
background tissue.

What is Negative & positive contrast?

The contrast agent that affects T2 relaxation is referred to as negative
contrast agent. The contrast agent that affects T1 relaxation is referred
as positive relaxation agent.

What is Net magnetic moment?

The external alignment of the protons results in a net magnetic moment
within the body. This results in a net magnetic moment within the body
that is aligned with the external magnetic field. The strength of this net
magnetization (Mo) is directly proportional to the strength of the external
magnetic field, o.

What is Net magnetization in MRI?

The signal measured in MRI is produced by the sum of all magnetic
moments called “net magnetization”

What is the N (H) weighted / Hydrogen density image?

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In which differences in hydrogen (proton) density are the major source
of image contrast.

What is the Standard of Number of Excitation (NEX)?

In practice, the NEX ranges from 1 to 6. The NEX implies the number of
times a particular line in sampled in K space. K space refers to the raw
data of an image.

What is Nuclear magnetic resonance?

Certain nuclei when introduced into a strong magnetic field take up
energy in the RF range and re-emit this energy afterwards. Because the
magnetic field strength and the RF must match each other, the
phenomenon was called NMR.

Why Nuclear magnetic resonance (NMR)?

Previously it was known as only the nuclei of the atoms which react;
magnetic because it happens in a magnetic field; and resonance
because of the direct dependence of field strength and frequency.

Why the Nuclear magnetic resonance has substituted as MRI?

Because, now it has been found that not only the nucleus of atom that
react to the magnetic field but also the other such as hydrogen,
phosphorus, and sodium possess magnetic properties.

What is the Noise during MR Imaging?

The continuous movement of the gradient coils make the loud noise
during MR procedure.

What is the Noise during the scan?

You will hear a variating knocking sound during the scan, which is a
biproduct of the scan process. Earplugs are available, and we will
provide an assortment of music to help you relax.

What is the Non-invasive vascular imaging?

Non-invasive vascular imaging refers to the clinical application of MRA.
But CT angio also can be considered as a non-invasive vascular
imaging.

Who are the Novel prizewinners in MRI?

a) The two scientists, Felix Bloch and Edward M. Purcell, were awarded
the Nobel Prize in Physics in 1952.
b) In 1991, the Nobel Prize for Chemistry was awarded to Richard R.
Ernst of Zurich for his contributions to the field of magnetic resonance
spectroscopy.
c) American Scientist, Prof C Lauterbur and British scientist, Sir Peter
Mansfield honoured with “Novel Prize” in 2003.
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Is there any Nerve conductivity after scan?
a) As early as 1893, the first results of experiments about a possible
influence of static magnetic fields upon nerve tissue were obtained.
These and all later experiments showed negative results.

b) There are apparently no effects on the conduction of impulses in

the nerve fiber up to field strength of 0.1 T generated by either changing
the electrical resistance or the potential of the excitation.

c) Theoretical examinations argue that fields of 24 T are required to

produce a 10% reduction of nerve impulse conduction velocity. A
preliminary study has indicated neurological effects in subjects exposed
to a whole-body imager at 4.0 T.

What are the Operator dependent-factors?

Operator-dependent parameters include the flip angle, pulse repetition
time, and echo-time, among others.

What is the Optimal field strength?

The optimal imaging field strength for clinical MR imaging is between
0.5 and 2.0 tesla

Is there any Orientation change of living-cell?

The result of replicable experiments on the orientation effects of retinal
rods in fields of 1 Tesla, the alignment of sickle cells at 0.35 T, and the
orientation of certain bacteria and animals might be explained by the
physical torque rather than the sensing of the turning torque by nervous
tissue.

Can patients use their Own cloth during scan?

Clothing with zippers, hooks and snaps will need to be removed.
Departments have gowns and scrubs for patients to change into. If
patients prefer, they may wear their own sweats, shorts or other loose
clothing.

What is the Parameter for T1, T2 and PDWI?

a) T1 - An image created by predominantly T1 signals and with short
TR&TE.
b) T2 - An image consisting of more T2 relaxation data and with a long
TR/TE.
c) PDWI - Image whose contrast influenced by PD, & with long TR &
short TE

What is the Parameter for infants?

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Infant brain consists more water and has long T1 and T2 relaxation
times; therefore, it is necessary to adjust the timing parameters of all
pulse sequence accordingly.

Is the Parents can stay with the child?

With the open MRI system, a parent may stay in the scan room with the
child, and hold their hand during the scan. This is a great way to relieve
any apprehension the child or the parent may have about the
procedure.

Patient Alarm
a) Every patient should be given the patient alarm ball to hold in hand
during the exam. The patient should be instructed to squeeze the ball if
he/she needs to speak with the technologist in between sequences.

b) The scanner cannot be put in a pause mode, stopping a scan to

speak to the subject will require one to start the scan over again from
the beginning.

c) Advise the patient to squeeze the ball only in situations of pain,

injury, or claustrophobia. Routine communication between sequences
will make less likely to squeeze the ball in the middle of a sequence.

d) With an in vivo system, one may be able to do the following: obtain

an ECG trace from the subject; obtain blood oxygen saturation
percentages from the subject; obtain blood pressures from the subject.

If Patient become unresponsive?

Remove the patient from the bore. Try to awaken the subject by
shaking gently. If there is no response, feel for a pulse at the carotid
artery. Listen for breathing near mouth and nose while looking at chest
to determine breathing. If the subject is not breathing or does not have
a pulse, call anesthetist and begin CPR.

What does the Patient need to tell the technologist?

Make the technologist aware of any previous surgeries, including heart
surgery for pacemaker or other implanted devices, brain surgery for
aneurysm clips, back surgery, cochlear implants, pregnancy, history of
working with metal, or in the metal trades.

How the Patients will lie?

He/she will be asked to lie down on the scanning table, usually on
his/her back. Technologist will make him comfortable with the aid of
pillows, blankets and sponges.

How to deal with a Patient with fever?

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Patient with fever, or diseases in which the patient is unable to sweat,
might be compromised by heat deposition. Keep them cool during the
exam. Choose sequences that do not result in high amounts of heat
deposition.

Is there any Pause during scan?

The scanner cannot be put in a pause mode, stopping a scan to speak
to the subject will require one to start the scan over again from the
beginning.

What is the use of Perfusion imaging?

CM is injected as a bolus using injector. Images are acquired very
rapidly during and immediately post injection. This helps to study the
first pass of the CM through the brain. With the help of software rCBV
and rMTT of a given area is calculated. Which can detect brain
ischemia and tissue at risk

Can patients keep the Personal belonging close to them?

Jewelry and other metallic items should be kept at a minimum because
it might interfere with the scan.

What is the Phase contrast?

Technique used in magnetic resonance angiography.

What is the Phase contrast MRA?

MRA technique that provides vascular contrast by making use of spin-
phase effect (flow effect)

What is the Phase contrast MRA based on?

Phase contrast MRA is based on the principle that protons within
flowing blood undergo phase shifts as they move through magnetic field
gradients. These phase shifts are directly proportional to flow velocity.

What is Phase encoding gradient?

The gradient is applied in one direction of the slice. Protons precess at
slightly different speeds (according to the intensity of the gradient) and
thus have different phase angles which make it possible to differentiate
them.

What is Phosphenes?
Phosphenes are stimulations of the optic nerve or the retina,
producing a flashing sensation in the eyes. They seem not to cause any
damage in the eye or the nerve.
Varying magnetic fields are also used to stimulate bone-healing in non-
unions and pseudarthroses. The reasons why pulsed magnetic fields
support bone healing are not completely understood.
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What is Placed on patient’s body?
A MRI coil is placed around the part of the body to be scanned. This
acts as an antenna directing the magnetic energy to that area. Patients
will be asked to lie still for the duration of the scan approximately 20-30
minutes.

What is the Pole in hydrogen nucleus?

Like any moving charged particle, the hydrogen nucleus has a magnetic
moment that is a North Pole and a South Pole.

What is Positive and negative contrast agents?

The contrast agent that affects T1 relaxation is referred as positive
relaxation agent. The contrast agent that affects T2 relaxation is
referred to as negative contrast agent.

What is the Post contrast suggestion?

A precautionary 24-hour suspension of breast-feeding was generally
recommended following the administration of gadolinium-containing
contrast agents. However, it has been proposed that this suspension be
reduced to 12h.

What is the Post contrast advice for breast-feeding mother?

The mother must be informed that her breast milk must be expressed
with a breast pump and thrown away for 48 hr following the injection of
contrast agent. It is important that she be aware of this in order to store
enough milk to feed the child during the 48 hr.

Does Power injector require for MRI?

Yes the use of a power injector allows better control of the injection rate
and facilitates the appropriate timing of contrast administration.

What if patient is Pregnant?

MRI is usually not recommended for pregnant patients, particularly in
the first trimester, although there are no known side effects from MR
imaging.

What is Precession in MRI?

A spinning top, which is hit, performs a wobbling type of motion, protons
in a strong magnetic field shows this motion, called precession.

What is Precessional rate/frequency?

The precessional frequency is described by the Larmor equation: W o=
yx Bo,
where o = precessional frequency; y = gyromagnetic ratio; and Bo =
magnetic field strength.
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What the Precessional frequency depends on?
The precession frequency is proportional to the strength of the magnetic
field.

On what the Precessional frequency proportionate?

The precessional frequency is proportionate to the strength of the
magnetic field.

Is Pregnant women can have an MRI?

There is no evidence that MR can harm the fetus or embryo. Used for
fetography, particularly for imaging the brain. As a safety precaution,
should be avoided first 3 months, and if only other nonionizing forms of
diagnostic imaging are inadequate.

Any contraindication for Pregnant women?

Research needs further investigation and that pregnancy should be
considered a relative contraindication for MRI and MRS. Taking into
account that clinical MR imaging devices operate at field strengths of
between 0.2 and 2.0 T.

Is Pregnant staff can works?

Mainly for psychological reasons, it might be a wise precaution that
pregnant staff do not remain in the scan room during scanning;
however, they are allowed to prepare and position the patient,
administer contrast agents, and scan and film.

What is the Preparation for an MRI?

The patients have no any restrictions on eating or drinking before scan.
Certain scans regarding the abdomen or pelvis might have restrictions.
But the patient require empty stomach if he/she need an IV contrast
media for any purpose.

How to Prevent Danger in MRI?

To prevent hazard such accidents, the installation of a metal detector
through which everybody has to pass before entering the MR suite has
been recommended, but is rather cumbersome.

What is the Protocol for coronary MRA?

Coronary MRA is usually performed with either TOF or CE MRA.

What is the Proton density WI?

MR image, which reflects mainly proton density (PD) on magnetic
resonance signal.

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What is the Partial saturation?
MR technique of applying repeated radiofrequency pulses with TR less
than or equal to T1.

How many Pulse sequence are there in MRI?

Routine Sequences used in MRI

1. Spin echo (SE) pulse sequence
c. Conventional spin echo (CSE) pulse sequence
d. Fast spin echo (FSE) pulse sequence
2. Inversion recovery (IR) pulse sequence
c. STIR (short tau/time inversion recovery)
d. FLAIR (fluid attenuated inversion recovery)
3. Gradient echo (GE) pulse sequence
a. Coherent gradient echo pulse sequence
b. Incoherent gradient echo pulse sequence
4. Steady state free precession (SSFP)
5. Ultrafast imaging
6. Echoplanar imaging
7. Saturated recovery pulse sequence (SR)
8. Partial saturation recovery pulse sequence (PS)

What is the Pulse sequence?

Set of RF (and/or gradient) magnetic field pulses and time spacing
between these pulses; used in conjunction with gradient magnetic fields
and MR signal reception to produce images.

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Principle contrast parameters in MRI

Intrinsic Extrinsic
 Proton density  Static and gradient magnetic field
 T1 relaxation strength
 T1- relaxation  Magnetic field homogeneity
 T2 relaxation  Hard- and software parameters
 Cross relaxation * type of coil
 Dia-and ferromagnetic * number of slices, thickness and
perturbations gaps, slice location + orientation
 Chemical shift * number of averages
 Temperature * pulse shape/bandwidth
 Diffusion * pixel and matrix size, field-of- view
* acquisition mode (2D/3D)
 Perfusion
* artefact suppression
 Physiologic motion
* triggering/gating
 Bulk flow (e.g., Blood, CSF) * orientation of phase- versus
 Viscosity frequency-encoding gradients
 Changes of tissue composition  RF pulse sequence + parameters
(e.g., Age, pathological changes)  Contrast-changing agents

What is the Q factor?

In radiology the term relates to the efficiency of an MR radiofrequency
coil.

What is a Quench?
When a system has a malfunction of its electronics and/or there is a
significant loss of cryogenic coolants, the magnetic field becomes
excessively incoherent causing it to malfunction or go inoperative - thus
a quench.

What is a Quench?
Used to describe the rapid boil off of the cryogens that keep the magnet
cooled and in a superconducting state. Cryogens are supercooled liquid
helium and nitrogen. Without cryogens, the magnet loses its magnetic
field. It is undesirable and is due to a malfunction within the system.

What are the Quench dangers?

Frostbite can be induced because the gases are extremely cold.
Secondly, nitrogen is to be considered hazardous, in particular under
pressure (no danger of direct intoxication from helium). All personnel
and patients must evacuate the area immediately. Oxygen monitors
with an audible alarm, situated at an appropriate height within the
magnet room as safety devices.

When the Quench may be needed?

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In rare instances, a quench may be necessary to free someone from
the magnet if they have been accidentally struck by a projectile ferrous
object and pinned to the magnet.

Where is the Quench switch located?

In each control room, there are boxes on the wall that enclose quench
buttons that should be pushed in the event that the magnetic field must
be manually run down.

If the Quench occurs automatically?

When a quench occurs, either spontaneously or manually, evacuate the
patient from the magnet room immediately to avoid being overcome by
helium gas, should the room not vent properly. Remember to stay low
so that helium or nitrogen is not breathed in.

If the Quench done manually?

If manual quenching of the magnet is to be done, make sure the door to
the scan room is left open to avoid a vacuum forming, which may seal
the door shut. Remember to stay low so that helium or nitrogen is not
breathed in.

If after Quench the door cannot open?

If the magnet quenches suddenly, and the door does not open, break
the window between the control room and the magnet room in order to
get the subject and possibly yourself out of the room. Remember to stay
low so that helium or nitrogen is not breathed in.

Quench - Projectile Injury (1)

If any one becomes pinned to the magnet by a ferromagnetic object,
evaluate the situation quickly before taking any action. If the person is
unconscious, bleeding profusely, at risk of losing a limb or extremity, or
in severe pain, manually quench the magnet to bring down the field in
order to release them.

Quench - Projectile Injury (2)

If the person is responsive and able to communicate well-being leave in
the position until a service engineer can respond and ramp the magnet
down slowly to avoid a full quench. If the latter is chosen, and the
person then loses consciousness, or condition worsens, immediately
quench the magnet manually.

Quench - Projectile Injury (3)

Keep in mind that the cryogens are expensive to replace, so evaluate
the situation carefully but never put cost above the life or well being of
the subject. Once released, secure the subject out of the room and call
for emergency medical help.
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What is the Radiofrequency fields & heat?
a) RF pulses are used in MR imaging for the excitation of the nuclei.
RF fields may interact with both tissues and foreign bodies, such as
metallic implants, in the patient. The main result of this type of
interaction is heat.

b) The higher the frequency, the larger will be the amount of heat
developed; and the more ionic the biochemical environment in the
tissue, the more energy that will be deposited as heat.

What is Radiofrequency & specific absorption rate?

MRI employs radiofrequency pulses to disturb the alignment of protons
in the nucleus of hydrogen atoms in the body. These RF pulses deposit
heat into the tissues of the body. This heat deposition is termed specific
absorption rate.

How the Radio waves create a picture?

Radio waves contain information about their physical and chemical
environment, a second low gradient magnetic field, determine the
position of nuclei within a sample and thus create a picture of their
distribution.

What is the Rate of adverse effects after injection?

Undesirable effects after IV injection of Gd-DTPA is approximately 1 to
2%.

What is Ratio of MR exams per year?

In 2001, some 35 m examinations were performed worldwide. Expected
to double by the year 2005. Some 2.5 million examinations were
vascular studies; in 2005, ten million studies are expected. The number
of orthopedic examination was 5.5 million in 2001; this will double to 11
million in 2005

What is the Ratio of MRA & CE-MRA?

In 2003, in the US, MRA examinations increased from 2.2 million to 2.6
million (increase in cerebral and carotid studies by 260,000; peripheral
studies by 140,000). An overall of 24.9 million MR examinations were
performed on more than 5,700 MR machines. Brain studies are still the
leading indication. 13.6% of all examinations were CE.

What are Relative contraindications?

Other pacemakers, e.g., for the carotid sinus; insulin pumps and nerve
stimulators; lead wires or similar wires non-ferromagnetic stapedial
implants cochlear implants
prosthetic heart valves (in high fields, if dehiscence is suspected)

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haemostatic clips makeup and tattoos congestive heart failure
pregnancy (claustrophobia).

Any Requirement of cardiopulmonary resuscitation?

It is a common requirement of MRI departments that all technologists,
students, other staffs or investigators, who will be conducting MRI
exam/experiments on humans, are certified in CPR.

What is Resonance?
An exchange of energy between two systems at a specific frequency

What is Resonance frequency?

Frequency at which protons process within an applied magnetic field
Frequency at which the resonance phenomenon occurs

When the Resonance occurs?

If radiofrequency equals the precessional frequency, then the
phenomenon of resonance occurs.

Who are the Recent Novel Prizewinners?

American Scientist, Prof C Lauterbur and British scientist, Sir Peter
Mansfield honoured with “Novel Prize” in 2003.

How to Reduce claustrophobia?

Explanation of the imaging procedure and the equipment prior to the
examination helps to reduce claustrophobia significantly.

What is the Radio-frequency pulse?

Transmission in the frequency of radio waves used to alter the
orientation of process of nuclei in magnetic resonance.

What is the Radiofrequency shielding?

The MR signal is relatively weak. Hence, small external RF
interferences can significantly degrade the image quality. As a result,
MRI systems generally require that the imaging room be shielded from
external sources of RF energy.

What is the Range stray field?

Ultralow- and low-field magnets possess a limited stray field of
sometimes less than one meter radius from the isocenter. The stray
field of large-bore, high-field systems may cover a radius of 15 or 20
meters, unless the magnet is heavily shielded.

Which type of PS is these RARE PS, EPI PS & GRASE PS?

The RARE PS, EPI PS & GRASE PS are all basically SE sequence.

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Who is Raymond Damadian?
Who showed that the nuclear relaxation times of healthy tissues differed
for tumors, and later produced a whole body MRI?

What is the Rho image?

The seventeenth letter of the Greek alphabet (), transliterated as ‘r’ or
‘rh’ sym. () density-PD image.

Which is the Routine MRA technique in brain?

The 3D TOF-MRA technique is routinely used for evaluation of the
intracranial circulation and the carotid bifurcation. The 3D data sets also
lend themselves to 3D image display algorithms, such as “transparent”
or “ SSD.”

What are the Routine sequences?

There are essentially 3 pulse sequences, which are routinely used in
MRI.
a) Spin echo (SE)
b) Inversion recovery (IR)
c) Gradient recalled echo (GRE) technique
But there are also some other pulse sequences like SR-PS, PS-PS.

What are the Run-off studies?

Run-off studies are performed using CE-MRA for vessels above the
knees and 2D TOF-MRA for vessels below the knees, using a single or
double dose of contrast material.

What are the Safety procedures during scan?

In order to know the status of the patient at all times, it is strongly
recommended that the pulse oximeter be placed on the finger. This will
provide the heart rate and oxygen saturation for the while he/she is in
the scanner.

What is the Scanning for soldiers?

People who have been involved in period of war activity may have
pieces of shrapnel or other metal fragments in their body, must be
investigated.

What is Screening form?

The magnets have a very strong magnetic field surrounding them,
which has the potential to attract certain types of metal. The magnetic
field can also interfere with the normal operation of electronic devices.
For these reasons, in a form, a detailed health history is checked.

Is the Screening for patient only?

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No, this includes all staff members, investigators, patients, and
volunteers.
The subject and the investigator or technologist who is performing the
scan must sign every screening form.

How to Screening unconscious patient?

Any gaps in memory or lack of information about patient or a surgical
procedure are grounds for canceling the subject, unless a family
member can provide a detailed history. If there is ever any question
about the past health history regarding metal in their body, it is required
that the exam be put on hold.

Does patient need Sedation?

Since some infants and children are unable to cooperate, there is an
increased demand for sedation. Some infants sleep soundly through the
examination, particularly if they have eaten; however, many infants and
children up to eight years require sedation.

What is the Sequence for BOLD?

The best sequence for observing the BOLD effect is T2W-GE EPI
sequence. However, other MR PS, such as spoiled GE PS is also used

What is the Signal in MRI?

External energy in the form of RF is applied to the precessing protons.
There is disturbance in the magnetic equilibrium of the protons.
Discontinuation of RF pulse causes the magnetic equilibrium of body to
return to normal. While magnetic equilibrium is return to normal it emits
energy which recorded as signal and forms the image.

If there are Skin patches?

Pharmaceutical products in transdermal skin patches may cause burns
due to the absorption of RF energy. Such patches must be removed
prior to MR examinations.

What is the Spatial resolution?

Spatial resolution is defined as the ability to separate closely spaced
anatomical details.

What is Specific absorption rate?

The SAR, helps to estimate RF heating effects. It increases with field
strength, radiofrequency power and duty cycle, transmitter-coil type and
body size. In high and ultrahigh fields, some of the multiple echoes,
multiple-slice pulse sequences may create a higher SAR than
recommended by the agencies.

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What is the Spin echo pulse sequence?
Standard pulse sequence used in MRI it uses 90º RF pulse to excite
magnetization and 180º pulse to refocus the spins to generate signal
echoes.

What is the SE PS form?

It exists in many forms:
The multi-echo pulse sequence using single or multislice acquisition,
The RARE PS, EPI PS & GRASE PS are all basically SE sequence

What is the SE-PS and GE-PS?

SE, Standard PS used in MRI it uses 90º RF pulse to excite
magnetization and 180º pulse to refocus the spins to generate signal
echoes. GE, One of the most frequent used pulse sequences in current
day magnetic resonance imaging often abbreviated GRE sequence.

What is Shielding?
Shielding is required to protect the MRI from surrounding environment.
Field to be protected from being distorted by the external environment,
maintain field homogeneity, etc.

How many Shielding are there?

Magnetic shielding, Active shielding, Passive shielding, RF Shielding,
etc.

What is Shielded gradients?

A modified gradient system, which eliminates eddy current problems.

What is Shim?
Correct magnetic field inhomogeneity caused by the magnet itself,
ferromagnetic objects, or the patient’s body. Involves the introduction of
small iron pieces in the magnet. The patient related fine shim is SW &
coil.

How many Shims are there?

Metal object used to shape the magnetic field flux lines into a desired
configuration are: Active shim, Global shim, Interactive shim, Local
shim, 3D shim etc.

What are Shim coils?

Coils that create weak additional magnetic fields in various spatial
directions and used to correct inhomogeneity in the main magnetic field.

What is the SI unit?

Unit of magnetic flux density in the older (CGS) system. 1 gauss = 10 -4
Tesla. The earth’s magnetic field is approximately one half gauss to one
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gauss, depending on location. The current preferred (SI) unit is the
Tesla (T) (1T = 10.000 G = 10kG).

What is the Signal intensity?

Strength of the signal from a voxel of tissue as detected by a MR
scanner.

What is the Signal intensity on T1, T2 or PDWI?

In T1 CSF is dark, the grey substance is more grey than the white. In a
normal PS if you see white fluid, you are dealing with a T2WI. PD, Fluid
is darker than the solid, signal intensity of GM is higher than WM.

What is the Signal to noise ratio?

Ratio of signal from an imaged object to random signal fluctuation as
recorded by an imaging system. The higher the SNR, the better the
image contrasts.

What is the Slew rate?

The slew rate is identifies that how fast the magnetic gradient field can
be ramped to the different field strengths.
a)Measurement
It is also called gradient echo rise time and measured in milliTesla per
metre and milliseconds (mT/m/ms) and is typically around 20 mT/m/ms
for standard MRI.
b) Maximum slew rate available
The new ultrafast MR with EPI capabilities have slew rates of 70 -150.

What is the Smallest picture element?

Pixel

What is Smart Preparation?

One of the automatic timing process for MRA, which is proprietary, and
vary from one manufacturer to the next. A small ROI is placed over a
vessel to monitor intravascular signal intensity after contrast for
triggering of image acquisition.

What is the Soft tissue contrast?

Soft tissue contrast is determines by both tissue-dependent factors,
such as T1 and T2, and operator –dependent factors.

What is Spacing and why does it required?

Spacing is the gap between two slices. When acquiring a multiplanar,
single acquisition, spacing controls cross-talk. As spacing increases,
cross-talt decreases.
Typically, a spacing that is 20 percent of the slice thickness is sufficient.

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What is the Standard TE & TR for T1, T2 & PD?
T1WI have a low TE and low TR. whereas both are high for T2WIs. PD
images have a low TE and high TR.

What is the Standard dose of gadolinium?

The standard dose of Gd is 0.1 mmol/kg, which is equivalent to 0.2
ml/kg. The contrast is generally available in 10 or 20 ml vials. It is
injected through the intravenous route and is rapidly excreted by
glomerular filtration through the kidneys.

What is Static field?

When the magnetic field does not vary with time, it is known as “static
field”

What is Stimulation?
Rapid echo-planar imaging and high-performance gradient systems
create fast-switching magnetic fields that can stimulate/excite muscle
and nerve tissues.

What is the Suggested threshold level for stimulations?

The mean threshold levels for various stimulations are 3,600 T/s for the
heart, 900 T/s for the respiratory system, and 60 T/s for the peripheral
nerves.

What is the STIR?

Sequence used to suppress the fat signal from the anatomy of interest.

Will patient here any Strong sound during scan?

No the patient will hear the faint knocking sound while the system is
scanning.

What are Subacute hazards?

The subacute risks of magnetic and RF fields have been intensively
examined and found unlike. There are some publications associating an
increase in the incidence of leukemia with the location of buildings close
to high-current power lines with ELF electromagnetic radiation of 50-60
Hz 46, and industrial exposure to electric and magnetic fields.

What is Surgical implants?

There are hundreds of metallic implants that can be surgically placed
into a person's body for various reasons. Some of these implants are
ferrous and may be attracted to the magnetic field. Some may be
electronic in nature.

If a patient has a Surgical implant?

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If the patient has had a surgical implant, ask: the procedure, cause,
nature of accident, kind of implant, and what does it do? What is it used
for? Done on, is it metal? Name of surgeon, and hospital, if it was an
accident, old x-rays, was the metal removed?

If the Surgical implants are MR compatible?

There are many metallic implants that are non-ferrous and may be
compatible for MRI such as orthopedic screws, rods, and plates. But it
is suggested that a waiting period of at least 2 weeks after surgery is
necessary for the tissues around the implant to take hold of it.

What are the Symptoms of contrast reaction?

There may be occasionally pain at the injection site. Nausea and
vomiting are the two most common reactions encountered. Headache,
paresthesia, dizziness, focal convulsion, skin reaction, flush are other
adverse effects are also noted.

What is T1 & T2 contrast agent?

Contrast agents have been broadly classified as positive relaxation
agents (T1 contrast agents) and negative relaxation agents (T2 contrast
agents) Signal will increase when hydrogen proton increases, T1
decreases and T2 increases. Signal will be decrease when hydrogen
protons decrease, T1 increases or T2 decreases

What is the T1WI?

MR image, which emphasizes T1 contrast, produced using a sequence
timed to emphasize the T1 tissue characteristics.

What is the T1 FLAIR?

Sequence that provides T1 contrast between grey and white matter and
cerebrospinal fluid.

What is the T2WI?

MR image, which emphasizes T2 contrast, produced using a sequence
timed to emphasize the T2 tissue characteristics.

What is T2*.
..................................................................................................................
................................................

What is Tesla in MRI?

The SI unit of magnetic flux density. One tesla is equal to 10,000
Gauss.

Is there any Tissue specific MR contrast?

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No, the tissue specific agents of MR contrast are yet to be
standardized.

Is 3T MRI used clinically?

Three-Tesla whole-body MRI is still remaining for R&D which becoming
fashionable in some clinic, ten systems were sold per month in 2002-
04.

What are the Time factors that influence the MR signals?

The five main time factors that change the MR appearance are spin
density (PD) T1, T2, flow and chemical shift.

What is the Tissue dependence factor?

Soft tissue contrast on MR images is determines by both tissue-
dependent factors, such as T1 and T2, and operator-dependent factors
controlled by the technologist.

What is the Thk?

This is the Abbreviation for slice thickness in magnetic resonance
imaging.

What are Tissue parameters in MR?

There are four main tissue MR parameters contributing to the signal
intensity of an image: a) PD b) T1, c) T2 and d) Blood flow

Is the TOF-MRA Enhanced / Unenhanced?

Usually performed as an unenhanced, it also works well after IV
contrast . In fact, the intravascular signal intensity tends to be brighter
when TOF sequences are performed after gadolinium chelate injection.

What is Tomographic image?

A tomographic image is an image of a thin slice.

What is Transit time in MRA?

Determining the transit time is only half battle. The next step is to
calculate the “delay time” which is used by the technologist. Time
interval between the beginning of the contrast injection and the initiation
of data acquisition. Delay time = (½ x injection time) + (transit time) –
(1/2 x image acquisition time)

What is TR & TE values for T1, T2 & PDWI?

T1WI have a low TE and low TR. whereas both are high for T2WIs. PD
images have a low TE and high TR. In SE method the following images
can be obtained by the combination of TR & TE
TR TE
Short Short T1 WI
Short Long T1 + T2 WI (not used)
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 Long Short PD WI
Long Long T2 WI

Short TR: More T1 contrast

Long TR: Less T1 contrast
Short TE: Less T2 contrast
Long TE: More T2 contrast

What are the Types of magnets used in MRI?

The main component of MRI is, of course, the magnet, which is
available in three types - viz., the permanent magnets, electromagnets
and superconducting magnets.

What are the Types of signals used in MRI?

Various types of signals obtained are labelled as T1, T2 relaxation
signals. The image is generated by three factors. The 3 parameters are:
PD, T1 & T2 Relaxation times

What is Uniform magnetic field strength?

A homogeneous magnetic field is known as uniform magnetic field
strength.

What are the Units of magnetic field strength?

There are two units used to describe magnetic field strength. They are
Tesla and Gauss: 1 Tesla equals 10,000 Gauss, which is approximately
20,000 times that of the earth's magnetic field.

What is the Unit of precessional frequency?

The unit of precessional frequency is “Mega Hertz” (MHz). Which can
be calculated by the Larmor’s equation, and is higher in stronger
magnetic fields.

What is the Unit of specific absorption rate?

SAR is measured in watts per kilogram and is a function of several
variables, including: (1) the type of RF pulse used (90° or 180°); (2) the
number of RF pulses in a sequence; (3) the pulse width; (4) the TR; (5)
the weight of the patient; and (6) the type of coil used.

What is the Use of contrast?

Administration of a gadolinium chelate can substantially improve lesion
identification, characterization and visualization of anatomical
structures.

What is the Use of MRA?

This is a way to look at the blood vessels and evaluate the
characteristics of blood flow. MRA can be used to screen for the
presence of vascular malformation, aneurysm and vasculitis.
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What is the necessary of Varying Magnetic Fields?
Varying magnetic fields are necessary for the localization of nuclei with
magnetic properties within the sample. A well-described effect of
varying magnetic fields is the so-called magnetic phosphenes, which
were first observed some 90 years ago. They are attributed to
magnetic-field variations and may occur in a threshold field change of
between 2 and 5 T/s.

What is Vectors?
A vector is a symbol (arrow / line) representing the magnitude and
direction of the magnetic field.

What is the Velocity?

VENC is the maximum flow velocity that can be accurately encoded by
PS. Generally; a VENC should be selected that is slightly greater than the
anticipated peak flow velocity.

What is the Velocity-encoding parameter?

The amplitude, which is chosen before the sequence is performed, is
referred to as the velocity-encoding parameter, or VENC.

What is Voxels?
The tomographic image plane contains many small volume elements
called: Voxels

What is Water suppression?

Pulse sequences in MRI or MRS in which image can be formed only fat
or water

Who cannot have an MRI?

Certain medical conditions will prevent someone from having an MRI.
The strong magnetic field can cause disruption to internally placed
devices such as pacemakers, heart valves, aneurysm clips etc.

1. Mr. Jones is feeling a little claustrophobic during his exam and would
like his wife to sit with him during his MRI exam. Mrs. Jones had a
pacemaker implanted 5 years ago, therefore, it is permissible to allow
her into the room as long as she stays at least 10 feet from the front of
the magnet. True / False

2. For subject safety purposes, which of the following items are

contraindicated for an MRI scan. Orthodontic braces / Orthopedic
screws in the ankle placed 6 months ago / Aneurysm clips / Pacer wires
(no pacemaker) left in the chest after open-heart surgery 3 years ago. c
and d only / All of the above

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3. You walk into the scan room and find a maintenance employee
pinned to the magnet by a floor buffer. He is unresponsive but has a
weak pulse. You soon
Throw cold water on him / Use smelling salts to try to rouse him / Call
his supervisor and tell him that the maintenance employee is sleeping
on the job
Call for help then attempt to free the employee; if unsuccessful, press
the quench button to eliminate the magnetic field

4. While scanning a subject for a heart study, he suddenly complains of

a stinging, burning sensation at the location of one of the electrodes
placed on his chest for cardiac gating. Tell him to remain quiet until the
sequence has finished / Turn the radio up louder so that you cannot
hear his complaint / Tell him the stinging will subside in a few hours /
Immediately remove him from the magnet and inspect the area of the
leads for loose or crossed wires

5. When positioning the ECG monitoring cable on a subject for a heart

study, it is OK to run the cable across the subject's body to plug it into
the connector box. True / False

6. You have just positioned a subject inside of the magnet for a knee
scan when she suddenly remembers she had a brain aneurysm
repaired 10 years ago. You, Rapidly pull the table out of the scanner,
immediately lower it, and rush her out of the room as fast as possible /
Continue with the exam because you are not scanning her head / Call
911 / Very slowly, pull the table out of the scanner and then have the
subject slowly slide onto a stretcher so that you can slowly cross her
through the magnetic field lines and out of the room

7. Which of the following represent the current FDA recommendations

for specific absorption rates for an MR scanner that does not have a
field strength >4 Tesla?
Not to exceed 4 W/kg averaged over the whole body for any period of
15 min
Not to exceed 3 W/kg averaged over the head for any period of 10 min
Not to exceed 8 W/kg in any gram of tissue in the head or torso, or 12
W/kg in any gram of tissue in the extremities, for any period of 5 min
All of the above

8. If a subject is unresponsive when you try to communicate with him in

between scanning sequence. Continue with the scan and assume that
he is sleeping
Call 911, Defibrillate him, Pull him out of the scanner or at the very least
go into the room to see if he is O.K.

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9. To avoid the confusion that a patient is well or not, it is a good idea to
use the pulse oximeter on everyone that is placed into the magnet.
True / False

10. Your subject has informed you that he has worked as a metal
grinder for 10 years but he has never had any metal shavings fly into
his eyes.
Proceed with the scan since he has never had any metallic foreign
bodies in his eyes. Do not proceed with the scan and at the discretion of
the principle investigator, send the subject for X-rays of his orbital area
to rule out possible metallic foreign bodies

11. Your subject has informed you that she had a metal sliver enter her
eye 10 years ago but that the doctor got it all out. You
Proceed with the scan since the metal sliver was removed. Do not
proceed with the scan and at the discretion of the principle investigator,
send the subject for X-rays of the orbital area to rule out possible
metallic foreign body

12. While performing a brain MRI on a 24-year-old woman, she begins

to complain of some stinging around her eyelids. Upon examining her
you find out that she has permanent tattoo eyeliner. You
Terminate the exam, take her out of the scanner, apply cold
compresses to her eyes, and seek the proper medical attention / Take
her out of the scanner, apply ice-cold compresses to her eyes to lower
the temperature in the area, and then continue with the scan if she feels
up to it. Inform the subject to shut her eyes and the pain will go away

13. Your subject has had a heart attack while undergoing an MRI exam.
Call 911 and immediately bring the crash cart into the magnet room to
begin resuscitation measures
Call 911 and bring the subject out of the room on a stretcher to begin
resuscitation measures
Call a hospital code team and bring the subject out of the room on a
stretcher to begin resuscitation measures
Call a hospital code team and immediately bring the crash cart into the
magnet room to begin resuscitation measures

14. During the middle of a measurement, you hear the subject

attempting to speak to you but you can not hear her clearly. You
Ignore her and continue the measurement
Stop the measurement and speak to her
Stop the measurement and yell at her for interrupting
Terminate the entire exam

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15. Your subject tells you she had surgery 20 years ago on her brain
but she can not remember exactly what it was for. You
Proceed with the scan because she seems credible
Cancel the scan for today until further investigation into the matter can
occur
Tell the subject of the risks involved due to her lack of history and allow
her to decide if she wants to have the MRI
Proceed with the test only after having the subject signs a waiver that
releases us from responsibility of injury

16. Which of the following are contraindicated for an MRI exam?

Cardiac pacemaker, Swan-Ganz catheter, Aneurysm clips, All of the
above

17. It is acceptable to loop an insulated surface coil cable around a

subject's arm or leg to help keep the cable from getting caught in the
table. True / False

18. Cryogens are: Industrial-strength cleaners

Sedatives / Liquefied gases used to cool a superconducting magnet
and that are deadly to breathe / Sewer gases

19. A quench is
A relief of thirst for a hardworking technologist / A rain cloud that occurs
inside of the magnet room due to overuse of the magnet by physicists /
A rapid, usually undesired, release of the cryogens, which causes a
rapid decline of the magnetic field / The German word for magnet

20. The first thing that you should do if a quench occurs is

Call 911 / Call the service engineers / Immediately remove the subject
from the scanner / Call the EPA (Environmental Protection Agency)

21. If during a quench the cryogens do not vent out of the room
properly, a vacuum may form, making it difficult to open the door of the
magnet room to get the subject out. If you are unable to open the door,
you should
Sit and wait / Use a blow torch to burn through the door
Break the window between the control room and the magnet room /
Panic

22. If your subject becomes short of breath while in the MR scanner,

you should immediately grab the oxygen tank off of the crash cart and
administer oxygen.
True / False

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23. It is acceptable to let someone go into the magnet without emptying
their pockets of metal objects if they are only going to be in there for
<30 min.
True / False

24. Which of the following objects are approved for entry into the MR
scanner room? Stethoscope / Hemostats / Employee I.D. badges /
Small paper clips and coins / None of the above

25. The system stop key will cut power to

All computer cabinets except for the gradient chiller cabinet / The lights
/ The fire alarms / The automatic sprinklers

26. If you get a message that the gradient chiller system is

malfunctioning, you
should immediately Continue to scan because the chiller is on
automatic controls
Run from the room screaming / Stop scanning to avoid overheating the
gradient coils / Call 911

27. If the subject sets off the patient alarm during the scan you should
Page the MRI technologists / Tell the subject to be patient /
Communicate with the subject to check on his/her status / Turn off the
alarm and keep scanning

28. Which of the following are contraindications for MRI?

Cochlear implants / Neurostimulators / Patient-controlled anesthesia
devices / All of the above

29. Pregnant women should never be scanned in our research facility.

True / False

30. Pregnant staff members are not permitted to enter the magnet
room.
True / False

31. Which of the following is the correct method of investigating a

metallic implant in a subject? Take the subject's word that his/her
implant is non-ferrous.
Call the surgeon responsible for placing the implant and get a detailed
written operating room dictation explaining where the implant was
placed, what it is, what it is made of, the manufacturer, and the model
name and number
Ask the subject's family member / Call a physician referral service

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32. Any time a patient is scanned for research purposes, a medical
doctor or other qualified medical personnel associated with the study
must be present or in the near vicinity, and available at all times. True /
False

33. An in vivo MR–compatible monitoring system is capable of

measuring which of the following? ECG and heart rate/ Blood pressure /
Blood oxygen saturation
All of the above

34. It is acceptable to leave a subject lying on the scan table outside of

the magnet bore while you leave the room. True / False

35. All subjects undergoing an MRI should be given ear protection in

the form of earplugs with or without the noise cancellation headphones.
True / False

36. Every person that enters the magnet room should have completed a
screening form regarding metal in the body. True / False

37. It is mandatory that subjects remove all metal, metal jewelry,

clothing with metal on it, and pocket contents before having an MRI
scan. True / False

38. Metallic objects in the body will produce artifacts on the images that
look like
A black signal void with bright edges / A green streak / A line through
the image / Pink swirls

39. If caught in the magnet room during a quench, where should you
place your body to avoid inhalation of the cryogens? On top of the scan
table / Perpendicular to the main magnetic field / As close to the floor as
possible / Pressed up against the window between the scan room and
the control room

40. The simplest way to stop a scan is to

Click the mouse on the “stop” (or its equivalent) button on the menu of
the scan console / Quench the magnet / Turn the key off / Speak the
word “stop” into the microphone

41. Which of the following is the correct reason to shut the MRI system
down (not the magnetic field)? Building utilities are to be shut off
The scanner applications have locked up / No one is going to be using
the system for several hours / All of the above

42. When should the doors to the magnet rooms be shut?

305
When measurements are running / Whenever the system is not in use
Whenever there is the potential that someone not associated with the
study will wander into the room / All of the above

43. If anyone asks you to take them into the magnet room to look at it,
what do you do? Take them right into the magnet room / Insist that they
empty their pockets and then take them into the magnet room / Tell
them absolutely not, under any circumstances, will you let them into the
magnet room
Screen them for metal in their bodies as if they were patients, and if
they are cleared, have them remove all loose metal from hair, pockets,
and clothing, and then take them into the magnet room

44. All subjects must complete consent forms of some type before
having MRI scans in the research facility. True / False

45. A volunteer had an MRI scan 6 months ago and they are now
participating in the research program again. What documents do they
need to complete?
None, the ones they completed before are still good / Screening form
only
Consent form only / Consent and screening forms

46. Under normal circumstances, when the MRI scan is not an

emergency, how long must subjects who have had non-ferrous metal,
e.g., orthopedic screws or plates, surgically implanted wait before
undergoing an MRI scan?
2 to 6 weeks / 5 years / 1 year / Forever

47. How long must subjects who have had ferrous metal devices that
are not contraindicated for MRI, i.e., heart valves, venous blood clot
filters, surgically implanted wait before undergoing an MRI scan? 2 to 6
weeks/ 5 years / 1 year
Forever

48. After completing a scan, you should

Leave the room clean and tidy / Leave the room as you found it
Leave the phantoms on the floor / Call the technologists to clean up the
room

49. Ferromagnetic objects are dangerous to take near the magnet

because. They can become projectiles and harm the subject / They will
burn the subject / They become very heavy / There are too many north
poles and the subject gets dizzy

50. The leads for cardiac gating must be handled as follows:

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Wound together and routed down the center of the magnet
Run in parallel across the subject's chest / Placed on the shin of the
subject
Coiled in a loop and placed across the subject's chest / None of the
above

51. Echo-planar imaging and other sequences can be quite loud. You
should
Tell the subject to grin and bear it / Have the subject cup his hands over
his ears
Use earplugs with or without earphones to dampen the sound
Have the subject sing during the scan to dampen the sound

52. Consent forms must be signed by all subjects when non-FDA

sequences are used. / True / False

53. While scanning a subject for a heart study, he suddenly complains

of chest
pain: Tell him to remain quiet until the sequence is finished / Ignore his
complaints / Immediately remove him from the scanner, get him out of
the room, and call 911 / Give him a drink of water and put him back into
the scanner to continue the exam

54. If ferrous devices and devices containing motors or questionable

ferrous parts are needed in the magnet room, they should be secured
when brought into the magnet room. True / False

55. The 5-Gauss line is: A pixel line in the matrix / The magnetic field
line territory at which the magnetic field can become harmful / A
catheter inserted into the femoral artery / A geometric theorem

56. Where is the 5-Gauss line located in most MR facilities?

At the front door of the building / In the street in front of the building
Between the foot of the table and the RF window/screen, which is
between the control room and the magnet room / At the opening of the
magnet bore

57. When a subject is in the bore of the magnet, it is okay for the
investigator or
Technologist to leave the control room. / To check the weather outside /
Whenever he/she feels like it / When he/she wants to get
himself/herself a soda
If, and only if, he/she gets someone else to monitor the subject while
gone

307
58. Potential subjects who have magnetically controlled artificial body
parts or prostheses, such as artificial limbs or eyes, can not undergo an
MRI exam.
True / False

59. Which of the following sequences tend to have the worst problems
with RF power deposition? Low flip angle RF spoiled gradient echo
sequences
Spin echo, FLAIR (fluid attenuated inversion recovery), and turbo-spin
echo sequences / TRUE FISP (true fast imaging with steady state free
precession) sequences
Both b and c
Answer:
01-b 02- e 03-d 04-d 05-b 06-d 07-d 08-d
09-a
10-b 11-b 12-a 13-b 14-b 15-b 16-d 17-b
18-c 19-c 20-c 21-c 22-b 23-b 24-e 25-a
26-c 27-c 28-d 29-a 30-b 31-b 32-a
33-d 34-b 35-a 36-a 37-a 38-a 39-c
40-a 41-d 42-d 43-d 44-a 45-d 46-a
47-a 48-a 49-a 50-b 51-c 52-a 53-c 54-a
55-b 56-c 57-d

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Checklist: » Examination procedure
An MRI examination involves the use of an extremity strong magnet.
For safety purpose, the presence of certain metalic objects must be
determined before enter the examination room. Place a mark in the
appropriate column for each listing as it applies to you. If you answer
“YES” to any item, please descrive in details below.
Y N
Pacemaker / Wire / Implantable defibrillator
Metallic heart valve prosthesis
Implanted pump (Insulin, Breast)
Coronary Artery bypass clips (CABG)
Limb or joint replacement or pinning
Biostimulator, Neurostimulator or Tens device
Aneurysm clips (e.g. Brain, Aorta)
Other Vascular clips
Intracranial clips (Brain surgery)
Middle ear prosthesis (Surgery on bones in ear)
Cochlear implant
Filter in a blood vessel (E>G>IVC, Giantur Coil)
Tattooed Dyeliner
Penile implant / Prosthesis
Surgical Clips or Wires
Dental implant (Head in place by a magnet)
Sharpnel or Bullet fragments (Anywere in Body)
Female patient IUD / Pregnant week
Have you had any injury of metal in eye?
Have you work in a War zone
Have you been a metal worker?
Have you had any previous surgery?
Have had any MRI scan before
Have you ever experianced claustrophobia?
Please describe in details any item above that you
answered with “YES” also list all surgical procedures:
Remove any of the following: Eye make-up, Wallets,
Bra, Wing or hair pins, jeweler retainers, Watches,
Bobby pins, Dentures, Hearing aids, eye glasses,
Braces
Remove your clothing. Dept will provided a robe and
pajama pants.

309
 Magnetic Resonance Angiography
MRA Techniques

Introduction
The use of MR imaging to evaluate vascular structures began soon
after clinical MR was introduced in the early d1980s.

Black blood
Blood flowing at normal velocities usually produces little or no signal or
no SE or FSE images, resulting in a natural contrast between flowing
blood and vessel walls. This is sometimes referred to as BBI, or BB
MRA.

Sequence
SE and FSE PS are used for BBVI. However, most MRA techniques are
based on GE PS.

Protocols
MRA is usually used to describe an imaging technique in which blood
flow appears bright. The first bright blood technique widespread clinical
use was TOF MRA. Early TOF protocols were limited by poor spatial
resolution, flow artefacts, and long acquisition times.

Solve
With the introduction of faster, more powerful gradient systems and
improved pulse sequence design, these problems have diminished.

2D/3D
Both 2D and 3D TOF techniques are now used routinely for many MRA
examinations, particularly for evaluation for the carotid arteries and
intracranial vessels.

CE MRA
The introduction of CE MRA has fuelled the rapid growth of MR
applications for evaluating extracranial vessels. The problems of signal
loss from turbulent flow and in-plane flow saturation have been virtually
eliminated with this technique.

Scan time
Techniques using 3D CE MRA can now be performed within a single
breath-hold on most current imaging systems. This is particularly
important for abdominal applications, such as assessment of the renal
arteries.

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 MRA Versus Conventional Angiography
Conventional angio
Conventional angiography still remain the gold standard for evaluating
the vascular system,

Roles
MRA is playing an increasingly important role.

Cost
MRA provides a safe, cost-effective, and accurate alternative for many
angiographic procedures. In many centre,

Replaced
MRA has replaced diagnostic angiography for some clinical indications.
With the recent advances in MR hardware and software,

Quality
MRA can provide high-quality diagnostic images of arteries and veins
throughout the human body.

Advantages
Non-invasive. No radiation exposure to patients and health care
personnel.
Attractive for patients with impaired renal function. Costs effective.
Provide high-quality diagnostic images of arteries and veins.

Disadvantages
Limited spatial resolution compared with that achieved by conventional
angio. However, the resolution gap between MRA and conventional
angio is expected to narrow with further advances in MR gradient
systems and imaging software.

Black Blood Imaging and its technique

Generic term
BBI is a generic term that is used for a variety of PS in which flowing
blood appears dark. Although it is used primarily for cardiac imaging, it
can be applied to any vascular territory.

Pulse sequence
PS used for BBI range from standard SE or FSE to specialized
sequences with inversion pulses or dephasing gradient designated to
suppress intravascular signal.

Signal loss
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Intravascular signal loss on SE images occurs because blood flowing
into an imaging section does not produce signal unless the protons are
exposed to both the 90o and 180o RF pulses. If the flow velocity
exceeds a critical threshold value (TE/2  slice thickness), an
intravascular flow void results.

When can performed

Black blood imaging of vascular structures is usually performed either
as an adjunct to bright blood MRA or incidentally during imaging
performed for other reasons.

Useful
BBI are useful for providing a global depiction of the anatomic ROI,
including the vascular structures. Extra-luminal disease and vessel wall
abnormalities are depicted well on black blood images.

Example
For example, the calibre of the abdominal aorta and the presences of
mural plaque or thrombus are often best shown on these images.

Flow signal
BBI is also extensively used in cardiac MR. Specialized, double-
inversion, ECG-gated pulse sequence have been developed to help
eliminate intracardiac flow signal. The signal void within the cardiac
chambers provides excellent contrast between the blood pool and the
surrounding myocardial walls.

Other uses
BBI is primarily used for assessment of cardiac morphology in
applications ranging from congenital heart disease to right ventricular
dysplasia. Bright blood cine sequence is used to assess ventricular
function and valvular patency.

Protocol for Coronary MRA

Coronary MRA is usually performed with either TOF or CE MRA.

Time-of-flight MRA
TOF MRA is a bright blood technique performed with either with 2D or
3D GE PS. The technique is based on the effects of fully magnetized
protons entering an imaging section in which the stationary tissues have
been saturated by the repetitive excitation pulses. This results in bright
intravascular signal.

Venous flow signal

In most anatomic regions, arterial signal can be isolated with the use of
saturation bands that eliminate venous flow signal.
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Venograms
Alternatively, MR venograms can be acquired by saturating arterial
signal. The resulting data set is typically post processed with the MIP
algorithm to produce projection images or “ angiograms.”

Enhanced / Unenhanced
Although TOF-MRA is usually performed as an unenhanced technique,
it also works well after IV contrast administration. In fact, the
intravascular signal intensity tends to be brighter when TOF sequences
are performed after gadolinium chelate injection.

complexity
A potential consequence is that the background tissues also have
increased signal intensity on postcontrast images, which can degrade
the appearance of the MIP reconstructions.

2D TOF-MRA
In 2D TOF-MRA, each imaging section (or slice) is acquired separately.
The excitation pulse is applied at the beginning of the PS and repeated
at time intervals equal to the TR. A magnetic field gradient, referred to
as the slice-selected gradient, is applied along the Z-axis during each
excitation pulse. The RF pulse is turned to excite only protons within
one specific imaging section.

Throughout the PS
During the PS, the stationary tissues in the imaging section are
exposed to repetitive excitation pulse. Each pulse reduces the
longitudinal magnetization, which then partially recovers during the next
TR interval. Eventually, an equilibrium is established at which the
longitudinal magnetization is depressed, or saturated, compared with its
baseline state at the beginning of PS.

Saturation
The saturation of stationary tissues results in reduced signal intensity.
This is a beneficial effect for MRA because it allows the vessels to be
highlighted against a relatively low-signal intensity background.

Produce bright signal compared with the saturated background

tissue
Meanwhile, blood flowing in from outside the imaging section contains
protons that are fully magnetized. Because they have not yet been
exposed to any excitation pulses, they their full complement of
longitudinal magnetization. As these intravascular protons enter the
imaging section, they produce very bright signal compared with the
saturated background tissue. Unlike the saturation in spin-echo
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imaging, the protons only have to be exposed to the excitation pulse in
order to produce signal. Because there is no refocusing RF pulse, the
flow void associated with rapidly flowing blood in spin-echo imaging
does not occur. Most TOF sequence also employ first-order gradient
moment nulling, which recaptures intravascular signal that would
otherwise be lost due to constant velocity flow.

MIP formation
Although 2D images are acquired one slice at a time, the images can
be stacked to create a 3D volume of data. Postprocessing techniques
such as MIP, can then be performed on the 3D data set. The individual
2d slices are often acquired with a slight overlap to achieve a cleaner-
appearing MIP.

3D TOF-MRA
The technique of 3D TOF-MRA is based on similar principles. However,
the data are collected from the entire imaging volume instead of from
one imaging section at a time. Several image-processing techniques
are used to facilitate image interpretation.

2D
The imaging volume is divided into individual slices or partitions so that
data can be displayed in a 2D format. Increasing the number of
partitions results in a thinner effective slice thickness and improved
through-plane spatial resolution, at the expense of increased scan time.

MPR
Image partitions can be displayed in any plane, a process referred to as
MPR. This technique is invaluable for delineating complex anatomic
relationships.

Algorithm
As in 2D TOF-MRA, the MIP algorithm is used to create projection
angiograms that highlight the vascular anatomy. MIP images can be
reconstructed in multiple views and displayed dynamically as rotating or
tumbling projections of the vessels-of-interest.

See-through
The 3D data sets also lend themselves to 3D image display algorithms,
such as “transparent” or “ SSD.” The 3D TOF-MRA technique is
routinely used for evaluation of the intracranial circulation and the
carotid bifurcation.

MTC
MTC is commonly used to enhance the quality of TOF examination of
the intracerebral arteries. MTC involves the use of an off-resonance RF
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pulse to saturate protons that are normally undetected by owing to their
very short T2 relaxation times.

These protons, which are primarily found in macromolecules and

macromolecule-bound water, transfer their magnetization to free water
protons, resulting in dephasing and signal loss. The effect is to
suppress the signal of parenchyma tissue with high concentrations of
macromolecules, with little or no effect on the signal intensity of fluids,
such as cerebrospinal fluid or flowing blood. In intracranial MRA, MTC
reduces the signal from brain parenchyma, thereby increasing the
contrast between the blood vessels and the background tissue.

Other uses
MTC is most often used in the brain; it can also be applied to other
vascular territories.

Problems with Time-of-Flight MRA

Spatial resolution
Early time-of –flight protocols were limited by poor spatial resolution and
signal loss due to turbulent blood flow.

Turbulent flow
Turbulent flow is associated with arterial stenosis and regurgitant or
stenotic heart valves. It causes rapid dephasing of protons, resulting in
an intravascular signal void. This effect, referred to as Intravoxel
dephasing, tends to exaggerate the apparent severity of stenotic
lesions.

Gradient system
The introduction of improved gradient systems has led to higher spatial
resolution and shorter TE values, both of which reduce Intravoxel
dephasing. Although this decreases the area of signal void due to
turbulent flow, it does not eliminate it. Care should still be taken to avoid
overcalling the severity of arterial stenosis on TOF-MRA examinations.

Another problems
Flow saturation is another problem encountered in TOF-MRA. In 2D
TOF-MRA, this difficulty is mainly limited to vessels that lie within the
imaging plane. The intravascular protons within these vessels are
exposed to multiple excitation pulses. This causes them to become
saturated and lose signal, in much the same way as the adjacent
stationary (background) tissue.

Solution

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Using thin imaging sections oriented perpendicular to the vessel-of-
interest can mitigate the problem.

MOTSA
In 3D TOF-MRA, the vessels typically travel through the full thickness of
the imaging volume, resulting in a longer time for saturation effects to
occur. Reducing the thickness of the imaging volume can minimize
intravascular signal loss. However, with reduced slab thickness, it is
often necessary to perform several 3D acquisitions to cover the
anatomic area of interest. This approach is referred to as multiple
overlapping thin slab angiographies.

Technique
In this technique, several overlapping 3D acquisition are performed and
displayed as a single data set. A disadvantage of the MOTSA technique
is that it can significantly increase the scan time.

Minimizing flow saturation effects

Another technique for minimizing flow saturation effects is the use of a
specially varying RF pulse. In this technique, intravascular protons
entering an imaging volume are initially exposed to an excitation pulse
with a relatively low flip angle is then gradually increased as the blood
flows through the imaging volume. This helps to compensate for the
saturation effects and to maintain relatively uniform signal within the
vessel-of-interest.

2D Versus 3D TOF-MRA

Advantage
The main advantage of 2D TOF-MRA is that a relatively large anatomic
can be imaged within a reasonable time. Vessels with a wide variety of
flow rates, including arteries and veins, can also be visualized in 2D
sequences.

Disadvantage
The major disadvantages of 2D TOF-MRA include limited through-plane
spatial resolution, in plane flow saturation, and signal loss due to
turbulent flow.

Overall
Overall, 2D sequences are best suited for blood vessels that are long
and straight, such as the carotid arteries and the vessels of the lower
extremities.

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 Imaging plane
The imaging plane should be oriented perpendicular to the vessels-of-
interest to derive maximum in-flow enhancement.

Gating
Additionally, 2D TOF sequences can be used in conjunction with ECG
gating, in which image acquisition is timed or triggered in relation to the
R-wave of the QRS complex. With gating, the MR signal can be
captured at a specific point in the cardiac cycle. This allows
intravascular signal to be acquired during the period of maximum flow
velocity.

Uses
Commonly, 2D TOF sequences are used for carotid MRA, although
many centre have switched to CE-MRA for this purpose. Also, 2D
techniques are used to evaluate the peripheral vasculature, especially
the arteries of the calf and foot.

Excellent
Finally 2D TOF is an excellent method for assessing venous
thrombosis, particularly in the lower extremities and pelvis.

3D sequence
It has been noted that 3D TOF sequence afford a higher degree of
spatial resolution and improved imaging of complex or turbulent flow.
Scan times are reasonable, but only a small volume can be imaged
effectively during a single acquisition.

2D sequence
Also, 3D TOF tends to be more sensitive to patient motion than 2D
TOF. Because 2D TOF sequences are acquired sequentially, patient
motion may affect only a few slices within the data set.

Motion
In a 3D acquisition, patient motion can affect the entire data set,
particularly if it occurs during acquisition of the central line of k-space.
The primary 3D TOF-MRA applications include imaging the intracranial
arterial system and the carotid bulb.

Phase Contrast MRA

Based
Phase contrast MRA (PC-MRA) is based on the principle that protons
within flowing blood undergo phase shifts as they move through

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magnetic field gradients. These phase shifts are directly proportional to
flow velocity.

Phase create in PC MRA

In PC-MRA, a bipolar flow-encoding gradient is used to create a phase
difference between protons within blood vessels and those in stationary
tissue. The bipolar gradient has positive and negative lobes of equal
amplitude. As a result, protons in stationary tissue exhibit a net phase
change of zero, while protons in flowing blood accumulate positive or
negative phase. Faster-moving protons undergo a greater phase shift
than do slower protons. PC sequence uses a four-point method for
acquiring phase-dependent velocity information. Three acquisitions are
performed with flow-encoding gradients applied along the X, Y, and Z-
axes, respectively. A fourth acquisition is performed without a flow-
encoding gradient.

PC sequence works
In order for a PC sequence to accurately depict flow and flow rates, the
proper amplitude for each flow-encoding gradient must be selected.

VENC parameter.
The amplitude which is chosen before the sequence is performed, is
referred to as the velocity-encoding parameter, or VENC.

VENC
VENC is the maximum flow velocity that can be accurately encoded by
pulse sequence. Generally, a VENC should be selected that is slightly
greater than the anticipated peak flow velocity. A VENC that is too low
cause aliasing, in which protons from the positive lobe of the flow-
encoding gradient are in the same position as from the negative lobe.
This results in fast-flowing blood being interpreted as slow flow in the
opposite direction.

PC sequence  TOF-MRA
As in TOF-MRA, PC sequences can be performed using 2D or 3D
acquisitions. Relatively short scan times are a benefit of 2D PC
sequences. They can be run at several different VENC volumes to
determine the optimal VENC for visualizing the vessels-of -interest.
However, spatial resolution is limited in 2D PC, and images are typically
displayed as one image per acquisition.

Spatial resolution
Higher spatial resolution is attained with 3D PC. With reasonably
advanced gradient systems, both 2D and 3D PC-MRA technique s are
sensitive to a wide variety of flow rates. The flow data in PC-MRA are

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also quantitative, allowing measurement of both flow direction and
velocity.

Contrast media
Either technique can be used effectively after gadolinium chelate
administration.

Motion artefact problem

A drawback of PC-MRA is its sensitivity to motion artefact. This is
particularly true of 3D PC-MRA, in which patient motion may corrupt the
entire data set. The acquisition times for 3D PC-MRA are typically quite
long, which exacerbates the motion artefact problem.

Stationary tissue
PC-MRA is useful for evaluating blood vessels in the vicinity of
structures with very short T1 values, such as fat or subacute
haemorrhage. These structures can appear bright on TOF-MRA
examinations, simulating flowing blood. This problem is avoided with
PC-MRA because the stationary tissues are subtracted out,
independently of their T1 value.

CE-MRA

Benefit
Contrast-enhanced MRA (CE-MRA) has greatly increased the utility of
MRA in evaluating the vascular system. This approach reduces or
alleviates many of the problems inherent in other MRA techniques,
including patient motion, inadequate spatial resolution, and lengthy
scan times.

Sequence
In CE-MRA, a T1-weighted 3D spoiled gradient-echo pulse sequence is
performed after gadolinium chelate administration.

Acquisition
Image acquisition is timed to achieve maximal enhancement of the
vascular territory-of interest.

Postprocessing
Postprocessing algorithms, such as MPR and MIP, are used to aid in
the interpretation of image data.

Parameter
In most cases, CE-MRA is performed with the shortest possible TR and
TE, given the constraints of the imaging system.

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TR
A short TR minimizes the scan time, which allows for breath-hold
imaging. This is particularly important for evaluating vessels in the chest
and abdomen where respiratory motion can lead to significant image
degradation.

TE
A short TE increases the degree of T1 weighting and boosts the signal
to noise ratio.

Coils
When possible, imaging system with state-of-the-art gradient coils
should be used for CE-MRA because they allow for very short TR and
TE values.

Flip angle
The optimal flip angle for CE-MRA is around 45o. This is a relatively
large flip angle, given the short TR values used in most CE-MRA
sequences. Tissue energy deposition increases with higher flip angles
and shorter TRs. On some scanners, a 45o FA results in higher-than-
allowable levels of tissue energy deposition.

Safeguards
MR systems have internal safeguards that prevent these sequences
from operating unless the FA is reduced. Fortunately, CE-MRA
techniques are fairly robust to reductions in FA. Good-quality
examinations can be obtained with FA of 30o and lower, if necessary.

Subtraction
Background signal intensity on CE-MRA examinations can be
suppressed by subtracting the precontrast image data from the
postprocessing data set. The resulting subtraction images can then be
used for further postprocessing procedures, typically with the MIP
algorithm.

Bolus Timing

Timing
The timing of image acquisition relative to the injection of contrast
material is a critical factor in the performance of high-quality CE-MRA
examination.

Goal
The goal is to flood the target vessels with contrast material during data
acquisition so that the vessels are the brightest structures on the image.

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T1 value
In order to accomplish this, the T1 value of blood, which is normally
greater than 1,000 msec, should be shortened to less than 100 msec. In
fact, it is often possible to shorten the T1 value of blood to below 50
msec with a bolus injection of intravenous contrast material.

Fat
To put that in perspective, the T1 value of fat –the brightest tissue of
unenhanced T1-weighted images- is around 270 msec.

Protocol
In setting up a CE-MRA protocol, it is important to know how the raw
image data are acquired. The data are initially sampled in a matrix
format referred to as k-space.

K-space
During k-space sampling, a series of phase-encoding steps are
performed through incremental adjustments to the phase-encoding
gradient after each excitation pulse.

Low-frequency
The low-frequency data acquired in the central portion of k-space
determine tissue contrast and overall signal intensity. These are the
critical data points in CE-MRA.

High-frequency
The high frequency data acquired in the more peripheral regions of k-
space contribute mainly to edge delineation.

K-space sampling
A variety of k-space-sampling schemes are available. In the standard
sequential approach, the central lines of k-space are acquired near the
middle of the pulse sequence. In other words, if a 20s pulse sequence
is used, the central lines of k-space will be acquired near the 10s mark.

Central line of k-space

The challenge is to acquire the central lines of k-space when the
intravascular concentration of contrast is at its peak.

Timing
Several methods can be used to time the image acquisition. A “timing
run” can be performed to measure the time interval between
intravenous injection and arrival of the contrast bolus in the vascular
territory-of-interest. This time interval is referred to as the transit time.

Test bolus
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It is measured by injecting a test bolus of 1 to 2 mL of contrast material
at 2 mL /sec followed by a saline flush. (It is important to use a sufficient
volume of saline to clear the intravenous tubing of contrast material.) A
series of images is then acquired in rapid succession to time the arrival
of the bolus.

Delay time
Determining the transit time is only half battle. The next step is to
calculate the “ delay time” which is used by the technologist performing
the study. The delay time is the time interval between the beginning of
the contrast injection and the initiation of data acquisition. This “delay
time” is calculated using the following formula: Delay time = (½ x
injection time) + (transit time) – (1/2 x image acquisition time)

Transit time
Note that once the transit time is determined, the other inputs for this
formula are readily available. The injection time is calculated by dividing
the volume of contrast material by the injection rate. The software on
the imaging system provides the image acquisition time.

Other Timing Methods

SmartPrep
Several alternative methods have been developed to automate or
semiautomate the timing process. These methods are proprietary and
vary from one manufacturer to the next. One approach, referred to as
SmartPrep (GE), uses automatic triggering of image acquisition. A small
region-of-interest is placed over a vessel to monitor intravascular signal
intensity after contrast injection.

Auto sequence
When the contrast material arrives in the vessel, the signal intensity
spikes upward. The pulse sequence is automatically started when the
signal intensity exceeds a preset threshold value. A centric-ordered k-
space sampling scheme is used to ensure that the central (low-
frequency) portion of k-space is sampled first. As with all timing
methods, the goal is to align the centre of k-space with the period of
maximal intravascular enhancement.

CARE Bolus / BolusTrack

Another approach, referred to as CARE Bolus (Siemens) or Bolus Track
(Philips), is to have the technologist monitor the vessel-of-interest in
real time. A series of 2D gradient-echo images is acquired at a rate of 1
to 2 images per second.

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Manually start Sequence
The images are reconstructed in real time and displayed on the
console, allowing the technologist to give the breath-hold instructions
and start the CE-MRA pulse sequence as soon as the contrast material
is seen entering the vessel-of-interest. As with SmartPrep, centric-
ordered k-space sampling should be used.

Injectors and Coils

Injectors
CE-MRA examinations are greatly facilitated by the use of an MR-
compatible power injector. Ideally an intravenous line should be
inserted before the patient is placed on the imaging table. The line
should be connected both to a syringe containing the contrast agent
and to a saline flush. The use of a power injector allows better control of
the injection rate and facilitates the appropriate timing of contrast
administration.

Coils
The choice of receiver coil is dictated mainly by the anatomic region
being imaged. For example, a head coil is used for intracranial MRA. In
the body, a multiarray surface coil is usually preferable, although a
circumferential body coil can be used to extend the anatomic coverage,
or for imaging large patients. Specialized coils have been developed for
imaging the carotid arteries and the vessels of the lower extremities.

Contrast Material

Dose
The current approach to CE-MRA is based of extracelular gadolinium
chelates. The standard clinical dose for these contrast agents is 0.1
mmol/kg. When CE-MRA was first introduced in the early 1990s, a triple
dose (0.3 mmol/kg) of contrast material was used to ensure adequate
intravascular enhancement. With advances in gradient coils and
imaging software, most examinations are now performed using a
standard single dose.

Higher Dose
However, higher doses are still used for studies covering large
anatomic areas that require multiple imaging stations, For example,
imaging the abdominal aorta and distal run-off vessels requires multi-
station imaging and a double or triple dose of contrast material.

Run-off Studies

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At some centres, run-off studies are performed using CE-MRA for
vessels above the knees and 2D TOF-MRA for vessels below the
knees. In this case, a single or double dose of contrast material should
suffice.

Injection Rate
Most CE-MRA examination are performed with an injection rate of 2
mL/s. Although this produce good results for a wide variety of studies, it
is not sacrosanct. The injection rate should be tailored to suit the clinical
situation. For example, it may be advantageous to spread the bolus
over a longer time period when multi-station MRA is performed.

Bolus Chase Technique

The so-called “bolus-chase technique” is often used to image the aorta
and distal run-off vessels. This involves acquiring data at two to four
imaging station in succession after a single injection of contrast
material. The patient table is repositioned after each acquisition to bring
the appropriate anatomic area into the centre (“sweet spot”) of the
magnet.

Biphasic
A biphasic injection protocol can help ensure adequate enhancement of
the target vascular territory. For example, for a three-station run-off
study, 40 mL of contrast material can be administered, starting with 15
mL at 1.4 mL/sec, followed by 25 mL at 0.7mL/sec. The first phase of
the bolus at the higher injection rate serves as a loading dose. The
remaining dose is administered at a slower rate to maintain adequate
intravascular enhancement over the period of image acquisition.

Contrast-class
A new class of MR contrast agent is being developed specially for
vascular imaging. These agents, referred to as blood pool agents, are
designed to remain within the intravascular space for a prolonged time
after injection. In this respect, they differ from the currently available
agents, which equilibrate rapidly with the extracelular fluid space.

Blood Pool Agents

Blood pool agents provide a longer time window during which MR data
acquisition can occur. This allows for high-spatial resolution imaging
and potentially eliminates the need for the timing methods described
previously.

Problem
A problem with these agents is that arteries and veins both show
marked enhancement on delayed postcontrast images. The presence of

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overlapping arterial and venous structures complicates images
interpretation.

New Algorithm
Postprocessing algorithms are being developed to address this
problem.

Image Processing

Image Processing
The technique of 3D data acquisition is now used routinely in TOF-, PC,
and CE-MRA. The growing use of 3D imaging has led to an exponential
increase in the volume of image data collected.

MIP+MPR
These data can be interrogated efficiently only with the use of image
processing methods, such as MIP, MPR, image subtraction, and 3D
volumetric techniques.

PACS
Most current PACS provide basic image processing capabilities.
However for optimal results, a dedicated 3D workstation should be used
to interpret these examinations.

Part III: Future Directions

Technique
MR angiographic techniques are still actively evolving. Continued
research and new advances in MR hardware and software will drive
future improvements in these techniques. Coronary MRA, for example,
is an important area of active research.

High-Field
The introduction of high-field strength magnets (3 tesla and higher) and
high-performance gradient systems should facilitate future
improvements in spatial and temporal resolution.

End

Courtesy: Jeffrey J. Brown

Kenneth Van Soelen

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WHAT ARE NMR AND MRI?
In 1946, independently from each other, two scientists working in the
United States described a physico-chemical phenomenon which was
based upon the magnetic properties of certain nuclei in the periodic
system.
When introduced into a strong magnetic field, they found that these
nuclei would take up energy in the radio-frequency range and re-emit
this energy afterwards. Because the magnetic field strength and the
radio-frequency must match each other, the phenomenon was called
nuclear magnetic resonance (NMR), nuclear because it is only the
nuclei of the atoms which react; magnetic because it happens in a
magnetic field; and resonance because of the direct dependence of
field strength and frequency.
The two scientists, Felix Bloch and Edward M. Purcell, were awarded
the Nobel Prize in Physics in 1952. In 1991, the Nobel Prize for
Chemistry was awarded to Richard R. Ernst of Zurich for his
contributions to the field of magnetic resonance spectroscopy.
Nearly twenty-five years after the first description of the magnetic
resonance phenomenon, a professor of chemistry at the State
University of New York at Stony Brook, Paul C. Lauterbur, developed
this method into an imaging technology, firstly aimed at medical
applications, but later also at industrial applications. Lauterbur became
the father of a new modality which today has a similar impact on
medicine as had Roentgen’s invention of x-rays some 100 years ago.

Who Developed NMR into imaging technology?

Nearly twenty-five years after the first description of the magnetic
resonance phenomenon, a professor of chemistry at the State
University of New York at Stony Brook, Paul C. Lauterbur, developed
this method into an imaging technology, firstly aimed at medical
applications, but later also at industrial applications. Lauterbur became
the father of a new modality which today has a similar impact on
medicine as had Roentgen’s invention of x-rays some 100 years ago.

Magnetic resonance imaging (MRI) is based on the observation that

certain nuclei in the periodic system such as hydrogen, phosphorus,
and sodium possess magnetic properties. They behave like small bar
magnets and align with an outside magnetic field like the needle of a
compass.

If radiowaves of a certain frequency, equal to the resonance frequency

of the nucleus in question, are transmitted into a sample, they will be
lifted to a higher state of energy. Once the radio transmitter is switched
off, the nuclei will start to return to the equilibrium state of energy and
re-emit radio waves.

326
As an encoded message, these radiowaves contain information about
their physical and chemical environment. By applying a second low
gradient magnetic field, one can determine the position of nuclei within
a sample and thus create a picture of their distribution or, for instance in
medical imaging, create an image of the body of a patient.

Compared to x-rays and radioisotope methods, much less energy is

required and no permanent harmful side-effects of MRI have been
demonstrated to date. The energy of magnetic resonance imaging and
spectroscopy is nine orders of magnitude lower than the one of X-rays
or radioisotope techniques.

Magnetic resonance spectroscopy (MRS) is the basic analytic

application of the technique. Originally used as a method for studying
the composition of chemical compounds in vitro, today there are
applications in a wide range of chemical, physical, biological, and
medical areas, from the analysis of foodstuffs to the study of the
phosphorus metabolism of humans in vivo.

For medical imaging magnetic resonance is a major break-through

because regions of the body such as the brain and the spinal cord, but
also the musculo-skeletal system, the pelvis, the heart, and the blood
vessels can be depicted for the first time without any invasive
manipulation in a way only direct inspection during operation or autopsy
previously allowed.
The same holds for biological imaging where plants and animals can be
imaged non-destructively.

The applications in industry are widespread. Routine analysis of

chemicals is probably the most common use but the NMR technique is
sufficiently flexible to be used for example to measure the water/fat ratio
in foods, monitor the flow of corrosive fluids in pipes, or to study the
structure of catalysts.
Industrial applications can be divided into chemical, biological,
paramedical, data processing, and non-destructive testing. This
overview is not exhaustive, but it gives some highlights of the possible
applications. It underlines the difficulties, challenges, and possibilities of
interdisciplinary research and teaching.

Chemical Applications
General Remarks Hydrogen-1 (1H) and carbon-13 (13C) NMR
spectroscopy of solutions of chemicals are indispensible to the organic
chemist in identifying the products of the latest reaction. The analysis is
quick and simple and does not require an especially pure sample. This
type of work is probably the most common type of NMR work done
throughout the world and will continue to be so for many years. Yet, it
327
does not begin to hint at the enormous versatility of the NMR technique
and the wide range of information which can be obtained from different
systems.

Oil and Coal Analysis of low molecular weight fractions of oils can be
done by NMR, although other techniques do exist. The higher molecular
weight fractions which are very viscous or even solid are more difficult
to analyze but solid-state NMR techniques can be very useful. Solid-
state 13C NMR has been performed on kerogens (an immature type of
coal). The information obtained when used in conjunction with other
types of analysis can be used to predict if the kerogen comes from a
site which is gas-forming or oil-forming. Such information is extremely
valuable when planning an exploration and drilling program. Among the
possible new applications in this area is the development of a
transportable MRI/MRS system which can be flown into a potential
drilling region.

Catalysts called zeolites are used in large quantities by the oil industry
to crack the higher molecular weight fractions to produce the smaller
carbon molecules used in motorcar and heavy vehicle fuels. The
zeolites are a complicated group of molecules composed mostly of
silicon and aluminium. Solid-state silicon-29 (29Si) and aluminium-27
(27Al) NMR has been used extensively to study the structure of these
molecules since an understanding of the way they work can lead to the
choosing or designing of more efficient types of catalysts.

The accurate measurement of flow in pipes is a difficult problem for

many industries. Oil in pipes (or even pipelines), fluidized coal,
corrosive fluids, etc. have all been measured with NMR and a
commercial NMR flow-meter has been available since 1968.

The non-invasive nature of NMR makes it extremely suitable for

systems with unpleasant chemicals or extreme pressures, but
despite excellent results in a few key examples there is room for much
greater use of NMR monitoring of flow, e.g. flow-meters for oil-pipelines
with simultaneous qualitative assessment of the transported oil.

Recently there has been quite a lot of effort put into spectroscopic and
imaging studies of drilling cores. The spectroscopic studies have
reported correlations between the NMR results and the mineral content,
the pore geometry, and the surface chemistry of these rocks. It is hoped
that this will either lead to new insights into the geology of the rocks or
that NMR will be a quicker, simpler or cheaper method at obtaining the
same information. MRI is being used to get a map of the three-
dimensional distribution of oil and water in the cores and eventually will
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be able to monitor the flow of oil and water through cores. This
information is vital to the models used to predict oil extraction from
oilfields, where a 1% improvement represents millions of dollars of
income gained or lost.

Plastics and Polymers

Some samples are mainly of interest as solids. Important examples are
found in polymer science where it is the properties of the solid which
are important and not the individual subunits which go to make up the
solid. Solid-state NMR is used to study how plastics are put together, to
relate their chemistry with their known physical properties. This
information can be used to help improve the plastics and develope new
ones. There are very few alternatives to NMR for getting this type of
information from polymers.

Liquid Crystals
Liquid crystals are used in watches, calculators, and television and
computer screens. They are also very difficult to study by other means
than NMR. Just like the plastics, information about the packing of the
molecules shows how structure relates to functional properties and so
can help in creating new products.

Pharmaceuticals
High resolution NMR is a valuable tool to use when identifying and
characterizing new drug molecules. It is possible for molecules to exist
in two or more different forms or polymorphs in the solid state and solid-
state NMR can be used to detect this. The polymorphs may have
different biological activity which may cause a manufacturer to try to
isolate one or another form. Furthermore it might prove possible for a
competitor to by-pass patents if the existence of polymorphs has not
been accurately documented.

Cement and Concrete

The study of the hydration process in cement is of great interest to the
industry. Increasing the speed of hydration and the degree of hydration
are both highly desirable since they increase the speed of setting and
the strength of the concrete. However, both processes were rather
difficult to quantify until it was shown that they can clearly be seen in
solid-state 29Si spectra of cement. Changes in the concrete can be
followed over periods of 90 days or more and thereby one can
characterize the effect of different additives on the curing process.

Wood Pulp and Paper

The pulp and paper industry uses the complex mixture of high
molecular weight compounds from wood pulp as its raw material. Solid-
state NMR has been used to characterize the pulp and it can be used to
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determine the effect of different mechanical or chemical treatments of
the type of pulp produced. Possibilities might also exist for the
monitoring of pulp production in the factory.

Explosives
Whilst it is not possible (or at least not safe) to examine explosives
directly it is possible to study chemical analogues of explosives like
acetyl cellulose to improve understanding of the chemical structure of
such materials. By relating chemical structure with functional properties
one can help in the designing of safer and more efficient explosives.

Leather
Attempts are being made to replace chromium salts in leather tanning
by environmentally friendlier aluminium salts. It seems possible that
solid-state 27Al NMR can be used to help to characterize tanned
leather.

Imaging of Solid Materials

Imaging of solids is in its infancy. Like medical imaging the nucleus
being observed is 1H, but unlike medical imaging where the signal is
relatively sharp and long lived, the signal from the proton in solid
materials is generally rather difficult to detect since it is a very broad
signal which lasts for a relatively short time. The purpose of such
experiments would be to test non-destructively the various plastics and
polymers used increasingly in modern manufacturing.

At present most published images are typically of a block of a solid

material with holes of varying size drilled in it to demonstrate the
resolution of the technique. There is one recent example of the use of
MRI to observe solid rocket fuel prior to combustion. The packing of the
solid fuel can have a large impact upon the burning properties.
Conventional analytical techniques would either disturb the packing or
prevent the sample being used in an ignition experiment. By the use of
solid-state MRI it was possible to image samples before ignition tests
and so directly correlate the effect of packing on burning properties.
However, it was hardly more than twenty years ago that people were
publishing MRI cross-sections of lemons and other fruits. MRI is now
used routinely in hospitals throughout the world, and MRI of solids will
probably make substantial progress in the next ten years.

Biological Applications
Food
Water content and fat/water ratio are two important parameters in many
manufactured foodstuffs. Control of product quality may depend
critically on them, but the traditional chemical methods of
measurements may take between a few hours to a day to complete.
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NMR methods exist to make such measurements in less than a minute
which is fast enough to help in the control of the production line. Some
companies already use spectrometers dedicated to this sort of work, but
there is still room for a huge expansion in the market.

A major problem is that whilst the routine analysis is a totally trivial task,
it may take many weeks for a research scientist and a line manager to
develop a suitable method for each particular analytical task, and the
number of suitably trained scientists is very small.

Another area of routine analysis is that of wine. The European

Community is currently developing an NMR test for the quality of wine,
particularly to detect glycol adulteration. A routine method for
determining the alcohol content in fermentation vats in two-three
minutes has recently been published. NMR is also useful as a research
tool in food science.

31P NMR spectroscopy has been used to demonstrate the hydrolysis of

the food additive sodium tripolyphosphate (E 400) when it is added to
meat, and chlorine-35 (35Cl) NMR was used to show how salt (sodium
chloride) interacted synergistically with this additive so that a smaller
amount of it still produced the desired effect. Detailed studies have
been made of starch and carageenans, a polysaccharide obtained from
seaweed and used in large quantities in food manufacturing.

Starch and carageenans are important in creating the correct texture in

many foods and a fuller understanding of their properties will help in
production of cheaper food of a higher quality and in the more efficient
use of raw materials. MR imaging is beginning to be applied to
foodstuffs as well. An early example was of chocolate showing how
heating to 40° C and then cooling produced a permanent change in the
chocolate. More recently the effect of freeze-thaw cycles on the
structure of soft fruit and vegetables has been followed, and a particular
promising use is the monitoring and visualization of the fat content of
farmed fish (e.g. aquaculture of salmon).

Agriculture, Forestry, and Environment

NMR techniques have only recently begun to be applied to plant
systems but one major area already established is the phosphorus and
nitrogen nutrition of plants. Basic research in this area can hopefully
lead to a more efficient use of fertilizers and thereby lead to reduced
pollution of rivers, lakes, and the seas.

MR imaging of plant systems is even younger than spectroscopy but in

one study of frost damage in pot grown pine and spruce seedlings it
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was possible to detect damaged and dead root systems weeks before
the shoots showed any sign of damage. For instance, with Sweden
alone producing 600 million seedlings per year at a price of roughly SKr
5.00 each there is considerable financial incentive to prevent frost-
damaged seedlings being planted out. As a basic research tool MRI of
intact root systems could be invaluable in increasing our understanding
of how root systems develop, and so help in tackling problems like
optimizing the uptake of nutrients (essential in nutrient-poor soil) or in
preventing the blowing over of forest trees ("wind throw") which is a
source of major economic losses.

Solid-state 13C NMR studies of soil have helped soil scientists to

understand the rather large and complex organic molecules present in
soil. For example, the chemical analytical methods used before the
advent of solid-state NMR had seriously underestimated the percentage
of aliphatic carbon groups as against aromatic carbon groups. An
understanding of soil chemistry is important when studying the nutrition
of plants and when considering the environmental effects of, e.g., acid
rain or radioactive fall-out after the Chernobyl nuclear power plant
accident.

A full understanding of the consequences caused by increasing levels

of green-house gases (especially carbon dioxide and methane) must
include the whole of the carbon-cycle. The soil is an important element
of this cycle having huge amounts of carbon temporarily stabilised in
the form of humus. Direct monitoring of pollution is also possible,
particularly in adverse environments, e.g. the artic seas. The size of
mussel populations, counted by divers, are currently used as an
indication of pollution. Recent laboratory results have shown quite
distinctive changes on the 31P spectra of mussels when subjected to
low doses of petrochemicals (benzene, phenol, formalin) or heavy
metals (cadmium, zinc, lead, mercury). It is hoped that a pollution
monitoring system might be developed from this work.

Proteins and Protein Engineering

The latest advances in biochemistry have made it possible to begin to
build proteins from scratch, and so in principle create a molecule to do a
specific task. Because it is the structure of the protein which controls its
function very precise information about thestructure is essential and
high-resolution NMR is one of the few ways of uncovering it. The NMR
spectra reveal information about the neighboring atoms for each atom
in the molecule. With even a small protein containing hundreds of
atoms one of the major problems is too much information. The
spectroscopist can design the NMR experiment to keep the amount of
information to a manageable level, and then molecular modelling
computer programs are used to generate three-dimensional structures
332
from the NMR data. Such research programs have for instance been
applied in the development of new antibiotics and x-ray and magnetic
resonance contrast agents.

Computer Applications and Pattern Recognition Techniques

With manifold tissue parameters, MRI has a great variety of image
contrast and substantial theoretical potential for tissue discrimination
and even characterization in different organs. This, on the one hand, is
a major advantage of MRI compared with other imaging modalities, on
the other hand, it may prove to be disadvantageous because several
series of images with different parameter weighting (i.e. proton density-,
T1, and T2-weighting, pre- and post-contrast) of the same region of the
body have to be acquired. This leads to several dozen images per
examination which have to be read by the radiologist. Image reading
and interpretation is basically done as (a) analysis of morphology, and
(b) analysis of signal behavior. In general, MRI is a qualitative and
subjective examination with a high level of uncertainty.

For routine clinical imaging, a simplification of the diagnostic procedure

would be advantageous. This would both cut down time and costs, as
well as diagnostic uncertainty. In addition, pattern recognition
techniques could lead to a preliminary diagnosis before images are
read and increase diagnostic performance. Tissue discrimination and
characterization on the basis of relaxation time calculations has been
shown to be unfeasible. Thus, other methods have to be considered.
Basic considerations must include: (a) MRI possesses several physical
parameters; (b) there are difficulties in computing and exploiting these
parameters; and (c) there is the possibility to devise a multivariate test
(pattern recognition techniques), which will decrease the level of
uncertainty in the diagnosis and increase the diagnostic performance.

In general, MR images are crude and it is inappropriate to process them

by pattern recognition techniques, mainly because of geometrical
distortion, intensity distortion, and noise. However, first results have
demonstrated that computers can recognize certain normal structures
and distinguish them from pathology. These methods could also be
applied to industrial use of MRI or other imaging techniques, e.g. for
quality assurance programs.

Non-Destructive Testing
Some applications of NMR in non-destructive testing have been
described before, e.g. the examination of plastic and ceramic
components. Here, a broad range of applications has been developed,
but the spectrum of possible new applications is wide. Space
technology will exploit the possibilities of NMR to assess the influence
of microgravity, acceleration, and vibration upon materials and their
333
possible degradation. Monitoring could be performed before and after
space flights, and with suitable equipment even in space. Quality
assurance programs with NMR include also measurement and control
of other techniques such as chromatography. Small, robust NMR
machines are already available, and machines for particular
applications custom-tailored for specific technical solutions can be
developed at competitive prices.

HOW MANY MR-SCANNERS ARE THERE?

The biggest markets are the United States of America with some 46%
of worldwide sales followed by Europe which buys approximately one
quarter of all units, and Japan with 15%. Worldwide, there are
approximately 22,500 MR machines.

Where do the Open systems available?

Markets differ in their demands. Open systems are mostly sold in the
United States, the market share of open system is limited in Europe and
Japan. Three-Tesla whole-body R&D systems are becoming
fashionable; at least ten systems will be sold per month in 2002-2004.

Markets differ in their demands. Open systems are mostly sold in the
United States, the market share of open system is limited in Europe and
Japan. Three-Tesla whole-body R&D systems are becoming
fashionable; at least ten systems will be sold per month in 2002-2004.

In 2001, some 35 million MR imaging examinations were performed

worldwide. This number is expected to double by the year 2005. Some
2.5 million examinations were vascular studies; in 2005, ten million
studies are expected. The number of orthopedic examination was 5.5
million in 2001, this will double to 11 million in 2005 (Source: EMRF
estimates).

The figure below shows the development of the number of installations

since 1983.

334
Sales of MR scanners by field strength per year (EMRF estimates).

Number of MR scanners per one million inhabitants

(2000/2001; EMRF estimates).

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AT WHAT FIELD STRENGTH DO THEY OPERATE?
MR systems are available in the well-known tunnel shape or as open
systems. The latter reduce patient claustrophobia and are better suited
for interventional purposes because there is access to the patient from
all sides. Open systems are available between 0.3 T with permanent
magnets to 1.5 T with superconducting magnets.

Most clinical systems operate at field strengths of 1.0 and 1.5 T. The
recent trend towards ultrahigh field scanners is aimed at research sites.
At present, there is no proof that such 3-Tesla imagers are of better
clinical value than medium or high-field machines; in addition, there are
still safety considerations for machines operating above 2.0 Tesla,
although the US-American FDA allows clinical examinations in adults
on systems up to 8 Tesla.

Scanner prices had gone up slightly in 2000; they have decreased

again in 2001. 1.5 Tesla systems are available between € / US$ 1.2
million and € / US$ 2.4 million, depending on required system
performance and region of the world. The prices of high-field systems
are about € (or US$) 2.5 million to 3.0 million; up to double the price of
basic 1.5 T machines. Open systems should cost slightly less than € /
US$ 1 million.

The annual world-wide overall sales revenue of MR scanners is

approximately € 2.3 billion.

The choice of an MR system might be quite agonizing (see pictures).

Field strength is one, but not the only and most important, parameter;
higher field strength does not necessarily guarantee a better quality
system or better diagnostic outcome for the patient. Needs must be
carefully assessed in the choice of an MR imager. The quality of the
component parts, both in terms of hardware and software, makes a
considerable impact. Service, maintenance, and knowledge of how to
run the system are of pivotal importance for image quality and
assessment.

336
AN OVERVIEW OF MR CONTRAST AGENTS

Enhancement
Short Name Generic Name* Trade Name**
Pattern
Extracellular Fluid (ECF) Space Agents ***
gadopentetate Magnevist /
Gd-DTPA positive
dimeglumine [Magnograf]
gadoterate Dotarem /
Gd-DOTA positive
meglumine [Artirem]
gadodiamide
Gd-DTPA-BMA Omniscan positive
injection
gadoteridol
Gd-HP-DO3A ProHance positive
injection
Gd-DTPA-BMEA gadoversetamide Optimark positive
Gd-DO3A-butrol gadobutrol Gadovist positive
gadobenate
Gd-BOPTA MultiHance positive
dimeglumine
Targeted / Organ-Specific Agents ****
Liver Agents
mangafodipir
Mn-DPDP Teslascan positive
trisodium
Gd-EOB-DTPA gadoxetic acid Primovist positive
gadobenate
Gd-BOPTA MultiHance positive
dimeglumine
ferumoxides Endorem /
AMI-25 negative
(SPIO) Feridex
ferucarbotran Resovist /
SH U 555 A negative
(SPIO) Cliavist
Other Targets
positive (lymph
gadofluorine-M — —
nodes)
positive or
ferumoxtran Sinerem /
AMI-227 negative (lymph
(USPIO) Combidex
nodes)
ferumoxides Endorem / negative (lymph
AMI-25
(SPIO) Feridex nodes)
positive
EP-2104R — —
(visualization of

337
 blood clots)
positive
(visualization of
P947 — — matrix metallo-
proteinases,
MMPs)
Gd-DTPA positive
mesoporphyrin — — (myocardium,
(gadophrin) necrosis)
Blood Pool Agents
PEG-feron
NC-100150** Clariscan positive
(USPIO)
ferucarbotran
SH U 555 C Supravist positive
(USPIO)
formerly
MS-325 gadofosveset Angiomark; positive
Vasovist

Code 7228 ferumoxytol positive

gadomer-17 — — positive

gadofluorine-M — — positive

P792 gadomelitol Vistarem positive

MnHa/PEG — — —

ferumoxtran Sinerem / positive or

AMI-227
(USPIO) Combidex negative
gadobenate
[GdBOPTA MultiHance positive]
dimeglumine
Enteral Agents (orally or rectally administered)
gadopentetate Magnevist
Gd-DTPA positive
dimeglumine enteral
ferric amonium
— Ferriseltz positive
citrate
manganese
— LumenHance positive
chloride
manganese-
— Gadolite positive
loaded zeolite

338
OMP ferristene Abdoscan negative
Lumirem /
AMI-121 ferumoxsil (SPIO) negative
Gastromark
perfluoro-
PFOB Imagent-GI negative
octylbromide
barium sulfate
— — negative
suspensions
— clays — negative
Ventilation Agents
perfluorinated
— — —
gases
gadolinium-based
— — —
aerosols
hyperpolarized
gases (He-3, Xe- — — —
129)

oxygen — — —

Classification of some magnetic resonance contrast agents approved,

or to be approved, for clinical use. Please read the Disclaimer — EMRF
does not recommend or disapprove of any of these agents; this is just a
list.

Some of the agents mentioned have been withdrawn from the market;
there are numerous other agents in development. Some agents have
different trade names, depending on the markets.

SPIO = superparamagnetic iron oxides, USPIO = ultrasmall SPIO. * or

short description; ** ™ or ®; ***with high local concentrations and/or
appropriate pulse sequence parameters, negative contrast can be
achieved (e.g., first-track bolus); ****all ECF space agents are also
kidney-specific agents.

339
 Frequently asked question: on MRA
Over the past few years, there has been explosive growth in the clinical
applications of magnetic resonance imaging (MRA). The development
of high-performance MR gradient system and fast imaging sequences
has unshared in a new era of non-invasive vascular imaging. The
purpose of this FAQ is to provide an introduction to the underlying
physical principles of MRA and a practical guide to the most commonly
used techniques.

Part I: Basic principle

Based
Clinical magnetic resonance imaging (MRI) is based on the hydrogen
nucleus (proton)

Hydrogen nucleus
Hydrogen nucleus is the most common and basic element found on
earth. It is also the most abundant element in the human body and most
of the hydrogen atoms in the body are found in water or fat.

Character
The hydrogen nucleus is a positively charged proton, which spins on its
axis much like a spinning top.

Pole
Like any moving charged particle, the hydrogen nucleus has a magnetic
moment that is a North Pole and a South Pole.

Arranged
In their natural state within the human body, the magnetic moments of
hydrogen nucleus are arranged randomly. Their magnetic moments,
therefore, cancel each other out, resulting in a net magnetic moment of
zero.

Align
When a patient is placed within the powerful magnetic field of an MRI
system, the hydrogen nuclei align either with the field (parallel) or
against it (antiparallel).

Proportions
A slightly greater proportion of protons align parallel to the external
magnetic field (o) than in the antiparallel direction.

Net magnetic moment

The external alignment of the protons results in a net magnetic moment
within the body.
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 Mo ,  o
This results in a net magnetic moment within the body that is aligned
with the external magnetic field. The strength of this net
magnetization (Mo) is directly proportional to the strength of the
external magnetic field, o.

Amount of protons that aligned

At 1.5 Tesla, about 6 billion excess protons are aligned parallel to o per
volume element or voxel (based on an average voxel size of 2 x 2 x 5
mm). Although this seems like a large number, it represents only about
3 protons per million within the voxel

Net Magnetization (Mo)

This numeric difference between parallel and antiparallel protons results
in the net magnetization (Mo) vector within imaging voxel.

Size of volume element or voxel

Average volume element or voxel size of 2 x 2 x 5 mm.

Frequency
Hydrogen protons spin or process about their axes at a specific
frequency. Different elements in the periodic table exhibit different
natural precessional rates.
The frequency at which a nucleus precesses (or resonate) is determined
by the external magnetic field strength (Bo) and the gyromagnetic ratio, a
constant that is unique to each element.

Precessional rate or frequency

The precessional frequency is described by the Larmor equation:
W o=yx Bo,
where o = precessional frequency; y = gyromagnetic ratio; and Bo =
magnetic field strength.

Precessional frequency axesIn order to visualize the effect of

radiofrequency pulses on Mo, consider a
3-dimantional coordinate systems defined by X.Y. and Z. axes.

Axes
The net magnetic moment of protons aligned along o, in equilibrium, is
described by the Mo. When a 90o RF pulse is applied to Mo at the
precessional frequency, the protons absorbed a small amount of
energy, causing them to spiral down toward the transverse (XY) plane.
The value of Mo decreases, approaching zero as it rotates into the
transverse plane. The part of Mo that has tipped into the transverse
plane is referred to as Mxy. Mxy is at its maximum value immediately
341
after a 90o RF pulse, in which all of Mo is oriented in the transverse
plane. Once the RF transmitter is turned off, Mxy begins to decrease in
size as the proton nuclei dephase and reoriented themselves along the
longitudinal axis (Z).

Measure the Mx and Mxy

Changes in Mz and Mxy are measured using:
 T1 relaxation: recovery of the longitudinal magnetization (Mz)
 T2* relaxation: loss or decay of transverse magnetization (Mxy)

T1
The T1 relaxation time refers to the rate at which longitudinal
magnetization. Is recovered after a 90o RF pulse. At a time interval of
T1 msec after the application of the 90o pulse, 63.2% of the original
longitudinal magnetization is recovered. At a given field strength each
tissue has its own characteristic T1 time constant. However, T1 values
are proportional to the external magnetic field strength. Therefore, the
T1 value for fat at 0.5 Tesla is less than it would be at 1.5 Tesla.

T2*
T2* relaxation describes the rate at which transverse magnetization
(Mxy) decays after the longitudinal magnetization vector is rotated into
the transverse plane. T2* relaxation reflects loss of transverse
magnetization from reversible causes. After a 90o RF pulse, transverse
magnetization falls to 36.8% of its original value during the first T2* time
interval. T2 relaxation reflects only the irreversible causes of transverse
magnetization decay. As with T1, each tissue has a unique T2 value.
Unlike T1, the T2 relaxation time is relatively independent of field
strength.

Precession
In a spin-echo pulse sequence, protons are tipped into the transverse
plane by a 90o RF pulse. After the 90o pulse the protons begin
processing within the transverse plane. However, they do not process
at exactly the same rate. Some protons precess faster than others
because of slight differences in their local magnetic fields.

Loss of net magnetic moment

This leads to a loss of net magnetic moment in the transverse plane,
referred to as dephasing.

Dephasing / Rephasing
The dephasing occurs as the result of magnetic field heterogeneities
that arise from imperfections in the magnet and variations in electron
shielding within different molecular structures. Nothing can be done to
counteract the differences in electron shielding at the molecular level.
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However, the dephasing caused by imperfection in the external field
can be reversed with a 180o RF pulse, referred to as a refocusing pulse.

180o pulse
The 180o pulse rephases protons in the XY plane, resulting in a
transient increasing in transverse magnetization, referred to as a spin
echo. In the spin-echo pulse sequence, the 180o refocusing pulse
occurs midway the initial 90o RF pulse and the peak of the echo.

ADC
The signal used to create the image is detected from the transverse
magnetization of the spin echo with a receiver coil and an analogue-to-
digital converter.

Spatial encoding
In order to localize the magnetic resonance (MR) signal to create an
image, magnetic field gradients are applied along the X, Y, and Z-axes.
These gradients create linear variances in the magnetic field that allow
spatial encoding of the signal.

Fourier transform
The raw MR data are collected in k-space (a map of the digital phase
and frequency data) and converted into an imaging, using a
mathematical process called the Fourier transform.

Tissue dependent factors

A tissue’s T1 and T2 relaxation times are sometimes referred to as
tissue-dependent factors because they are inherent properties of the
tissue itself. T1 and T2 values are unaffected by the technologist’s
choice of different imaging parameters or pulse sequence.

Soft Tissue Contrast

Soft tissue contrast on MR images is determines by both tissue-
dependent factors, such as T1 and T2, and operator –dependent
factors controlled by the MR technologist.

Operator dependent-factors
Operator-dependent parameters include the flip angle, pulse repetition
time (TR), and echo-time (TE), among others. The flip angle is
determined by measuring the amplitude and duration of the excitation
pulse.
A 90o flip angle is used in SE and FSE PS
TR is the time interval between successive excitation pulses

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 TE is the time interval between the excitation pulse and the peak of
the echo

Sequence
SE and FSE PS are used for BB imaging. However, most MRA
techniques are based on GE-PS. GE sequence differ from SE
sequences in that the initial RF pulse is typically less than 90o, and
there is no 180o refocusing pulse. The signal is generated by reversing
some of the imaging gradients, which results in a GE (as opposed to a
SE). Signal detection, spatial localization, and image reconstruction
then proceed in a similar manner to SE imaging.

A SHORT HISTORY OF MAGNETIC RESONANCE IMAGING

Looking back at the main protagonists involved in MR imaging is vital

for an understanding of the development of the modality. The topic is
interesting, but rather sensitive.
Like any history, the history of MR imaging has no real beginning.
"Everything flows and nothing stays," as Heraklitos pointed out.
One major contribution to the technique can be found in Napoleon's
realm. Jean-Baptiste-Joseph Fourier served three years as the
secretary of the Institut d'Egypte at the beginning of the nineteenth
century, and later became prefect of the Isère département in France.
However, the focus of his life was mathematics, and without his Fourier
transform we would not be able to create MR images.

Jean-Baptiste-Josepf Fourier
In 1946, two scientists in the United States, independently of each
other, described a physicochemical phenomenon which was based
upon the magnetic properties of certain nuclei in the periodic system.
This was 'nuclear magnetic resonance', for short 'NMR'
The two scientists, Felix Bloch and Edward M. Purcell, were awarded
the Nobel Prize in Physics in 1952.
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Felix Bloch and Edward M Purcell
Purcell was born in Illinois in the United States of America. He worked
at the Massachusetts Institute of Technology, MIT, and later joined the
faculty of Harvard University.
Bloch was born in Zurich in 1905 and taught at the University of Leipzig
until 1933; he then emigrated to the United States and was naturalized
in 1939. He joined the faculty of Stanford University at Palo Alto in 1934
and became the first director of CERN in Geneva in 1962. In 1983 he
died in Zurich.
Bloch was a protagonist for the interaction between Europe and the
United States. NMR and MRI would not exist without this interaction.
At some stage of their career, many European scientist contemplate
emigration to the U.S.A. Some move transatlantic and some even stay
for good. Others return. There is hardly any movement in the other
direction. The historical reasons were different prior to and after the
Second World War. Before the war, plain survival for many depended
on emigration, or it was at least guided by political necessity. It was the
attraction of the Statue of Liberty which made scientists move
westward.
After the war, research facilities in the United States were more
attractive than those in Europe because the academic system in the
U.S.A. was more flexible than the university structures in Europe - and
dollars were plentiful for research and for personal income.
Bloch and Purcell were not the only scientists working in the field. The
1920s had been roaring and inflationary, but also extremely fruitful in
science. In 1924, Wolfgang Pauli suggested the possibility of an
intrinsic nuclear spin. The year after, George Eugene Uhlenbeck and
Samuel A. Goudsmit introduced the concept of the spinning electron.
Two years later Pauli and Charles Galton Darwin developed a
theoretical framework for grafting the concept of electron spin into the
new quantum mechanics developed the year before by Edwin
Schrödinger and Werner Heisenberg.
Pauli, Uhlenbeck, and Goudsmit went to the United States to work. The
British stayed in Britain - at that time.

345
This development continued in the 1930s. After their initial pacemaking
work, in 1933, Otto Stern and Walther Gerlach were able to measure
the effect of the nuclear spin by deflection of a beam of hydrogen
molecules. During the early 1930s, Isidor Isaac Rabi's laboratory at
Columbia University in New York became a major center for related
studies.

Otto Stern and I.I. Rabi

Rabi's research was successful, but only the visit by Cornelis Jacobus
Gorter from the Netherlands in September 1937 finally showed how to
measure the nuclear magnetic moment. Gorter had tried similar
experiments and failed. Rabi accepted and realized Gorter's
suggestions concerning his experiments, changed them, and was able
to observe resonance experimentally. This led to the publication of 'A
New Method of Measuring Nuclear Magnetic Moment' in 1938 [49].

C.J. Gorter
Gorter first used the term 'nuclear magnetic resonance' in a publication
which appeared in the war-torn Netherlands in 1942, attributing the
coining of the phrase to Rabi [20].
The Second World War had a major influence upon research - and its
interruption. Germany, for instance, the leading country in science and
medicine at the time, quit the race in the 1930s.
But there was another country in which major contributions to nuclear
magnetic resonance were made. They originated in Kazan in Tatarstan,
which was part of the Soviet Union at that time and is now an
independent republic within Russia. Until recently, Russian
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contributions to NMR and radiology were frowned upon or not even
discussed in the West.
Electron spin resonance was discovered at Kazan's university by
Yevgeni K. Zavoisky towards the end of the war [54]. Zavoisky had first
attempted to detect NMR in 1941, but like Gorter he had failed.

Yevgeni K. Zavoisky
The final breakthrough came with Bloch and Purcell in 1946.
During the next few decades NMR developed in a wide range of
applications. Hardly any of them were medical, although in vivo NMR
already had been performed since the early 1950s.
In 1955/1956, Erik Odeblad and Gunnar Lindström from Stockholm
published their first NMR studies, including relaxation time
measurements, of living cells and excised animal tissue [47]. Odeblad
continued working on tissues throughout the 1950s and 1960s. He is
the major early contributor to NMR in medicine.
Oleg Jardetzky and coll. performed sodium NMR studies in blood,
plasma and red blood cells in 1956 [32]. T1- and T2-measurements of
living frog skeletal muscle were published by Bratton and coll. in 1965
[5]. In the 1960s and 1970s a very large amount of work was published
on relaxation, diffusion, and chemical exchange of water in cells and
tissues of all sorts. In 1967, Ligon reported the measurement of NMR
relaxation of water in the arms of living human subjects [40]. In 1968,
Jackson and Langham published the first NMR signals from a living
animal [31].
In the late 1960s, Jim Hutchison at the University of Aberdeen in
Scotland began working with magnetic resonance on in vivo electron
spin resonance studies in mice.
Hazlewood added to the work on relaxation time measurements by
studying developing muscle tissue [24, 25]. Cooke and Wien worked on
similar topics [9]. Hansen added NMR studies of brain tissue [23].
Others joined in this kind of research, among the better known being
the research groups of Raymond Damadian at Downstate Medical
Center in Brooklyn and Donald P. Hollis at Johns Hopkins University in
Baltimore. Damadian's group measured T1 and T2 relaxation times of
excised normal and cancerous rat tissue and stated that tumorous
347
tissue had longer relaxation times than normal tissue [11]. Hollis and his
collaborators achieved similar results, but were more balanced and
scientifically critical in their postulations and deductions [29].
Damadian thought that he had discovered the ultimate technology to
detect cancer and, in 1972, filed a patent claim for an 'Apparatus and
Method for Detecting Cancer in Tissue' [10]. The patent included the
idea but no description of a method or technique of using NMR to scan
the human body.
In February 1973 Abe and his colleagues applied for a patent on a
targeted NMR scanner [1]. They published this technique in 1974 [53].
Damadian reported a similar technique in a publication two years later,
dubbed 'field-focusing NMR (Fonar)' which contained a image of
scanned volume elements through a mouse [13].
Still today Damdian trys to maintain the myth that tumor detection is
possible with the method he described. However, it is impossible and
would be detrimental to patients to try to detect, diagnose or
characterize malignancies in this way. Furthermore, his apparatus (see
picture below) is not an imaging device, and cannot be adapted for
imaging.

Damadian's equipment to measure relaxation times in vivo.

Ganssen's equipment to measure blood flow.

Flow measurements by NMR had also been discussed for some time.
By 1959, Jay Singer had studied blood flow by NMR relaxation time
measurements of blood in living humans [52]. Such measurements
were not introduced into common medical practice until the mid-1980s,
348
although a patent for a whole-body NMR machine to measure blood
flow in the human body was already filed by Alexander Ganssen in
early 1967 [18].
This machine was meant to measure the NMR signal of flowing blood at
different locations of a vessel with a series of small coils, allowing to
calculate the blood flow within that vessel. It could be described as the
first MR scanner. However, it is not an MR imaging machine.
Actual in vivo NMR spectroscopy took off in Oxford from 1974, with the
group of Rex E. Richards and George K. Radda. Among others, David
Hoult and David G. Gadian belonged to this group.

Spatial Encoding
All the experiments up to now had been one-dimensional and lacked
spatial information. Nobody could determine exactly where the NMR
signal originated within the sample. After MR imaging had first been
described, several individuals and companies claimed that they had
achieved imaging earlier, but their machines were not conceived of as
imagers.
In roentgenology, the times of conventional imaging ended in
September 1971, when the world's first axial x-ray computed tomograph
was installed in England.
In the same month, Paul Lauterbur of the State University of New York
at Stony Brook had the idea of applying magnetic field gradients in all
three dimensions and the computerized axial tomography (CAT)-scan
back-projection (= projection-reconstruction) technique to create NMR
images. He published the first images of two tubes of water in March
1973 in the journal Nature [35]. This was followed later in the year by
the picture of a living animal, a clam, and in 1974 by the image of the
thoracic cavity of a mouse [36]. Lauterbur called his imaging method
zeugmatography, a term which was later replaced by (N)MR imaging.

349
Lauterbur and the first magnetic resonance images (from Nature)
Field gradients had been used before. They are an essential feature of
the study of molecular diffusion in liquids by the spin-echo method
developed by Erwin L. Hahn in 1950 [22]; his group used a gradient
approach also to create a storage memory [2]. In 1951, Roger Gabillard
from Lille in France had imposed one-dimensional gradients on
samples [16, 17]. Carr and Purcell described the use of gradients in the
determination of diffusion in 1954 [7].
However, Lauterbur's idea revolutionized NMR because it opened the
field to imaging. Many of today's innovations were thought of and
developed in his laboratory in the late 1970s and 1980s [3, 15, 34, 37-
39, 46, 51]. When he presented his approach to NMR imaging at the
International Society of Magnetic Resonance (ISMAR) meeting in
January 1974 in Bombay, Raymond Andrew, William Moore, and Waldo
Hinshaw from the University of Nottingham, England, were in the
audience and took note. As a result, Hinshaw developed his own
approach to MR imaging with their sensitive point method [26, 27].
In April 1974, Lauterbur gave a talk at a conference in Raleigh, North
Carolina. This conference was attended by Richard Ernst from Zurich,
350
who realized that instead of Lauterbur's back-projection one could use
switched magnetic field gradients in the time domain. This led to the
1975 publication, 'NMR Fourier Zeugmatography' by Anil Kumar, Dieter
Welti, and Richard Ernst [33], and to the basic reconstruction method
for MR imaging today.

Richard Ernst and the first two-dimensional Fourier-transformed

images.
A second NMR group in Nottingham got also involved in MR imaging.
Its leader, Peter Mansfield, worked on studies of solid periodic objects,
such as crystals. At a Colloque Ampère conference in Cracow in
September 1973, Mansfield and his collaborator Peter K. Grannell
presented a one-dimensional interferogram to a resolution of better than
1 mm [43]. This, however, cannot be considered an MR image.
However, one year later, Alan Garroway and Mansfield filed a patent
and published a paper on image formation by NMR [19]. By 1975,
Mansfield and Andrew A. Maudsley proposed a line technique which, in
1977, led to the first image of in vivo human anatomy, a cross section
through a finger. In 1978, Mansfield presented his first image through
the abdomen [44, 45].

Peter Mansfield
In 1977, Hinshaw, Paul Bottomley, and Neil Holland, succeeded with an
image of the wrist [28]. Damadian and collaborators created a cross
section of a human chest [12]. More human thoracic and abdominal
images followed, and by 1978, Hugh Clow and Ian R. Young, working at
351
the British company EMI, reported the first transverse NMR image
through a human head [8].
Two years later, William Moore and colleagues presented the first
coronal and sagittal images through a human head.
In the research group of John Mallard at the University of Aberdeen,
Jim Hutchison, Bill Edelstein, and coll. developed the spin-warp
technique. They published a first image through the body of a mouse in
1974 [14, 30]. Margaret Foster contributed much to this work.

The prototype MR equipment in Aberdeen with Jim Hutchison.

At this time, many of the researchers working in Britain went to the
United States. It was a major brain-drain for British universities, but
there was (and still is) little money in the British university system. Most
of the researchers stayed abroad, whereas many of the Continental
Europeans who worked in the U.S.A. in the late 1970s and early 1980s
returned home.
Some of them had performed quite impressive research in the United
States; among them was Robert N. Muller, who - in 1982 - described
off-resonance imaging, a technique known today as 'magnetization-
transfer' imaging [46]. Rinck et al. described the first fluorine lung
images [51].

352
The first fluorine images of a lung (Rinck et al.; 1982).

The first magnetization-transfer images (Muller et al.; 1982).

Peter Rinck and Robert N. Muller at Paul Lauterbur's laboratory after

the first acquisition of a three-dimensional MR image of the heart
(1982).
Paul C. Lauterbur received the Nobel Prize in Medicine or Physiology in
2003 for the invention of magnetic resonance imaging. Peter Mansfield
shared the Nobel Prize for his further development of MRI.
In the 1980s, Continental Europe started to contribute intensively to MR
imaging. Rapid imaging originated in European laboratories. Jürgen
Hennig, together with A. Nauerth and Hartmut Friedburg, from the
University of Freiburg introduced RARE (rapid acquisition with
relaxation enhancement) imaging in 1986. This technique is probably
better known under the commercial names of fast or turbo spin-echo.

353
Jürgen Hennig
At about the same time, FLASH (fast low angle shot) appeared,
opening the way to similar gradient-echo sequences. This sequence
was developed at Max-Planck-Institute, Göttingen, by Axel Haase, Jens
Frahm, Dieter Matthaei, Wolfgang Hänicke, and Dietmar K. Merboldt.

Axel Haase and Jens Frahm

FLASH was very rapidly adopted commercially. RARE was slower, and
echo-planar imaging (EPI) - for technical reasons - took even more
time. Echo-planar imaging had been proposed by Mansfield's group in
1977, and the first crude images were shown by Mansfield and Ian
Pykett in the same year [41]. Roger Ordidge presented the first movie in
1981. Its breakthrough came with the invention of shielded gradients
[42].

Clinical Applications
At about this time, MR imaging started being clinically evaluated. One of
the most admirable research groups worked at Hammersmith Hospital
in London. The head of the group was Robert E. Steiner, but Ian R.
Young and Graeme M. Bydder were the moving forces. Among others,
Frank H. Doyle and Jacqueline M. Pennock supplemented this group.
Because MR imaging is at the crossroads between medicine and
chemistry, physics, and computer science, groups with strong
interdisciplinary relationships and cross-fertilization became
scientifically extremely fruitful, which led to the 'odd couple' system,
involving one physician and one scientist. At congresses, you would
always see Graeme Bydder together with Ian Young, a seemingly ideal
combination. There were (and are) other couples like them, but

354
apparently this kind of relationship between radiologists and physicists
does not fit into all European academic systems.

Graeme Bydder and Ian Young

Early clinical imaging was extremely difficult, time-consuming, and often
disappointing. Spin-echo imaging, for instance, was a bigger step than
many imagine. Today it is taken for granted, and it has helped MR
imaging immensely to become a routine technique.
Early MR images were mainly based upon proton-density differences,
later upon differences in T1-weighting. By 1982-1983, the
Hammersmith and Wiesbaden groups pointed out that long heavily T2-
weighted SE sequences were better at highlighting pathology [6, 50]. It
took some years until this was generally accepted, mostly because
many companies claimed that long TE was neither possible nor
necessary.
Another European affair was the development of contrast agents. The
possible concept had been described at universities in the United
States by Maria Helena Mendonça-Dias and Paul C. Lauterbur [39], by
Robert Brasch, and Gerald Wolf. However, most of the commercial
development and scientific research took place in Europe. Schering
submitted a patent application for Gd-DTPA dimeglumine in July 1981
in a project involving Hanns-Joachim Weinmann and Ulrich Speck. In
1984, Dennis H. Carr from the Hammersmith and Wolfgang Schörner
from Berlin published the first images in men. Since the late 1980s,
Magnevist has been commercially available, followed shortly afterwards
by Dotarem from Guerbet in Paris.

355
Hanns-Joachim Weinmann
MR Equipment
With the exception of the scientific instrument manufacturers, the
hardware makers had no background in NMR. The most important
scientific manufacturers were Varian in the U.S.A., JEOL in Japan, and
Bruker-Spectrospin in Europe. Most scientific developments in MR
imaging were done on Bruker machines.
The first hardware manufacturer to get involved in whole-body imaging
was EMI in 1974. Later the company was taken over by Picker (later
Marconi, today Philips). Philips started research into MR imaging at the
same time; P. Rob Locher, André Luiten, and Piet van Dijk were seen at
many scientific meetings. Siemens got involved in 1977, Johnson &
Johnson/Technicare in 1978/79, Instrumentarium at about the same
time, and the others followed in the 1980s.
M&D Aberdeen was a company originating from the research group at
Aberdeen University. It had one machine in Geneva, but it disappeared
a long time ago, as have a number of other companies.
Another effort was the Finnish MR imaging machine. Raimo E.
Sepponen, together with a number of other researchers, among them
the surgeon Jorma T. Sipponen, aimed to develop a method and device
for detection of internal hemorrhages. Their first clinical MR imaging
model was installed at Helsinki University Central Hospital in June 1982
operating at a field strength of 0.17 T. The second unit operated at 0.02
T, and later units operating at 0.04 T, which at that time was politico-
commercially a step in the wrong direction.
With few exceptions, all early magnets for MR imagers were produced
by Oxford Magnets. Still today many magnets come from companies in
the Oxford area.

Teaching, Training, Conferences

There was and is an enormous need for user education in magnetic
resonance imaging. The first European NMR imaging meeting was held
in Nottingham in April 1976, followed by a second conference in
Winston-Salem in North Carolina in the U.S.A. in 1981. Soon
afterwards, the number of meetings exploded.
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Another effort aimed at teaching users in Europe started also in the
United States in the early 1980s: the European Workshop on Nuclear
Magnetic Resonance in Medicine, now known as the EMRF
Foundation. The first Annual Meeting of the European Workshop was
held in Mons, Belgium, in 1983, followed by meetings all over Europe.
Today, the EMRF Foundation specializes in smaller meetings and
supports young scientists with sponsorships and grants. The major
European MR meetings are organized by the European Society for
Magnetic Resonance in Medicine and Biology which was founded in
Geneva in 1983, the European Congress of Radiology, and national
radiological, medical physics, and MR societies.

IS MR IMAGING A SAFE TECHNOLOGY?

July 30, 2001
Child Dies in MRI Machine
By THE ASSOCIATED PRESS • Filed at 2:42 p.m. ET
VALHALLA, N.Y. (AP) -- A child undergoing an MRI exam received a
fatal head wound when the machine's powerful magnet pulled a metal
oxygen canister inside, the Westchester Medical Center said Monday.
The child, whom the medical center would not identify by name, sex or
age,died Sunday.
The hospital said the child was sedated following an operation Friday
and was inside the machine when the 10-ton electromagnet drew the
canister.
Edward Stolzenberg, president and chief executive of the medical
center, said the hospital assumes full responsibility and "will do anything
it can to ease the family's grief.''

Investigations are under way by the medical center and the state Health
Department.

Introduction
Any new method in medicine, be it diagnostic or therapeutic, must be
thoroughly checked for possible adverse side effects. More than 100
years ago, x-rays represented a major step forward, but then sobered
radiologists and the public after the hazards of ionizing radiation were
detected.

No ionizing radiation is involved in MR imaging. However, because of

the known problems with x-rays and radioisotope examinations,
magnetic resonance imaging and spectroscopy have been intensively
examined for possible dangerous side effects.

357
During the last century, several hundred papers focusing on the effects
or side effects of magnetic or radiofrequency fields have been
published.

They range from anecdotal reports about therapeutical applications of

magnetic fields as published by Zhang et al. [47] to reports on
unwelcome side effects, such as Beischer’s study [11].

This overview cannot cover all potential sources of hazards. Several

reviews of the literature have been published recently, e.g., by Shellock
and Kanal [41], by Persson and Ståhlberg [31], and by Magin, Liburdy,
and Persson [25].

Several of the side effects associated with MR are unique to this kind of
medical diagnostic tool; others are similar to hazards of other diagnostic
methods. Possible hazards can arise from or be connected to:
• static magnetic fields;
• varying magnetic fields (gradient fields);
• radiofrequency fields;
and specifically:
• devices necessary to operate the imager (such as cooling gases) or to
ensure the quality of life of the patients (such as intracorporal implants
and extracorporal monitors);
• conducting loops such as electrical leads or accidental anatomical
positions of the patient.
These hazards can affect patients, personnel, and other persons within
the field of the magnet. They can be categorized as acute and
subacute.

Acute Hazards

Acute hazards are created by the static magnetic field usually covering
an ellipsoid region around the isocenter of the magnetic resonance
imager. The range of this fringe or stray field depends on the field
strength of the system, the type of magnet, and the kind of shielding
used.
Ultralow- and low-field magnets possess a limited stray field of
sometimes less than one meter radius from the isocenter. The stray
field of large-bore, high-field systems may cover a radius of 15 or 20
meters, unless the magnet is heavily shielded.

Danger and prohibition symbols and signs used in MR

installations

danger — strong magnetic field

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 danger — high-frequency electromagnetic field

active implants and metallic implants, such as pacemakers,

prohibited

loose ferromagnetic objects prohibited

metal body implants prohibited

magnetic media such as credit cards, diskettes, magnetic tapes

prohibited

mechanical watches, cameras and similar devices prohibited

External Objects and Devices

Projectiles.
The most imminent danger for both patients and personnel in the
magnetic field of an imaging system may result from ferromagnetic
objects such as scalpels, scissors, pens, and even sand bags (not filled
with sand but with iron shot) and gas dewars, which can be attracted by
the magnet and thus behave like projectiles.

To prevent such accidents, the installation of a metal detector through

which everybody has to pass before entering the MR suite has been
recommended, but is rather cumbersome.

Every person working or entering the magnet room or adjacent rooms

with a magnetic field has to be instructed about the dangers. This
should include the intensive-care staff, and maintenance, service and
cleaning personnel, as well as the crew at the local fire station.

The best protection against this danger is not to allow personnel other
than those directly involved in patient examinations, i.e., the operator
and the radiologist, into the magnet room. Constant education of
everybody involved is also vital.
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Monitors and respirators
The dependence on physiological monitoring, on mechanical
respiration, and electric infusion pumps during MR examinations
renders difficulties, and in certain instances does not allow such an
examination.

However, with the development of appropriate monitoring and life-

support equipment during the last few years, dependence is no longer a
contraindication of MR imaging. Details on monitoring can be found in
an article by Kanal and Shellock [20].

Contrast agents
Paramagnetic, superparamagnetic or ferromagnetic magnetic
resonance contrast agents or other substances which have to be
injected or applied in another way may present risks similar to those in
any other invasive technique. The clinical experience of administering
gadolinium-based or other agents intravenously to patients has shown
that these agents are generally safe and well-tolerated. Only very few
severe anaphylactoid reactions and cases of glottis edema have been
reported.

Still, all necessary precautions for intensive-care treatment have to be

considered when injecting such contrast agents, particularly in patients
with a history of allergy or drug reaction [37].

A precautionary 24-hour suspension of breast-feeding was generally

recommended following the administration of gadolinium-containing
contrast agents. However, it has been proposed that this suspension be
reduced to 12 hours [18].

MR Equipment
Noise. The noise created by the switching of the gradients is an
additional source of inconvenience and, possibly, ear damage for the
patient and, occasionally, personnel. This noise is comparable to very
heavy traffic. Noise levels increase with field strength.

Disposable earplugs for the patient are recommended in high-field

systems. Noise-cancelling systems and special earphones are
available, and active acoustic control systems are being developed [26].

Cooling gases.
In superconductive magnet systems, helium and nitrogen are used as
cooling gases. In the case of a quench, gases are released to the
outside. Under normal circumstances, the gases should escape through

360
a pipe system and not reach the magnet-room atmosphere. However,
accidentally some gas could be released into the magnet room.
In this case, there are two potential dangers. Frostbite can be induced
because the gases are extremely cold. Secondly, nitrogen is to be
considered hazardous, in particular under pressure (whereas there is
no danger of direct intoxication from helium). All personnel and patients
must evacuate the area immediately and return only after proper
ventilation of the magnet room. Oxygen monitors with an audible alarm,
situated at an appropriate height within the magnet room are
recommended safety devices [41].

Patient-Related Devices
Implants. A particular danger is presented by small metallic surgical
implants. Hemostatic or other clips in the CNS can move in their
position. Dislocation by magnetic attraction or torque presents a risk of
hemorrhage. In other parts of the body, we consider this to be a minimal
risk, because after the healing phase of six to eight weeks, fibrosis and
encasement of the clip help to keep it in a stable position. The label
stainless steel is not a guarantee for non-ferromagnetic steel.
Implants that involve magnets such as magnetic sphincters, stoma
plugs, dental implants, etc., can be demagnetized by the MR imager.
They should be removed prior to the examination.

An extensive overview of the behavior of implants is given by Shellock

40, including a list of several hundred devices which are not prone to
dislocation. It also lists a selection of those metallic implants, materials,
and foreign bodies that are potential risks for patients undergoing MR
imaging examinations.

Foreign bodies.
Occult ferromagnetic foreign bodies incorporated in accidents are
dangerous, in particular those close to the eyes. The patient's history
may help to rule out such foreign bodies. Many patients, however, do
not remember such accidents. In case of doubt, x-rays should be taken
prior to MR imaging.

Ferromagnetic makeup and tattoos cannot only distort MR images, but

also can be irritated and makeup can even be pulled into the eye by
magnetic forces. Makeup should be removed before the examination, if
possible.

Pacemakers.
Research on the influence of magnetic and radiofrequency fields upon
cardiac pacemakers reported that the RF radiation of the MR imager
might disturb the function of demand pacemakers by closing the reed
relay and switching to the asynchronous mode; varying magnetic fields
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may mimic cardiac activity. Magnetic attraction can provoke motion of
the pacemaker in its pocket and thus move the conducting lead.
Therefore, pacemaker patients or other persons bearing pacemakers
should not be examined in, or come close to, an MRI or MRS system,
although recently some exceptions have been described for new-
generation pacemakers [43].

Pavlicek et al. reported a threshold for initiating the asynchronous mode

of a pacemaker at 17 Gauss [30]. The national regulatory boards
decided to limit the threshold for access to MRI areas to 5 Gauss. It
seems advisable to mark this area by signs or lines on the floor.

It is of special interest for the observer of bureaucratic procedures that

the 5-Gauss limit is ten times higher than the average earth magnetic
field, but lower than the magnetic field in electric trains such as
subways (up to 7 Gauss). The fields measured on the surface of the
receiver of a telephone are 35 Gauss and of an audio headset 100
Gauss.
Similar considerations hold for pacemakers used for stimulation of the
carotid sinus or intracorporal insulin pumps, for instance. Here, no
adverse effects have been observed [38]. However, interference in
electronic cochlear implants and ferromagnetic mechanical stapedial
replacements has been reported [17].

Prosthetic heart valves are not considered to be dangerous in low

fields. Patients should not undergo MR imaging in high fields if valve
dehiscence is clinically suspected [44].

Wires, other metallic objects, and skin contact.

Wire configurations such as pacemaker lead wires, ECG and
plethysmographic cables, and surface-coil connections can act as
antennae. Gradient and RF fields may induce current into these wires
and thus cause fibrillations and burns. This presents a risk to the patient
and must be eliminated prior to the examination.
This holds in a similar way for all clothing containing metallic threads or
components, as well as all metallic objects such as eye glasses,
jewelry, hairpins, buttons, watches, bracelets, prostheses, etc. All of
these objects must be removed prior to the examination.
The patient’s skin should not be in contact with the inner bore of the
magnet. Large-radius wire loops should not be formed by leads or wires
that are used in the magnet bore during imaging procedures.

If the patient’s arms and legs are not completely covered with clothing,
insulating material must be placed between the legs and between legs
and magnet. Leg-to-leg and leg-to-arm skin contact must be prevented

362
in order to avoid the risk of burning due to the generation of high current
loops if the legs or arms are allowed to touch.

IUDs.
Most of the commonly used intrauterine contraceptive devices (IUD) do
not move under the influence of the magnetic field, do not heat up
during sequences usually applied for pelvic imaging, and do not
produce major artifacts in vitro or in vivo. Thus, patients with either all
plastic or copper IUDs can be safely imaged with magnetic resonance
[27].

Joint and limb prostheses. Generally, such prostheses present no risk.

However, they can introduce image artifacts. If possible, they should be
removed prior to the MR examination.

Skin patches.
Pharmaceutical products in transdermal skin patches may cause burns
due to the absorption of RF energy. Such patches must be removed
prior to MR examinations.

Other Considerations
Sedation.
MR has become an important tool in pediatric imaging. Since some
infants and children are unable to cooperate with the examiners, there
is an increased demand for sedation.

Some infants sleep soundly through an MR examination, particularly if

they have eaten; however, many infants and children up to eight years
require sedation, even if they are accompanied by their parents into the
scanner room. In most instances, teenagers can be treated like adults.

Details on sedation and procedures can be found in the literature [3, 4,

20].

Claustrophobia.
This is a very real psychological danger for some patients.
Claustrophobia and other psychological stress situations have been
reported severe enough to interrupt the examination in about 1-4% of
cases. In this respect, small and wide-bore MR imagers are
advantageous because the percentage of claustrophobic incidents
drops significantly.

Explanation of the imaging procedure and the equipment prior to the

examination helps to reduce claustrophobia significantly.

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The possibility of the patient falling from the examination couch and
hypotonic syndrome (due to heat, motionless horizontal lying for a
certain time, and psychological agitation) are additional hazards.

Pregnancy.
There is no evidence that MR can harm the fetus or embryo - MR
imaging is used for fetography, particularly for imaging the brain. An
epidemiological study by Kanal, et al. concluded that data collected
from MR imaging technologists were negative with respect to any
statistically significant elevations in the rates of spontaneous abortion,
infertility, and premature delivery [21]. As a safety precaution, MR
scanning should be avoided in the first three months of pregnancy. MR
imaging is indicated for use in pregnant women if other nonionizing
forms of diagnostic imaging are inadequate, or if the examination
provides important information which would otherwise require exposure
to ionizing radiation such as x-ray or CT. Similar considerations hold for
pregnant staff of a magnetic resonance department. Mainly for
psychological reasons, it might be a wise precaution that pregnant staff
members do not remain in the scan room during actual scanning;
however, they are allowed to prepare and position the patient,
administer contrast agents, and scan and film.

Contraindications for MR imaging and spectroscopy.

Never forget that the magnetic memory of credit and similar cards, as
well as magnetic devices such as tapes, will be erased by MR magnets.
Leave home without them or leave them outside the magnet room.

Absolute Contraindications
electronically, magnetically, and mechanically activated implants:
cardiac pacemakers
ferromagnetic or electronically operated stapedial implants
hemostatic clips (CNS)
metallic splinters in the orbit

Relative Contraindications
electronically, magnetically, and mechanically activated implants:
other pacemakers, e.g., for the carotid sinus; insulin pumps and nerve
stimulators; lead wires or similar wires
non-ferromagnetic stapedial implants
cochlear implants
prosthetic heart valves (in high fields, if dehiscence is suspected)
hemostatic clips (body)
makeup and tattoos
congestive heart failure
pregnancy
(claustrophobia)
364
Legal Requirements
In the early 1980s, a number of national health and radiation protection
boards first established recommendations concerning magnetic
resonance imagers and spectroscopic units [15, 19, 33, 34]. All limits
set by them were recommended levels, not mandatory ones.
Legal requirements in some European and Asian countries exist; some
of them are without any scientific background, imposed by economic
lobbies rather than learned societies. Others have no connection to
reality or clinical routine [19, 29].
In the meantime, however, some manufacturers started using field
strengths beyond 2.0 T, different pulse sequences, and gradient-
switching procedures without any reported ill effects. Thus, these
recommendations are partly outdated.
Adjustments made do not cover all possible medical applications of MR
imaging, although the US-American Food and Drug Administration
(FDA) extended the designation of ‘nonsignificant risk’ to MR systems
with field strengths of up to 4.0 T in 1997 [5b] and 8.0 T in 2003 (4.0 T
in neonates younger than one month) [5c].
However, there is no sufficient evidence that imaging at fields higher
than 2.0 Tesla is risk-free. Until reliable scientific studies about the
effects of ultrahigh fields are available, MR equipment operating at
fields higher than 2.0 Tesla should be purchased with caution.
For legal reasons, the owner of MR equipment has to ensure that the
equipment does fulfil the local requirements. In some countries, the
regulations are more stringent than in others; in other countries, they
are nonexistent. These requirements must be guaranteed by the
manufacturer because the user in general is unable to check power
output, gradient strength, or even field strength. This guarantee must
cover authorized hardware and software updates after the initial
installation. Specially designed computer programs usually supervise
the power output of MR systems and will not allow or will interrupt any
imaging or spectroscopy procedure exceeding those limits considered
safe.

Subacute Hazards
The subacute risks of magnetic and RF fields have been intensively
examined for a long time.
There are some publications associating an increase in the incidence of
leukemia with the location of buildings close to high-current power lines
with extremely low-frequency (ELF) electromagnetic radiation of 50-60
Hz 46, and industrial exposure to electric and magnetic fields [28].
However, a transposition of such effects to MRI or MRS seems unlikely.
According to the National Radiological Protection Board of the United
Kingdom [35], the available experimental evidence weighs against
electromagnetic fields acting directly to damage cellular DNA, implying
365
that these fields may not be capable of initiating cancer in a manner that
parallels that of ionizing radiation and many chemical agents. The
results of some animal and cellular studies suggest the possibility that
electromagnetic fields may act as co-carcinogens or tumor promotors,
but taken overall, the data are inconclusive.
In the following paragraphs, we shall discuss some possible subacute
hazards.

Static Magnetic Fields

In every MR examination, a large static magnetic field is applied. Field
strengths for clinical equipment can vary between 0.2 and 3.0 T (2,000
and 30,000 Gauss); experimental imaging units have a field strength of
up to 17.5 T, depending on the equipment used. In MRS, field strengths
up to 12 T (120,000 Gauss) are currently used. No permanent
hazardous effects of static magnetic fields upon human beings have yet
been demonstrated [8].
However, there have been no long-term studies following persons who
have been exposed to a static magnetic field.
Budinger calls the following five biophysical mechanisms into question
whereby static magnetic fields might influence biological processes or
an organism’s behavior [14]:

Changes in enzyme kinetics. Up to 45 Tesla, no important effects on

enzyme systems have been observed.

Orientation changes of macromolecules and living-cell subcellular

components.
The result of replicable experiments on the orientation effects of retinal
rods in fields of 1 Tesla, the alignment of sickle cells at 0.35 T, and the
orientation of certain bacteria and animals might be explained by the
physical torque rather than the sensing of the turning torque by nervous
tissue.

Nerve conductivity.
As early as 1893, the first results of experiments about a possible
influence of static magnetic fields upon nerve tissue were obtained [6].
These and all later experiments showed negative results. There are
apparently no effects on the conduction of impulses in the nerve fiber
up to a field strength of 0.1 T generated by either changing the electrical
resistance or the potential of the excitation [1, 2]. Theoretical
examinations argue that fields of 24 T are required to produce a 10%
reduction of nerve impulse conduction velocity [23].
A preliminary study has indicated neurological effects in subjects
exposed to a whole-body imager at 4.0 T [41]. Here, additional research
is necessary.

366
Cardiac changes.
A field-strength-dependent increase in the amplitude of the ECG in rats
has been observed during exposure to homogeneous stationary
magnetic fields. The minimum level at which augmentation could be
observed was 0.3 T; at 2.0 T, the increase was by an average of 400%.
The augmentation in T-wave amplitude occurred instantaneously and
was immediately reversible after exposure to the magnetic field ceased.
There have been no abnormalities in the ECG in the later follow-up [16].
The authors suggest that augmentation of the signal amplitude in the T-
wave segment may result from a superimposed electrical potential. At
field strengths of between 7 and 10 T, no arrhythmia could be proven
[10].
According to the national radiation protection and health agencies, it is
unlikely that cardiac fibrillation would occur as a result of induced flow
potential in the major blood vessels or heart chambers at this level of
field intensity.
No circulatory alterations coincide with the ECG changes. Therefore, no
biological risks are believed to be associated with them.

Magnetohydrodynamic effects.
A blood pressure increase of 28% is predicted theoretically for a field of
10 T. This is claimed to be caused by interaction of induced electrical
potentials and currents within a solution, e.g. blood, and an electrical
volume force causing a retardation in the direction opposite to the fluid
flow. This decrease in flow velocity must be compensated for by an
elevation in pressure. At 1.5 T, no significant changes are expected; at
6.0 T a 10% pressure change is expected [14, 45}.
In addition to Budinger's reflections, the following points are valid for
discussion:

Genetic effects.
There have been several reports that static magnetic fields may
provoke genetic mutations, changes in growth rate and leukocyte count
and other effects [36]. The results of these experiments could not be
reproduced [39]. Inhibition of growth rate of Eschericha coli induced by
low-frequency magnetic field could be shown. Nevertheless, some
authors claim it be unlikely that mutagenic effects are introduced by
fields lower than 1.0 T [24]. No reports have been published that
persons exposed to magnetic fields, including personnel at MR
departments, have a higher incidence of genetic damage to their
children than found in the average population.
We believe, however, that this research needs further investigation and
that pregnancy should be considered a relative contraindication for MRI
and MRS. Taking into account that clinical MR imaging devices operate
at field strengths of between 0.2 and 2.0 T, caution demands further
experiments at higher field strengths.
367
Membrane transportation and blood sedimentation.
Other potential hazards from static fields include, for instance,
membrane transportation and blood sedimentation induced by the field.
As Mansfield and Morris pointed out, static magnetic field gradients of
0.01 T/cm (100 G/cm) make no significant difference in the membrane
transport processes. The influence of a static magnetic field upon
erythrocytes is not sufficient to provoke sedimentation, as long as there
is a normal blood circulation [24].
As discussed above, many results presented in publications about
effects of static magnetic fields are contradictory and cannot be
explained by biophysical or biochemical mechanisms. In some cases,
the effects observed must be attributed to other causes which had not
been considered by the researchers in the setup of the experimental
protocol. Critical considerations of such experiments can be found in a
number of reviews [14, 31]. However, the data available are not
comprehensive enough to assume MR imaging and spectroscopy are
absolutely safe.

Varying Magnetic Fields

Varying magnetic fields are necessary for the localization of nuclei with
magnetic properties within the sample.
A well described effect of varying magnetic fields is the so-called
magnetic phosphenes [16], which were first observed some 90 years
ago [7]. They are attributed to magnetic-field variations and may occur
in a threshold field change of between 2 and 5 T/s. Phosphenes are
stimulations of the optic nerve or the retina, producing a flashing
sensation in the eyes. They seem not to cause any damage in the eye
or the nerve.
Varying magnetic fields are also used to stimulate bone-healing in non-
unions and pseudarthroses. The reasons why pulsed magnetic fields
support bone-healing are not completely understood [9].
Rapid echo-planar imaging and high-performance gradient systems
create fast-switching magnetic fields that can stimulate muscle and
nerve tissues.
The mean threshold levels for various stimulations are 3,600 T/s for the
heart, 900 T/s for the respiratory system, and 60 T/s for the peripheral
nerves. Guidelines in the United States limit switching rates at a factor
of three below the mean threshold for peripheral nerve stimulation.

Radiofrequency Fields
Radiofrequency pulses are used in MR imaging for the excitation of the
nuclei. RF fields may interact with both tissues and foreign bodies, such
as metallic implants, in the patient. The main result of this type of
interaction is heat.

368
The higher the frequency, the larger will be the amount of heat
developed; and the more ionic the biochemical environment in the
tissue, the more energy that will be deposited as heat [22, 35]. This
effect is well-known for homogeneous model systems, but the complex
structure of various human tissues makes detailed theoretical
calculations very difficult, if not impossible.
The specific absorption rate, SAR, helps to estimate RF heating effects.
It increases with field strength, radiofrequency power and duty cycle,
transmitter-coil type and body size. In high and ultrahigh fields, some of
the multiple echo, multiple-slice pulse sequences may create a higher
SAR than recommended by the agencies.
Hot spots may occur in the exposed tissue. At present, it seems unlikely
that such hot spots in the body exist, but to avoid or at least minimize
effects of such theoretical complications, the frequency and the power
of the RF irradiation should be kept at the lowest possible level.

In several in vitro and in vivo experiments, no threatening increase in

temperature could be shown [13, 23]. Even in high magnetic fields, no
local temperature increase greater than 1°C occurred. The highest skin
temperature increase described reached 2.1°C [41]. Eddy currents may
heat up implants and thus may cause local heating. In vitro worst-case
experiments performed with a large and very thin thermally insulated
aluminium sheet at 1.5 T after 15 minutes of exposure showed a
temperature rise of only 0.08°C.

According to the specific FDA criteria for SAR limits, the SAR must not
be greater than:
• 4 W/kg averaged over the whole body for any 15-minute period;
• 3 W/kg averaged over the head for any 10-minute period; or
• 8 W/kg in any gram of tissue in the extremities for any period of 5
minutes.
Some European countries have issued SAR restriction too. No common
denominator has been found.

References
Additional references and information are available at the following
(featuring Kanal E, Borgstede JP, Barkovich AJ et al.
http://kanal.arad.upmc.edu/mrsafety.html, at http://www.mrisafety.com
http://www.fda.gov/cdrh/safety/mrisafety.html

369
 ABBREVIATION USED IN MEDICAL

 decay alpha decay

 emission alpha emission
 emission
-
beta minus emission
 motor n / n alpha motor nerve neurone
 particle alpha particle
 particle beta particle
 radiation alpha radiation
 radiation beta radiation
 ray alpha ray
 delta; ..
 gyromagnetic ratio
 differential diagnosis
+ emission beta plus emission
+decay beta plus decay
-1 Antitryp alpha 1antitrypsin
-1 AT alpha 1antitrypsin
-blocker beta-blocker
-decay beta minus decay
fp , FP alphafetoprotein
-HCG beta-human chorionic gonadotrophin
-IFP alpha interferon
-LPH beta lipotrophin
-MSH alpha melanocyte stimulating hormone
-MSH beta melanocyte stimulating hormone
1,25-DHCC dehydroxycholecalciferol
111
In, 111-In indium-111
113
In, 113mIn indium-113m
123
I, 123-I iodine-123

370
125
Ca …………
125
I, 123-I iodine-125
131
I, 123-I iodine-131
14
C carbone-14
14
CO2 carbon dioxide-14
17
FDG, 17-FDG fluorodeoxyglucose
18
F, 18-F fluorine-18
195m Au gold-195m
o
1 HPT primary hyperparathyroidism
o
1 HB first-degree heart block
2,3 DPG 2,3-diphosphoglycerate
25-HCC 25-hydroxycholecalciferol
2-D two-dimensional
2DFT two-dimensional Fourier transforms
o
2 HPT secondary hyperparathyroidism
o
2 HB second degree heart block
3-D three-dimensional
3-D FASTER - three-dimensional
3D GRE 3d gradient echo
3D MP RAGE-3d magnetization prepared rapid gradient echo
3D-CT Art three-dimensional CT arteriography
3-DFT three-dimensional Fourier transforms
3o HPT tertiary hyperparathyroidism
3oHB third degree heart block
51
Cr chromium-51
52
Fe, 52-Fe iron-52
57
Co, 570Co cobalt-57
58
Co, 58-Co cobalt-58
59
Fe, 59-Fe iron-59
5-ASA 5-Aminosalicyclic acid/mesalazine
5-HIAA 5-hydroxyindole acetic acid

371
5-HT 5-hydroxytryptamine (serotonin)
67
Ga, 67-Ga gallium-67
81m
Kr, 81m-Kr-krypton-81m
85
Kr, 85-Kr krypton-85
Å angstrom (10-10 meters)
A&E accident and emergency
A Echo asymmetric echo
A absorbance; activity; admittance
A accommodation; arterial blood
Å angstrom
A adenine; adenosine; ampere; anode; anterior atrial
branch; Mass number; alanine; alveolar
A anterior / Amphère / Mass number
a area
a.c. alternating current; ante cibum
A.N. Other another
A/D analogue-to-digital converter
A/N / AN antenatal
A/O alter and oriented
A/P, AP antepartum; antero posterior
A2 aortic valve
A2 aortic second sound
AA abdominal aorta; alcoholics anonymous; amino acid;
amyloid A; aortic arch; arch aortography; atlantoaxial;
autoantibodies
AAA abdominal aortic aneurysm; acute anxiety attack
AAC antibiotic-associated (pseudomembranous) colitis
AAL anterior axillary line
AAo ascending aorta
AAPC antibiotic-associated pseudomembranous colitis
AAS acute anxiety syndrome

372
AAV adeno-associated virus
AB abnormal beliefs; apex beat; asbestos body
Ab antibiotic; antibody
ABA allergic bronchopulmonary aspergillosis; antibacterial
activity
ABC acalculous biliary colic; airway, breathing, circulation;
aneurismal bone cyst; aspiration biopsy cytology
abd abduction
ABE acute bacterial endocarditis
ABG arterial blood gases
ABI ankle-brachial index
ABMT autologous bone marrow transplantation
Abn. abnormal
ABO. abortion; ABO system
Abor. abortion
ABP arterial blood pressure
ABPA allergic bronchopulmonary aspergillosis
ABPC antibody-producing cell
ABPI Association of British Pharmaceuticals in Industry
ABR absolute bed rest
ABT autologous blood transfusion
ABU asymptomatic bacteriuria
ABVD adriamycin, bleomycin, vinblastine and dacarbazine
AC abdominal circumference; abdominal compression; air
conduction; acute cholecystitis; alcoholic cirrhosis
A-C Acromioclavicular
AC, ac acromioclavicular; alternating current
ACA anterior cerebral artery; anterior communicating artery;
anticentromere antibody
ACC articular chrondrocalcinosis

373
ACD acid citrate dextrose; allergic contact dermatitis;
anaemia of chronic disorders
AC-DC bisexual (slang)
ACE angiotensin-converting enzyme
ACEI angiotensin-converting enzyme inhibitor
ACG angiocardiography; apexcardiogram
Ach, Ach acetylcholine
Ach’esterase I- acetylcholinesterase inhibitor
AchE acetylcholinesterase
Acid phos (ph)- acid phosphate
ACKD acquired cystic kidney disease
ACL anterior cruciate ligament
ACLS advanced cardiac life support
ACOM anterior communicating artery
ACOP approved code of practice
ACP acid phosphatase
ACR American College of Radiologist
ACR-NEMA American College of Radiologist-
ACT anticoagulant therapy
ACTH adrenocorticotrophic hormone
AD converter analogue-to-digital converter
AD adult body
AD alzheimer’s diseases; alzheimer’s dementia;
ADA alternated delay acquisition
ADC analogue-to-digital converter / apparent diffusion
coefficient
ADCC antibody-dependent cell-mediated cytotoxicity
ADCH adrenocorticotrophic hormone
Add. adduction
ADEM acute disseminated encephalomyelitis
AdenoCa adenocarcinoma

374
ADH anti-diuretic hormone
ADHD attention deficit hyperactivity disorder
ADL activities of daily living; annual dose limit
ADP adenosine diphosphate
ADPD autosomal dominant polycystic disease
ADR adrenaline (epinephrine); adverse drug reaction
ADRF adibetic demagnetization in the rotating frame
ADSL asymmetrical digital single line
ADT admission, discharge and transfer
AE asymmetric echo
AE air entry; asymmetric echo; atrial ectopic (beat)
AEF amyloid-enhancing factor
AF amniotic fluid; atrial fibrillation
AFB acid fast bacilli
AFLP acute fatty liver of pregnancy
AFM after fatty meal
AFO ankle-foot orthosis
AFP adiabatic fast passage
Afp, AFP alphafetoprotein; adiabatic fast passage
AFV amniotic fluid volume
AFX atypical fibroxanthoma
Ag / AG antigen; silver; atrial gallop
Ag-Ab antigen-antibody
AgBr silver bromide
AGC automatic gains control
AGN acute glomerulonephritis
AGT antiglobulin test
AGV aniline gentian violet
AH adult head
AHCD acquired hepatocellular degeneration
AHF antihaemophilic factor

375
AHG antihaemophilic globulin
AI amplitude image; aortic incompetence; aortic
insufficiency;
AI aluminium
AI2O3 aluminium oxide
AICA anterior inferior cerebral artery
AID artificial insemination by a donor
AIDP acute inflammatory demyelinating polyneuritis
AIDS acquired immunodeficiency syndrome
AIH artificial insemination by the husband
AIHA autoimmune haemolytic anaemia
AII second auditory area; mass number
AIIS anterior inferior iliac spine
AIN acute interstitial nephritides
AION anterior ischaemic optic neuropathy
AIP acute intermittent porphyria;
AIUM American Institute of Ultrasound in Medicine
AJ ankle jerk
AJR American Journal of Roentgenology
A-K, AK above knee
AKA above knee amputation; also known as
AL amyloid L
ALA 5-aminolaevulinate
ALARA as low as is reasonably achievable
ALD adrenoleukodystrophy; alcoholic liver disease
ALF acute liver failure
ALFMA abnormal low-frequency magnetic activity
ALI annual limit on intake
Alk. Phos. alkaline phosphatase
ALL acute lymphocytic leukaemia;
acute lymphoblastic leukaemia

376
Allo-BMT allogeneic bone marrow transplantation
ALP alkaline phosphatase; anterior lobe of pituitary
ALS amyotrophic lateral sclerosis
ALT alanine aminotransferase
ALVF acute left ventricular failure
AM acute marginal artery; Adnexal mass
Am.J.Roent American Journal of Roentgenology
AMA antimitochondrial antibody
AMC arthrogryphosis multiplex congenita
AMI acute / anterior myocardial infarction
AML acute myeloid leukaemia; angiomyolipoma
A-Mode amplitude mode
AMP adenosine monophosphate
AMS  amylase; amyotrophic lateral sclerosis
amu atomic mass unit
aMVL anterior mitral valve leaflet
AN acoustic neuroma; anorexia nervosa
ANA anti-nuclear antibody
ANC absolute neutrophil count
ANCA anti-neutrophil cytoplastic antibody
Angio. angiographic suite; angiography
Ank. Spond. ankylosing spondylitis
ANOVA analysis of variance
ANS anterior nasal spine; autonomic nervous system
Ant. pit. anterior pituitary
Ant. prand. ante prandium
Ant. tib. anterior tibial
ant., ANT anterior; anterior mitral leaflet
Anti-CEA anti-carcinoembryonic antigen antibody
anticoagulant; ascending colon
Anti-D anti-D immunoglobulin

377
Anti-GBM anti-glomerular basement membrane
Anti-RNP anti-ribonucleoprotein antibody
Ao aorta
AO/ AAo ascending aorta
AOB alcohol on breath
AOD adult onset diabetes;
arterial occlusive disease
AODM adult onset diabetes mellitus
AOE admission order entry
AOM acute otitis media
AOT Andersson Olsson table; ‘head over heels’
AoV aortic valve
AP acid phosphate; acute pancreatitis;
alpha pulse;
APB atrial premature beat(s)
APC antigen presenting cell;
atrial premature contraction/complex
APCD adult polycystic depolarisation/disease
APD aminohydroxypropylidenediphosphonate
APER abdomino-perineal excision of rectum
APG antegrade pyelogram
APH ante partum haemorrhage
API applications programming interface
APKD adult polycystic disease
APN acute pyelonephritis
Apo. A apoprotein A
APORF acute postoperative renal failure
APR abdomino-perineal resection;
acute phase reaction
APS antiphospholipid syndrome
APSAC anisoylated plasminogen-streptokinase

378
APSCVIR Asian Pacific Society of Cardiovascular and
Interventional Radiology
APSGN acute post-streptococcal glomerulonephritis
APTT activated partial thromboplastin time
APUD amine precursor uptake and decarboxylation
APVR anomalous pulmonary venous return
APW aortopulmonary window
AR allergic rhinitis; aortic regurgitation;
autosomal recessive
ARA anal-rectal agenesis; anorectal agenesis
ARC AIDS-related complex; archive controller
ARDMS American Registry of Diagnostic Medical Sonographers
ARDS adult/acute respiratory distress syndrome
ARF acute renal failure
ARM/AROM artificial rupture of membranes
ARP adibetic rapid passage
ARPD autosomal recessive polycystic disease
ARPKD autosomal recessive polycystic kidney disease
ARR automatic repeat request
ARSAC reg Admin of Radioactive Substances Advisory Committee
regulations
ARSAC Admin of Radioactive Substances Advisory Committee
AS ankylosing spondylitis; aortic stenosis;
arteriosclerosis/otic
ASAP as soon as possible
ASC asthma symptom checklist
Asc. ascending
ASCII american standard code for information interchange
ASCVD arteriosclerotic cardiovascular disease
ASD alzheimer’s senile dementia; atrial septal defect
ASDH acute sub-dural haemorrhage

379
ASE advance spin echo / asymmetric spin echo
ASFAIK as far as I know
ASH asymmetrical septal hypertrophy
ASHD arteriosclerotic heart disease
ASIC application specific integrated circuit
ASIS anterior superior iliac spine
ASIS aromatic solvent induced shift
ASO anti-streptolysin O
ASOT anti-streptolysin O titre
ASPVD arteriosclerotic peripheral vascular disease
ASS acute spinal stenosis
AST arterial spin trapping
AST aspartate aminotransferase/
aspartate transaminase
ASVS arterial stimulation and venous sampling
at no atomic number
ATB antibiotic
ATCL, ATLL adult T-cell lymphoma/leukaemia
ATEC automated tissue excision and collection
ATG antithymocyte globulin
ATLS advanced trauma life support
ATM asynchronous transfer mode
ATN acute tubular necrosis
ATP adenosine triphosphate
ATP adenosine triphosphate / attached proton test
atrial premature depolarization;
automated peritoneal dialysis
Atyp. atypical
AUA asymptomatic urinary abnormalities
Auto-BMT autologous bone marrow transplantation
autonomic neuropathy; avascular necrosis

380
 autosomal dominant
AUV anterior urethral valves
AV aortic valve; arterio-venous; arterio-ventricular
avascular necrosis
AVCx atrioventricular circumplex branch
AVD aortic valve disease
AVF arteriovenous fistula
aVF augmented volt foot
AVH acute viral hepatitis
AVHD acquired valvular heart disease
aVL augmented volt left
AVM arterio Venous Malformation
AVM arteriovenous malformation
AVN artrioventricular node;
artrioventricular node artery
AVNRT AV node re-entry tachycardia
AVP arginine vasopressin
AVR aortic valve replacement / repair
aVR augmented volt right
AVRT artrioventricular re-entry tachycardia
AVS aortic valve stenosis
AWOL absent without leave
ax axis
AXR abdominal x-ray
Az area under receiver-operator characteristic curve
AZT azidothymidine (Zidovudine)
B / Bo static magnetic field
B cell bursa-equivalent cell
B bucky factor; byte; minimal detectable blurring
B&D bondage and discipline
B, Bo magnetic field; magnetic flux density

381
B1 the induced field in MR imaging
B1 the induced field in MRI
B1 the radio frequency magnetic field
B1R Receive B1 magnetic field
B1T Transmit B1 magnetic field
BA backfolding artefact, blurring artefact
BA, Ba backfolding artefact; blurring artefact; barium
BaE barium enema
BAER brainstem auditory evoked responses
BAFT barium follow-through
BAI basilar artery insufficiency
BAL British anti-Lewisite (dimercaprol); bronchoalveolar
lavage
Balanced FFE- balanced fast field echo
BALF bronchoalveolar lavage fluid
Bas barium swallow
BASCHD bronchiectasis, asbestosis, scleroderma and other
connective tissue diseases, cryptogenic fibrosing
alveolitis, Hammon-Rich, drugs base excess
base of the natural logarithm
BASE basis imaging with selective inversion- prepared
Baud rate baudot rate
BB blood bank; breakthrough bleeding
BBA black blood angiography
BBB blood-brain barrier; bundle branch block
BBBB bilateral bundle branch block
BBS bulletin board system
BC biliary colic; blood-culture
BCC basal cell carcinoma
BCE basal cell epithelioma
BCG Bacille Calmette-Guérin

382
BCNU N,N-bis (2-chloroethyl)-N-Nitrosurea
BCR British comparative ratio
BCS Budd-Chiari syndrome
bd bis in die
BDE bile duct exploration
BDL bile duct ligation
BDR background diabetic retinopathy
BE below-elbow; bacterial endocarditis;
barium enema;
bEPI blipped echo planar imaging
BEST blood vessel enhancement by selective suppression
technique
BeV, Bev billion electron volts
BFFE balanced fast field echo
BFL bird fancier’s lung
BFS blood fasting sugar
BG blood glucose
BH Braxton-Hicks contractions
BHCG beta-human chorionic gonadotrophin
BHL bilateral hilar lymphadenopathy
BHR bronchial hyper-reactivity
BHT-S/M breath holding technique-Single/Multiple
BI bladder
BID brought in dead
BIH benign intracranial hypertension
BIN tt-butylisonitrile
BIP biparietal diameter
BIR British Institute of Radiology
BIRD bilinear rotation decoupling
Bit / bit binary digit
BJ biceps jerk

383
BJP Bence-Jones protein
BJR British Journal of Radiology
B-K, BK below-knee
BKA bellow knee amputation
BKG background
BKWP bellow-knee walking plaster
BLC blood culture
Bld Bnk/BB blood bank
Bleo. bleomycin
BLS basic life support
BM barium meal
BMA British Medical Association
BMD bone mineral density
BMI body mass index
BMJ British Medical Journal
B-MODE brightness mode
BMR basal metabolic rate
BMS bulk magnetic susceptibility
BM-stix blood monitoring sticks
BMT bone marrow transplantation/transplant
BMUS British Medical Ultrasound Society
BMZ basement membrane zone
BNF British National Formulary
BNO bladder neck obstruction; bowel not open
Bo field constant magnetic field of a MR scanner
BO body odour; bowels open;
bronchiotitis oliterans
Bo magnetic field
BOLD blood oxygen level dependent (contrast)
BOOP bronchiolitis obliterans with organizing pneumonia
BOSS bimodal slice select rf pulse

384
BP MR biphasic MR imaging
BP blood pressure; breech presentation
BPD biparietal diameter
BPH benign prostatic hyperplasia
bpm beats per minute
BPS biophysical profile score
bps bits per second
BPV benign positional vertigo; bioprosthetic valve
Bq becquerel
Br bromine
Br. Med. J. British Medical Journal (BMJ)
BRBPR bright red blood per rectum
BREASTS bronchopulmonary aspergillosis; radiotherapy; extrinsic
allergic alveolitis; Ankylosing spondylitis; sarcoidosis;
tuberculosis; silicosis
breath sounds
BRH benign recurrent haematuria; Bureau of Radiological
Health
Bronch. bronchoscopy
B-S valve Bjork-Shiley valve
BS Bachelor of Surgery; blood sugar;
bowel sounds
BSA body surface area
BSc Bachelor of Science
BSE breast self-examination
BSIR British Society of Interventional Radiology
BSO bilateral salpingo-oophorectomy
BT shunt blalock-Taussig shunt
BT bladder tumour; bleeding time
BTB breakthrough bleeding
BTD biliary tract disease

385
BTS brady-tachy syndrome
BTx bloodtransfusion
BU burns unit
BUN blood urea nitrogen
BV basilic vein; blood vessel
BVH biventricular hypertrophy
BW birth weight; bandwidth; bladder washout; body weight
Bwt birth weight; body weight
Bx biopsy
C contrast
C coulomb; count
C Arm C-shaft arm
c mm cubic millimetre
C MRI cine magnetic resonance imaging
C of A coarctation of aorta
C of E Church of England
c calorie; canine; speed of light
C calorie; carbon; Celsius; centigrade;
c/o complaining of
C/S, CS caesarian section
C-14 14-C Carbon 14; 14C
C2H5OH ethanol
CA 125 cancer antigen 125
Ca calcium
CA carrier wave
CA candida albicans; cardiac arrest; celiac axis; coronary
artery
Ca. cancer; carcinoma
Ca2+ calcium
Ca2+-blocker calcium channel blocker

386
CAAT Scan computer/computed assisted/aided axial tomography
scan
CAAS MRV cardiovascular angiogram analysis system mrv
CAAT computer/computed assisted/aided axial tomography
CAB coronary artery bypass
CABG coronary artery bypass graft
CAD computer aided/assisted diagnosis;
coronary artery disease
CAH congenital adrenal hyperplasia;
chronic active hepatitis
CAL chronic airflow limitation
CAM cystic adenomatoid malformation
CAMELSPIN cross relaxation appropriate for minimolecules
emulated by locked spins
cAMP cyclic adenosine monophosphate
CAMs cell adhesion molecules
CAPD continuous ambulatory peritoneal dialysis
CAR computer assisted radiology
CARE combind application of radiol…………
CARS computer assisted radiology surgery
Cas casualty
CAS computer assisted surgery
CAST coputeraided automated scan technique
CAT scan computer/computed axial/assisted tomography scan
CAT scanner computer/computed axial/assisted tomography scanner
CAT computer/computed axial/assisted tomography
CAVB complete atrioventricular block
CAVG coronary artery vein graft(s)
CAVHD continuous arteriovenous haemodialysis
CaWO4 calcium tungstate
CB child body

387
CB conus branch
CBC complete blood count
CBD Common bile duct
CBD common bile duct
CBF I cerebral blood flow; imaging
CBF cerebral blood flow
CBFI cerebral blood flow imaging
CBT computer based training
CBV cerebral blood volume
cc chief complain; cubic centimetre; copies circulated
CC craniocaudad
CC cholecalciferol, Vitamin D; craniocaudad; creatinine
clearance
CCA common carotid artery
CCD charged-coupled device
CCF congestive cardiac failure;
counter current flow
CCITT Comite Consultatif Internationale Telegraphique et
Telephonique
CCK cholecystokinin
CCL communications control language
CCP complement control protein
CCPD continuous cyclic peritoneal dialysis
CCT conventional CT
CCT/CECT contrast enhanced computed tohography
CCU coronary care unit; critical care unit
CD curve contrast detail curve
CD celiac disease; Colour Doppler; common (hepatic) duct
CD4 cluster of differentiation antigen
CDE Colour Doppler energy imaging
CDH congenital dislocation of the hip

388
CDI Colour Doppler imaging
CDJ crevico dorsal junction
CD-ROM compact disc-read-only memory
CE carotid endarterectomy; comb echo; contrast
enhancement
CE FLASH contrast-enhanced fast low angle shot
CEA carcinoembryonic antigen
CEC central echo complex
CECT contrast enhanced computed tomography
CE-FAST contrast-enhanced Fourier-acquired steady state
CE-FFE FAST-Contrast-enhanced*fast field echo / FAST
CE-FFE T1 contrast-enhanced fast field echo (T1-W)
CE-FFET2 contrast-enhanced Fast field echo T2-W
CEP congenital erythropoietic porphyria
cervical nerve root; cervical vertebra; contrast
CES cranial electrical stimulation
CF cystic fibrosis
CFA cryptogenic fibrosing alveolitis
CFDU colour flow Doppler ultrasound
CFI colour flow imaging
CFOV central field of view
CFT complement fixation test
CGA colour graphics adaptor
CGN chronic glomerulonephritis
CH Child head
CHA common hepatic artery
CHAD cold haemagglutinin disease
CHB complete heart block
CHD Common hepatic duct
CHD coronary heart disease;
congenital heart disease

389
CHE chemoembolization, chemo, chemotherapy
CHESS chemical shift selective (imaging sequence)
CHF congestive heart failure; congenital hepatic fibrosis
CHISS chemical shift insensitive slice selective RF pulse
CI cardiac index; correlation Imaging;
confidence interval
CI chloride
CI correlation Imaging
ci curie
CIC clean intermittent catheterisation
CIDNP chemically induced dynamic nuclear depolarization
CIDP chronic inflammatory demyelinating polyneuropathy
CIE counter-current immune electrophoresis
CIN cervical intra-epithelial neoplasm
CIRSE Cardiovascular and Interventional Radiological …..
CIS carcinoma in situ
CJD Creutzfeldt-Jacob disease
CK Convolution Kernels
CK creatinine (phospho) kinase
CKMB creatine kinase myocardial bound
Clin. Rad. Clinical Radiology
CLIP corticotrophin-like intermediate lobe peptide
CLL chronic lymphocytic / lymphatic leukaemia
cm centimetre
CM MRA contrast medium MR angiography
CM rate Contrast medium injection rate
CM contrast medium
CMA cardiac motion artefact
CMC computer mediated communication
CMCJ carpometacarpal joint
CMD congenital muscular dystrophy

390
CME continuing medical education
CMG cystometrogram
CML chronic myeloid (myelogenous) leukaemia
CMLine cantho meatal line
CMML chronic myelomonocytic leukaemia
CMT chemotherapy
CMV cytomegalovirus
C-N Ratio contrast to noise ratio
CN cranial nerve
CNI, CN1; 1 first cranial nerve (olfactory)
CNII, CN2; II second cranial nerve (optic)
CNIII, CN3; III- third cranial nerve (oculomotor)
CNIV, CN4; IV fourth cranial nerve (trochlear)
CNIX, CN9; IX ninth cranial nerve (glossopharyngeal)
Cnjugata diagonalis; controlled drugs; Crohn’s disease
CNR contrast-to-noise ratio
CNS cranial nervous system
CNV, CN5; V fifth cranial nerve (trigeminal)
CNVI, CN6; VI sixth cranial nerve (abducencs)
CNVII, CN7; VII seventh cranial nerve (facial)
CNVIII, CN8; VIII-eighth cranial nerve (vestibulocochlear)
CNX, CN10; X tenth cranial nerve (vagus)
CNXI, CN11; eleventh cranial nerve (accessory)
CO carbon monoxide
2
CO carbon dioxide
COAD chronic obstructive airways disease
COAL chronic obstructive air-flow limitation
COC combined oral contraceptive
COCONOESY Combined COSY / NOESY
COCP combined oral contraceptive pill
COD cause of death

391
COLD chronic obstructive lung disease
Colles Colles’ fracture
Collimation Slice thickness determination
COLOC Correlated spectroscopy for long range coupling
COM chronic otitis media
Com. port communications port
com.(s) communication(s)
COP cryptogenic organizing pneumonitis
COPD chronic obstructive pulmonary disease
cos. cosine
COSY Correlated spectroscopy
COSY-45 COSY with 45 degree mixing pulse
COSYDEC COSY with F1 decoupling
COSYLR COSY for long range couplings
CP MG seq Carr-Purcell Meiboom-Gill sequence
CP Sequence Carr-Purcell sequence
CP sequence Carr-Purcell sequence
CP cephalic presentation; cerebral palsy; chronic
pancreatitis
CP cross polarization
CP.Angle cotro-phrenic angle
CPA cerebellopontine angle
CPAP continuous positive airways pressure
CPD cephalo-pelvic disproportion
CPD composite pulse decoupling
CPDA citrate/phosphate/dextrose-adenine
CPH chronic persistent hepatitis
CPK creatine phosphokinase
CPMG seq Carr-Purcell-Meiboom-Gill sequence
CPP cerebral perfusion pressure
CPPD calcium pyrophosphate dihydrate

392
CPR cardiopulmonary resuscitation
cps counts per second; cycles per second
CPS characters per second
CPU central processing unit
CQI continuous quality improvement
CR clinical remission (complete remission);
CR Computed radiography
Cr,Creat. creatinine
CRAMPS Combined rotational and multiple pulse spectroscopy
CRAO central retinal artery occlusion
CRAW computed radiography acquisition workstation
CREST Calcinosis, Raynaud’s phenomenon, Oesophageal
disorder, Sclerodactyly, Telangiectasia
CRF chronic renal failure; corticotrophin releasing factor
CRH corticotrophin releasing hormone
CRITOL capitellum, radial head, inner epicondyle, trochlear,
olecranon, lateral epicondyle,
CRL crown rump length
Crohn’s colitis;
CRP C-reactive protein
CRR Curve planer reformation
CRT cadaveric renal transplant / cathode ray tube
CRVO central retinal vein occlusion
Cryoppt cryoprecipitate
CS FSE contiguous-slice fast-acquisition spin echo
CS FSE contiguous-slice fast-acquisition spin echo
CSA chemical shift artifact / anosotrophy
CSDMS Canadian Society of Diagnostic Medical Sonographers
CSE conventional spin echo
CSF cerebrospinal fluid
CSFSE Contiguous-slice fast-acquisition spin echo

393
CSG cholecystogram
CSI chemical shift imaging
CsI caesium iodide
CSI chemical shift imaging
CSMA / CD carrier sense multiple access/collision detection
CSMAP celiac-superior mesenteric arterial portography
CSMEPM contiguous slice MEMP
CSOM chronic suppurative otitis media
CSSD central sterile department
CSSU central sterile supply unit
CST contractions stress test
CT Myelo CT myelography
CT scan computed/computerized tomography scan
CT scanner computed / computerized tomography scanner
CT calcitonin; cardiothoracic ratio; computed tomography
CTA CT angiography
CTAP computed tomography (during) arterial portography
CTBG CT guided biopsy
CTC computed / computerized tomography colonography
CTG cardiotocogram (-graph)
CTGAD CT guided aspiration /drainage
CTG-NB CT guided-nerve block
CTK-CMP CT kidney-corticomedullary phase
CTK-EXP CT kidney excretory phase
CTK-NGP CT kidney nephrography phase
CTK-PCP CT kidney pre-contrast phase
CTLM computed tomography laser mammography
CTN Sur-plan-CT navigation plan before surgeon
CTR cardiothoracic ratio; carpal tunnel release
CTRT-plan CT guided radio theraphy planning
CTS carpal tunnel syndrome

394
CTX clinical trial exemption
Cu copper
CV MRI cardiovascular magnetic resonance imaging
CV cephalic vein; conjugata vera
CVA cerebrovascular accident; costrovertebral angle
CVB chorionic villous biopsy
CVIR Cardio Vascular and Interventional Radiology
CVJ cranio vertebral junction
CVO conjugata vera obstetrica
CVP central venous pressure
CVS cardiovascular system; chorionic villous sampling
CVVHD continuous veno-venous haemodialysis
CW continuous wave / contrast weighting
CW continuous wave; contrast weighting
CWP coal worker’s pneumoconiosis
Cx cervical; cervix; complication
CXR chest x-ray
CYCLPOT-VOSING Volume selective single scan heteronuclear
D saline dextrose saline
d day (s); diameter; distance; object film distance
D absorbed dose; delta; diagonal branch; diastole;
distance; donor; dorsal vertebra; duct, ductus; focus-
object distance; optical density;
D&A drugs and allergies
D&C dilatation and curettage
D&V diarrhoea and vomiting
D.phil. Doctor of Philosophy
D/S dextrose saline
D+d focus film distance
D=E dates equal to examination
DA converter digital to analogue converter

395
DA developmental age; dopamine; drug addict; ductus
arteriosus
DAC derived air concentration
DAF decay-accelerating factor
DAI diffuse axonal injury
DANTE delay alternating with nutation for tailored excitation
DAP dose area product (meter)
DAT digital audiotape; dementia of Alzheimer’s type
dB decibel
dB/dt rate of change magnetic flux density with time
dB/dt rate of change magnetic flux density with time
DBM doubly balanced mixer
DBMS database management system
DBP diastolic blood pressure
DBS deep brain stimulation; double blind study
DC TSE double contrast turbo spin echo
DC descending colon; direct current; dorsal column
DCBE double contrast barium enema
DCC digital compact cassette
DCCV direct current cardioversion
DCE data communication equipment
DCG dacryocystography
DCIS ductal carcinoma in situ
DCM digital cardiomyopathy
DCS MRI dynamic susceptibility contrast MRI
DCT discrete cosine transform; distal convoluted tubule
DD developmental delay; differential diagnosis
DDAVP 1-Demino-8-Darginine-vasopressin
DDC diethyldithiocarbamate
DDP default display protocol
DDU Duplex Doppler ultrasound

396
Ddx differential diagnosis
DDX doctor drug exemption
DE FAISE dual echo fast-acquisition interleaved spin echo
DE FGR driven equilibrium fast gradient-recalled acquisition in
the steady state
DE prep driven equilibrium magnetization preparation
DE dose equivalent
DEAFF detection of early antigen fluorescent foci
DEFT driven equilibrium Fourier transform
DEPT distortion less enhancement by polarization
transfer
DEPTH (SE sequence for spectral localization)
desc. descending
DESS double-echo steady state (combination of FISP and
PSIF)
Dex. dextrose
DEXA dual energy x-ray absorption / absorptometry
DF-118 dihydrocodeine
DFM decreased fetal movements
DFP diisofluorophosphate
DFR digital fluororadiography
DFSE double/double fast spin echo / dual (echo) fast spin
echo
DFT discrete fourier transform
DGH district general hospital
DH delayed hypersensitivity; dermatitis herpetiformis; drug
history
DHEA dehydroepiandrosterone
DHF dengue haemorrhagic fever
DHR delayed hypersensitivity reaction
DHS dynamic hip screw

397
DHSS Department of Health and Social Security
DHT di-hydrotestosterone
DI diabetes insipidus; diffusion imaging, depressive ilness
DIB difficulty in breathing
DIC direct isotope cystogram;
DICOM digital image communications in medicine
DIL drug-induced lupus erythematosus
DILD diffuse infiltrative lung disease
DIMSE DICOM message service element
DIP desquamative interstitial pneumonia
DIPJ distal interphalangeal joint
DIRT1 double inversion recovery T1 measurement
discoid lupus erythematosus
DISE driven inversion spin echo
DISH diffuse idiopathic skeletal hyperostosis
disseminated intravascular coagulation
DIT di-iodotyrosine
diverticular disease; double density
DJD degenerative join disease
DKA diabetic ketoacidosis
DKI dextrose potassium insulin
Dl decilitre
DL diffusing capacity of the lung
DLE disseminated lupus erythematosus/
DLJ Dorso lumber spine junction
DLR digital luminescence radiography
DM dermatomyositis; diabetes mellitus; diastolic murmur
DM dorsal mylography
DMA direct memory access
DMAD dimethylaminodiphosphonate

398
DMAP diffusion apparent diffusion coefficient mapping
DMD Duchenne muscular dystrophy
DMRD Diploma in Medical Radio-Diagnosis
DMRI deuterium magnetic resonance imaging
DMRS deuterium/diffusion magnetic resonance spectroscopy
DMRT Diploma in Medical Radiotherapy
DMS dermatomyositis
DMSA 2,3-dimercaptosuccinic acid
DMSSFP double mode steady state free precession
DMV diurnal mood variation
DN district nurse
Dn/Dn-1, 2,3,4 duodenum
DNA deoxyribonucleic acid; did not attend
DNS deviated nasal septum
DOA dead on arrival
DOB date of birth
DOC date of conception; deoxycorticosterone
DOCA deoxycorticosterone acetate
doctor of Medicine; dorsal mylography
DOE dyspnoea on exertion
DOF double quantum filters
DOG deoxyglucose
DOH Department of Health
DOLV double-outlet left ventricle
DOPA dihydroxyphenylethylamine
DOPAMINE dihydroxyphenylethylamine
DOPING double pulse interlaced echo imaging
DORSADouble resonance sandwich
DORV double outlet right ventricle
Down’s syndrome; (mongolism)
DP diastolic pressure; dorsalis pedis (pulse)

399
DPS delayed primary suture
DPSF diffusion/perfusion snapshot flash
DR delivery room; digital radiography
DRC diagnostic reporting console
DRESS depth-resolved surface spectroscopy
DS double sided; disseminated sclerosis;
DSA digital subtraction angiography
DSC MRI dynamic susceptibility contrast MR imaging
DSH deliberate self harm
DSM (III) R Diagnostic and Statistical Manual (Third)
DST dexamethasone suppression test
DT MRI diffusion tensor magnetic resonance imaging
DTE data terminal equipment
DTI Doppler tissue imaging
DTIA Doppler tissue imaging acceleration
DTIE Doppler tissue imaging, energy
DTIV Doppler tissue imaging, velocity
DTP desktop publishing; diphtheria, tetanus, pertussis
DTPA diethylene triamine penta-acetic acid
DTPM dixon two-point method
DTs delirium tremens
DU duodenal ulcer
DV Doe volentes; ductus venosus
DVT deep vein thrombosis, deep venous thrombosis
DW MRI diffusion weighted MR imaging
DW SE-EPI diffusion-weighted spin echo-EPI
DWI diffusion weighted imaging
DWT discrete wave transform
Dx diagnosis; disease
DXA dual energy x-ray absorption/absorptometry
DXR deep x-radiation

400
DXT deep x-ray therapy
dynamic integral proctography
Dysp. Shortness of breath
E short Elscient brand name for a refocused GE-PS
E SHORT steady-state gradient echo with spin-echo sampling
E energy, the capacity of a system to do work.
E energy; exposure;
e- / e electron; charge of an electron; electron Quantum
E.coli Escherichia coli
e.g. exempli gratia (for example)
E/A emergency admission
+
e positron
EAA extrinsic allergic alveolitis
EAC External auditory canal
EAEC Entero-adherent E. coli
EAm External auditory meatus
EAM external auditory meatus
EAR European Association of Radiology
EBCT electron-beam computed tomography (cine CT)
EBL estimated blood loss
eBNF Electronic British National Formulary
EBT Electron beam tomography
EBT electron beam tomography
EBV Epstein-Barr virus
EC, E/C enteric-coated
ECA External carotid artery
ECA external carotid artery
ECD endocardial cushion defect; ethylcysteinate
ECF extracelular fluid
ECG electrocardiogram
Echo. Echocardiography

401
ECM external cardiac massage
ECMO extracorporeal membrance oxygenation
ECOSY Exclusive correlation spectroscopy
ECR European Congress of Radiology
ECS endocervical swab
ECT electroconvulsive therapy; emission-computed
tomography
EDD estimated date of delivery
EDE effective dose equivalent
EDH Extra dural haemorrhage
EDM early diastolic murmur
EDP electronic data processing
EDRF endothelial derived relaxation factor
EDS Ehlers-Danlos syndrome
EDT expected date of confinement
EDTA ethylenediaminetetraacetic acid
EDV end-diastolic volume
EEG electroencephalogram
EEMR coil endo-esophageal magnetic resonance imaging coil
EEMRI endo-esophageal MR imaging
EF ejection fraction; external fixation
EFG electric field gradient
EFW estimated fetal weight
EG eosinophilic granuloma
EGA extended graphics adaptor
EHBO Extra hepatic biliary obstruction
EHEC enterohaemorrhagic Escherichia coli
EHL effective half-life
EIEC Enteroinvasive Escherichia coli
EJV external jugular vein
EKG elektrokardiogram

402
ELD energy level diagram
ELF fields extremely low frequency fields
ELF fields extremely low frequency fields
ELISA enzyme linked immunosorbent assay
Elscient brand name for an ultrafast GE-PS
EM pathway Embden-Meyerhof pathway
EM radiation electromagnetic radiation
EM spectrum electromagnetic spectrum
EM wave electro-magnetic wave
EM electromagnetic; erythma multiforme
EMD electro-mechanical dissociation
EMG electromyography
EMG electromyography
EMI/RFI electromagnetic and radio frequency interference
EMRF European magnetic resonance forum
E-MRI electro-magnetic resonance imaging
EMRI esophageal magnetic resonance angiography
E-MRS resonance spectroscopy
EMU early morning urine; energy mode ultrasound
EMW early morning waking
ENA extractable nuclear antibodies
enc. enclose
ENT ear, nose and throat
EP MRA echo planner MR angiography
EP evoked potential
EPA Environmental Protection Agency; erect postero
anterior
EPC echo phase correction
EPEC enteropathogenic escherichia coli

403
EPI echo-planar imaging
EPI STAR EPI with signal targeting & alternating radio frequency
EPO (Epo) erythropoietin
EPR electron paramagnetic resonance
EPS echo-planar spectroscopy
EPSI echo-planar spectroscopic imaging
ER European Radiology
ERC endoscopic retrograde cholangiography
ERCP endoscopic retrograde
ERP endoscopic retrograde pancreatography
ERPC evacuation of retained products of conception
ERPF effective renal plasma flow
ERT examination room terminal
ERV expiratory reserve volume
ES echo shift
ESF edge spread function
E-SHORT Steady state gradient echo with spin-echo sampling
ESM ejection systolic murmur
ESN educationally subnormal
ESR electron spin resonance; erythrocyte sedimentation rate
ESRF end-stage renal failure
ESV end-systolic volume
ESWL extracorporal shock wave lithotripsy
et al. et alia
ET examination terminal; ecdotracheal; ecdotracheal tube
etc et cetera (and the rest, and so on)
ETEC enterotoxigenic Escherichia coli
ETL echo train length
EtOH ethanol
ETT endotracheal tube; exercise tolerance test
EUA examination under anaesthesia

404
eV electron volt
EVS endovaginal sonography
Ext. Jug. V. external jugular vein
Ext. external
EZM HD high density (Barium)
FDG
f frequency; foramen
F short Elscient brand name for a refocused GE-PS
F SHORT steady-state gradient echo based on free induction
decay
F frequency; Fr.; n; Faraday; focal spot; focal spot size
F/F Feet first
F/S frozen section
F/W discri fat and water discrimination
F/W discrimi fat and water discrimination
F2F face to face
FA flip angle / flow artifact / ferromagnetic artifact
FACE fid acquired echoes
FADE FASE acquisition double echo Picker name for GE-PS
FAIR flow sensitive alternating inversion recoveries
FAME fast acquisition multi-echo
FAP familial adenomatous polyposis
FAQ frequently asked questions
FAS fetal alcohol syndrome
FASE fast advanced spin echo / fast spin echo
FAST Fourier acquired steady state technique
fast gradient-recalled acquisition in the steady state
Fat. Sat. fat saturation
FATE Fast turbo echo (=FADE)
FATS fat suppressed acquisition with TE and TR times
shortened

405
FAX facsimile
FB MRI functional brain magnetic resonance imaging
FB MRS functional brain magnetic resonance spectroscopy
FB foreign body
FBC full blood count
FBG fasting blood glucose
FBM fetal breathing movements
FBSE flip back spin echo
FC flow compensation
FC MRI field cycle magnetic resonance imaging
FD film digitizer; floppy disk; forceps delivery
FDA Food and Drugs Administration
FDAW film digitizer acquisition workstation
FDD Floppy disk drive
FDDI fibre distributed data interface
FDP(s) fibrin degradation product (s)
FE flow effect / field echo / fractional echo / frequency
encode
FE functional enquiry
Fe2+ iron
FEDIF Field echo with TE set for water and fat signals in
opposition
FEER field echo with/with even echo rephasing
FEER field even echo rephasing / field even-echo by reversal
Fem. femoral
FESUM field echo with TE set for water and fat signals in phase
FEV1 forced expiratory volume in 1 second
FF filtration fraction; fine focus
FFA free fatty acids
FFD focus film distance
FFE fast field echo

406
FFF fast Fourier flow
FFLAIR fast fluid attenuated inversion recovery
FFP fast Fourier projection
FFP fresh frozen plasma
FFR Fellow of Faculty of Radiologists
FFT fast Fourier transform
FGR fast gradient-recalled acquisition in the steady state.
FH femoral hernia; family history
FHC familial hypercholesterolaemia
FHH fetal heart heard
FHNH fetal heart not heard
FHR fetal heart rate
FHS fetal heart sound
FHx family history
FI fast imaging / functional imaging
FIA fistula in ano.
Fib. fibula
FID free induction decay / free induction decay signal
FIDIF field echo with an echo time set so that water and fat
spin are opposed when the echo occurs. OPPOSED-
PHASE IMAGE
FIGO class International Federation of Gynaecology and Obstetrics
FIO2 partial pressure of oxygen in inspired air
FIR fast inversion recovery
FIS free induction signal
FISP fast imaging with steady state procession
FJP fell, jumped or pushed
FL femur length
FLA fronto laevo anterior

407
FLAG flow adjusted gradients
FLAIR fluid attenuated inversion recovery
FLARE fast low-angle recalled echo
FLASH Fast low angle (single) shot
FLAX-ISIS fully relaxed ISIS
FLK funny looking kid
FLOPSY flip-flop spectrocopy
FLP fronto laevo posterior
FLT fronto laevo transversa
Flu influenza
FM fetal movement
FMF Familial Mediterranean fever
FMP first menstrual period
FMPGR fast multiplannar gradient echo
fMRI functional (Brain) magnetic resonance imaging
FN false negative
fn. Function
FNA Fine needle aspiration
FNAB Fine needle aspiration biopsy
FNAC Fine needle aspiration cytology
FNH focal nodular hyperplasia
fo Larmor frequency
fo Larmor frequency
FO fronto-occipital
FOB faecal occult blood; fibreoptic bronchoscopy
FOCSY foldover corresponding spectroscopy
FOD focus to object distance
FOI fibreoptic interface
FONAR focused nuclear resonance
FOOSH fell on outstretched
For. foramen

408
FOV field of view
FP false positive; family planning; family practitioner
FPDM fibrocalculous pancreatic diabetes mellitus
FR frequency encode
Fr. French; frequency
FRC functional residual capacity
FRCP Fellow of the Royal College of Physicians
FRCR Fellow of the Royal College of Radiologists
FRCS Fellow of the Royal College of Surgeons
FRE flow related enhancement / field reversal echo
FRFSE fast recovery fast SE; FSE
FRJM full range of joint movement
FROM full range of movement
FRS Fellow of the Royal Society
FRV functional residual volume
FS fast scans
FSD focus to skin distance
FSE fast spin echo (turbo spin echo)
FSGS focal sclerosing glomerulosclerosis
FSH follicle stimulating hormone
F-SHORT short repetition technique based on free induction
decay steady-state gradient echo based on free
induction decay
FSIP fast imaging with steady state procession; SSFP
FSPGR fast spoiled gradient-recalled / fast spoiled GRASS
FSTIR fast short tau inversion recovery
FT Fourier transform / full term / Fallot’s tetralogy;
fT4 free serum thyroxine
FTA fluorescent treponema antibodies absorbed
FTND full term normal delivery
FTP file transfer protocol

409
FTT failure to thrive
FTVD full term vaginal delivery
FU, f/u follow up
FUCOUP fully coupled spectroscopy
FVC forced vital capacity
FWB fully weight bearing
FWHM full width at half maximum
FWHM full width half maximum
FWTM full width tenth maximum
FYI for your information
G suit gravity suit
G vs HD graft versus host disease
G gated / gauss / non-SI unit of magnetic flux density
G gauss; gravida; gated
g gram
G&A Grainger and Allison
G&S group and save
G phase encoding gradient
G6P glucose-6-phosphate
G6PD glucose-6-phosphate dehydrogenase
GA general anaesthetic, gestational age
GABA gamma-aminobutyric acid
GALT galactose-1-phosphate uridyl transferase
GALT gastrointestinal/gut associated lymphoid tissue
gamma-glutamyltranspeptidase
GARP globally optimized alternating phase rectangular pulse
GATORCIST respiratory gated imaging
GB Gb gall bladder / Geiga bytes
GBM glomerular basement membrane
GBP bipolar magnetic field gradient
Gbq gigabequerel

410
GBS group B Streptococcus; Guillain-Barré syndrome
GC gonococcus
GCS Glasgow coma scale
GCSF granulocyte colony stimulating factor
GCT Giant cell tumour
Gd gadolinium
Gd gadolinium
GDA gastrodudenal artery
GDA gastrodudenal artery
Gd-CDTA gadolinium cyclohexanediaminetetraacetic acid
Gd-DOTA gadolinium tetraazacyclododecanetetraacetic acid
Gd-DTPA gadolinium diethylenetriamine-pentacetic acid
GDU gastroduodenal ulcer
GE gastroenteritis; General Electric; gradient echo
GE gradient echo
GE imaging gradient echo imaging
GEPS gradient echo pulse sequence
GES gradient echo spectroscopy
GET gastric emptying time
Gf frequency encoding gradient
GF Glandular fever; gradient field
GFE gradient field echo
GFEC gradient field echo with contrast / compensation
GFR Glomerular filtration rate
GGT gamma-glutamyltransferase /
GH growth hormone
GHRH growth hormone releasing hormone
GHz gigahertz
GHz gigahertz
GI radiology gastrointestinal radiology
Gi field gradient in the i direction / gastrointestinal

411
GI iastrointestinal
GICM gastrointestinal contrast medium
GIF graphic interchange format
GIFT Gamete intrafollicular transfer
GIGGEST direct imaging of local gradients by group echo
selection tomography
GIH gastrointestinal haemorrhage
GINSEST generalised interferography using SE and stimulated
echo
GIS gastrointestinal series
GIT gastrointestinal tract; gated imaging technique
GKI glucose potassium insulin
Glu. Glucose
GM counter Geiger Muller counter
GM plateau Geiger Muller plateau
GM grey matter
Gmax Maximum value of phase encoding gradient.
GMC General Medical Council
GM-CSF granulocyte macrophage-colony-stimulating factor
GMF gradient magnetic field
GMN gradient moment nulling
GMR gradient motion rephrasing; gradient moment rephasing
GMR gradient motion / moment rephrasing
GMRH Germinal matrix related haemorrhage
GMRI gated magnetic resonance imaging
GN glomerulonephritis
GNN global network navigator
Gn-RH gonadotrophin releasing hormone
GOJ gastro-oesophageal junction
GOK God only knows
GOR gastro-oesophageal reflux

412
GORD gastro-oesophageal reflux disease
GOS gastro-oesophageal sphincter
GOT glutamatic oxaloacetic transaminase
GP general practitioner; gradient pulse
GPI general paralysis of the insane
GPS Goodpasture’s syndrome
GPT glutamate pyruvate transaminase
GR gradient rephasing
GRAE generally regarded as effective
GRAS generally regarded as safe
GRASE PS gradient recalled acquisition in the steady state
GRASE PS gradient refocused acquisition in the steady state
GRASE gradient and spin echo pulse sequence
GRASP gradient accelerated spectroscopy
GRASS gradient recalled echo in the steady state
GRASS gradients (recalled) acquisition in the steady state
GRASS gradients refocused acquisition in steady state
GRE gradient recalled/refocused echo
GRE Seq gradient echo pulse sequence
GRE gradient echo / gradient echo imaging
GREAT ghost reduction by equalized acquisition triplets
GREC gradient echo / gradient field echo with contrast
GRECHO short for gradient echo / gradient recalled echo
GRECO gradient-recalled echo
GRE-EPI gradient echo - echo planar imaging
GRF growth hormone releasing factor
GROPE gene compen for resonance offset & pulse length errors
GS gallstone / gradient spectroscopy
Gs slice selection gradient
GSD glycogen storage disease
GSLIM generalized spectral localization imaging method

413
GSS Gertsmann-Straussler-Scheinker disease
GSV gestational sac volume
GTN glyceryl trinitrate
GTT glucose tolerance test
GU gastric ulcer; genitourinary
GUI graphical user interface
GUT genito urinary tract
GVHD graft versus host disease
Gx,Gy, Gz symbols for magnetic field gradients
Gy gray
Gyn. gynaecology
H hydrogen; deuterium; dose equivalent
H of F height of fundus
h height of lead strips in a grid; hour; Planck’s constant
h Planck's constant
H&L heart and lung
H&P history and physical examination
H&T hospitalisation and treatment
H,C-COSY 1H, 13C chemical shift correlation spectroscopy
H,X-COSY 1H,X-nucleus chemical shift correlation
H. influenzae haemophilus influenzae
H.pylori helicobacter pylori
H/F head first
H1 obsolete symbol for the induced field in MRI
H1/2 half-value layer
H3 MRI hyperpolarized helium-3 magnetic resonance imaging
HA phase hepatic artery phase
HA haemolytic anaemia
HAM human albumin microspheres
HAPVC hemianomalous pulmonary venous connection
HAPVD hemianomalous pulmonary venous drainage

414
HAPVR hemianomalous pulmonary venous return
HAS human albumin solution
HAS human serum albumin
HASTE half-Fourier/acquisition single shot turbo-spin echo
HAV hepatitis A virus
Hb F fetal haemoglobin
Hb haemoglobin
HBD hydroxybutyrate dehydrogenase
HbsAg hepatitis B surface antigen
HBV hepatitis B virus
HBW hard bone window
HC head circumference
HCC hepatocellular carcinoma
HCG human chorionic gonadotrophin
HCP hereditary coproporphyria
Hct haematoerit
HCV hepatitis C virus
HD hard disk; haemodialysis;
HDD hard disk drive
HDL high-density lipoprotein
HDN haemolytic disease of the newborn
HDP hydrogen diphosphonate
HDRBC heat damaged red blood cells
HDU high dependency unit
HDV hepatitis D virus
HE stain haemotoxylin-eosin stain
HE hypertensive encephalopathy
He helium Element with atomic mass number 2
Helical CT helical computed tomography
Hep A hepatitis A virus
Hep B hepatitis B

415
Hep C hepatitis C
Hep D hepatitis D
HepBsAg hepatitis B surface antigen
HETCOR heteronuclear correlation spectroscopy
Hev hepatitis virus
HF MRI high field magnetic resonance imaging
HF haemofiltration; heart failure
HFD high fibre diet
HFI half Fourier imaging
Hge haemorrhage
HGH human growth hormone
HH hiatus hernia
HHD home haemodialysis
HHM humoral hypercalcaemia of malignancy
HHT hereditary haemorrhagic telangiectasia
HI head injury
HIB haemophilus influenzae type B
HICH hypertensive intracerebral haemorrhage
HIDA hepatic iminodiaceti acid
HIE hypoxic ischaemic encephalopathy
HIG human immunoglobulin
HIPDM N-trimethyl-n-(2-hydroxyl-3methyl-5-iodobenzyl)-
1,3propendiamine
HIS hadamard spectroscopic imaging
HIS hospital information system
Histo (I). Histology
HIV human immunodeficiency virus
HL Hodgkin’s lymphoma
HLA human leucocyte antigen
HLDLC high-level data link control
HLHS hypoplastic left heart syndrome

416
HLTx heart-lung transplant
HLV hypoplastic left ventricle
HMBC heteronuclear multiple-bond correlation
HMD hyaline membrane disease
HMDP hydroxymethylenediphosphonate
hMG human menopausal gonadotrophin
HMIBI hexakis-2-methoxyisobutylisonitrile
HMMA 4-hydroxy-3-methoxymandelic acid
HMPAO hexamethylpropyleneamine oxime
HMQC heteronuclear multiple quantum coherence
HMSN hereditary motor-sensory neuropathy
HNKC hyperosmolar nonketotic coma
HNR head and neck region
Ho magnetic field
HO, H/O, h/o history of / house officer
HOA hypertrophic osteoarthropathy
HOCM high osmolar contrast media / hypertrophic
cardiomyopathy
HOESY heteronuclear overhauster effect spectroscopy
HOHAHA homonuclear Hartmann-hahn spectroscopy
HONC hyperosmolar nonketotic coma
HONK hyperosmolar non-ketosis
HP helicobacter pylori; hepatic porphyria; house physician
HPA hypertrophie pulmonary arthropathy
HPB hepatobiliary
HPC history of presenting complaint; history of present
condition
HPD home peritoneal dialysis
HPG …………………………………………………………
HPG MRI hyperpolarized helium-3 MRI
HPI history of presenting illness

417
HPL human placental lactogen
HPOA hypertrophic pulmonary osteoarthropathy
HPS hybrid pulse sequence
HPT hyperparathyroidism
HPV hepatic portal vein; human papilloma virus
HQ headquarters
HR MRS high-resolution magnetic resonance spectroscopy
HRCT High resolution computed tomography
HRP high-risk pregnancy
HRS hepatorenal syndrome
HRT hormone replacement therapy
HS heart sounds; house surgeon
HSCD Hand-Schuller-Christian disease
HSE herpes simplex encephalitis
HSG hysterosalpingogram
HSN hereditary sensory neuropathy
HSP Henoch-Schönlein purpura
HSSD hospital sterile supply department
HSSU hospital sterile supply unit
HSTAT health services technology assessment test
HSV herpes simplex virus; highly selective vagotomy
HT dose equivalent to individual tissue
Ht height
HT hypertension
HTLM hypertext markup language
HTLV 1 human T-cell leukaemia / lymphotropic virus
HTTP hypertext transfer protocol
HU heat unit; Hounsfield unit
HUS haemolytic uraemic syndrome
HVL half value layer
HVR Hepatic venous redicle

418
HVS high vaginal swab
HVT half value thickness, hepatic vein thrombosis
HWCD Hans-Weber-Christian disease
HWP hepatic wedge pressure
HWY hundred women years
Hx history / Hypersensitivity pneumonitis
Hz hertz, SI unit of frequency
HZ herpes zoster
Hz hertz SI unit of frequency
HZV herpes zoster virus
I inferior
i effective current; incosor
I electric current; first cranial nerve (olfactory);
I&D incision and drainage
I&O intake and output
i.e. id est ‘That is’.
i.u. International Units
I/O input / output
i/p, inpatient
IA intra-arterial; intra-articular; irradiation area
IAA interrupted aortic arch
IABP intra-aortic balloon pump
IAC internal auditory canal
IACD implantable automatic cardioverter defibrillator
IADSA intra-arterial digital subtraction angiography
IAEA International Atomic Energy Agency
IAM internal auditory meatus
IAP intermittent acute porphyria
IAS interartrial septum
IBC iron binding capacity
IBD inflammatory bowel disease

419
IBI intermittent bladder irrigation
Ibid. ibidem
IBM International Business Machines
IBS irritable bowel syndrome
IBW ideal body weight
IC inspiratory capacity; intracardiac; intracerebral
ICA internal carotid artery; islet cell antibodies
ICBG idiopathic calcification of the basal ganglia
ICD implantable cardioverter defibrillator
ICDS International Cardiac Doppler Society
ICF intracellular fluid
ICH intracerebral haemorrhage
ICP infantile cerebral palsy; intracranial pressure
ICR International Congress of Radiology
ICRE International Commission on Radiological Education
ICRP International Commission on Radiation Protection
ICRU International Commission on Radiologic Units
ICS intercostals space
ICSH interstitial cell-stimulating hormone
ICSK intracoronary streptokinase
ICT intracranial tumour
ICU intensive care unit
id idem
ID card identification card
ID identification; infectious disease; intradermal
IDA iminodiacetic acid; iron deficiency anaemia
IDC idiopathic dilated cardiomyopathy
IDDM insulin-dependent diabetes mellitus
IDE integrated drive electronics
Idiopathic pulmonary hypertension
IDL intermediate density lipoprotein

420
IE infective endocarditis
IEC intraepithelial carcinoma
IEEE Institute of Electrical and Electronic Engineers
IEM inborn error of metabolism
IET inter echo time
IET inter echo time; intrauterine exchange transfusion
IF immunofluorescence; internal fixation; interstitial fluid
IFA idiopathic fibrosing alveolitis; immunofluorescence
assay
IFN interferon
IFT Inverse Fourier transform
Ig immunoglobulin
IgA immunoglobulin A
IgD immunoglobulin D
IgE immunoglobulin E
IgG immunoglobulin G
IgM immunoglobulin M
IGT impaired glucose tolerance
IH inguinal hernia
IHBC Intra hepatic biliary canaliculi
IHBD Inter hepatic biliary dilatation
IHBO Intra hepatic biliary obstruction
IHD ischaemic heart disease
IHSS idiopathic hypertrophic subaortic stenosis
II image intensifier; second cranial nerve (optic)
III third cranial nerve (oculomotor)
IJV internal jugular vein
IL-1 interleukin-1
IL-2 interleukin-2
IL-3 interleukin-3
ILF idiopathic lung fibrosis

421
ILP interstitial laser photocoagulation
ILV independent lung ventilation
IM Imaginary part of a complex number
IM infectious mononucleosis; intramuscular
IMA inferior mesenteric artery; internal mammary artery
IMACS image archiving and communications system
IMB intermenstrual bleeding
IMHO in my humble opinion
IMI inferior myocardial infarction
IMP N-isopropyl-p-iodamphetamine
IMR imaging intraoperative/intraprocedural magnetic resonance
imaging
IMRI interventional / intraoperative / intraprocedural MRI
IMS information management system
IMV inferior mesenteric vein; intermittent mandatory
ventilation
IN interstitial nephritis
in. inch
INADEQUATE incredible natural abundance double quantum transfer
exp
INDORE internuclear double resonance
INEPT insensitive nuclei enhanced by polarization
inf. inferior
Ing. inguinal
Inj. injury
INO internuclear ophthalmoplegia
INR international normalized ratio
Int. Jug. V internal jugular vein
INVERSE H,X correlation via 1H detection
IOC Internal auditory canal
IOD image object definition

422
IOFB intra-ocular foreign body
IOL induction of labour
IOML Infra orbito meatal line
IOP intra-ocular pressure
IORT intraoperative radiotherapy
IOUS intraoperative ultrasound
IP inpatient; imaging plate; interphalangeal
IPA Inter polation algorithm
IPC inter-process communications
IPCD infantile polycystic disease
IPD intermittent peritoneal dialysis
IPF interstitial pulmonary fibrosis
IPH idiopathic pulmonary haemosiderosis/haemorrhage
IPJ interphalangeal joint
IPPV intermittent positive pressure ventilation
IPR Immersive perspective rendering
IPS idiopathic pain syndrome
IQ intelligence quotient
IR FGR inversion recovery fast GRASS
IR FSE inversion recovery fast spin echo
IR prep inversion recovery magnetization preparation
IR PS inversion recovery pulse sequence
IR infrared; interventional radiology; inversion recovery
IRC inspiratory reserve capacity
IR-EPI inversion recovery echo-planar imaging (MRM)
IRI Image reconstruction interval
IRL Image reconstuction length
IRR 1985 the Ionising Radiation Regulations 1985
IRR 1988 the Ionising Radiation (Protection of Persons
Undergoing Medical Examinations or Treatment)
Regulations 1988

423
IRR Ionising Radiation Regulations
ISBN International Standard Book Number
ISCE inclined slab for contrast enhancement
ISD Inter scan delay
ISDN integrated services digital network; isosorbide dinitrate
ISE inversion spin echo pulse sequence
ISIS image selected in vivo spectroscopy
ISMN isosorbide mononitrate
ISO-OSI International Standards Organization
ISQ in status quo
IT information technology; injection time
ITP idiopathic thrombocytopenic purpura
ITT insulin tolerance test
ITU intensive therapy unit
IU International Units; intrauterine
IUCD intrauterine contraceptive device
IUD intrauterine death; intrauterine device
IUGR intrauterine growth retardation
IUP intrauterine pregnancy
IUT intrauterine transfusion
IV / IV fourth cranial nerve (trochlear); intravenous
IV MR CM intravascular magnetic resonance contrast medium
IV MRI intravascular magnetic resonance imaging
IVC Inferior vena cava
IVC inferior vena cava
IV-CM Intra venous contrast medium
IVCM-SVT IVCM standard volume technique
IVD Inter vertebral disc
IVD intravertebral disc
IVDA intravenous drug abuser
IVDSA intravenous digital subtraction angiography

424
IVF in vitro fertilization
IVGTT intravenous glucose tolerance test
IVH intraventricular haemorrhage
IVI intravenous infusion
IVIM intravoxel incoherent motion
IVP intravenous pylography
IVS inter-ventricular septum
IVU intravenous urography
IVUS intravascular ultrasound
IWI intermediately weighted image (PDWI)
IX ninth cranial nerve (glossopharyngeal)
J wire j wire (angiographic guide wire with a curved end.)
J joule
J. (Jour.) journal
JAMA Journal of the American Medical Association
JANET joint academic network
JCA juvenile chronic arthritis
JCAT Journal of Computerized Axial Tomography
JCD (JKD) Jacob-Creutzfeldt disease
JD John Doe; Jane Doe
JE Japanese encephalitis
JGA juxtaglomerular apparatus
JIR Journal of Interventional Radiology
JJ stent double J stent
JJ jaw jerk
JMD joint motion device
jn. Junction
Jour. Journal
JPEG Joint Photographic Experts Group
JRA juvenile rheumatoid arthritis
JSAIR Japanese Society of Angiography and

425
Jug. V / JV jugular vein
JVIR Journal of Vascular and Interventional Radiology
JVP jugular venous pressure; jugular venous pulse
JVPT jugular venous pulse tracing
k boltzmann constant / kilo (103) / proportionality constant
K constant
K contrast improvement factor; kelvin temperature
K+ potassium
kb kilobytes
KB Kilo bytes
kBq kilobequerrel
KCCT Koalin cephalin clotting time
KCO transfer coefficient
KERMA kinetic energy released per unit mass
keV kilo electron volt
kg kilogram
kHz kilohertz
kHz kilohertz 1000hertz (Hz)
KJ knee jerk
KLS kidneys, liver, spleen
kMRI kinematics’ magnetic resonance imaging
KO/Ko’d/KOed knocked out
kPa Kilo Pascal
Kr krypton
KS Kaposi’s sarcoma
KSS Kearns-Sayre syndrome
KTx kidney transplant
KUB kidney ureter bladder
KV kilovolt
kVp peak kilovoltage
kW kilowatt

426
KWD Kimmelsteill-Wilson disease
KWS Kimmelsteill-Wilson syndrome
L lat. left lateral
L threshold Low Threshold visualization SR/VR
L Avogadro constant, Avogadro’s number;
L left; lumber nerve root; lumber vertebra
l litre
L/S lecithin-sphingomyelin ratio
LA lactic acidosis; laser angioplasty; left arm; left atrium
LAC left atrial circumflex
LAD left anterior descending; left axis deviation
LADA left anterior descending artery
LAE left atrial enlargement
LAG labiogingival; lymphangiogram
LAH left anterior hemiblock; left atrial hypertrophy
LAHB left anterior hemiblock
LAI labioincisal
LAM left atrial myxoma; lymphangioleiomyomatosis
LAN local area network
LAO left anterior oblique
lap. And dye laparoscopy and injection of dye
lap. steri. Laparoscopic sterilization
lap. laparotomy; laparoscopic
LAS left anterior superior / lymphadenopathy syndrome
Lat. Lateral
Lat.Dol. lateri dolenti
LATS long-acting thyroid stimulator
LAV lymphadenopathy-associated virus
LB left bronchus
LBBB left bundle branch block
LBP low back pain / lumber back pain

427
LBW low birth weight
LCA left coronary artery
LCAT lecithin-cholesterol acyltransferase
LCD liquid crystal display
LCIS lobular carcinoma in situ
LCM left costal margin
LCNB Large cutting needle biopsy
LCR low contrast resolution. CD-CURVE
LCx left circumflex coronary artery
LD lactate dehydrogenase
LD50 lethal dose 50
LD50/30 lethal dose 50/30
LDA left dorsal anterior
LDH lactate dehydrogenase
LDL low density lipoprotein
LE lupus erythematosus
LEMS Lambert-Eaton myasthenic syndrome
LES lower oesophageal sphincter
LET linear energy transfer
LETZ loop excision of the transformation zone
LF MRI low field magnetic resonance imaging
LFD large for dates
LFH left femoral hernia
LFT liver function tests; lung function tests
lg. Common logarithm
LGA large for gestational age
LGD limb girdle dystrophy
LGL Lown-Ganong-Levine syndrome
LGTI lower genital tract infection
LGV lymphogranuloma venereum
LH left hand

428
LHC left hypochondrium
LHF left heart failure
LHL left hepatic lobe
LHRM leuteinizing hormone-releasing hormone
LHS left hand side
LHV left hepatic vein
LI lactose intolerance
Li lithium
LICA left internal carotid artery
LID large intraluminal density
LIF left iliac fossa
LIH left inguinal hernia
LIJ left internal jugular
LIMA left internal mammary arter
LINAC linear accelerator
LIP lymphocytic interstitial pneumonitis
LIQ lower inner quadrant
LIS Lanthanide induced shift
LJM limited joint movement
LJP localized juvenile periodontitis
LK left kidney
LKKS liver, kidney (right), kidney (left), spleen
LLB long leg brace
LLC long leg cast
LLL left lobe of liver; left lower lobe
LLLE lower lid left eye
LLQ left lower quadrant
LLR large local reaction; left lateral rectus
LLRE lower lid right eye
LLZ left lower zone
LMA left main artery

429
LMB Laurence-Moon-Biedl; left mainstem bronchus
LMCA left main coronary artery; left middle cerebral artery
LMN lower motor nerve/neurone
LMNL lower motor nerve lesion
LMP last menstrual period
LMR left middle rectus; localized magnetic resonance
LMS left main stem (coronary artery)
LMWH low molecular weight heparin
LMZ left mid zone
ln natural logarithm
LN lymph node
LNA
LNBx lymph node biopsy
Lnn lymph node(s)
LOC loss of consciousness / local anaesthesia / anaesthetic
LOCM low osmolar contrast medium
log. Logarithm
log.e natural logarithm
Long. Longitudinal section
LOPP chlorambucil, vincristine, procarbazine and premisolene
LOQ lower outer quadrant
LOS/LES lower oesophageal sphincter
LOSP lower oesophageal sphincter pressure
LP linear prediction
LP lumber puncture
lp/mm line pairs per millimetre
LPA left pulmonary artery
LPO left posterior oblique
LPV left portal vein
LQTS long Q-T syndrome
L-R shunt left to right shunt

430
LR lateral rectus
L-R Left to right orientation
LRCP Licentiate of the Royal College of Physicians
LRD living (live) related donor
LRT lower respiratory tract
LRTI lower respiratory tract infection
LS line scaning (MRM) / lumber spine
LS, L/S longitudinal section
LSC left subclavian
LSCS lower segment Caesarian section
LSD lysergic acid diethylamide
LSE left sternal edge
Lsect. Longitudinal section
LSF line spread function
LSJ Lumbo sacral spine junction
LSM late systolic murmur
LSR lanthanide shift reagent / liver / spleen ratio
Lt. Left
LTA long-term archive
LTM long-term memory
LTOT long-term oxygen therapy (treatment)
LTS long-term storage
LUE left upper extremity
LUF luteinized unruptured follicle
LUL left upper lobe
LUO left ureteric orifice
LUOQ left upper outer quadrant
LUQ left upper quadrant
LUT look-up table
LUZ left upper zone

431
LV left ventricle; left ventricular branch; ligamentum
venosum
LVEF left ventricular ejection fraction
LVF left ventricular failure
LVH left ventricular hypertrophy
LVOT left ventricular outflow tract
LVWT left ventricular wall thickness
m mass; metastable; metre; molar
M magnetization vector, 3 spatial components Mx, My &
Mz.
m milli (10-3)
M macroscopic magnetization vector; magnification; male;
MA mental age; magic angle
MAA microaggregates of albumin
Mac macintosh
MAC media access control; minimum antibiotic concentration
MAD major affective disorder
MAFI Medic Alert Foundation International
MAG-3 benzoylmercaptoacetyltriglycerine
MAGIC mucosal and genital inflammation with inflamed
cartilage
MAI mycobacterium avium intracellulare
MAL Mid-axilary line
Mammo. Mammogram
MAN metropolitan area network
MAO monoamine oxidase
MAOI monoamine oxidase inhibitor
MAP mean arterial pressure
MARC machine-readable cataloguing
MARF magic angle in the rotating frame
MARP multi angle reconstruction plan

432
MARS The Medicines (Administration of Radioactive
Substances)
MAS magic angle spinning / Milli ampere second
mAs milliampere second
MASS magic angle sample spinning
MAST motion artefact suppression technique
MAST motion artefact suppression technique
MAVD mixed aortic valve disease
Max. maximum
MB Mega bytes
MB ChB Bachelor of Medicine, Bachelor of Surgery
Mb megabyte
MBA motorbike accident
MBBS Bachelor of Medicine, Bachelor of Surgery
MBC maximal breathing capacity; minimum bactericidal
concentration
Mbq megabecquerel
MBS-MRA minimum basis set magnetic resonance angiography
MC & S microscopy, culture and sensitivity
MCA middle cerebral artery
MC-C Metacarpo-carpal
MCDK multicystic dysplastic kidney
mcg microgram
MCGN minimal change glomerulonephritis
MCH mean corpuscular haemoglobin
MCHC mean corpuscular haemoglobin concentration
mCi millicurie
MCK multicystic kidney
MCL minimal-change nephropathy
MCPJ metacarpophalangeal joint
MCQ multiple-choice question

433
MCTD mixed connective tissue disease
MCTSE multi-contrast turbo spin echo
MCU / MCUG micturating cystourethrogram
MCV mean corpuscular / cell volume
MCx main circumflex
MD Doctor of Medicine; managing Director;
MDCT Multidetector CT
MDIS medical diagnostic imaging system
MDM mid-diastolic murmur; magnetic dipole moment
MDP methylene diphosphonate
MDS myelodysplasic syndrome
ME myalgic encephalomyelitis
MEA multiple endocrine adenopathy
Medical department; mini disc
MEDUSA technique for determination of dynamic structure
MEG magneto encephalography; MSI
MEM maximum entropy method
MEMP multi-echo multiplanar
MEN (1/2) multiple endocrine neoplasia (type 1/2)
MEN 1 multiple endocrine neoplasia type 1
MEN 2 multiple endocrine neoplasia type 2
MEN 2a multiple endocrine neoplasia type 2a
MEN 2b multiple endocrine neoplasia type 2b
MEN 3 multiple endocrine neoplasia type 3
MEN multiple endocrine neoplasia
MEP message exchange protocol
ME-PS multi-echo pulse sequence
MESS multiple-echo single shot
MET maximal exercise test; modality examination terminal
MeV mega electron volt
mF millifared

434
MFH malignant fibrous histiocytoma
mFISP mirrored FISP
MFV maximal flow-volume loop
mg milligram
MG myasthenia gravis
2+
Mg magnesium
MGUS monoclonal gammopathy of undetermined
mGy milligray
MHC major histocompatibility gene complex
MHDP methylene hydroxydiphosphonate
MHU Mega heat units
MHV middle hepatic vein
Mhz megahertz
MI mitral incompetence; myocardial infarction
MIB management information base
MIBG meta-iodobenzylguanidine
MIBI 2-methoxy 2-methylpropyl isonitrile
MIC minimum inhibitory concentration
micro. Microbiology
microCi microcurie
Min Minimum
MIOP magnetic iron oxide particles
MIP Maximum intensity projection
MLEV-n m.Levitt’s sequence
MLSI multiple line scan imaging
Mo the magnetization vector Mo
Mo the magnetization vector, Bo / Equilibrium magnetization
MOD Magneto optical disc
MPGR Multiplanar/multiple planar gradient recalled (ASS)

435
MPGRE magnetization protocol/prepares gradient echo
sequence
MPI myocardial perfusion imaging
MPIR multiplanar inversion recovery
MPR multiplanar reconstruction
MP-RAGE magnetization prepared rapid gradient echo
MPR-Cor Multi planer recon-coronal
MPR-Obl Multi planer recon-oblique
MPR-Sag Multi planer recon-sag
MPVR Multiplaner volume rendering recons
MQC Multiple quantum coherence
MQF multiple quantum filter
MQHPT multiquantum heternonuclear polarization transfer
MQS multiple quantum spectroscopy
MR magnetic resonance
MR DSA magnetic resonance digital subtraction angiography
MR GI magnetic resonance guided intervention
MR imager magnetic resonance imager
MR scanner magnetic resonance imager
MRA magnetic resonance angiography / arthrography
MRC magnetic resonance cholengio-pancreatography
MRCM magnetic resonance contrast medium
MRCP magnetic resonance cholangio-pancreatography
MRF magnetic resonance fluoroscopy
MRI machine magnetic resonance imaging machine
MRI scanner magnetic resonance imaging scanner
MRI scans magnetic resonance imaging scans
MRi magnetic resonance imager
MRI magnetic resonance imaging
MRM magnetic resonance mammography / myelography
MRP/U magnetic resonance pylography / urography

436
MRPS magnetic resonance pulse sequence
MRS magnetic resonance spectroscopy / signal
MRSI magnetic resonance spectroscopy imaging
MSCT Multi-slice CT
MS-EPI multi shot echo planar imaging
MSI magnetic source imaging
MSK Musculo skeletal
MSME seq multislice multiecho sequence
MSOFT multi slice off resonance fat separation technique
MT magnetization transfer
mT/m/ms magnetic GF in milliTesla per metre and milliseconds
MTC magnetization transfer contrast
MTF modulation transfer function
MTR magnetization transfer ratio
MTSA multiple thin slab acquisition
MVS multi-volume spectroscopy
Mx X component of magnetization
Mx,y transverse component of magnetization
Mx,y transverse magnetization
My’ Y' component of magnetization
Mz longitudinal magnetization
Mz Z (longitudinal) component of magnetization
N signal size , hydrogen density / H weighted
n frequency
-
N spin population in high energy state
N/2 ghost ghost artefact in MRI in the phase encoding direction
N+ spin population in low energy state
Nacq number of acquisitions
NE navigator echo
NECT Non-enhanced CT
NEX number of excitations (number of signal averages)

437
NMM nuclear magnetic moment.
NMR imaging nuclear magnetic resonance imaging
NMR signal nuclear magnetic resonance signal
NMR spec nuclear magnetic resonance spectroscopy
NMR nuclear magnetic resonance
NMV net magnetization vector
NOE nuclear overhauster enhancement
NOESY nuclear overhauster effect spectroscopy
NQCC nuclear quadrupole coupling constant
NSA number of signal averaged
O oxygen
O2-17 MR MR applications using oxygen as resonating nucleus.
OC Operator’s console
OGER Ortho graphic external rendering
OL Line Orbito meatal line
OML Orbito metal line
OSIRIS modification of the ISIS method for localized
spectroscopy
P posterior / power
PACS picture archiving and communication system; IMACS
PC phase contrast
PC MRA phase contrast magnetic resonance angiography
PCE paramagnetic contrast enhancement
PCM positive contrast media
PCr phosphocreatinine
PD WI proton density weighted image, T1/T2 generated image
PE phase encoding
PEAR phase encoding artefact reduction
PEG phase encoding grouping
PEM positron emission tomography
PEST phase encode selection technique

438
PET-CT positron emission tomography CT
PFA partial flip angle
PFI partial flip imaging
PFNB percutaneous fine needle biopsy
PI perfusion imaging
Pitch table incrementation/collimation
PM perfusion measurement / point-resolved spectroscopy
PMRFI phase modulated rotating frame imaging
PMRS proton magnetic resonance spectroscopy
POMP phase ordered Multiplanar
POMP phase-offset multi-planar
PPG peripheral pulse gating
PPM parts per million
PR imaging projection reconstruction imaging
Pr. Inj pressure injector
PRE proton relaxation enhancement
PRESS point-resolved spectroscopy
PRESS technique for localized spectroscopy using a spin echo
PS
PRFT partially relaxed fourier transform
PRI projection reconstruction imaging enhanced
reconstruction
PROSE/PROBE?????
PRO PELLER periodically rotated overlapping parallel lines with
enhanced reconstruction
PS partial saturation / saturation recovery pulse sequence
PS sequence saturation recovery pulse sequence SR-PS
PSD phase sensitive detection
PSIF reverse fast imaging with steady-state procession
PSR phase sampling ratio
PSSE partial saturation spin echo

439
PUJ pelvi ureteric junction
Pulse MR technique that applies RF pulses in contrast cont. wave
PV phase portal vein phase
PVE partial volume effect
PVR portal venous radicles
PWI perfusion weighted imaging
Q coil
Q factor efficiency of a magnetic resonance radiofrequency coil.
Q RF coil quality factor
QA quality assurance
QCSI quantitative chemical shift imaging
QD coil quadrature detection coil
QMRI quantitative MRI
QUEST quick echo-split imaging technique
QUIPPS quantitative imaging of perfusion using a single
subtraction
R1 longitudinal relaxivity or efficiency
R2 transverse relaxivity or efficiency
RAGE rapid gradient echo
RAM FAST rapidly acquired magnetization prepared FAST
RAM FAST reduced acquisition matrix Fourier acquired steady
state
RAPP-ISIS
RARE PS rapid acquisition with relaxation enhancement PS
RARE rapid acquisition with refocussed echoes
RASE rapid acquisition spin echo
RAW DATACT data acquired during each exposure
RC respiratory compensation
rCBF regional cerebral blood flow
RCC renal cell carcinoma
RE real part of a complex number

440
RECSY multistep relayed coherence spectroscopy
REDOR rotational double echo resonance
Ref S-V reference scout view
Refoc FLASH a type of gradient echo pulse sequence
RELAY relayed correlation spectroscopy
resonance frequency in Hertz / in radians per second
REST regional saturation technique
Rev FISP reverse fast imaging with steady procession
RF resonant frequency / radio frequency
RF coil radiofrequency coil
RF echo NMR signal formed by the action of two or more RF
pulses
RF FAST radio frequency spoiled fast acquisition in the steady
state
RF field rotating magnetic field B1 used in NMR
RF pulse radio-frequency pulse
RF screen radiofrequency screen
RF spoiled radiofrequency-spoiled Fourier acquired
RFA reduced flip angle
RFI radio frequency interference
RFS FAST RF spoiled Fourier-acquired steady-state technique
RFS rotating-frame spectroscopy
RFspoiledFAST radio frequency spoiled fast acquisition in the steady
state
RI rapid imaging
RISE rapid imaging spin echo
ROAST resonant offset averaging in the steady state
ROESY rotating frame overhauser effect spectroscopy
ROI Region of interest
ROPE respiratory ordered phase encoding
ROTO roesy – tocsy relay

441
RS SARGE rapid scan specific absorption rate gradient echo
RS rapid scan
RSE rapid spin echo
RSSG seq
RUFIS rotating ultra-fast imaging sequence
S/s superior / second
S# Serial number
S/N short for signal to noise ratio
SA shielding anisotropy
SAAV simultaneous acquisition of artery and vein
SAH Sub arachnoid haemorrhage
SAR specific absorption rate
SARGE short absorption rate gradient echo
SC joints Sterno-clavicular joints
SC scalar coupling
SCRF surface coil rotating frame
SCT Spiral CT / Helical CT / Volume CT
SCTSE single contrast turbo spin echo
SD S.Delay Scan delay
SDDS spin decoupling difference spectroscopy
SDH Subdural haematoma
SE spin echo / stimulated echo
SE EPI spin-echo echo-planar imaging
SE imaging spin echo pulse sequence imaging
SE PS spin echo pulse sequence
Sec. Second
SECSY spin echo correlation spectroscopy
SEDOR spin echo double resonance
SEFT spin echo fourier transform spectroscopy
SELINCOR selective inverse correlation
SEMUT subspectral editing using a multi-quantum trap

442
SENSE sensitivity encoding for MRI
sEPI spiral EPI
SFORD single frequency off-resonance decoupling
SGGR spoiled gradient refocused acquisition in the steady
state
SHORT short repetition technique
SHOT selection with high
SI signal intensity / spectroscopic imaging
SIMUSIM simultaneous multi slice imaging
SIMUVOSP simultaneous multi volume spectroscopy
Sinc Sin(x)/x
SIP saturation inversion projection
SKEWSY skewed exchange spectroscopy
SL# Slice number
SLIM spectral localization by imaging / suppressed lipid
imaging
SLK THK Slice thickness
SMA Superior mesenteric artery
SMART Shimadzu motion artefact reduction technique
SMART simultaneous multislice acquisition using rosette
trajectories
SMaRT simultaneous multislice acquisition with arterial flow
tragging
SMASH short minimum angle shot
SMASH simultaneous acquisition of spatial harmonics
SMI simultaneous multislice imaging
SMV Superior mesenteric vein
SNR signal to noise ratio
Society of Europe
SOL Space occupying lesion

443
SORSSTC slice selective off resonance since pulse saturation TC
SP saturation pulse / shaped pulse / square pulse
SPACE spatial and chemical shift encoded excitation
SPACE-RIP sensitivity profiles from an array of coils for encoding
and reconstruction in parallel
SPAMM spatial modulation of magnetization
SPARS
SPECSTEAM8
SPECT single photon emission computed tomography
SPGR spoiled gradient recalled (spoiled GRASS-GE)
SPGR spoiled gradient refocused acquisition in the steady
state
SPI selective population inversion
SPIO small particle iron oxide MR contrast media
SPIO super paramagnetic iron oxides
SPIR spectrally selective inversion recovery
Spiral CT Spiral computed tomography
Spiral MRI spiral scanning
Spoiled FLASH Name for a spoiled gradient echo pulse sequence
Spoiled GEI spoiled gradient echo imaging
Spoiled GES spoiled gradient echo pulse sequence
SPRITE single-point ramped imaging with T1 enhancement
SPT selective population transfer
SQUID superconducting quantum interference device
SQUID superconducting quantum interference device
SR saturation recovery / slew rate / surface rendering
SR-PS saturation recovery pulse sequence
SS FSE single shot fast spin echo
SS GRE steady state gradient echo sequence
SS slice select gradient
SSA single slice acquisition

444
SSD Shaded surface display
SSFP steady state free precession (GE) SSPF; steady state
SSFP Steady-state free precession
SSGE Imaging steady state gradient echo imaging
SSPF steady state procession in free induction decay
ST sequence Stejskal-Tanner sequence
ST/B Algo Soft tissue/b one algorithm
STAGE: T1W small tip angle gradient-echo T1-weighted
STANDOUT soft shresholding and depth cueing of unspecified tech
STD Algo Standard Algorithm
STE stimulated echo, steady state technique with refocused
STEAM stimulated echo acquisition mode
STEP stimulated echo progressive imaging
STERF steady state technique with refocused free induction decay
stimulated echo
STIR short tau (inversion time) inversion recovery
STREAM suppressed tissue with refreshment angiography
method
STS Single-turn solenoid
SVC superior vena cavography
SVC superior vena cavography
T tesla, SI unit of magnetic flux density / temperature
T1 / T1 T1 relaxation/longitudinal relaxation time, characteristic
time (time constant) of spin-lattice relaxation time
T1 FAST T1-weighted Fourier-acquired steady-state technique
T1 FFE Contrast-enhanced fast field echo (T1-weighted)
T1 FFE T1-weighted fast field echo
T1 FLAIR sequence forT1 contrast between G & W matter and
CSF
T1 relaxation process by which the longitudinal magnetization Mz
attains its equilibrium value Mzo

445
T1W / T1WI T1 weighted / T1 weighted image
T2 / T2 spin-spin relaxation time / transverse relaxation time
T2 FFE Contrast-enhanced fast field echo (T2-weighted)
T2 PEDD T2 proton electron dipole dipole interjection
T2 PRE T2 proton relaxation enhancement
T2* / T2* T2 star / effective transverse relaxation time
T2inhomo Inhomogeneous T2
T2W / T2WI T2 weighted / T2 weighted image
TBT Tracheo bronchial tree
TCF time correlation function
TCMV Total contrast medium volume
TD trigger delay
TE echo time / time delay between excitation and echo
TEI TE interleaved
TFE turbo field echo
Thk slice thickness
TI inversion time / time following inversion pulse
TIM total imaging matrix
TMJ Temporo mandibular joint
TMR therapeutic/topical magnetic resonance imaging
TOCSY total correlation spectroscopy
TOE truncated noe
TOF time of flight
TOF MRA time of flight magnetic resonance angiography
Tomo Tomogram
TONE tilted optimized nonsaturation excitation
Topo Topogram, Scout view, Scanogram
TORO tocsy roesy relay
TOSS total suppression of sidebands
TPPI time proportional phase incrementation
TQ triple quantum

446
TQF triple quantum filter
TR repetition time / repeat time / time to/of repetition
True FISP fast imaging with steady precession (heavily T2-
weighted)
True FISP Siemens brand name for a refocuses GE-PS 3D
TSE turbo spin echo RARE pulse sequence
TSR total saturation recovery
Turbo FE ‘Turbo’ field echo Philips brand name for an ultrafast
GE-PS
Turbo FLASH turbo fast low angle shot Siemens/ultrafast GE-PS
Turbo MRA ultrafast magnetic resonance angiography technique
Turbo SE ‘Turbo’ SE Philips and Siemens name for a RARE PS
Turbo Short turbo short repetition technique Elscient ultrafast GEPS
TVMF time varying magnetic fields
U GE-PS ultrafast gradient echo pulse sequence
U MRI ultrafast magnetic resonance imaging
UBOs unidentified bright objects
UE unpaired electron
Ultrafast CT Cine CT / Electron beam CT
USPIO ultrasmall particle iron oxide
USPIO ultrasmall/particle superparamagnetic iron oxide
VAS variable angle spinning
VEMP variable echo multiplanar
VENC velocity encoding / velocity encoding value
VEST volume excitation using stimulated echoes
VIGRE gradient echo
VINNIE velocity encode CINE imaging (GE)
VOI volume of interest
VOSING volume-selective single-scan heteronuclear editing
VOSY volume selective spectroscopy
VPS views per segment

447
VR Volume rendering
VRT Volume rendering technique
VUJ Vesico ureteric junction
VVF Vesico veginal fistula
W tryptophan; tungsten (Ger. Wolfram); watt; work;
W/L Window level
w/v weight (of solute) per volume (of solvent)
W/W Window width
WAIS Wechslar Adult Intelligence Scale
WALTZ-8
WALTZ-n
WATERGATE water suppression pulse sequence
wave
Wb weber
WBC white blood cell; white blood cell count
WC window centre
WEE western equine encephalomyelitis
WEFT water eliminated fourier transform
WHHL Watanable heritable hyperlipidemic
WHO World Health Organization
WISC Wechslar Intelligence Scale for Children
WL window level
WMH white matter hyperintensities
Wo
WS water suppression / work station
WSC water soluble contrast
WSCM water soluble contrast medium
wt weight
WW window width

448
X - gradient x-component of the magnetic gradient field
X - gradient x-component of the magnetic gradient field
X axis in laboratory coordinate system
X abscissa
X KienbÖck unit; xanthine; xanthosine; sample
mean; reactance
X’ rotating frame X axis
Xe xenon, element with 54 protons
Xe xenon, element with 54 protons.
Xe 129 MRI hyperpolarized gas magnetic resonance imaging
Xe 129 MRI hyperpolarized gas MR imaging
Xenon MRI MR imaging of lung using xenon gas as a MR CM
XMP xanthosine monophosphate
XOAN X-linked (Nettleship) ocular albinism
XU excretory urography
Y – gradient y-component of the magnetic gradient field
Y – gradient y-component of the magnetic gradient field

Ƴ camera gamma camera

Ƴ decaygamma decay

Ƴ radiation gamma radiation

Ƴ ray gamma ray

Y axis in laboratory coordinate system

Ƴ film gamma; gyromagnetic ratio

Y ordinate / tyrosine; yttrium
Y’ rotating frame Y axis
Yb ytterbium

Ƴ-GT gamma-glutamyltransferase/gamma

Ƴ-IFN alpha interferon (s)

449
Ƴ-LPH gamma lipotrophin

Ƴ-MSH gamma melanocyte stimulating hormone

Z – gradient z-component of the magnetic gradient field
Z atomic number; impedance
Z axis in laboratory coordinate system
Z-COSY cosy with z-filter
ZECSY zero-quantum echo correlated spectroscopy
ZIFT zygote intrafallopian transfer
Zn zinc
ZQC zero quantum coherence
ZQF zero quantum filter
Zr zirconium
ZSR zeta sedimentation ratio
ZZ spectr selection of coherence involving zz or longitudinal spin-
spin order
Zz L. zingiber (ginger)
μ linear attenuation coefficient
μCi microcurie
μF microfarad
μg microgram
μGy microgray
μl microlitre
μs microsecond
μSv microsievert

450
Artifacts in MRI

Source
Various Websites
Medical Imaging
EMRF

Collected and Compiled by:

Mohd Golam FARUQUE
Application Specialist
451
 This book is belong to

Name ..........................................................................................................................

Designation................................................................................................................
........................................................................................................................................
........................................................................................................................................
Phone..............................................................................................................................

Courtesy
Mohd Golam FARUQUE
[email protected]
Mobile: # 019-7777 0000

452
This book is dedicated to

Late Prof. S. A. Sobhan

453
 PREFACE
I presented a seminar as speaker, which was arranged on 30TH Nov
2007 in the name of MRI / MR Image in Chittagong Medical College
and Hospital, at the Department of Imaging Radiology, Organized by
Bangladesh Association of Radiology and Imaging Technologists,
Sponsored by National Trading Syndicate Limited.

Area like Signal and noise, Signal average and noise, Contrast
dependence on TR & TE, Adjusting TR & TE, The necessity of
different TR & TE, Rapid spin-echo, Contrast dependence on TI, Fat
suppression with STIR, Fluid suppression with FLAIR, Gradient-
echo, Protocols etc. was covered

Among other points, a suggestion came forward from the senior MR

user that it would be extremely useful if the most salient
characteristic of MR artifacts could be compiled and be made
available to them for their use.

I presented my self in the 1st Annual conference and scientific

seminar on “Radiology and imaging Technology” with the subject
Artifacts in MRI which was held on 14th March 2008 at the Institute
of Health Technology, Dhaka.

After the presentation it was assured that as suggested by them

efforts would be made to compile salient features of artifacts in MRI
as early as possible and would be send to them.

454
I am now pleased to prepare same which is being made available to
them for their study. I hope it will be useful and would be of some
benefit to them.

I would greatly welcome any contributions from readers/users

concerning artifacts that I could not collect.
Mohd Golam FARUQUE
Application Specialist
Medionics Imaging Ltd.
CONTENTS

Aliasing / Back folding / Wrap around artifacts......................:

Aperiodic motion artifacts ................................................:
Array processing artifacts ................................................:
Artifacts in Multiple SE sequences ....................................:
Back folding artifacts ...........................................................:
Bo field inhomogeneity artifacts ...................................:
Black boundary artifacts ...............................................:
Back folding artifacts ...........................................................:
Blurring artifacts ...........................................................:
Cardiac motion artifacts :
Central point artifacts :
Chemical shift artifacts :
Coil Selection artifacts :
Contours artifacts :
Cross-talk artifacts :
Donald Duck artifacts :
Errors in data artifacts :
Flow artifacts :
Fold over artifacts :
455
Ghost artifacts :
Gibbs or truncation artifacts :
K-Space-Related artifacts :
Line artifacts :
Local inhomogeneity artifacts :
Magic angle artifacts :
Magnetic field perturbations :
Motion artifacts :
 Aperiodic motion :
 Blood flow motion artifacts :
 Cardiac motion artifacts :
 CSF pulsation artifacts :
 MOTSA :
Non-linear gradient field Artifacts :
Noose artifacts :
Patient motion artifacts :
Respiratory motion artifacts :
Non-linear gradient field artifacts :
Point artifacts :
Quadrature artifacts :
Respiratory motion artifacts :
Radiofrequency Feed-through artifacts :
RF and gradient artifacts :
Ringing artifacts :
Slice overlap artifacts :
Slice profile artifacts :
Spatial misregistration, Spins phase effects artifacts :
Stars artifacts :
456
Susceptibility artifacts :
Truncation artifacts :
Undersampling / Aliasing artifacts :
Unknown artifact :
Venetian blind artifacts :
Wrap around artifacts :
Zipper artifacts :
Artefacts reduction techniques :

Common Artifacts in MR Imaging

Introduction

Shortly after the introduction of MR as a new imaging modality, it

was hailed as a technique which did not suffer from the common
beam-hardening artifacts which destroy the images in x-ray
computed tomography.

However, it was soon realized that an unfortunate side effect of the

complex nature of MR imaging was a whole new set of artifacts.

Artifacts in MR images can take the form of variations in signal

intensities or mispositioning of signals.

Usually artifacts can be easily recognized when their causes are

known. However, cases have been described where artifacts led to
surgical intervention because pathology was falsely described.

457
Artifacts may be defined as any irregular false features noted in an
MR image, related to imaging process rather than an anatomical or
physiological abnormality.

The random fluctuation of intensity due to noise can be considered

separately from artifacts.

It is necessary to be familiar with specific artifacts since they can

conceal pathological elements or simulate pathology that does not
exist.

Artifacts can be easily rectified when their causes are known.

However, cases have been described where artifacts led to surgical
intervention because pathology was falsely described.

Artifacts caused by defective components, malfunctions of the

imaging system, or artifacts connected to the equipment of specific
manufacturers might be different from the common artifacts.

There are many artifacts noted on MR image, which can be

categorized into four main groups:
a) Motion and flow artifacts;
b) Magnetic field perturbations;
c) RF artifacts and gradient-related artifacts;
d) Signal processing and mapping artifacts, & different
categories, viz.

Aliasing / Back folding / Wrap around Artifacts

458
Wrap around or Aliasing appears when the diameter of the scanned
area is greater than the dimensions of the field of view used, a part
of the image is ‘folded’ on it self. It can occur in both the phase-and-
frequency-encoding direction. In the frequency-encoding direction
the artifact results from the presence of signals with too high a
frequency being mispositioned. A: FOV: 18 cm Aliasing of the back of the
head onto the forehead in the phase direction is seen. B: FOV 32 cm. C: Back
folding artifact. D: Fold over artifact.
Remedy:
a) Increased FOV
b) Limit excitation volume
c) Sample higher frequencies
d) Band limit the data by filtration
e) Filtering the frequency encoded direction
f) Oversampling in the phase encoded direction

459
Aperiodic Motion Artifacts
» See Motion Artifacts page-

Array Processing Artifacts

The array processor (AP) is part of the computation system. It is a
very fast parallel processor for execution of simultaneous tasks. The
array processor is involved in the signal averaging process during
data acquisition and reconstruction. Grid-like artifacts superimposed on
the image are characteristic of a faulty array processor

Artifacts in Multiple SE Sequences

Multiple SE or SE-based sequences are widely used in MR imaging.
Problems can arise with such sequences due to the fact that the
refocusing pulses will not be perfect 180o pulses across the whole

460
slice, and in the transition zone (from 0o to 180o) at the edge of the
slice, a whole range of flip angles will be present.
This means that the refocusing pulses will not only form the desired
spin echoes, but also will generate other signals which, if not
suppressed, can degrade the images obtained from the second
echo onwards.
Remedy: -
a) Use of phase-cycling.
b) Addition of spoiler gradients to the sequence
c) Use suitable phase schemes for the RF pulses

Back folding Artifacts

» See Aliasing / Wrap around Artifacts

Bo field inhomogeneity Artifacts

Bo inhomogeneity due to strongly paramagnetic or ferromagnetic
implants, magnetic susceptibility, and particular iron, chemical shift,
etc. and caused spatial distortion of the image and signal loss in the
main magnetic field, (also called magnetic flux density or induction).
» Local Field Inhomogeneity.
Remedy:
a) Use spin echo
b) Shim the magnet
c) Remove interfering object
d) Increase the read-out gradient

Black Boundary Artifacts

461
Sometimes well-defined black contours following anatomical
structures are seen. These artifacts are another class of chemical-
shift artifacts. Pulse sequences prone to such artifacts are inversion
recovery (IR) and gradient-echo (GRE) sequences. The water and
fat signals can be in-phase or out-of-phase. If this happens
accidentally in volume elements with partial volume effects between
water-rich and lipid-rich organs, the signal disappears and artifactual
contours are seen. The figure is an example of a GRE sequence of the
abdomen.
Remedy:
a) Need fat suppression
b) Use spin echo sequence
c) In-phase echo times must be used.

Back folding Artifacts

Back folding artifacts also known as: Fold over, Aliasing, Wrap
around artefact

Blurring Artifacts
Any mechanism which leads to image blurring in MR imaging.
Blurring comes most obviously from patient motion, but other

462
mechanisms like low-resolution sampling also lead to image
blurring.

Cardiac Motion Artifacts

» See Motion Artifacts page-

Central point artifacts

Central point artifacts are white or black dots in the centre of the MR
image, and seen only on older MR equipment. » See Line Artifacts

Chemical Shift Artifacts

Chemical shift artifacts appear at the interfaces between water and
fat because the precessional frequency of protons is slightly different
in these two substances. This leads to misregistration of the signals.
They are displayed by the equipment as dark region of signal void
on one side of water containing tissue and a region of bright signal
at the other end of the water fat interface due to super imposition of
fat and water signals on the frequency encoding direction.
The chemical shift artifacts is commonly noticed in the abdomen,
spine and orbits where fat and other tissues from boarders. This
artifact is greater at higher field strengths. A: Chemical shift
misregistration artifact water in the kidneys is misregistered along the frequency
axis. This causes black signal (arrow) voids at the kidneys left margins and
white lines at their right margin (arrow) B: Bright and dark rims around the kidneys.
Remedy:
a) Increase the bandwidth
b) Use a fat suppression technique
463
 fig—1—Ency72

Coil Selection Artifacts

Artifacts also appear if the coil is not selected properly and/or if the
selected coils name is not match. Select a proper suitable coil, if you
do not enter correct one. Structured noise caused due to coil
selection.
Select a coil from the coil name window . An example of lumber spine
sagittal image is shown, arrows show artifact (Improper selection of coil)
Remedy:
a) Select a proper suitable coil
b) Coil name should match with connected one

464
Contours Artifacts
Dark boundaries between region are seen in the image due to
inversion recovery null point, chemical shift, opposed phase image,
motion shear (flow effect) etc.,
Remedy:
a) Change TI
b) Real reconstruction
c) Use spin-echo or CSI
d) Gradient moment rephasing

Cross-talk Artifacts
Cross-talk is a general term referring to unwanted interference
between two signals which, ideally should be independent. An
example is the nonperfect insulation of two channels of a
QUADRATURE COIL or a PHASED ARRAY COIL. The artefact is seen in
the diagnostic or therapeutic MR guided intervention from an MR

465
needle short concentrations, e.g. during MR guided fine needle
aspiration cytology (FNAC) and/or biopsy.
Remedy:
a) Use an interleaved slice sequence.
b) In short slice distance, set concatenation to 2

Donald Duck Artifacts

Artifacts in MR images can take the form of variations in signal
intensities or mispositioning of signals. Dentures caused this artifact
in sagittal midline images through a head. Such artifacts can mimic
pathology to such an
extent that examinations have to be redone or other diagnostic
modalities have to be used to exclude pathology. A: IWI, a low signal
intensity area is seen in the pons, suggesting a lesion. This lesion is not visible
on B: T2WI. It is caused by image distortion created by ferromagnetic implants.
Remedy:
a) Repeat the scan
b) Use other modality
c) Check ferromagnetic implants

466
Errors in data Artifacts
This type of artifacts are occur due to one bad data point; frequency
encoding error, frequency channel with problem, ADC over range,
discrete RF noise, etc., which striped image; washed out image; line
in phase direction, etc.
Remedy:
a) Shield room
b) Delete bad data
c) Use alternate receiver

Flow Artifacts
The origin of flow artifacts is very similar to that of motion artifacts,
namely that the blood and CSF flow can be pulsatile. Thus, different
flow velocities will be present in different lines of the scan. The read
and slice gradients induce a phase shift for flowing material,
resulting in a range of phase shifts being produced in the course of a
scan. The resulting artifacts can take the form of a general smearing
or a number of distinct artifacts in the phase-encoding direction.

Flow artifacts are particularly severe in gradient-echo images since

in a 2D scan, the flowing spins will not have experienced the
preceding pulses and will therefore be fully recovered. This leads to
a very strong signal from the flowing blood, and therefore to severe
artifacts in the absence of gating and motion compensation.
Remedy:
a) ECG gating
b) Apply additional RF pulses

467
 c) Presaturation on both sides of the slice
d) Use compensated gradients to null the phase shift from
flowing material

17-9 2004

Fold over Artifacts

Fold over artifacts also known as: Back folding, Aliasing, Wrap
around artefact. Phase of the signal just out side of the field of view,
increase field of view, changes presaturation direction increased
phase encoding

Ghost Artifacts
Artifacts occurring during periodic movement such as breathing
presenting as displaced reduplications of bright structures such as
subcutaneous fat or vascular signal along the phase-encoding
direction.
Phase encoding generates sinusoidally varying data points in the
MR receiver at multiple integers of TR. There can be additional low-
level signal due to noise and movements occurring with periods
higher than TR, such as cardiac motion. The signal resulting from
these latter processes is smeared out over the entire phase
encoding direction and frequency encoding (entire pixel column or
row). A: showing ghost artifacts (arrows) B: distance between aorta and ghost
artifacts (without triggering)
Remedy:
468
 a) Triggering
b) Spatial Presaturation
c) Rephase all higher order echoes
d) Use cardiac and respiratory gating
e) Keep phase gradients on integer amplitudes

Gibbs or Truncation Artifacts

Gibbs or Truncation artifacts are bright and dark lines that are seen
parallel and adjacent to boarders of abrupt intensity changes, as
may be seen at CSF, spinal cord, fat and muscle. These artifacts
are commonly seen in phase encoding direction. Low intensity lines
appearing near the boundaries of the brain/skull interface, are characteristic of a
160 phase encoding acquisition.
Remedy:
a) Using a filter
b) Increasing the matrix
c) Change the direction of phase and frequency

469
K-Space-Related Artifacts
Many artefacts in magnetic resonance imaging are caused or
enhanced by k-space, e.g. from bad data points or spikes. (Error in
sampling of a periodic signal when the sampling frequency is too low
to properly capture the signal) A: Undersampling/Aliasing B: RF feed
through,
Remedy: Adjust receiver perfectly.

Line Artifacts
A relatively common artifact is the presence of a high intensity line
(sometimes looking like a “zipper”) at the centre of the image,
oriented in the phase encoding direction. RF leaking from the
transmitter to the receiver usually causes this. Since the leakage is
at the resonance frequency, it will appear at the centre of each
projection. Slight variations in the amount of leakage in each
470
projection cause the artifact to be smeared out across the field-of-
view in the phase-encoding direction. This problem can be difficult to
track down and eliminate completely.
Line artifacts in the phase-encoding direction away from the centre
of the image usually result from RF interference at a well-defined
frequency.
Remedy:
a) Check the door
b) Clean the door periodically
c) Check the RF pollution from radio or television
d) Collect 2 averages in conjunction with phase alternation of
the excitation pulses

Local Inhomogeneity Artifacts

Any local internal distortion of the magnetic field cannot be corrected
by shimming. The most common causes of such local distortions are
the presence of internal ferromagnetic foreign bodies (implanted
ferromagnetic material obviously has to be tolerated) and
susceptibility effects. Ferromagnetic objects usually cause an area
of total signal loss around the object and distort the signal intensity
at the edge of this region. Owing to their conductive properties,
some nonferrous metal implants can disturbed the magnetic field by
low-level eddy currents.
Remedy:
a) Use SE
b) Change clothing
c) Avoid gradient-echo
d) Avoid metallic zippers
e) Removed jewellery and watches
471
 f) Removed makeup, ferromagnetic pigments.

Magic Angle Artifacts

Magic Angle Artifact seen mostly in tendons and ligaments of knee-
joint that are oriented at a magic angle, i.e. 55o to the main magnetic
field. This artifact is seen commonly in the rotator cuff and
occasionally in the patellar tendon region and elsewhere. Figure
shows magic angle artifacts.

Magnetic Field Perturbations

The main magnetic field (or more precisely, the lines of magnetic
flux) can be distorted by a number of factors outside the MR imaging
suite, for instance by large stationary or moving ferromagnetic
objects such as elevators or passing vehicles.
The field has to be protected by shimming or shielding, which is
generally performed properly by the manufacturer of the MR
equipment during installation. Therefore, field inhomogeneities from
the outside are at present seldom responsible for image artifacts .
See Local inhomogeneity, Susceptibility Artifacts, Bo field inhomogeneity, etc.

472
Motion Artifacts
Motion artifacts are the most frequently observed artifacts in MR.
appear as repeating densities oriented in the phase direction
occurring as the results of motion during acquisition of a sequence.
These artifacts may be seen from arterial pulsations, swallowing,
breathing, peristalsis and physical movement of a patient. The
motion of the patient causes this type of artifacts, voluntarily or
involuntarily during the scanning. The various types of motion
artifacts are as follows:

Aperiodic Motion
The involuntary motion of the patient like peristalsis, swallowing and
blinking of the eye, causes this type of artefacts. Except for the
peristalsis, the patient motion is best control by cooperation and
suitable education. In order to reduce motion artifacts caused by the
bowel movement administration of Glucagon (IV) or Buscupen (IM).
Preprocedural is advisable. Figure A: Without respiratory compensation
and B: With respiratory compensation. Arrow shows motion of the abdomen has
produced several curved lines.

473
Blood flow motion Artifacts
This type of artifact is caused by the flow of blood throughout the
cardiac cycle. The artifacts are prominent in axial images. Spoiled
gradient echo images, the distance between aorta and ghost artifacts (without
triggering)
Remedy: Spatial Presaturation (SAT)”.

Cardiac motion Artifacts

This type of artifact is caused by the contraction and relaxation of
heart (chest) while the scanning is going on. The respiratory motion
produces a number of distinct ghost images of the chest wall, while
the cardiac motion results in the column of noise associated with the
heart.
A: Motion of the heart has produced ghost images without cardiac
synchronization. B: Ghost image resulting from respiratory and cardiac motion
with both sets of artifacts being oriented along the phase-encoding gradient.
Remedy:
a) Cardiac gating

17.7 (2004)

474
CSF Pulsation Artifacts
The remedy for CSF pulsation ghosting is “Gating “ to the cardiac
cycle, e.g. plethysmograph (peripheral gating). However,
combination of “Gating” and flow compensation (flow comp) is
optimal for cervical and thoracic imaging. A and B: Transversal image of
the T spine showing flow voids in CSF
Remedy:
a) Gating to the cardiac cycle
b) Spatial Presaturation

475
MOTSA
It also occurs on 3D TOF and multiple overlapping thin slab
acquisitions images of the neck. Patient motion and vascular
pulsations during acquisition resulted in a stair-step pattern in the 3D
TOF of MIP. The MOTSA images have higher SNR but greater
background signal. Image showing step artifact due to MOTSA (3D TOF).

Patient Motion Artifacts

Since all the images in one sequence are taken at the same time, it
is important not to use excessively long sequences, as movement
for a brief period spoils all the images. Remedy: Make patient lie

476
comfortably, stabilize, with straps and cushions. Axial section of the
brain caused by motion of the head.
Remedy:
a) Make patient lie comfortably
b) Stabilize with straps and cushions

Respiratory Motion Artifacts

This type of artifacts is caused by respiration during the scanning.
This can be corrected by breath holding. It also can be avoided by
placing bellows (pressure transducers) around the patient’s chest or
abdomen. A: Respiration-induced artifacts on axial section of the abdomen. B:
Resulting from respiratory and cardiac motion with both sets of artifacts being
oriented along the phase-encoding gradient, while cardiac motion results in the
column if noise associated with the heart.
Remedy:
a) Breathe holding
b) Respiratory gating and compensation

17-7 2004
477
Non-linear gradient field Artifacts
The image distortion, asymmetrical edge ringing band in multi echo
sequence due to gradient non-ideal design, gradient amplifier
limitations, and interference between stimulated and spin-echo.
Remedy:
a) Spoiler gradients
b) Better gradient design
c) Over compensate the amplifier

Noose Artifacts

478
Point Artifacts
Point artifact is seen as a bright spot of increased signal intensity in
the centre of the image. This is caused due to constant offset of the
DC voltage in the receiver coil, which after Fourier transformation
appear as a bright spot in the centre of the image. This is an axial
image of the cardiac showing a central point artifact.

479
Quadrature Artifacts
The MR signal is detected using a receiver which has two channels,
with the reference signal to the second channel being phase-shifted
by exactly 90o with respect to the reference used for the first
channel. Any maladjustment of this phase-shift result in a ghost
image being observed, which is rotated about both the x-and y-axes
with respect to the main image. Quadrature artifact resulting from an
incorrectly adjusted receiver.
Remedy:
a) This can be eliminated by adjusting the phase and gain of
the receiver, which is most easily done by trying to minimize
the quadrature peak in a transform, off-resonance signal.

Respiratory Motion Artifacts

» See Motion artifact

Radiofrequency Feed-through Artifacts

480
Phase of the signal just out of the field of view; changes preparation
direction. This is on of the k-Space-Related Artifacts
Remedy:
a) Filtering the frequency encoding direction
b) Oversampling in the phase encoding direction

RF and Gradient Artifacts

» See Slice profile artifacts, Artifacts in Multiple SE Sequences, Line Artifacts

Ringing Artifacts
» See Gibbs / Truncation Artifact page-

Slice Overlap Artifacts

This slice overlap artifact is a name given to the loss of signal seen
in an image from a multiangle, multislice acquisition, as is obtained
commonly in the lumber spine and orbits.
If the slices obtained at different disk spaces are not parallel, then
the slices may overlap.
If two levels are not done at the same time, e.g. L4/L5 and L5/S1
then the level acquired second will include spins that have already
481
been saturated. This causes a band of signal loss crossing
horizontally or vertically in our image, usually prominent posteriorly.
A and B: Para-axial (oblique) T2WI through optic nerves from a multiangle. This
causes a band of signal loss crossing vertically in sagittal image. C and D: This
is a para-axial T2WI through L5/S1 from a multiangle, multislice acquisition, as
is obtained commonly in the lumber spine)

482
Slice Profile Artifacts
The slice profile of an RF pulse can be distorted when repetition
times not allowing full recoveries of the signal are used. For any
given profile, there is always a transition zone where the value of the
flip angle goes from zero up to the desired value. In the case of
incomplete recovery of the magnetization, the strongest signal is
produced at a flip angle which is less than 90o. The slice profile will
therefore show maximum peaks on either side of a central dip.
This becomes particularly acute when very short TR values are used
in conjunction with a large flip angle (e.g., spoiled FLASH sequence
with good T1 contrast).
In such cases the desired contrast is not obtained since we will have
a mixture of contrasts due to the variation in the flip angle across the
slice. This can be overcome by using RF pulses, which give very
sharp transition zones, or by using a 3D sequence.

Spatial misregistration, Spins phase effects Artifacts

Displace image ghost, Vascular ghosts, anomalous intensities in
image due to repetition time asynchrous with pulsatile flow (flow
effect) delay between phase encoding and frequency encoding etc.,
Remedy:
a) Gradient moment correction methods

Stars Artifacts
» See Zipper Artifact

483
Susceptibility Artifacts
The susceptibility of a tissue tells us how easily it can be
magnetized. Normally most of the tissues have susceptibility values
which fall in a fairly narrow range. However, the presence of
paramagnetic material (e.g., localized concentrations of hemoglobin
after a hemorrhage or high concentration of ferromagnetic contrast
agents) or tissue-air interfaces lead to local variations in the
susceptibility, which result in a reduction of the quality of the local
field. The form of the susceptibility artifact depends on the local
conditions, and both increases and decreases in signal intensity are
possible. Tissue-air interfaces, which give rise to such artifacts, can
be found in the lungs, around the sinuses and in the nasopharynx.
The air in the lungs causes the lake of signal from the lungs and the
susceptibility artifacts produced by the interfaces between air and
lung tissue. A to C: Arrows indicate distortion due to susceptibility differences
between metal and body tissue. Artifacts caused by metallic objects, causing
severe signal loss and geometric distortion, a) Make up eyeliner b) Magnetic
field distortion due to hair pin c) Herrington rod)
Remedy:
a) Using spin echo
b) Acquire full k-space imaging
c) Use phase image or special pulse sequence
d) Avoid partial (asymmetric) echo sampling and/or half scan

484
Truncation Artifacts
The truncation artifact is also known as ringing or Gibbs artifact. It
appears as parallel striations, close to interfaces between tissues
with different signal intensities, such as fat-muscle or CSF-spinal
cord. Because these lines mimic regular structures, they can present
interpretation problems if they are not recognized as artifacts.
Truncation artifacts are particularly severe when small image
matrices are used. Oversampling, while having no effect on the
intensity of the truncation artifacts, does reduce their spacing which
often results in the artifact becoming blurred and imperceptible.
Truncation artifacts are most commonly seen in the phase-encoding
direction since increasing the matrix in this direction results in an
undesirable increase in scan time. A: 60% acquisition with ringing
artifacts; B: 80% acquisition, no artifacts visible. C: and D: truncation artifact

485
mimicking syringomyelia. (c: T1W, d: T2WI). As shown in a: and b, the
reduction in such artifacts is achieved by increasing the matrix size from, e.g.,
128x128 to 256x256, or by increasing the percentage of phase-encoding profile.
Remedy:
a) Apply a low pass filter
b) Combination of suitable scan orientation
c) Reduced by simply using a larger image matrix.
d) Increase the data matrix in the frequency-encoding direction

17-13-2008

Undersampling / Aliasing Artifacts

The image changes into an image with an aliasing (wraparound)
artifact.
This is also one of the k-space related artifacts.
Remedy:
a) Increase FOV
b) Filtering the FED
c) Oversampling in the PED

Unknown Artifact
Haemangioma of the right arm. a) Transverse intermediately, and b)
T2-weighted images depict an ill-defined high signal intensity lesion
in the right lung. Follow-up studies on another day and the use of CT
did not show such a lesion. The cause of the artifact remained
unclear.
Remedy:

486
 a) Use other modality
b) Any unknown artifacts need follow-up study

Venetian blind Artifacts

Multiple overlapping thin slab acquisition (MOTSA). Instead of one
thick slab, multiple thinner slabs are acquired. MOTSA reduces
overall saturation effects, but introduces the ‘Venetian blind’ artifact.
Such artifacts do not exist when one uses ‘tilted optimized non-
saturation excitation’ (TONE). TONE applies ramped flip angles to
the different slices of the slab. Increasing the flip angle counteracts
saturation effects, in this case of slow flowing blood in deeper slices.
Combined with magnetization transfer contrast (MTC), which
suppresses background signal from brain parenchyma, TONE
boosts the visibility of small vessels.

Wrap around Artifacts

» See Aliasing, Backfolding or Undersampling Artifacts

487
Zipper Artifacts
This artifact is caused by external RF entering the room at a certain
frequency and interfering with inherently weak signal coming from
the patient.
There are various causes for zipper artifacts in images. Most of
them are related to hardware or software problems. The zipper
artifacts that can be controlled easily are those due to RF entering
the scanning room when the door is open during acquisition of
images. RF from radio transmitters will cause zipper artifacts that
are oriented perpendicular to the frequency axis of the image.
Frequently there is more than one artifact line on an image from this
cause. A and B: Effect of right interface causing streak artifacts. A leaking RF, causing
pick-up of external RF signals, can cause this.

Remedy:
a) Check the door
b) Check the hardware & software
c) System generated artifacts should be reported service
engineer.
 Phase cycle; displace to boundary with alternate phases; spoil
stimulated echo with gradients.

488
Artefacts reduction techniques
There are several artifact reduction techniques that help to produce
images with a competitive edge. Most artifacts are inappropriately
encoded signals with in an image, so their elimination or reduction
will improve the image quality. Artifact reduction techniques are able
to minimize flow (CSF and blood), breathing, swallowing, and other
artifacts. In the form of presaturation pulses, artifact reduction
techniques are used to improve significantly image quality by
selectively eliminating signal production.

489
 Name Aliasing / Wrap around / Foldover / Back folding Artifacts
Description Aliasing, backfolding, wraparound artifacts
Aliasing

Causes Undersampling in k-space/ Fourier space

Solution Sample higher frequencies; band limit the data by filtration; limit excitation
volume (↑FOV, Filtering the FED, Oversampling in the PED)
Name Aperiodic Motion Artifacts
Aperiodic

Description Repeating densities, curved lines

Causes Involuntary motion (Peristalsis, swallowing, blinking of eye)
Solution Except peristalsis, need cooperation & education (Glucagen+Buscopen)
Name Array processing artifacts
Description Grid-like artifacts superimposed on the image due to faulty array processor
Array

Causes Array processing error in computation system

Solution Check the array processing system & reconstruction system
Name Artifacts in Multiple SE Sequences
Artifacts in

Description At the edge of the slice, a whole range of flip angles will be present.
Causes Refocusing pulses will not be perfect 180o pulses across the whole slice
Solution Addition of spoiler gradients to the sequence or the use of phase-cycling
Name Bo field inhomogeneity
B
o
f
i

490
 Description Image distortion signal loss
Causes Strongly paramagnetic or ferromagnetic implants
Solution Protect the field by shimming, Remove the ferrometallic objects
Name Black boundary Artifacts
Description Well-defined black contours
Black

Causes Pulse sequences prone to such artifacts

Solution Use in-phase echo times, & use spin echo pulse sequence
Name Blood Flow Motion Artifacts
Description Ghost artifacts
Blood

Causes Flow of blood throughout the cardiac cycle

Solution Spatial Presaturation (SAT)
Name Blurring
Blurring

Description Image bluring

Causes Patient motion, low-resolution sampling
Solution

Name Cardiac Motion Artifacts

Cardiac

Description Ghost image

Causes Contraction and relaxation of the heart (chest)
Solution Cardiac gating is mandatory during the procedure.
Name Chemical Shift Artifacts
Chemical

Description Dark and bright signal

Causes Super imposition of fat and water signals
Solution The only way to eliminate this artifact is to use a fat suppression technique
Name Coil Selection Artifacts
selection

Description Structure noise caused due to coil selection

Coil

Causes Improper coil selection at the site of the exam

Solution Select a suitable coil, and name from the coil name window
Name Contours
Counters

Description Dark boundaries between regions

Causes IR null point; chemical shift; opposed phase image; motion shear
Solution Real reconstruction or change TI; use SE or CSI; gradient moment rephasing
Name Cross talk
Cro
ss

Description Interventional MR needle

491
 Causes Short concatenations
Solution Use cross talk
Name CSF Pulsation Artifacts
pulsation

Description Flow voids in CSF

CSF

Causes Flow of the CSF

Solution Combination of Gating & flow compensation
Name Image distortion
Distortion

Description Inhomogeneity in the magnetic field, ferromagnetic

Causes Presence of ferromagnetic foreign bodies and susceptibility effects
Solution Remove external metallic objects, Avoid GRE, wash ferromagnetic pigments
Name Donald Duck
DonaldDuc

Description Low signal intensity area

k

Causes Dentures / ferromagnetic implants

Solution Repeat scan on another sitting, use other modality like CT, PET
Name Error in data
Error in

Description Stripe in image washed-out image

data

Causes Bad frequency encoding, frequency channel with problem, ADCI over range
Solution Delete and interpolate bad data alternate receiver; shield room, etc.,
Name Flow, Spatial misregistration, Spins phase effect Artifact
Description Displaced image ghosts; anomalous intensities in image
Flow

Causes Incorrect phases due to motion; refreshed spines or loss of spins

Solution Gradient moment correction methods
Name Flow, spatial misregistration artifacts, spin phase effects
Description Vascular ghosts (ghost artifacts), anomalous intensities in image
*Flow

Causes TR asynchrous with pulsatile flow (flow effect) delay between PE & FE
Solution Gating, Flow compensation, Spatial Presaturation
Name Ghost Artifacts
Description 180o rotate; displaced ghost reduplication of image in phase encoding dir
Causes Quasi-cyclic motion (heart-beat respiration) motion (Quadrature imbalance;
Ghost

stimulated echo in multi echo; digitalization errors on the DAC motion)

Solution Correct; rephase all higher order echoes; keep phase gradients on integer
amplitudes; many partial solutions
Name Gibbs / Truncation / Ringing
b
b

G
i

492
 Description Edge ringing, Syrinx-like stripe; (Gibbs phenomenone)
Causes Sharp changes in contrast (limited extent of k-space)
Solution Oversample filter; model the data
Name Local Inhomogeneity Artifacts
eity
Inhomogen

Description Signal loss and signal distortion

Causes Presence of ferromagnetic foreign bodies and susceptibility effects
Solution All external metallic objects such as jewellery & watch should be removed
Name K-space related Artifacts
K-space

Description RF feed-through / aliasing or wrap-around / foldover

Causes Enhanced by k-space, error in k-space filter, Bad data points or spikes.
Solution Adjust receiver perfectly
Name Line artifacts
artifacts

Description High intensity line at the centre of the image in the phase-encoding direction
Line

Causes Polluting RF/RF leaking from the transmitter to the receiver

Solution Can be removed by collecting two averages data.
Name Magic Angle Artifact
Magic angle

Description Homogeneous appearance of collagen fibres

Causes Highly anisotropic structure and water have a high preferential alignment.
Solution

Name Magnetic Field Perturbation

Magnetic

Description Special distortion of the image or loss of signal

field

Causes Bo inhomo; ferromag implants, susceptibility, particular iron; chemical shift

Solution Shim the magnet; remove interfering object, use SE; ↑ read-out gradient
Name Motion Artifacts
Motion

Description Repeating densities oriented in the phase direction

Causes Occurring as the results of motion during acquisition of a sequence.
Solution Comfort & stabilize the patient with straps and cushions.
Name Multiple Overlapping Thin Slab Acquisition (Angiography)
MOTSA

Description Stair-step pattern in the 3D TOF of MIP

Causes Patient motion and vascular pulsations during acquisition
Name Non-ideal / Non-linear / Gradient field
idea

Non
-
l

Description Image distortion; asymmetrical edge ringing; band in multiecho sequence

493
 Causes Gradient non-linear due to design or gradient amplifier limitation;
interference between S & SE
Solution Better gradient design; over compensate the amplifier; spoiler gradients
Name Point Artifact
Description Bright spot of increased signal intensity in centre of the image
Point

Causes Constant offset of the DC voltage in the receiver

Solution

Name Quadrature Artifacts

Quadrature

Description Ghost image

Causes Incorrect / maladjustment of receiver coil
Solution Correct / Adjustment the receiver coil
Name Respiratory Motion Artifacts
Respiratory

Description Repeating densities

Causes Respiration during the scanning
Solution Respiratory gating & compensation. Use bellows
Name RF feed through Artifacts
RF feed

Description Feed-through artifacts

Causes Resulting from k-space image processing
Solution

Name Ringing / Gibbs / Truncation Artifacts

Ringing

Description Edge ringing, syrinx-like stripe. (» Gibbs phenomenone)

Causes Sharp changes in contrast (limited extent of k-space) boundary discontinuity
Solution ↑matrix, using filter, change the direction of phase and frequency
Name Slice Overlap Artifacts
Description Signal loss
Sliceo

Causes Multislice acquisition at multiple angle

Solution

Name Slice Profile Artifacts

Slice profile

Description

Causes
Solution

Name Smearing Artifacts

Sme
arin
g

Description Smears the image in phase-encoding direction & incorrect phase-encoding

494
 Causes Eye movement and periodic movement
Solution Education, Cooperation, etc
Name Zippers / Stars Artifacts
Stars/Zippe

Description Bands through centre image / lines perpendicular to the frequency axis
rs

Causes Imperfect faraday cage; residual FID or stimulated echo

Solution Phase cycle; displace to boundary with alternate phases;
Name Susceptibility Artifacts
Susceptibili

Description Signal dropout / bright spots / no signal at all

ty

Causes Presence of paramagnetic optic material, tissue-air interphases

Solution Remove all paramagnetic material, eyeliner, make up use SE PS
Name Truncation / Gibbs / Ringing
Truncation

Description Edge ringing, syrinx-like stripe

Causes Discontinuity of the boundary of Fourier space
Solution ↑matrix, using filter, change the direction of phase and frequency)
Name Venetian blind artifacts
Venetian

Description Venetian blind types artifacts

Causes Angiogram using TONE and MTC
Solution Can be partly overcome with the MOTSA technique
Name Zippers / Stars Artifacts
Zippers/Sta

Description Bands through centre image oriented perpendicular to the frequency axis
rs

Causes RF feedthrough; HW & SW problem, weak signal coming from patient

Solution spoil stimulated echo with gradients, closed the door,

Untitled-1.jpg

495
496
ACCRONYM AND SYNONYM IN CT

3D Three dimensions
3D-CT Art 3D CT Arteriography
AD Adult body
AH Adult head
AJR American journal of radiography
ALARA As low as is reasonably achievable
AP Antero-Posterior
AVM Arterio Venous Malformation
BHT-S/M Breath holding technique-Single/Multiple
BIR British institute of radiology
BJR British journal of radiology
C Contrast
C.P.Angle Cotro-phrenic angle
CAAT Computer assisted axial tomography
CAR Computer assisted radiology
CAS Computer assisted surgery
CAST Coputeraided automated scan technique
CAT scan Computer assisted tomography scan
CAT scanner-Computer assisted tomography scanner
CAT Computer assisted tomography
CB Child body
CBD Common bile duct
CC Craniocaudad
CCA Common carotid artery
CCT Conventional CT
CCT/CECT Contrast enhanced computed tohography
CD Common (hepatic) duct
CDJ Crevico dorsal junction
CH Child head
CHA Common Hepatic artery
CHA Common hepatic artery
CHD Common hepatic duct
CHD Common hepatic duct
CK Convolution Kernels
CM rate Contrast medium injection rate
CM Contrast media
497
CMLine Cantho meatal line
C-N Ratio Contrast to noise ratio
Collimation Slice thickness determination
COPD Chronic obstructive pulmonary disease
CR Computed radiography
CRR Curve planer reformation
CSF Cerebro spinal fluid

CT Abbreviation
CT Myelo CT myelography
CT scan Computed tomography scan
CT scanner-Computed tomography scanner
CT Computed tomography
CTA CT angiography
CTAP Computed tomography (during) arterial portography
CTAP CT arterial portography
CTBG CT guided biopsy
CTC Computed tomography colonography
CTGAD CT guided aspiration /drainage
CTG-NB CT guided-nerve block
CTK-CMP CT kidney-corticomedullary phase
CTK-EXP CT kidney excretory phase
CTK-NGP CT kidney nephrography phase
CTK-PCP CT kidney pre-contrast phase
CTLM Computed Tomography mammography laser
CTN Sur-plan-CT navigation plan before surgeon
CTRT-plan CT guided radio theraphy planning
CVJ Cranio vertebral junction
CXR Chest x-ray
DICOM Digital image communication in medicine
DILD Diffuse infiltrative lung disease
DLJ Dorao lumber spine junction
DR Digital radiography
DSA Digital subtraction angiography
E Exposure
EAm External auditory meatus
EBCT Electron beam CT (cine CT)
EBT Electron beam tomography
ECA External carotid artery
498
ECT Emission computed tomography
EDH Extra dural haemorrhage
EHBO Extra hepatic biliary obstruction
F/F Feet first
FDD Floppy disk drive
FNA Fine needle aspiration
FNAB Fine needle aspiration biopsy
FNAC Fine needle aspiration cytology
FOV Field of view
FSD Focus to skin distance
GB Geiga bytes
GDA Gastrodudenal artery
GI radiology-Gastrointestinal radiology
GI Gastrointestinal
GIT Gastrointestinal tract
GUT Genito urinary tract
H/F Head first
H/O History of
HA phase Hepatic artery phase
HBW Hard bone window
HDD Hard disk drive
Helical CT Helical computed tomography
HI Head injury
HIS Hospital information system
HNR Head and neck region
HOCM High osmolar contrast media
HRCT High resolution computed tomography
HRCT High resolution CT
HU Hounsfield units
HVR Hepatic venous redicle
IAM Internal auditory meatus
ICA Internal carotid artery
IHBC Intra hepatic biliary canaliculi
IHBD Inter hepatic biliary dilatation
IHBO Intra hepatic biliary obstruction
IOC Internal auditory canal
IOML Infra orbito meatal line
IP Imaging plate
IPA Inter polation algorithm
499
IPR Immersive perspective rendering
IRI Image reconstruction interval
IRL Image reconstuction length
ISD Inter scan delay
IT Injection time
IVC Inferior vena cava
IV-CM Intra venous contrast medium
IVCM-SVT IVCM standard volume technique
IVD Inter vertebral disc
IVP Intravenous pylography
IVU Intra venous urogram
IVU Intravenous urography
KB Kilo bytes
KV Kilo volts
Kw Kilo watt
L threshold Low Threshold visualization SR/VR
LA Left atrium
LAC Left atrial circumflex
LADA Left anterior descending artery
LAO Left anterior oblique
LAS Left anterior superior
Lat. Lateral
LCNB Large cutting needle biopsy
LMZ Left mid zone
LN Lymph nodes
LOCM Low osmolar contrast media
LOCM Low osmolar contrast medium
LPO Left posterior oblique
L-R Left to right orientation
LSJ Lumbo sacral spine junction
MAL Mid-axilary line
MAS Milli ampere second
Max Maximum
MB Mega bytes
MHU Mega heat units
Min Minimum
MIP Maximum intensity projection
MIP Maximum intensity projection
MOD Magneto optical disc
500
MPR Multi planer reconstruction
MPR-Cor Multi planer recon-coronal
MPR-Obl Multi planer recon-oblique
MPR-Sag Multi planer recon-sag
MPVR Multiplaner volume rendering recons
MSCT Multi-slice CT
MSK Musculo skeletal
NECT Non-enhanced CT
OC Operator’s console
OGER Ortho graphic external rendering
OL Line Orbito meatal line
OML Orbito metal line
PET-CT Positron emission tomography CT
Pitch Table incrementation/collimation
Pr. Inj Preasure injector
PUJ Pelvi ureteric junction
PV phase Portal vein phase
PVE Partial volume effect
PVR Portal venous radicles
RAM Random access memory
RAW DATACT data acquired during each exposure
RCC Renal cell carcinoma
Recon Reconstruction
Ref S-V Reference scout view
ROI Region of interest
ROI Region of interest
S# Serial number
S.Delay Scan delay
SAH Sub arachnoid haemorrhage
SC joints Sterno-clavicular joints
SCT Spiral CT / Helical CT / Volume CT
SDH Subdural haematoma
Sec. Second
SL# Slice number
SLK THK Slice thickness
SMA Superior mesenteric artery
SMV Superior mesenteric vein
SOL Space occupying lesion
SPECT Single photon emission computed tomography
501
Spiral CT Spiral computed tomography
SR Surface rendering
SSD Shaded surface display
SSD Shaded surface display
ST/B Algo Soft tissue/b one algorithm
STD Algo Standard Algorithm
SVC Suprior vena cava
TB Temporal bone
TBT Tracheo bronchial tree
TCMV Total contrast medium volume
TIM Total imaging matrix
TMJ Temporo mandibular joint
Tomo Tomogram
Topo Topogram, Scout view, Scanogram
Ultrafast CTCine CT / Electron beam CT
VOI Volume of interest
VR Volume rendering
VRT Volume rendering technique
VUJ Vesico ureteric junction
VVF Vesico veginal fistula
W/L Window level
W/W Window width
WC Window centre
WL Window level
WS Work station
WSC Water soluble contrast
WSCM Water soluble contrast medium
WW Window width

502
ALL MEDICAL ABBREVIATION

 decay alpha decay

 emission alpha emission
- emission beta minus emission
 motor n / n alpha motor nerve neurone
 particle alpha particle
 particle beta particle
 radiation alpha radiation
 radiation beta radiation
 ray alpha ray
 delta; ..
 gyromagnetic ratio
 differential diagnosis
+ emission beta plus emission
+decay beta plus decay
-1 Antitryp alpha 1antitrypsin
-1 AT alpha 1antitrypsin
-blocker beta-blocker
-decay beta minus decay
fp , FP alphafetoprotein
-HCG beta-human chorionic gonadotrophin
-IFP alpha interferon
-LPH beta lipotrophin

503
-MSH alpha melanocyte stimulating hormone
-MSH beta melanocyte stimulating hormone
1,25-DHCC dehydroxycholecalciferol
111
In, 111-In indium-111
113
In, 113mIn indium-113m
123
I, 123-I iodine-123
125
Ca …………
125
I, 123-I iodine-125
131
I, 123-I iodine-131
14
C carbone-14
14
CO2 carbon dioxide-14
17
FDG, 17-FDG fluorodeoxyglucose
18
F, 18-F fluorine-18
195m Au gold-195m
1o HPT primary hyperparathyroidism
1oHB first-degree heart block
2,3 DPG 2,3-diphosphoglycerate
25-HCC 25-hydroxycholecalciferol
2-D two-dimensional
2DFT two-dimensional Fourier transforms
2o HPT secondary hyperparathyroidism
2oHB second degree heart block
3-D three-dimensional
3-D FASTER
3D GRE 3d gradient echo

504
3D MP RAGE 3d magnetization prepared rapid
gradient echo
3D-CT Art three-dimensional CT arteriography
3-DFT three-dimensional Fourier transforms
3o HPT tertiary hyperparathyroidism
3oHB third degree heart block
51
Cr chromium-51
52
Fe, 52-Fe iron-52
57
Co, 570Co cobalt-57
58
Co, 58-Co cobalt-58
59
Fe, 59-Fe iron-59
5-ASA 5-Aminosalicyclic acid/mesalazine
5-HIAA 5-hydroxyindole acetic acid
5-HT 5-hydroxytryptamine (serotonin)
67
Ga, 67-Ga gallium-67
81m
Kr, 81m-Kr krypton-81m
85
Kr, 85-Kr krypton-85
Å angstrom (10-10 meters)
A&E accident and emergency
A Echo asymmetric echo
A absorbance; activity; admittance
A accommodation; arterial blood
Å angstrom

505
A adenine; adenosine; ampere; anode; anterior
atrial branch; Mass number; alanine; alveolar
gas
A anterior / Amphère / Mass number
a area
a.c. alternating current; ante cibum
A.N. Other another
A/D analogue-to-digital converter
A/N / AN antenatal
A/O alter and oriented
A/P, AP Antepartum; Antero posterior
A2 aortic valve
A2 aortic second sound
AA abdominal aorta; alcoholics anonymous;
amino acid; amyloid A; aortic arch; arch
aortography; atlantoaxial; autoantibodies
AAA abdominal aortic aneurysm; acute anxiety
attack
AAC antibiotic-associated (pseudomembranous)
colitis
AAL anterior axillary line
AAo ascending aorta
AAPC antibiotic-associated pseudomembranous
colitis
AAS acute anxiety syndrome
AAV adeno-associated virus
506
AB abnormal beliefs; apex beat; asbestos body
Ab antibiotic; antibody
ABA allergic bronchopulmonary aspergillosis;
antibacterial activity
ABC acalculous biliary colic; airway, breathing,
circulation; aneurismal bone cyst; aspiration
biopsy cytology
abd abduction
ABE acute bacterial endocarditis
ABG arterial blood gases
ABI ankle-brachial index
ABMT autologous bone marrow transplantation
Abn. abnormal
ABO. abortion; ABO system
Abor. abortion
ABP arterial blood pressure
ABPA allergic bronchopulmonary aspergillosis
ABPC antibody-producing cell
ABPI Association of British Pharmaceuticals in
Industry
ABR absolute bed rest
ABT autologous blood transfusion
ABU asymptomatic bacteriuria
ABVD adriamycin, bleomycin, vinblastine and
dacarbazine

507
AC abdominal circumference; abdominal
compression;
A-C Acromioclavicular
AC, ac acromioclavicular; alternating current

ACA anterior cerebral artery; anterior

communicating artery; anticentromere
antibody
ACC articular chrondrocalcinosis
ACD acid citrate dextrose; allergic contact
dermatitis; anaemia of chronic disorders
AC-DC bisexual (slang)
ACE angiotensin-converting enzyme
ACEI angiotensin-converting enzyme inhibitor
ACG angiocardiography; apexcardiogram
Ach, Ach acetylcholine
Ach’esterase I acetylcholinesterase inhibitor
AchE acetylcholinesterase
Acid phos (ph) acid phosphate
ACKD acquired cystic kidney disease
ACL anterior cruciate ligament
ACLS advanced cardiac life support
ACOM anterior communicating artery
ACOP approved code of practice
ACP acid phosphatase
ACR American College of Radiologist
508
ACR-NEMA American College of Radiologist-
ACT anticoagulant therapy
ACTH adrenocorticotrophic hormone
AD converter analogue-to-digital converter
AD adult body
AD alzheimer’s diseases; alzheimer’s dementia;
ADA alternated delay acquisition
ADC analogue-to-digital converter / apparent
diffusion coefficient
ADCC antibody-dependent cell-mediated cytotoxicity
ADCH adrenocorticotrophic hormone
Add. adduction
ADEM acute disseminated encephalomyelitis
AdenoCa adenocarcinoma
ADH anti-diuretic hormone
ADHD attention deficit hyperactivity disorder
ADL activities of daily living; annual dose limit
ADP adenosine diphosphate
ADPD autosomal dominant polycystic disease
ADR adrenaline (epinephrine); adverse drug reaction
ADRF adibetic demagnetization in the rotating frame
ADSL asymmetrical digital single line
ADT admission, discharge and transfer
AE asymmetric echo
AE air entry; asymmetric echo; atrial ectopic (beat)
AEF amyloid-enhancing factor
509
AF amniotic fluid; atrial fibrillation
AFB acid fast bacilli
AFLP acute fatty liver of pregnancy
AFM after fatty meal
AFO ankle-foot orthosis
AFP adiabatic fast passage
Afp, AFP alphafetoprotein; adiabatic fast passage
AFV amniotic fluid volume
AFX atypical fibroxanthoma
Ag / AG antigen; silver; atrial gallop
Ag-Ab antigen-antibody
AgBr silver bromide
AGC automatic gains control
AGN acute glomerulonephritis
AGT antiglobulin test
AGV aniline gentian violet
AH adult head
AHCD acquired hepatocellular degeneration
AHF antihaemophilic factor
AHG antihaemophilic globulin
AI amplitude image; aortic incompetence; aortic
insufficiency;
AI aluminium
AI2O3 aluminium oxide
AICA anterior inferior cerebral artery
AID artificial insemination by a donor
510
AIDP acute inflammatory demyelinating polyneuritis
AIDS dementia complex
AIDS acquired immunodeficiency syndrome
AIH artificial insemination by the husband
AIHA autoimmune haemolytic anaemia
AII second auditory area; mass number
AIIS anterior inferior iliac spine
AIN acute interstitial nephritides
AION anterior ischaemic optic neuropathy
AIP acute intermittent porphyria
air conduction; acute cholecystitis; alcoholic
cirrhosis
AIUM American Institute of Ultrasound in Medicine
AJ ankle jerk
AJR American Journal of Roentgenology
A-K, AK above knee
AKA above knee amputation; also known as
AL amyloid L
ALA 5-aminolaevulinate
ALARA as low as is reasonably achievable
ALD adrenoleukodystrophy; alcoholic liver disease
ALF acute liver failure
ALFMA abnormal low-frequency magnetic
activity
ALI annual limit on intake
Alk. Phos. alkaline phosphatase
511
ALL acute lymphocytic leukaemia; acute
lymphoblastic leukaemia
Allo-BMT allogeneic bone marrow transplantation
ALP alkaline phosphatase; anterior lobe of pituitary
ALS amyotrophic lateral sclerosis
ALT alanine aminotransferase
ALVF acute left ventricular failure
AM acute marginal artery; Adnexal mass
Am.J.Roent American Journal of Roentgenology
AMA antimitochondrial antibody
AMC arthrogryphosis multiplex congenita
AMI acute / anterior myocardial infarction
AML acute myeloid leukaemia; angiomyolipoma
A-Mode amplitude mode
AMP adenosine monophosphate
AMS  amylase; amyotrophic lateral sclerosis
amu atomic mass unit
aMVL anterior mitral valve leaflet
AN acoustic neuroma; anorexia nervosa
ANA anti-nuclear antibody
ANC absolute neutrophil count
ANCA anti-neutrophil cytoplastic antibody
and Measurements
angena pectoris; anterior pituitary
Angio. angiographic suite; angiography
Ank. Spond. ankylosing spondylitis
512
ANOVA analysis of variance
ANS anterior nasal spine; autonomic nervous
system
Ant. pit. anterior pituitary
Ant. prand. ante prandium
Ant. tib. anterior tibial
ant., ANT anterior
anterior mitral leaflet
Anti-CEA anti-carcinoembryonic antigen antibody
anticoagulant; ascending colon
Anti-D anti-D immunoglobulin
Anti-GBM anti-glomerular basement membrane
Anti-RNP anti-ribonucleoprotein antibody
Ao aorta
AO/AAO, AAo ascending aorta
AOB alcohol on breath
AOD adult onset diabetes; arterial occlusive
disease
AODM adult onset diabetes mellitus
AOE admission order entry
AOM acute otitis media
AOT Andersson Olsson table; ‘head over heels’
AoV aortic valve
AP acid phosphate; acute pancreatitis; alpha
pulse;
APB atrial premature beat(s)
513
APC antigen presenting cell; atrial premature
contraction/complex
APCD adult polycystic depolarisation/disease
APD aminohydroxypropylidenediphosphonate
APER abdomino-perineal excision of rectum
APG antegrade pyelogram
APH ante partum haemorrhage
API applications programming interface
APKD adult polycystic disease
APN acute pyelonephritis
Apo. A apoprotein A
APORF acute postoperative renal failure
APR abdomino-perineal resection; acute phase
reaction
APS antiphospholipid syndrome
APSAC anisoylated plasminogen-streptokinase
APSCVIR Asian Pacific Society of Cardiovascular and
Intv. Radiology
APSGN acute post-streptococcal
glomerulonephritis
APTT activated partial thromboplastin time
APUD amine precursor uptake and decarboxylation
APVR anomalous pulmonary venous return
APW aortopulmonary window
AR allergic rhinitis; aortic regurgitation; autosomal
recessive
514
ARA anal-rectal agenesis; anorectal agenesis
ARC AIDS-related complex; archive controller
ARDMS American Registry of Diagnostic Medical
Sonographers
ARDS adult/acute respiratory distress syndrome
ARF acute renal failure
ARM/AROM artificial rupture of membranes
ARP adibetic rapid passage
ARPD autosomal recessive polycystic disease
ARPKD autosomal recessive polycystic kidney
disease
ARR automatic repeat request
ARSAC regula Admin of Radioactive Substances
Advisory Comm.regulations
ARSAC Admin of Radioactive Substances Advisory
Committee
arthritis syphilitica deformans
artificial / assisted respiration
artificial insemination; artificial intelligence
AS ankylosing spondylitis; aortic stenosis;
arteriosclerosis/otic
ASAP as soon as possible
ASC asthma symptom checklist
Asc. ascending
ASCII american standard code for information
interchange
515
ASCVD arteriosclerotic cardiovascular disease
ASD alzheimer’s senile dementia; atrial septal
defect
ASDH acute sub-dural haemorrhage
ASE advance spin echo / asymmetric spin echo
ASFAIK as far as I know
ASH asymmetrical septal hypertrophy
ASHD arteriosclerotic heart disease
ASIC application specific integrated circuit
ASIS anterior superior iliac spine
ASIS aromatic solvent induced shift
ASO anti-streptolysin O
ASOT anti-streptolysin O titre
ASPVD Arteriosclerotic peripheral vascular
disease
ASS acute spinal stenosis
AST arterial spin trapping
AST aspartate aminotransferase/aspartate
transaminase
ASVS arterial stimulation and venous sampling
at no atomic number
ATB antibiotic
ATCL, ATLL adult T-cell lymphoma/leukaemia
ATEC automated tissue excision and collection
ATG antithymocyte globulin
ATLS advanced trauma life support
516
ATM asynchronous transfer mode
ATN acute tubular necrosis
ATP adenosine triphosphate
ATP adenosine triphosphate / attached proton test
atrial premature depolarization; automated
peritoneal dialysis
Atyp. atypical
AUA asymptomatic urinary abnormalities
Auto-BMT autologous bone marrow transplantation
autonomic neuropathy; avascular necrosis
autosomal dominant
AUV anterior urethral valves
AV aortic valve; arterio-venous; arterio-ventricular
avascular necrosis
AVCx atrioventricular circumplex branch
AVD aortic valve disease
AVF arteriovenous fistula
aVF augmented volt foot
AVH acute viral hepatitis
AVHD acquired valvular heart disease
aVL augmented volt left
AVM arterio Venous Malformation
AVM arteriovenous malformation
AVN artrioventricular node; artrioventricular node
artery;
AVNRT AV node re-entry tachycardia
517
AVP arginine vasopressin
AVR aortic valve replacement / repair
aVR augmented volt right
AVRT artrioventricular re-entry tachycardia
AVS aortic valve stenosis
AWOL absent without leave
ax axis
AXR abdominal x-ray
Az area under receiver-operator characteristic
curve
AZT azidothymidine (Zidovudine)
B / Bo static magnetic field
B cell bursa-equivalent cell
B bucky factor; byte; minimal detectable blurring
B&D bondage and discipline
B, Bo magnetic field; magnetic flux density
B1 the induced field in magnetic resonance
imaging
B1 the induced field in MRI
B1 the radio frequency magnetic field
B1R Receive B1 magnetic field
B1T Transmit B1 magnetic field
BA backfolding artefact, blurring artefact
BA, Ba backfolding artefact; blurring artefact; barium
BaE barium enema
BAER brainstem auditory evoked responses
518
BAFT barium follow-through
BAI basilar artery insufficiency
BAL British anti-Lewisite (dimercaprol);
bronchoalveolar lavage
Balanced FFE balanced fast field echo
BALF bronchoalveolar lavage fluid
Bas barium swallow
BASCHD bronchiectasis, asbestosis, scleroderma and
other connective tissue diseases, cryptogenic
fibrosing alveolitis, Hammon-Rich, drugs
base excess
base of the natural logarithm
BASE basis imaging with selective inversion-
prepared
Baud rate baudot rate
BB blood bank; breakthrough bleeding
BBA black blood angiography
BBB blood-brain barrier; bundle branch block
BBBB bilateral bundle branch block
BBS bulletin board system
BC biliary colic; blood-culture
BCC basal cell carcinoma
BCE basal cell epithelioma
BCG Bacille Calmette-Guérin
BCNU N,N-bis (2-chloroethyl)-N-Nitrosurea
BCR British comparative ratio
519
BCS Budd-Chiari syndrome
bd bis in die
BDE bile duct exploration
BDL bile duct ligation
BDR background diabetic retinopathy
BE below-elbow; bacterial endocarditis; barium
enema;
bEPI blipped echo planar imaging
BEST blood vessel enhancement by selective
suppression tech
BeV, Bev billion electron volts
BFFE balanced fast field echo
BFL bird fancier’s lung
BFS blood fasting sugar
BG blood glucose
BH Braxton-Hicks contractions
BHCG beta-human chorionic gonadotrophin
BHL bilateral hilar lymphadenopathy
BHR bronchial hyper-reactivity
BHT-S/M breath holding technique-Single/Multiple
BI bladder
BID brought in dead
BIH benign intracranial hypertension
BIN tt-butylisonitrile
BIP biparietal diameter
BIR British Institute of Radiology
520
BIRD bilinear rotation decoupling
Bit / bit binary digit
BJ biceps jerk
BJP Bence-Jones protein
BJR British Journal of Radiology
B-K, BK below-knee
BKA bellow knee amputation
BKG background
BKWP bellow-knee walking plaster
BLC blood culture
Bld Bnk/BB blood bank
Bleo. bleomycin
BLS basic life support
BM barium meal
BMA British Medical Association
BMD bone mineral density
BMI body mass index
BMJ British Medical Journal
B-MODE brightness mode
BMR basal metabolic rate
BMS bulk magnetic susceptibility
BM-stix blood monitoring sticks
BMT bone marrow transplantation/transplant
BMUS British Medical Ultrasound Society
BMZ basement membrane zone
BNF British National Formulary
521
BNO bladder neck obstruction; bowel not open
Bo field constant magnetic field of a MR
scanner
BO body odour; bowels open; bronchiotitis
oliterans
Bo magnetic field
BOLD blood oxygen level dependent
(contrast)
BOOP bronchiolitis obliterans with organizing
pneumonia
BOSS bimodal slice select rf pulse
BP MR biphasic MR imaging
BP blood pressure; breech presentation
BPD biparietal diameter
BPH benign prostatic hyperplasia
bpm beats per minute
BPS biophysical profile score
bps bits per second
BPV benign positional vertigo; bioprosthetic valve
Bq becquerel
Br bromine
Br. Med. J. British Medical Journal (BMJ)
BRBPR bright red blood per rectum
BREASTS bronchopulmonary aspergillosis; radiotherapy;
extrinsic allergic alveolitis; Ankylosing
spondylitis; sarcoidosis; tuberculosis; silicosis
522
 breath sounds
BRH benign recurrent haematuria; Bureau of
Radiological Health
Bronch. bronchoscopy
B-S valve Bjork-Shiley valve
BS Bachelor of Surgery; blood sugar; bowel
sounds;
BSA body surface area
BSc Bachelor of Science
BSE breast self-examination
BSIR British Society of Interventional Radiology
BSO bilateral salpingo-oophorectomy
BT shunt blalock-Taussig shunt
BT bladder tumour; bleeding time
BTB breakthrough bleeding
BTD biliary tract disease
BTS brady-tachy syndrome
BTx bloodtransfusion
BU burns unit
BUN blood urea nitrogen
BV basilic vein; blood vessel
BVH biventricular hypertrophy
BW birth weight; bandwidth; bladder washout;
body weight
Bwt birth weight; body weight
Bx biopsy
523
C contrast
C coulomb; count
C Arm C-shaft arm
c mm cubic millimetre
C MRI cine magnetic resonance imaging
C of A coarctation of aorta
C of E Church of England
c calorie; canine; speed of light
C calorie; carbon; Celsius; centigrade;
c/o complaining of
C/S, CS caesarian section
C-14 14-C Carbon 14; 14C
C2H5OH ethanol
CA 125 cancer antigen 125
Ca calcium
CA carrier wave
CA candida albicans; cardiac arrest; celiac axis;
coronary artery
Ca. cancer; carcinoma
Ca2+ calcium
Ca2+-blocker calcium channel blocker
CAAT Scan computer/computed assisted/aided axial
tomography scan
CAAS MRV cardiovascular angiogram analysis system
mrv

524
CAAT computer/computed assisted/aided axial
tomography
CAB coronary artery bypass
CABG coronary artery bypass graft
CAD computer aided/assisted diagnosis;coronary
artery disease
CAH congenital adrenal hyperplasia; chronic active
hepatitis
CAL chronic airflow limitation
CAM cystic adenomatoid malformation
CAMELSPIN cross relaxation appropriate for minimolecules
emulated by locked spins
cAMP cyclic adenosine monophosphate
CAMs cell adhesion molecules
CAPD continuous ambulatory peritoneal dialysis
CAR computer assisted radiology
CARE combind application of radiol………………..
CARS computer assisted radiology surgery
Cas casualty
CAS computer assisted surgery
CAST coputeraided automated scan technique
CAT scan computer/computed axial/assisted
tomography scan
CAT scanner computer/computed axial/assisted
tomography scanner

525
CAT computer/computed axial/assisted
tomography
CAVB complete atrioventricular block
CAVG coronary artery vein graft(s)
CAVHD continuous arteriovenous
haemodialysis
CaWO4 calcium tungstate
CB child body
CB conus branch
CBC complete blood count
CBD Common bile duct
CBD common bile duct
CBF I cerebral blood flow; imaging
CBF cerebral blood flow
CBFI cerebral blood flow imaging
CBT computer based training
CBV cerebral blood volume
cc chief complain; cubic centimetre; copies
circulated
CC craniocaudad
CC cholecalciferol, Vitamin D; craniocaudad;
creatinine clearance
CCA common carotid artery
CCD charged-coupled device
CCF congestive cardiac failure; counter current
flow
526
CCITT Comite Consultatif Internationale
Telegraphique et Telephonique
CCK cholecystokinin
CCL communications control language
CCP complement control protein
CCPD continuous cyclic peritoneal dialysis
CCT conventional CT
CCT/CECT contrast enhanced computed tohography
CCU coronary care unit; critical care unit
CD curve contrast detail curve
CD celiac disease; Colour Doppler; common
(hepatic) duct
CD4 cluster of differentiation antigen
CDE Colour Doppler energy imaging
CDH congenital dislocation of the hip
CDI Colour Doppler imaging
CDJ crevico dorsal junction
CD-ROM compact disc-read-only memory
CE carotid endarterectomy; comb echo; contrast
enhancement
CE FLASH contrast-enhanced fast low angle shot
CEA carcinoembryonic antigen
CEC central echo complex
CECT contrast enhanced computed tomography

527
CE-FAST contrast-enhanced Fourier-acquired steady
state
CE-FFE FAST Contrast-enhanced*fast field echo /
FAST
CE-FFE T1 contrast-enhanced fast field echo (T1-
weighted)
CE-FFET2 contrast-enhanced Fast field echo T2
weighted
CEP congenital erythropoietic porphyria
cervical nerve root; cervical vertebra; contrast
CES cranial electrical stimulation
CF cystic fibrosis
CFA cryptogenic fibrosing alveolitis
CFDU colour flow Doppler ultrasound
CFI colour flow imaging
CFOV central field of view
CFT complement fixation test
CGA colour graphics adaptor
CGN chronic glomerulonephritis
CH Child head
CHA common hepatic artery
CHAD cold haemagglutinin disease
CHB complete heart block
CHD Common hepatic duct
CHD coronary heart disease; congenital heart
disease
528
CHE chemoembolization
chemo chemotherapy
CHESS chemical shift selective (imaging
sequence)
CHF congestive heart failure; congenital hepatic
fibrosis
CHISS Chemical shift insensitive slice
selective RF pulse
CI cardiac index; correlation Imaging; confidence
interval;
CI chloride
CI correlation Imaging
ci curie
CIC clean intermittent catheterisation
CIDNP chemically induced dynamic nuclear
depolarization
CIDP chronic inflammatory demyelinating
polyneuropathy
CIE counter-current immune electrophoresis
CIN cervical intra-epithelial neoplasm
CIRSE Cardiovascular and Interventional
Radiological
CIS carcinoma in situ
CJD Creutzfeldt-Jacob disease
CK Convolution Kernels
CK creatinine (phospho) kinase
529
CKMB creatine kinase myocardial bound
Clin. Rad. Clinical Radiology
CLIP corticotrophin-like intermediate lobe peptide
CLL chronic lymphocytic / lymphatic leukaemia
cm centimetre
CM MRA contrast medium magnetic resonance
angiography
CM rate Contrast medium injection rate
CM contrast medium
CMA cardiac motion artefact
CMC computer mediated communication
CMCJ carpometacarpal joint
CMD congenital muscular dystrophy
CME continuing medical education
CMG cystometrogram
CML chronic myeloid (myelogenous) leukaemia
CMLine cantho meatal line
CMML chronic myelomonocytic leukaemia
CMT chemotherapy
CMV cytomegalovirus
C-N Ratio contrast to noise ratio
CN cranial nerve
CNI, CN1; 1 first cranial nerve (olfactory)
CNII, CN2; II second cranial nerve (optic)
CNIII, CN3; III third cranial nerve (oculomotor)
CNIV, CN4; IV fourth cranial nerve (trochlear)
530
CNIX, CN9; IX ninth cranial nerve (glossopharyngeal)
Cnjugata diagonalis; controlled drugs; Crohn’s
disease
CNR contrast-to-noise ratio
CNS cranial nervous system
CNV, CN5; V fifth cranial nerve (trigeminal)
CNVI, CN6; VI sixth cranial nerve (abducencs)
CNVII, CN7; VII seventh cranial nerve (facial)
CNVIII, CN8; VIII-eighth cranial nerve (vestibulocochlear)
CNX, CN10; X tenth cranial nerve (vagus)
CNXI, CN11; eleventh cranial nerve (accessory)
CO carbon monoxide
CO2 carbon dioxide
COAD chronic obstructive airways disease
COAL chronic obstructive air-flow limitation
COC combined oral contraceptive
COCONOESY Combined COSY / NOESY
COCP combined oral contraceptive pill
COD cause of death
COLD chronic obstructive lung disease
Colles Colles’ fracture
Collimation Slice thickness determination
COLOC Correlated spectroscopy for long range
coupling
COM chronic otitis media
Com. port communications port
531
com.(s) communication(s)
COP cryptogenic organizing pneumonitis
COPD chronic obstructive pulmonary disease
cos. cosine
COSY Correlated spectroscopy
COSY-45 COSY with 45 degree mixing pulse
COSYDEC COSY with F1 decoupling
COSYLR COSY for long range couplings
CP MG seq Carr-Purcell Meiboom-Gill sequence
CP Sequence Carr-Purcell sequence
CP sequence Carr-Purcell sequence
CP cephalic presentation; cerebral palsy; chronic
pancreatitis
CP cross polarization
CP.Angle cotro-phrenic angle
CPA cerebellopontine angle
CPAP continuous positive airways pressure
CPD cephalo-pelvic disproportion
CPD composite pulse decoupling
CPDA citrate/phosphate/dextrose-adenine
CPH chronic persistent hepatitis
CPK creatine phosphokinase
CPMG sequence-Carr-Purcell-Meiboom-Gill sequence
CPP cerebral perfusion pressure
CPPD calcium pyrophosphate dihydrate
CPR cardiopulmonary resuscitation
532
cps counts per second; cycles per second
CPS characters per second
CPU central processing unit
CQI continuous quality improvement
CR clinical remission (complete remission);
CR Computed radiography
Cr,Creat. creatinine
CRAMPS Combined rotational and multiple pulse
spectroscopy
CRAO central retinal artery occlusion
CRAW computed radiography acquisition
workstation
CREST Calcinosis, Raynaud’s phenomenon,
Oesophageal disorder, Sclerodactyly,
Telangiectasia
CRF chronic renal failure; corticotrophin releasing
factor
CRH corticotrophin releasing hormone
CRITOL capitellum, radial head, inner epicondyle,
trochlear, olecranon, lateral epicondyle,
CRL crown rump length
Crohn’s colitis;
CRP C-reactive protein
CRR Curve planer reformation
CRT cadaveric renal transplant / cathode ray tube
CRVO central retinal vein occlusion
533
Cryoppt cryoprecipitate
CS FSE contiguous-slice fast-acquisition spin echo
CS FSE contiguous-slice fast-acquisition spin echo
CSA chemical shift artifact / anosotrophy
CSDMS Canadian Society of Diagnostic Medical
Sonographers
CSE conventional spin echo
CSF cerebrospinal fluid
CSFSE Contiguous-slice fast-acquisition spin
echo
CSG cholecystogram
CSI chemical shift imaging
CsI caesium iodide
CSI chemical shift imaging
CSMA / CD carrier sense multiple access/collision
detection
CSMAP celiac-superior mesenteric arterial
portography
CSMEPM contiguous slice MEMP
CSOM chronic suppurative otitis media
CSSD central sterile department
CSSU central sterile supply unit
CST contractions stress test
CT Myelo CT myelography
CT scan computed/computerized tomography scan

534
CT scanner computed / computerized tomography
scanner
CT calcitonin; cardiothoracic ratio; computed
tomography
CTA CT angiography
CTAP computed tomography (during) arterial
portography
CTBG CT guided biopsy
CTC computed / computerized tomography
colonography
CTG cardiotocogram (-graph)
CTGAD CT guided aspiration /drainage
CTG-NB CT guided-nerve block
CTK-CMP CT kidney-corticomedullary phase
CTK-EXP CT kidney excretory phase
CTK-NGP CT kidney nephrography phase
CTK-PCP CT kidney pre-contrast phase
CTLM computed tomography laser mammography
CTN Sur-plan- CT navigation plan before surgeon
CTR cardiothoracic ratio; carpal tunnel release
CTRT-plan CT guided radio theraphy planning
CTS carpal tunnel syndrome
CTX clinical trial exemption
Cu copper

535
CV MRI cardiovascular magnetic resonance
imaging
CV cephalic vein; conjugata vera
CVA cerebrovascular accident; costrovertebral
angle
CVB chorionic villous biopsy
CVIR Cardio Vascular and Interventional Radiology
CVJ cranio vertebral junction
CVO conjugata vera obstetrica
CVP central venous pressure
CVS cardiovascular system; chorionic villous
sampling
CVVHD continuous veno-venous haemodialysis
CW continuous wave / contrast weighting
CW continuous wave; contrast weighting
CWP coal worker’s pneumoconiosis
Cx cervical; cervix; complication
CXR chest x-ray
CYCLPOT-VOSING Volume selective single scan
heteronuclear
D saline dextrose saline
d day (s); diameter; distance; object film
distance
D absorbed dose; delta; diagonal branch;
diastole; distance; donor; dorsal vertebra;

536
 duct, ductus; focus-object distance; optical
density;
D&A drugs and allergies
D&C dilatation and curettage
D&V diarrhoea and vomiting
D.phil. Doctor of Philosophy
D/S dextrose saline
D+d focus film distance
D=E dates equal to examination
DA converter digital to analogue converter
DA developmental age; dopamine; drug addict; ductus
arteriosus
DAC derived air concentration
DAF decay-accelerating factor
DAI diffuse axonal injury
DANTE delay alternating with nutation for
tailored excitation
DAP dose area product (meter)
DAT digital audiotape; dementia of Alzheimer’s
type
dB decibel
dB/dt rate of change magnetic flux density with time
dB/dt rate of change magnetic flux density with time
DBM doubly balanced mixer
DBMS database management system
DBP diastolic blood pressure
537
DBS deep brain stimulation; double blind study
DC TSE double contrast turbo spin echo
DC descending colon; direct current; dorsal
column
DCBE double contrast barium enema
DCC digital compact cassette
DCCV direct current cardioversion
DCE data communication equipment
DCG dacryocystography
DCIS ductal carcinoma in situ
DCM digital cardiomyopathy
DCS MRI dynamic susceptibility contrast MRI
DCT discrete cosine transform; distal convoluted
tubule
DD developmental delay; differential diagnosis
DDAVP 1-Demino-8-Darginine-vasopressin
DDC diethyldithiocarbamate
DDP default display protocol
DDU Duplex Doppler ultrasound
Ddx differential diagnosis
DDX doctor drug exemption
DE FAISE dual echo fast-acquisition interleaved spin
echo

538
DE FGR driven equilibrium fast gradient-recalled
acquisition in the steady state
DE prep driven equilibrium magnetization preparation
DE dose equivalent
DEAFF detection of early antigen fluorescent
foci
DEFT driven equilibrium Fourier transform
DEPT distortion less enhancement by polarization
transfer
DEPTH (SE sequence for spectral localization)
desc. descending
DESS double-echo steady state (combination of
FISP and PSIF)
Dex. dextrose
DEXA dual energy x-ray absorption / absorptometry
DF-118 dihydrocodeine
DFM decreased fetal movements
DFP diisofluorophosphate
DFR digital fluororadiography
DFSE double/double fast spin echo / dual (echo) fast
spin echo
DFT discrete fourier transform
DGH district general hospital
DH delayed hypersensitivity; dermatitis
herpetiformis; drug history
DHEA dehydroepiandrosterone
539
DHF dengue haemorrhagic fever
DHR delayed hypersensitivity reaction
DHS dynamic hip screw
DHSS Department of Health and Social Security
DHT di-hydrotestosterone
DI diabetes insipidus; diffusion imaging,
depressive ilness
DIB difficulty in breathing
DIC direct isotope cystogram;
DICOM digital image communications in
medicine
DIL drug-induced lupus erythematosus
DILD diffuse infiltrative lung disease
DIMSE DICOM message service element
DIP desquamative interstitial pneumonia
DIPJ distal interphalangeal joint
DIRT1 double inversion recovery T1 measurement

discoid lupus erythematosus

DISE driven inversion spin echo
DISH diffuse idiopathic skeletal hyperostosis
disseminated intravascular coagulation
DIT di-iodotyrosine
diverticular disease; double density
DJD degenerative join disease
DKA diabetic ketoacidosis
540
DKI dextrose potassium insulin
Dl decilitre
DL diffusing capacity of the lung
DLE disseminated lupus erythematosus/
DLJ Dorso lumber spine junction
DLR digital luminescence radiography
DM dermatomyositis; diabetes mellitus; diastolic murmur
DM dorsal mylography
DMA direct memory access
DMAD dimethylaminodiphosphonate
DMAP diffusion apparent diffusion coefficient
mapping
DMD Duchenne muscular dystrophy
DMRD Diploma in Medical Radio-Diagnosis
DMRI deuterium magnetic resonance imaging
DMRS deuterium/diffusion magnetic resonance
spectroscopy
DMRT Diploma in Medical Radiotherapy
DMS dermatomyositis
DMSA 2,3-dimercaptosuccinic acid
DMSSFP double mode steady state free precession
DMV diurnal mood variation
DN district nurse
Dn/Dn-1, 2,3,4 duodenum
DNA deoxyribonucleic acid; did not attend
DNS deviated nasal septum
541
DOA dead on arrival
DOB date of birth
DOC date of conception; deoxycorticosterone
DOCA deoxycorticosterone acetate
Doctor of Medicine; dorsal mylography
DOE dyspnoea on exertion
DOF double quantum filters
DOG deoxyglucose
DOH Department of Health
DOLV double-outlet left ventricle
DOPA dihydroxyphenylethylamine
DOPAMINE dihydroxyphenylethylamine
DOPING double pulse interlaced echo imaging
DORSA Double resonance sandwich
DORV double outlet right ventricle
Down’s syndrome; (mongolism)
DP diastolic pressure; dorsalis pedis (pulse)
DPS delayed primary suture
DPSF diffusion/perfusion snapshot flash
DR delivery room; digital radiography
DRC diagnostic reporting console
DRESS depth-resolved surface spectroscopy
DS double sided; disseminated sclerosis;
DSA digital subtraction angiography
DSC MRI dynamic susceptibility contrast MR imaging
DSH deliberate self harm
542
DSM (III) R Diagnostic and Statistical Manual (Third)
DST dexamethasone suppression test
DT MRI diffusion tensor magnetic resonance imaging
DTE data terminal equipment
DTI Doppler tissue imaging
DTIA Doppler tissue imaging acceleration
DTIE Doppler tissue imaging, energy
DTIV Doppler tissue imaging, velocity
DTP desktop publishing; diphtheria, tetanus,
pertussis
DTPA diethylene triamine penta-acetic acid
DTPM dixon two-point method
DTs delirium tremens
DU duodenal ulcer
DV Doe volentes; ductus venosus
DVT deep vein thrombosis, deep venous
thrombosis
DW MRI diffusion weighted magnetic resonance
imaging
DW SE-EPI diffusion-weighted spin echo-echo planar
imaging
DWI diffusion weighted imaging
DWT discrete wave transform
Dx diagnosis; disease
DXA dual energy x-ray absorption/absorptometry
DXR deep x-radiation
543
DXT deep x-ray therapy
dynamic integral proctography
Dysp. Shortness of breath
E short Elscient brand name for a refocused
GE-PS
E SHORT steady-state gradient echo with spin-echo
sampling
E energy, the capacity of a system to do work.
E energy; exposure;
e- /e electron; charge of an electron;
electron Quantum
E.coli Escherichia coli
e.g. exempli gratia (for example)
E/A emergency admission
e+ positron
EAA extrinsic allergic alveolitis
EAC External auditory canal
EAEC Entero-adherent E. coli
EAm External auditory meatus
EAM external auditory meatus
EAR European Association of Radiology
EBCT electron-beam computed tomography (cine
CT)
EBL estimated blood loss
eBNF Electronic British National Formulary
EBT Electron beam tomography
544
EBT electron beam tomography
EBV Epstein-Barr virus
EC, E/C enteric-coated
ECA External carotid artery
ECA external carotid artery
ECD endocardial cushion defect; ethylcysteinate
ECF extracelular fluid
ECG electrocardiogram
Echo. Echocardiography
ECM external cardiac massage
ECMO extracorporeal membrance
oxygenation
ECOSY Exclusive correlation spectroscopy
ECR European Congress of Radiology
ECS endocervical swab
ECT electroconvulsive therapy; emission-computed
tomography
EDD estimated date of delivery
EDE effective dose equivalent
EDH Extra dural haemorrhage
EDM early diastolic murmur
EDP electronic data processing
EDRF endothelial derived relaxation factor
EDS Ehlers-Danlos syndrome
EDT expected date of confinement
EDTA ethylenediaminetetraacetic acid
545
EDV end-diastolic volume
EEG electroencephalogram
EEMR coil endo-esophageal magnetic resonance
imaging coil
EEMRI endo-esophageal magnetic resonance
imaging
EF ejection fraction; external fixation
EFG electric field gradient
EFW estimated fetal weight
EG eosinophilic granuloma
EGA extended graphics adaptor
EHBO Extra hepatic biliary obstruction
EHEC enterohaemorrhagic Escherichia coli
EHL effective half-life
EIEC Enteroinvasive Escherichia coli
EJV external jugular vein
EKG elektrokardiogram
ELD energy level diagram
ELF fields extremely low frequency fields
ELF fields extremely low frequency fields
ELISA enzyme linked immunosorbent assay
Elscient brand name for an ultrafast GE-PS
EM pathway Embden-Meyerhof pathway
EM radiation electromagnetic radiation
EM spectrum electromagnetic spectrum
EM wave electro-magnetic wave
546
EM electromagnetic; erythma multiforme
EMD electro-mechanical dissociation
EMG electromyography
EMG electromyography
EMI/RFI electromagnetic and radio frequency
interference
EMRF European magnetic resonance forum
E-MRI electro-magnetic resonance imaging
EMRI esophageal magnetic resonance angiography
E-MRS resonance spectroscopy
EMU early morning urine; energy mode ultrasound
EMW early morning waking
ENA extractable nuclear antibodies
enc. enclose
ENT ear, nose and throat
EP MRA echo planner magnetic resonance
angiography
EP evoked potential
EPA Environmental Protection Agency; erect
postero anterior
EPC echo phase correction
EPEC enteropathogenic escherichia coli

547
EPI echo-planar imaging
EPI STAR EPI with signal targeting & alternating radio
frequency
EPO (Epo) erythropoietin
EPR electron paramagnetic resonance
EPS echo-planar spectroscopy
EPSI echo-planar spectroscopic imaging
ER European Radiology
ERC endoscopic retrograde cholangiography
ERCP endoscopic retrograde
ERP endoscopic retrograde pancreatography
ERPC evacuation of retained products of conception
ERPF effective renal plasma flow
ERT examination room terminal
ERV expiratory reserve volume
ES echo shift
ESF edge spread function
E-SHORT Steady state gradient echo with spin-echo
sampling
ESM ejection systolic murmur
ESN educationally subnormal
ESR electron spin resonance; erythrocyte
sedimentation rate
ESRF end-stage renal failure
ESV end-systolic volume

548
ESWL extracorporal shock wave lithotripsy
et al. et alia
ET examination terminal; ecdotracheal;
ecdotracheal tube
etc et cetera (and the rest, and so on)
ETEC enterotoxigenic Escherichia coli
ETL echo train length
EtOH ethanol
ETT endotracheal tube; exercise tolerance test
EUA examination under anaesthesia
eV electron volt
EVS endovaginal sonography
Ext. Jug. V. external jugular vein
Ext. external
EZM HD high density (Barium)
FDG
f frequency; foramen
F short Elscient brand name for a refocused
GE-PS
F SHORT steady-state gradient echo based on free
induction decay
F frequency; Fr.; n; Faraday; focal spot; focal
spot size
F/F Feet first
F/S frozen section
F/W discri fat and water discrimination
549
F/W discrimi fat and water discrimination
F2F face to face
FA flip angle / flow artifact / ferromagnetic artifact
FACE fid acquired echoes
FADE FASE acquisition double echo Picker name
for GE-PS
FAIR flow sensitive alternating inversion recoveries
FAME fast acquisition multi-echo
FAP familial adenomatous polyposis
FAQ frequently asked questions
FAS fetal alcohol syndrome
FASE fast advanced spin echo / fast spin echo
FAST Fourier acquired steady state technique
fast gradient-recalled acquisition in the steady
state
Fat. Sat. fat saturation
FATE Fast turbo echo (=FADE)
FATS fat suppressed acquisition with TE and TR
times shortened
FAX facsimile
FB MRI functional brain magnetic resonance imaging
FB MRS functional brain magnetic resonance
spectroscopy
FB foreign body
FBC full blood count
FBG fasting blood glucose
550
FBM fetal breathing movements
FBSE flip back spin echo
FC flow compensation
FC MRI field cycle magnetic resonance imaging
FD film digitizer; floppy disk; forceps delivery
FDA Food and Drugs Administration
FDAW film digitizer acquisition workstation
FDD Floppy disk drive
FDDI fibre distributed data interface
FDP(s) fibrin degradation product (s)
FE flow effect / field echo / fractional echo /
frequency encode
FE functional enquiry
Fe2+ iron
FEDIF Field echo with TE set for water and fat
signals in opposition
FEER field echo with/with even echo rephasing
FEER field even echo rephasing / field even-echo by
reversal
Fem. femoral
FESUM field echo with TE set for water and fat signals
in phase
FEV1 forced expiratory volume in 1 second
FF filtration fraction; fine focus
FFA free fatty acids
FFD focus film distance
551
FFE fast field echo
FFF fast Fourier flow
FFLAIR fast fluid attenuated inversion recovery
FFP fast Fourier projection
FFP fresh frozen plasma
FFR Fellow of Faculty of Radiologists
FFT fast Fourier transform
FGR fast gradient-recalled acquisition in the steady
state.
FH femoral hernia; family history
FHC familial hypercholesterolaemia
FHH fetal heart heard
FHNH fetal heart not heard
FHR fetal heart rate
FHS fetal heart sound
FHx family history
FI fast imaging / functional imaging
FIA fistula in ano.
Fib. fibula
FID free induction decay / free induction decay
signal
FIDIF field echo with an echo time set so that water
and fat spin are opposed when the echo
occurs. OPPOSED-PHASE IMAGE
FIGO class International Federation of Gynaecology and
Obstetrics
552
FIO2 partial pressure of oxygen in inspired air
FIR fast inversion recovery
FIS free induction signal
FISP fast imaging with steady state procession
FJP fell, jumped or pushed
FL femur length
FLA fronto laevo anterior
FLAG flow adjusted gradients
FLAIR fluid attenuated inversion recovery
FLARE fast low-angle recalled echo
FLASH Fast low angle (single) shot
FLAX-ISIS fully relaxed ISIS
FLK funny looking kid
FLOPSY flip-flop spectrocopy
FLP fronto laevo posterior
FLT fronto laevo transversa
Flu influenza
FM fetal movement
FMF Familial Mediterranean fever
FMP first menstrual period
FMPGR fast multiplannar gradient echo
fMRI functional (Brain) magnetic resonance
imaging
FN false negative
fn. Function
FNA Fine needle aspiration
553
FNAB Fine needle aspiration biopsy
FNAC Fine needle aspiration cytology
FNH focal nodular hyperplasia
fo Larmor frequency
fo Larmor frequency
FO fronto-occipital
FOB faecal occult blood; fibreoptic bronchoscopy
FOCSY foldover corresponding spectroscopy
FOD focus to object distance
FOI fibreoptic interface
FONAR focused nuclear resonance
FOOSH fell on outstretched
For. foramen
FOV field of view
FP false positive; family planning; family
practitioner
FPDM fibrocalculous pancreatic diabetes mellitus
FR frequency encode
Fr. French; frequency
FRC functional residual capacity
FRCP Fellow of the Royal College of Physicians
FRCR Fellow of the Royal College of Radiologists
FRCS Fellow of the Royal College of Surgeons
FRE flow related enhancement / field reversal echo
FRFSE fast recovery fast SE; FSE
FRJM full range of joint movement
554
FROM full range of movement
FRS Fellow of the Royal Society
FRV functional residual volume
FS fast scans
FSD focus to skin distance
FSE fast spin echo (turbo spin echo)
FSGS focal sclerosing glomerulosclerosis
FSH follicle stimulating hormone
F-SHORT short repetition technique based on free
induction decay
steady-state gradient echo based on free
induction decay
FSIP fast imaging with steady state procession;
SSFP
FSPGR fast spoiled gradient-recalled / fast
spoiled GRASS
FSTIR fast short tau inversion recovery
FT Fourier transform / full term / Fallot’s tetralogy;
fT4 free serum thyroxine
FTA fluorescent treponema antibodies absorbed
FTND full term normal delivery
FTP file transfer protocol
FTT failure to thrive
FTVD full term vaginal delivery
FU, f/u follow up
FUCOUP fully coupled spectroscopy
555
FVC forced vital capacity
FWB fully weight bearing
FWHM full width at half maximum
FWHM full width half maximum
FWTM full width tenth maximum
FYI for your information
G suit gravity suit
G vs HD graft versus host disease
G gated / gauss / non-SI unit of magnetic flux
density
G gauss; gravida; gated
g gram
G&A Grainger and Allison
G&S group and save
G phase encoding gradient
G6P glucose-6-phosphate
G6PD glucose-6-phosphate dehydrogenase
GA general anaesthetic, gestational age
GABA gamma-aminobutyric acid
GALT galactose-1-phosphate uridyl transferase
GALT gastrointestinal/gut associated lymphoid
tissue
gamma-glutamyltranspeptidase
GARP globally optimized alternating phase
rectangular pulse
GATORCIST respiratory gated imaging
556
GB Gb gall bladder / Geiga bytes
GBM glomerular basement membrane
GBP bipolar magnetic field gradient
Gbq gigabequerel
GBS group B Streptococcus; Guillain-Barré
syndrome
GC gonococcus
GCS Glasgow coma scale
GCSF granulocyte colony stimulating factor
GCT Giant cell tumour
Gd gadolinium
Gd gadolinium
GDA gastrodudenal artery
GDA gastrodudenal artery
Gd-CDTA gadolinium cyclohexanediaminetetraacetic
acid
Gd-DOTA gadolinium tetraazacyclododecanetetraacetic
acid
Gd-DTPA gadolinium diethylenetriamine-pentacetic acid
GDU gastroduodenal ulcer
GE gastroenteritis; General Electric; gradient echo

GE gradient echo
GE imaging gradient echo imaging
GEPS gradient echo pulse sequence
GES gradient echo spectroscopy
557
GET gastric emptying time
Gf frequency encoding gradient
GF Glandular fever; gradient field
GFE gradient field echo
GFEC gradient field echo with contrast /
compensation
GFR Glomerular filtration rate
GGT gamma-glutamyltransferase /
GH growth hormone
GHRH growth hormone releasing hormone
GHz gigahertz
GHz gigahertz
GI radiology gastrointestinal radiology
Gi field gradient in the i direction / gastrointestinal
GI iastrointestinal
GICM gastrointestinal contrast medium
GIF graphic interchange format
GIFT Gamete intrafollicular transfer
GIGGEST direct imaging of local gradients by group
echo selection tomography
GIH gastrointestinal haemorrhage
GINSEST generalised interferography using SE and
stimulated echo
GIS gastrointestinal series
GIT gastrointestinal tract; gated imaging technique
GKI glucose potassium insulin
558
Glu. Glucose
GM counter Geiger Muller counter
GM plateau Geiger Muller plateau
GM grey matter
Gmax Maximum value of phase encoding gradient.
GMC General Medical Council
GM-CSF granulocyte macrophage-colony-stimulating
factor
GMF gradient magnetic field
GMN gradient moment nulling
GMR gradient motion rephrasing; gradient moment
rephasing
GMR gradient motion / moment rephrasing
GMRH Germinal matrix related haemorrhage
GMRI gated magnetic resonance imaging
GN glomerulonephritis
GNN global network navigator
Gn-RH gonadotrophin releasing hormone
GOJ gastro-oesophageal junction
GOK God only knows
GOR gastro-oesophageal reflux
GORD gastro-oesophageal reflux disease
GOS gastro-oesophageal sphincter
GOT glutamatic oxaloacetic transaminase
GP general practitioner; gradient pulse
GPI general paralysis of the insane
559
GPS Goodpasture’s syndrome
GPT glutamate pyruvate transaminase
GR gradient rephasing
GRAE generally regarded as effective
GRAS generally regarded as safe
GRASE PS gradient recalled acquisition in the steady
state
GRASE PS gradient refocused acquisition in the steady
state
GRASE gradient and spin echo pulse sequence
GRASP gradient accelerated spectroscopy
GRASS gradient recalled echo in the steady
state
GRASS gradients (recalled) acquisition in the
steady state
GRASS gradients refocused acquisition in
steady state
GRE gradient recalled/refocused echo
GRE Seq gradient echo pulse sequence
GRE gradient echo / gradient echo imaging
GREAT ghost reduction by equalized acquisition
triplets
GREC gradient echo / gradient field echo with
contrast
GRECHO short for gradient echo / gradient
recalled echo
560
GRECO gradient-recalled echo
GRE-EPI gradient echo - echo planar imaging
GRF growth hormone releasing factor
GROPE gene compen for resonance offset & pulse
length errors
GS gallstone / gradient spectroscopy
Gs slice selection gradient
GSD glycogen storage disease
GSLIM generalized spectral localization
imaging method
GSS Gertsmann-Straussler-Scheinker disease
GSV gestational sac volume
GTN glyceryl trinitrate
GTT glucose tolerance test
GU gastric ulcer; genitourinary
GUI graphical user interface
GUT genito urinary tract
GVHD graft versus host disease
Gx,Gy, Gz symbols for magnetic field gradients
Gy gray
Gyn. gynaecology
H hydrogen; deuterium; dose equivalent
H of F height of fundus
h height of lead strips in a grid; hour; Planck’s
constant
h Planck's constant
561
H&L heart and lung
H&P history and physical examination
H&T hospitalisation and treatment
H,C-COSY 1H, 13C chemical shift correlation
spectroscopy
H,X-COSY 1H,X-nucleus chemical shift correlation
H. influenzae haemophilus influenzae
H.pylori helicobacter pylori
H/F head first
H1 obsolete symbol for the induced field in MRI
H1/2 half-value layer
H3 MRI hyperpolarized helium-3 magnetic
resonance imaging
HA phase hepatic artery phase
HA haemolytic anaemia
HAM human albumin microspheres
HAPVC hemianomalous pulmonary venous
connection
HAPVD hemianomalous pulmonary venous
drainage
HAPVR hemianomalous pulmonary venous
return
HAS human albumin solution
HAS human serum albumin

562
HASTE half-Fourier/acquisition single shot
turbo-spin echo
HAV hepatitis A virus
Hb F fetal haemoglobin
Hb haemoglobin
HBD hydroxybutyrate dehydrogenase
HbsAg hepatitis B surface antigen
HBV hepatitis B virus
HBW hard bone window
HC head circumference
HCC hepatocellular carcinoma
HCG human chorionic gonadotrophin
HCP hereditary coproporphyria
Hct haematoerit
HCV hepatitis C virus
HD hard disk; haemodialysis;
HDD hard disk drive
HDL high-density lipoprotein
HDN haemolytic disease of the newborn
HDP hydrogen diphosphonate
HDRBC heat damaged red blood cells
HDU high dependency unit
HDV hepatitis D virus
HE stain haemotoxylin-eosin stain
HE hypertensive encephalopathy
He helium Element with atomic mass number 2
563
Helical CT helical computed tomography
Hep A hepatitis A virus
Hep B hepatitis B
Hep C hepatitis C
Hep D hepatitis D
HepBsAg hepatitis B surface antigen
HETCOR heteronuclear correlation spectroscopy
Hev hepatitis virus
HF MRI high field magnetic resonance imaging
HF haemofiltration; heart failure
HFD high fibre diet
HFI half Fourier imaging
Hge haemorrhage
HGH human growth hormone
HH hiatus hernia
HHD home haemodialysis
HHM humoral hypercalcaemia of malignancy
HHT hereditary haemorrhagic telangiectasia
HI head injury
HIB haemophilus influenzae type B
HICH hypertensive intracerebral haemorrhage
HIDA hepatic iminodiaceti acid
HIE hypoxic ischaemic encephalopathy
HIG human immunoglobulin
HIPDM N-trimethyl-n-(2-hydroxyl-3methyl-5-
iodobenzyl)-1,3propendiamine
564
HIS hadamard spectroscopic imaging
HIS hospital information system
Histo (I). Histology
HIV human immunodeficiency virus
HL Hodgkin’s lymphoma
HLA human leucocyte antigen
HLDLC high-level data link control
HLHS hypoplastic left heart syndrome
HLTx heart-lung transplant
HLV hypoplastic left ventricle
HMBC heteronuclear multiple-bond correlation
HMD hyaline membrane disease
HMDP hydroxymethylenediphosphonate
hMG human menopausal gonadotrophin
HMIBI hexakis-2-methoxyisobutylisonitrile
HMMA 4-hydroxy-3-methoxymandelic acid
HMPAO hexamethylpropyleneamine oxime
HMQC heteronuclear multiple quantum
coherence
HMSN hereditary motor-sensory neuropathy
HNKC hyperosmolar nonketotic coma
HNR head and neck region
Ho magnetic field
HO, H/O, h/o history of / house officer
HOA hypertrophic osteoarthropathy

565
HOCM high osmolar contrast media / hypertrophic
cardiomyopathy
HOESY heteronuclear overhauster effect
spectroscopy
HOHAHA homonuclear Hartmann-hahn spectroscopy
HONC hyperosmolar nonketotic coma
HONK hyperosmolar non-ketosis
HP helicobacter pylori; hepatic porphyria; house
physician
HPA hypertrophie pulmonary arthropathy
HPB hepatobiliary
HPC history of presenting complaint; history of
present condition
HPD home peritoneal dialysis
HPG
……………………………………………
……………
HPG MRI hyperpolarized helium-3 MRI
HPI history of presenting illness
HPL human placental lactogen
HPOA hypertrophic pulmonary osteoarthropathy
HPS hybrid pulse sequence
HPT hyperparathyroidism
HPV hepatic portal vein; human papilloma virus
HQ headquarters

566
HR MRS high-resolution magnetic resonance
spectroscopy
HRCT High resolution computed tomography
HRP high-risk pregnancy
HRS hepatorenal syndrome
HRT hormone replacement therapy
HS heart sounds; house surgeon
HSCD Hand-Schuller-Christian disease
HSE herpes simplex encephalitis
HSG hysterosalpingogram
HSN hereditary sensory neuropathy
HSP Henoch-Schönlein purpura
HSSD hospital sterile supply department
HSSU hospital sterile supply unit
HSTAT health services technology assessment test
HSV herpes simplex virus; highly selective
vagotomy
HT dose equivalent to individual tissue
Ht height
HT hypertension
HTLM hypertext markup language
HTLV 1 human T-cell leukaemia / lymphotropic virus
HTTP hypertext transfer protocol
HU heat unit; Hounsfield unit
HUS haemolytic uraemic syndrome
HVL half value layer
567
HVR Hepatic venous redicle
HVS high vaginal swab
HVT half value thickness, hepatic vein thrombosis
HWCD Hans-Weber-Christian disease
HWP hepatic wedge pressure
HWY hundred women years
Hx history / Hypersensitivity pneumonitis
Hz hertz, SI unit of frequency
HZ herpes zoster
Hz hertz SI unit of frequency
HZV herpes zoster virus
I inferior
i effective current; incosor
I electric current; first cranial nerve (olfactory);
I&D incision and drainage
I&O intake and output
i.e. id est ‘That is’.
i.u. International Units
I/O input / output
i/p, inpatient
IA intra-arterial; intra-articular; irradiation area
IAA interrupted aortic arch
IABP intra-aortic balloon pump
IAC internal auditory canal
IACD implantable automatic cardioverter defibrillator
IADSA intra-arterial digital subtraction angiography
568
IAEA International Atomic Energy Agency
IAM internal auditory meatus
IAP intermittent acute porphyria
IAS interartrial septum
IBC iron binding capacity
IBD inflammatory bowel disease
IBI intermittent bladder irrigation
Ibid. ibidem
IBM International Business Machines
IBS irritable bowel syndrome
IBW ideal body weight
IC inspiratory capacity; intracardiac; intracerebral
ICA internal carotid artery; islet cell antibodies
ICBG idiopathic calcification of the basal ganglia
ICD implantable cardioverter defibrillator
ICDS International Cardiac Doppler Society
ICF intracellular fluid
ICH intracerebral haemorrhage
ICP infantile cerebral palsy; intracranial pressure
ICR International Congress of Radiology
ICRE International Commission on Radiological
Education
ICRP International Commission on Radiation
Protection
ICRU International Commission on Radiologic Units
ICS intercostals space
569
ICSH interstitial cell-stimulating hormone
ICSK intracoronary streptokinase
ICT intracranial tumour
ICU intensive care unit
id idem
ID card identification card
ID identification; infectious disease; intradermal
IDA iminodiacetic acid; iron deficiency anaemia
IDC idiopathic dilated cardiomyopathy
IDDM insulin-dependent diabetes mellitus
IDE integrated drive electronics
Idiopathic pulmonary hypertension
IDL intermediate density lipoprotein
IE infective endocarditis
IEC intraepithelial carcinoma
IEEE Institute of Electrical and Electronic Engineers
IEM inborn error of metabolism
IET inter echo time
IET inter echo time; intrauterine exchange
transfusion
IF immunofluorescence; internal fixation;
interstitial fluid
IFA idiopathic fibrosing alveolitis;
immunofluorescence assay
IFN interferon
IFT Inverse Fourier transform
570
Ig immunoglobulin
IgA immunoglobulin A
IgD immunoglobulin D
IgE immunoglobulin E
IgG immunoglobulin G
IgM immunoglobulin M
IGT impaired glucose tolerance
IH inguinal hernia
IHBC Intra hepatic biliary canaliculi
IHBD Inter hepatic biliary dilatation
IHBO Intra hepatic biliary obstruction
IHD ischaemic heart disease
IHSS idiopathic hypertrophic subaortic stenosis
II image intensifier; second cranial nerve (optic)
III third cranial nerve (oculomotor)
IJV internal jugular vein
IL-1 interleukin-1
IL-2 interleukin-2
IL-3 interleukin-3
ILF idiopathic lung fibrosis
ILP interstitial laser photocoagulation
ILV independent lung ventilation
IM Imaginary part of a complex number
IM infectious mononucleosis; intramuscular
IMA inferior mesenteric artery; internal mammary
artery
571
IMACS image archiving and communications
system
IMB intermenstrual bleeding
IMHO in my humble opinion
IMI inferior myocardial infarction
IMP N-isopropyl-p-iodamphetamine
IMR imaging intraoperative/intraprocedural magnetic
resonance imaging
IMRI interventional / intraoperative / intraprocedural
MRI
IMS information management system
IMV inferior mesenteric vein; intermittent
mandatory ventilation
IN interstitial nephritis
in. inch
INADEQUATE incredible natural abundance double
quantum transfer exp
INDORE internuclear double resonance
INEPT insensitive nuclei enhanced by polarization
inf. inferior
Ing. inguinal
Inj. injury
INO internuclear ophthalmoplegia
INR international normalized ratio
Int. Jug. V internal jugular vein
INVERSE H,X correlation via 1H detection
572
IOC Internal auditory canal
IOD image object definition
IOFB intra-ocular foreign body
IOL induction of labour
IOML Infra orbito meatal line
IOP intra-ocular pressure
IORT intraoperative radiotherapy
IOUS intraoperative ultrasound
IP inpatient; imaging plate; interphalangeal
IPA Inter polation algorithm
IPC inter-process communications
IPCD infantile polycystic disease
IPD intermittent peritoneal dialysis
IPF interstitial pulmonary fibrosis
IPH idiopathic pulmonary
haemosiderosis/haemorrhage
IPJ interphalangeal joint
IPPV intermittent positive pressure ventilation
IPR Immersive perspective rendering
IPS idiopathic pain syndrome
IQ intelligence quotient
IR FGR inversion recovery fast GRASS
IR FSE inversion recovery fast spin echo
IR prep inversion recovery magnetization
preparation
IR PS inversion recovery pulse sequence
573
IR infrared; interventional radiology; inversion
recovery
IRC inspiratory reserve capacity
IR-EPI inversion recovery echo-planar imaging
(MRM)
IRI Image reconstruction interval
IRL Image reconstuction length
IRR 1985 the Ionising Radiation Regulations 1985
IRR 1988 the Ionising Radiation (Protection of Persons
Undergoing Medical Examinations or
Treatment) Regulations 1988
IRR Ionising Radiation Regulations
ISBN International Standard Book Number
ISCE inclined slab for contrast enhancement
ISD Inter scan delay
ISDN integrated services digital network; isosorbide
dinitrate
ISE inversion spin echo pulse sequence
ISIS image selected in vivo spectroscopy
ISMN isosorbide mononitrate
ISO-OSI International Standards Organization
ISQ in status quo
IT information technology; injection time
ITP idiopathic thrombocytopenic purpura
ITT insulin tolerance test
ITU intensive therapy unit
574
IU International Units; intrauterine
IUCD intrauterine contraceptive device
IUD intrauterine death; intrauterine device
IUGR intrauterine growth retardation
IUP intrauterine pregnancy
IUT intrauterine transfusion
IV / IV fourth cranial nerve (trochlear); intravenous
IV MR CM intravascular magnetic resonance contrast
medium
IV MRI intravascular magnetic resonance
imaging
IVC Inferior vena cava
IVC inferior vena cava
IV-CM Intra venous contrast medium
IVCM-SVT IVCM standard volume technique
IVD Inter vertebral disc
IVD intravertebral disc
IVDA intravenous drug abuser
IVDSA intravenous digital subtraction
angiography
IVF in vitro fertilization
IVGTT intravenous glucose tolerance test
IVH intraventricular haemorrhage
IVI intravenous infusion
IVIM intravoxel incoherent motion
IVP intravenous pylography
575
IVS inter-ventricular septum
IVU intravenous urography
IVUS intravascular ultrasound
IWI intermediately weighted image (PDWI)
IX ninth cranial nerve (glossopharyngeal)
J wire j wire (angiographic guide wire with a curved
end.)
J joule
J. (Jour.) journal
JAMA Journal of the American Medical Association
JANET joint academic network
JCA juvenile chronic arthritis
JCAT Journal of Computerized Axial Tomography
JCD (JKD) Jacob-Creutzfeldt disease
JD John Doe; Jane Doe
JE Japanese encephalitis
JGA juxtaglomerular apparatus
JIR Journal of Interventional Radiology
JJ stent double J stent
JJ jaw jerk
JMD joint motion device
jn. Junction
Jour. Journal
JPEG Joint Photographic Experts Group
JRA juvenile rheumatoid arthritis
JSAIR Japanese Society of Angiography and
576
Jug. V / JV jugular vein
JVIR Journal of Vascular and Interventional
Radiology
JVP jugular venous pressure; jugular venous pulse
JVPT jugular venous pulse tracing
k boltzmann constant / kilo (103) / proportionality
constant
K constant
K contrast improvement factor; kelvin
temperature
K+ potassium
kb kilobytes
KB Kilo bytes
kBq kilobequerrel
KCCT Koalin cephalin clotting time
KCO transfer coefficient
KERMA kinetic energy released per unit mass
keV kilo electron volt
kg kilogram
kHz kilohertz
kHz kilohertz 1000hertz (Hz)
KJ knee jerk
KLS kidneys, liver, spleen
kMRI kinematics’ magnetic resonance imaging
KO/Ko’d/KOed knocked out
kPa Kilo Pascal
577
Kr krypton
KS Kaposi’s sarcoma
KSS Kearns-Sayre syndrome
KTx kidney transplant
KUB kidney ureter bladder
KV kilovolt
kVp peak kilovoltage
kW kilowatt
KWD Kimmelsteill-Wilson disease
KWS Kimmelsteill-Wilson syndrome
L lat. left lateral
L threshold Low Threshold visualization SR/VR
L Avogadro constant, Avogadro’s number;
L left; lumber nerve root; lumber vertebra
l litre
L/S lecithin-sphingomyelin ratio
LA lactic acidosis; laser angioplasty; left arm; left
atrium
LAC left atrial circumflex
LAD left anterior descending; left axis deviation
LADA left anterior descending artery
LAE left atrial enlargement
LAG labiogingival; lymphangiogram
LAH left anterior hemiblock; left atrial hypertrophy
LAHB left anterior hemiblock
LAI labioincisal
578
LAM left atrial myxoma; lymphangioleiomyomatosis
LAN local area network
LAO left anterior oblique
lap. And dye laparoscopy and injection of dye
lap. steri. Laparoscopic sterilization
lap. laparotomy; laparoscopic
LAS left anterior superior / lymphadenopathy
syndrome
Lat. Lateral
Lat.Dol. lateri dolenti
LATS long-acting thyroid stimulator
LAV lymphadenopathy-associated virus
LB left bronchus
LBBB left bundle branch block
LBP low back pain / lumber back pain
LBW low birth weight
LCA left coronary artery
LCAT lecithin-cholesterol acyltransferase
LCD liquid crystal display
LCIS lobular carcinoma in situ
LCM left costal margin
LCNB Large cutting needle biopsy
LCR low contrast resolution. CD-CURVE
LCx left circumflex coronary artery
LD lactate dehydrogenase
LD50 lethal dose 50
579
LD50/30 lethal dose 50/30
LDA left dorsal anterior
LDH lactate dehydrogenase
LDL low density lipoprotein
LE lupus erythematosus
LEMS Lambert-Eaton myasthenic syndrome
LES lower oesophageal sphincter
LET linear energy transfer
LETZ loop excision of the transformation zone
LF MRI low field magnetic resonance imaging
LFD large for dates
LFH left femoral hernia
LFT liver function tests; lung function tests
lg. Common logarithm
LGA large for gestational age
LGD limb girdle dystrophy
LGL Lown-Ganong-Levine syndrome
LGTI lower genital tract infection
LGV lymphogranuloma venereum
LH left hand
LHC left hypochondrium
LHF left heart failure
LHL left hepatic lobe
LHRM leuteinizing hormone-releasing hormone
LHS left hand side
LHV left hepatic vein
580
LI lactose intolerance
Li lithium
LICA left internal carotid artery
LID large intraluminal density
LIF left iliac fossa
LIH left inguinal hernia
LIJ left internal jugular
LIMA left internal mammary arter
LINAC linear accelerator
LIP lymphocytic interstitial pneumonitis
LIQ lower inner quadrant
LIS Lanthanide induced shift
LJM limited joint movement
LJP localized juvenile periodontitis
LK left kidney
LKKS liver, kidney (right), kidney (left), spleen
LLB long leg brace
LLC long leg cast
LLL left lobe of liver; left lower lobe
LLLE lower lid left eye
LLQ left lower quadrant
LLR large local reaction; left lateral rectus
LLRE lower lid right eye
LLZ left lower zone
LMA left main artery
LMB Laurence-Moon-Biedl; left mainstem bronchus
581
LMCA left main coronary artery; left middle cerebral
artery
LMN lower motor nerve/neurone
LMNL lower motor nerve lesion
LMP last menstrual period
LMR left middle rectus; localized magnetic
resonance
LMS left main stem (coronary artery)
LMWH low molecular weight heparin
LMZ left mid zone
ln natural logarithm
LN lymph node
LNA
LNBx lymph node biopsy
Lnn lymph node(s)
LOC loss of consciousness / local anaesthesia /
anaesthetic
LOCM low osmolar contrast medium
log. Logarithm
log.e natural logarithm
Long. Longitudinal section
LOPP chlorambucil, vincristine, procarbazine and
premisolene
LOQ lower outer quadrant
LOS/LES lower oesophageal sphincter
LOSP lower oesophageal sphincter pressure
582
LP linear prediction
LP lumber puncture
lp/mm line pairs per millimetre
LPA left pulmonary artery
LPO left posterior oblique
LPV left portal vein
LQTS long Q-T syndrome
L-R shunt left to right shunt
LR lateral rectus
L-R Left to right orientation
LRCP Licentiate of the Royal College of Physicians
LRD living (live) related donor
LRT lower respiratory tract
LRTI lower respiratory tract infection
LS line scaning (MRM) / lumber spine
LS, L/S longitudinal section
LSC left subclavian
LSCS lower segment Caesarian section
LSD lysergic acid diethylamide
LSE left sternal edge
Lsect. Longitudinal section
LSF line spread function
LSJ Lumbo sacral spine junction
LSM late systolic murmur
LSR lanthanide shift reagent / liver / spleen ratio
Lt. Left
583
LTA long-term archive
LTM long-term memory
LTOT long-term oxygen therapy (treatment)
LTS long-term storage
LUE left upper extremity
LUF luteinized unruptured follicle
LUL left upper lobe
LUO left ureteric orifice
LUOQ left upper outer quadrant
LUQ left upper quadrant
LUT look-up table
LUZ left upper zone
LV left ventricle; left ventricular branch;
ligamentum venosum
LVEF left ventricular ejection fraction
LVF left ventricular failure
LVH left ventricular hypertrophy
LVOT left ventricular outflow tract
LVWT left ventricular wall thickness
m mass; metastable; metre; molar
M magnetization vector, 3 spatial components
Mx, My & Mz.
m milli (10-3)
M macroscopic magnetization vector;
magnification; male;

584
MA mental age; magic angle
MAA microaggregates of albumin
Mac macintosh
MAC media access control; minimum antibiotic
concentration
MAD major affective disorder
MAFI Medic Alert Foundation International
MAG-3 benzoylmercaptoacetyltriglycerine
MAGIC mucosal and genital inflammation with
inflamed cartilage
MAI mycobacterium avium intracellulare
MAL Mid-axilary line
Mammo. Mammogram
MAN metropolitan area network
MAO monoamine oxidase
MAOI monoamine oxidase inhibitor
MAP mean arterial pressure
MARC machine-readable cataloguing
MARF magic angle in the rotating frame
MARP multi angle reconstruction plan
MARS The Medicines (Administration of Radioactive
Substances)
MAS magic angle spinning / Milli ampere second
mAs milliampere second
MASS magic angle sample spinning
MAST motion artefact suppression technique
585
MAST motion artefact suppression technique
MAVD mixed aortic valve disease
Max. maximum
MB Mega bytes
MB ChB Bachelor of Medicine, Bachelor of Surgery
Mb megabyte
MBA motorbike accident
MBBS Bachelor of Medicine, Bachelor of Surgery
MBC maximal breathing capacity; minimum
bactericidal concentration
Mbq megabecquerel
MBS-MRA minimum basis set magnetic resonance
angiography
MC & S microscopy, culture and sensitivity
MCA middle cerebral artery
MC-C Metacarpo-carpal
MCDK multicystic dysplastic kidney
mcg microgram
MCGN minimal change glomerulonephritis
MCH mean corpuscular haemoglobin
MCHC mean corpuscular haemoglobin concentration
mCi millicurie
MCK multicystic kidney
MCL minimal-change nephropathy
MCPJ metacarpophalangeal joint
MCQ multiple-choice question
586
MCTD mixed connective tissue disease
MCTSE multi-contrast turbo spin echo
MCU / MCUGmicturating cystourethrogram
MCV mean corpuscular / cell volume
MCx main circumflex
MD Doctor of Medicine; managing Director;
MDCT Multidetector CT
MDIS medical diagnostic imaging system
MDM mid-diastolic murmur; magnetic dipole
moment
MDP methylene diphosphonate
MDS myelodysplasic syndrome
ME myalgic encephalomyelitis
MEA multiple endocrine adenopathy
Medical department; mini disc
MEDUSA technique for determination of dynamic
structure
MEG magneto encephalography; MSI
MEM maximum entropy method
MEMP multi-echo multiplanar
MEN (1/2) multiple endocrine neoplasia (type 1/2)
MEN 1 multiple endocrine neoplasia type 1
MEN 2 multiple endocrine neoplasia type 2
MEN 2a multiple endocrine neoplasia type 2a
MEN 2b multiple endocrine neoplasia type 2b
MEN 3 multiple endocrine neoplasia type 3
587
MEN multiple endocrine neoplasia
MEP message exchange protocol
ME-PS multi-echo pulse sequence
MESS multiple-echo single shot
MET maximal exercise test; modality examination
terminal
MeV mega electron volt
mF millifared
MFH malignant fibrous histiocytoma
mFISP mirrored FISP
MFV maximal flow-volume loop
mg milligram
MG myasthenia gravis
Mg2+ magnesium
MGUS monoclonal gammopathy of
undetermined
mGy milligray
MHC major histocompatibility gene complex
MHDP methylene hydroxydiphosphonate
MHU Mega heat units
MHV middle hepatic vein
Mhz megahertz
MI mitral incompetence; myocardial infarction
MIB management information base
MIBG meta-iodobenzylguanidine
MIBI 2-methoxy 2-methylpropyl isonitrile
588
MIC minimum inhibitory concentration
micro. Microbiology
microCi microcurie
Min Minimum
MIOP magnetic iron oxide particles
MIP Maximum intensity projection
MLEV-n m.Levitt’s sequence
MLSI multiple line scan imaging
Mo the magnetization vector Mo
Mo the magnetization vector, Bo / Equilibrium
magnetization
MOD Magneto optical disc
MPGR Multiplanar/multiple planar gradient
recalled (ASS)
MPGRE magnetization protocol/prepares gradient
echo sequence
MPI myocardial perfusion imaging
MPIR multiplanar inversion recovery
MPR multiplanar reconstruction
MP-RAGE magnetization prepared rapid gradient echo
MPR-Cor Multi planer recon-coronal
MPR-Obl Multi planer recon-oblique
MPR-Sag Multi planer recon-sag
MPVR Multiplaner volume rendering recons
MQC Multiple quantum coherence
MQF multiple quantum filter
589
MQHPT multiquantum heternonuclear polarization
transfer
MQS multiple quantum spectroscopy
MR magnetic resonance
MR DSA magnetic resonance digital subtraction
angiography
MR GI magnetic resonance guided
intervention
MR imager magnetic resonance imager
MR scanner magnetic resonance imager
MRA magnetic resonance angiography /
arthrography
MRC magnetic resonance cholengio-
pancreatography
MRCM magnetic resonance contrast medium
MRCP magnetic resonance cholangio-
pancreatography
MRF magnetic resonance fluoroscopy
MRI machine magnetic resonance imaging machine
MRI scanner magnetic resonance imaging scanner
MRI scans magnetic resonance imaging scans
MRi magnetic resonance imager
MRI magnetic resonance imaging
MRM magnetic resonance mammography /
myelography
MRP/U magnetic resonance pylography / urography
590
MRPS magnetic resonance pulse sequence
MRS magnetic resonance spectroscopy / signal
MRSI magnetic resonance spectroscopy imaging
MSCT Multi-slice CT
MS-EPI multi shot echo planar imaging
MSI magnetic source imaging
MSK Musculo skeletal
MSME seq multislice multiecho sequence
MSOFT multi slice off resonance fat separation
technique
MT magnetization transfer
mT/m/ms magnetic GF in milliTesla per metre and
milliseconds
MTC magnetization transfer contrast
MTF modulation transfer function
MTR magnetization transfer ratio
MTSA multiple thin slab acquisition
MVS multi-volume spectroscopy
Mx X component of magnetization
Mx,y transverse component of magnetization
Mx,y transverse magnetization
My’ Y' component of magnetization
Mz longitudinal magnetization
Mz Z (longitudinal) component of magnetization
N signal size , hydrogen density / H weighted
n frequency
591
N- spin population in high energy state
N/2 ghost ghost artefact in MRI in the phase encoding
direction
N+ spin population in low energy state
Nacq number of acquisitions
NE navigator echo
NECT Non-enhanced CT
NEX number of excitations (number of signal
averages)
NMM nuclear magnetic moment.
NMR imaging nuclear magnetic resonance imaging
NMR signal nuclear magnetic resonance signal
NMR spec nuclear magnetic resonance spectroscopy
NMR nuclear magnetic resonance
NMV net magnetization vector
NOE nuclear overhauster enhancement
NOESY nuclear overhauster effect spectroscopy
NQCC nuclear quadrupole coupling constant
NSA number of signal averaged
O oxygen
O2-17 MR MR applications using oxygen as resonating
nucleus.
OC Operator’s console
OGER Ortho graphic external rendering
OL Line Orbito meatal line
OML Orbito metal line
592
OSIRIS modification of the ISIS method for localized
spectroscopy
P posterior / power
PACS picture archiving and communication system;
IMACS
PC phase contrast
PC MRA phase contrast magnetic resonance
angiography
PCE paramagnetic contrast enhancement
PCM positive contrast media
PCr phosphocreatinine
PD WI proton density weighted image, T1/T2
generated image
PE phase encoding
PEAR phase encoding artefact reduction
PEG phase encoding grouping
PEM positron emission tomography
PEST phase encode selection technique
PET-CT positron emission tomography CT
PFA partial flip angle
PFI partial flip imaging
PFNB percutaneous fine needle biopsy
PI perfusion imaging
Pitch table incrementation/collimation
PM perfusion measurement / point-resolved
spectroscopy
593
PMRFI phase modulated rotating frame
imaging
PMRS proton magnetic resonance spectroscopy
POMP phase ordered Multiplanar
POMP phase-offset multi-planar
PPG peripheral pulse gating
PPM parts per million
PR imaging projection reconstruction imaging
Pr. Inj pressure injector
PRE proton relaxation enhancement
PRESS point-resolved spectroscopy
PRESS technique for localized spectroscopy
using a spin echo PS
PRFT partially relaxed fourier transform
PRI projection reconstruction imaging enhanced
reconstruction
PROSE/PROBE?????
PRO PELLER periodically rotated overlapping parallel
lines with enhanced reconstruction
PS partial saturation / saturation recovery pulse
sequence
PS sequence saturation recovery pulse sequence
SR-PS
PSD phase sensitive detection
PSIF reverse fast imaging with steady-state
procession
594
PSR phase sampling ratio
PSSE partial saturation spin echo
PUJ pelvi ureteric junction
Pulse MR technique that applies RF pulses in contrast
cont. wave
PV phase portal vein phase
PVE partial volume effect
PVR portal venous radicles
PWI perfusion weighted imaging
Q coil
Q factor efficiency of a magnetic resonance
radiofrequency coil.
Q RF coil quality factor
QA quality assurance
QCSI quantitative chemical shift imaging
QD coil quadrature detection coil
QMRI quantitative MRI
QUEST quick echo-split imaging technique
QUIPPS quantitative imaging of perfusion using a
single subtraction
R1 longitudinal relaxivity or efficiency
R2 transverse relaxivity or efficiency
RAGE rapid gradient echo

595
RAM FAST rapidly acquired magnetization prepared
FAST
RAM FAST reduced acquisition matrix Fourier acquired
steady state
RAPP-ISIS
RARE PS rapid acquisition with relaxation enhancement
PS
RARE rapid acquisition with refocussed echoes
RASE rapid acquisition spin echo
RAW DATACT data acquired during each exposure
RC respiratory compensation
rCBF regional cerebral blood flow
RCC renal cell carcinoma
RE real part of a complex number
RECSY multistep relayed coherence
spectroscopy
REDOR rotational double echo resonance
Ref S-V reference scout view
Refoc FLASH a type of gradient echo pulse sequence
RELAY relayed correlation spectroscopy
resonance frequency in Hertz / in radians per
second
REST regional saturation technique
Rev FISP reverse fast imaging with steady procession
RF resonant frequency / radio frequency
RF coil radiofrequency coil
596
RF echo NMR signal formed by the action of two or
more RF pulses
RF FAST radio frequency spoiled fast acquisition in the
steady state
RF field rotating magnetic field B1 used in NMR
RF pulse radio-frequency pulse
RF screen radiofrequency screen
RF spoiled radiofrequency-spoiled Fourier acquired
RFA reduced flip angle
RFI radio frequency interference
RFS FAST RF spoiled Fourier-acquired steady-state
technique
RFS rotating-frame spectroscopy
RFspoiledFAST radio frequency spoiled fast acquisition in
the steady state
RI rapid imaging
RISE rapid imaging spin echo
ROAST resonant offset averaging in the steady
state
ROESY rotating frame overhauser effect spectroscopy
ROI Region of interest
ROPE respiratory ordered phase encoding
ROTO roesy – tocsy relay
RS SARGE rapid scan specific absorption rate gradient
echo

597
RS rapid scan
RSE rapid spin echo
RSSG seq
RUFIS rotating ultra-fast imaging sequence
S/s superior / second
S# Serial number
S/N short for signal to noise ratio
SA shielding anisotropy
SAAV simultaneous acquisition of artery and vein
SAH Sub arachnoid haemorrhage
SAR specific absorption rate
SARGE short absorption rate gradient echo
SC joints Sterno-clavicular joints
SC scalar coupling
SCRF surface coil rotating frame
SCT Spiral CT / Helical CT / Volume CT
SCTSE single contrast turbo spin echo
SD S.Delay Scan delay
SDDS spin decoupling difference spectroscopy
SDH Subdural haematoma
SE spin echo / stimulated echo
SE EPI spin-echo echo-planar imaging
SE imaging spin echo pulse sequence imaging
SE PS spin echo pulse sequence
Sec. Second
SECSY spin echo correlation spectroscopy
598
SEDOR spin echo double resonance
SEFT spin echo fourier transform spectroscopy
SELINCOR selective inverse correlation
SEMUT subspectral editing using a multi-quantum trap
SENSE sensitivity encoding for MRI
sEPI spiral EPI
SFORD single frequency off-resonance decoupling
SGGR spoiled gradient refocused acquisition in the
steady state
SHORT short repetition technique
SHOT selection with high
SI signal intensity / spectroscopic imaging
SIMUSIM simultaneous multi slice imaging
SIMUVOSP simultaneous multi volume spectroscopy
Sinc Sin(x)/x
SIP saturation inversion projection
SKEWSY skewed exchange spectroscopy
SL# Slice number
SLIM spectral localization by imaging / suppressed
lipid imaging
SLK THK Slice thickness
SMA Superior mesenteric artery

599
SMART Shimadzu motion artefact reduction
technique
SMART simultaneous multislice acquisition using
rosette trajectories
SMaRT simultaneous multislice acquisition with
arterial flow tragging
SMASH short minimum angle shot
SMASH simultaneous acquisition of spatial
harmonics
SMI simultaneous multislice imaging
SMV Superior mesenteric vein
SNR signal to noise ratio
Society of Europe
SOL Space occupying lesion
SORSSTC slice selective off resonance since pulse
saturation TC
SP saturation pulse / shaped pulse / square pulse
SPACE spatial and chemical shift encoded excitation
SPACE-RIP sensitivity profiles from an array of coils for
encoding and reconstruction in parallel
SPAMM spatial modulation of magnetization
SPARS
SPECSTEAM8
SPECT single photon emission computed
tomography

600
SPGR spoiled gradient recalled (spoiled GRASS-GE)
SPGR spoiled gradient refocused acquisition in the
steady state
SPI selective population inversion
SPIO small particle iron oxide MR contrast media
SPIO super paramagnetic iron oxides
SPIR spectrally selective inversion recovery
Spiral CT Spiral computed tomography
Spiral MRI spiral scanning
Spoiled FLASH Name for a spoiled gradient echo pulse
sequence
Spoiled GEI spoiled gradient echo imaging
Spoiled GES spoiled gradient echo pulse sequence
SPRITE single-point ramped imaging with T 1
enhancement
SPT selective population transfer
SQUID superconducting quantum interference
device
SQUID superconducting quantum interference
device
SR saturation recovery / slew rate / surface
rendering
SR-PS saturation recovery pulse sequence
SS FSE single shot fast spin echo
SS GRE steady state gradient echo sequence
SS slice select gradient
601
SSA single slice acquisition
SSD Shaded surface display
SSFP steady state free precession (GE) SSPF;
steady state
SSFP Steady-state free precession
SSGE Imaging steady state gradient echo imaging
SSPF steady state procession in free induction
decay
ST sequence Stejskal-Tanner sequence
ST/B Algo Soft tissue/b one algorithm
STAGE: T1W small tip angle gradient-echo T1-
weighted
STANDOUT soft shresholding and depth cueing of
unspecified tech
STD Algo Standard Algorithm
STE stimulated echo, steady state technique with
refocused
STEAM stimulated echo acquisition mode
STEP stimulated echo progressive imaging
STERF steady state technique with refocused free
induction decay
stimulated echo
STIR short tau (inversion time) inversion recovery

602
STREAM suppressed tissue with refreshment
angiography method
STS Single-turn solenoid
SVC superior vena cavography
SVC superior vena cavography
T tesla, SI unit of magnetic flux density /
temperature
T1 / T1 T1 relaxation/longitudinal relaxation time,
characteristic time (time constant) of spin-
lattice relaxation time
T1 FAST T1-weighted Fourier-acquired steady-state
technique
T1 FFE Contrast-enhanced fast field echo (T1-
weighted)
T1 FFE T1-weighted fast field echo
T1 FLAIR sequence forT1 contrast between G & W
matter and CSF
T1 relaxation process by which the longitudinal
magnetization Mz attains its equilibrium value
Mzo
T1W / T1WI T1 weighted / T1 weighted image
T2 / T2 spin-spin relaxation time / transverse
relaxation time
T2 FFE Contrast-enhanced fast field echo (T2-
weighted)
T2 PEDD T2 proton electron dipole dipole interjection
603
T2 PRE T2 proton relaxation enhancement
T2* / T2* T2 star / effective transverse relaxation time
T2inhomo Inhomogeneous T2
T2W / T2WI T2 weighted / T2 weighted image
TBT Tracheo bronchial tree
TCF time correlation function
TCMV Total contrast medium volume
TD trigger delay
TE echo time / time delay between excitation and
echo
TEI TE interleaved
TFE turbo field echo
Thk slice thickness
TI inversion time / time following inversion
pulse
TIM total imaging matrix
TMJ Temporo mandibular joint
TMR therapeutic/topical magnetic resonance
imaging
TOCSY total correlation spectroscopy
TOE truncated noe
TOF time of flight
TOF MRA time of flight magnetic resonance angiography
Tomo Tomogram
TONE tilted optimized nonsaturation excitation
Topo Topogram, Scout view, Scanogram
604
TORO tocsy roesy relay
TOSS total suppression of sidebands
TPPI time proportional phase incrementation
TQ triple quantum
TQF triple quantum filter
TR repetition time / repeat time / time to/of
repetition
True FISP fast imaging with steady precession (heavily
T2-weighted)
True FISP Siemens brand name for a refocuses GE-PS
3D
TSE turbo spin echo RARE pulse sequence
TSR total saturation recovery
Turbo FE ‘Turbo’ field echo Philips brand name for an
ultrafast GE-PS
Turbo FLASH turbo fast low angle shot
Siemens/ultrafast GE-PS
Turbo MRA ultrafast magnetic resonance angiography
technique
Turbo SE ‘Turbo’ SE Philips and Siemens name for a
RARE PS
Turbo Short turbo short repetition technique Elscient
ultrafast GE-PS
TVMF time varying magnetic fields
U GE-PS ultrafast gradient echo pulse sequence
U MRI ultrafast magnetic resonance imaging
605
UBOs unidentified bright objects
UE unpaired electron
Ultrafast CT Cine CT / Electron beam CT
ultrasmall superparamagnetic iron oxide.
USPIO ultrasmall particle iron oxide
USPIO ultrasmall/particle superparamagnetic iron
oxide
VAS variable angle spinning
VEMP variable echo multiplanar
VENC velocity encoding / velocity encoding value
VEST volume excitation using stimulated echoes
VIGRE gradient echo
VINNIE velocity encode CINE imaging (GE)
VOI volume of interest
VOSING volume-selective single-scan heteronuclear
editing
VOSY volume selective spectroscopy
VPS views per segment
VR Volume rendering
VRT Volume rendering technique
VUJ Vesico ureteric junction
VVF Vesico veginal fistula
W tryptophan; tungsten (Ger. Wolfram); watt;
work;
W/L Window level
w/v weight (of solute) per volume (of solvent)
606
W/W Window width
WAIS Wechslar Adult Intelligence Scale
WALTZ-8
WALTZ-n
WATERGATE water suppression pulse sequence
wave
Wb weber
WBC white blood cell; white blood cell count
WC window centre
WEE western equine encephalomyelitis
WEFT water eliminated fourier transform
WHHL Watanable heritable hyperlipidemic
WHO World Health Organization
WISC Wechslar Intelligence Scale for Children
WL window level
WMH white matter hyperintensities
Wo
WS water suppression / work station
WSC water soluble contrast
WSCM water soluble contrast medium
wt weight
WW window width
X - gradient x-component of the magnetic gradient field
X - gradient x-component of the magnetic gradient field
X axis in laboratory coordinate system

607
X abscissa
X KienbÖck unit; xanthine; xanthosine; sample
mean; reactance
X’ rotating frame X axis
Xe xenon, element with 54 protons
Xe xenon, element with 54 protons.
Xe 129 MRI hyperpolarized gas magnetic resonance
imaging
Xe 129 MRI hyperpolarized gas MR imaging
Xenon MRI MR imaging of lung using xenon gas as a MR
CM
XMP xanthosine monophosphate
XOAN X-linked (Nettleship) ocular albinism
XU excretory urography
Y – gradient y-component of the magnetic gradient field
Y – gradient y-component of the magnetic gradient field
Ƴ camera gamma camera
Ƴ decay gamma decay
Ƴ radiation gamma radiation
Ƴ ray gamma ray
Y axis in laboratory coordinate system
Ƴ film gamma; gyromagnetic ratio
Y ordinate / tyrosine; yttrium
Y’ rotating frame Y axis
Yb ytterbium
Ƴ-GT gamma-glutamyltransferase/gamma
608
Ƴ-IFN alpha interferon (s)
Ƴ-LPH gamma lipotrophin
Ƴ-MSH gamma melanocyte stimulating
hormone
Z – gradient z-component of the magnetic gradient field
Z atomic number; impedance
Z axis in laboratory coordinate system
Z-COSY cosy with z-filter
ZECSY zero-quantum echo correlated
spectroscopy
ZIFT zygote intrafallopian transfer
Zn zinc
ZQC zero quantum coherence
ZQF zero quantum filter
Zr zirconium
ZSR zeta sedimentation ratio
ZZ spectr selection of coherence involving zz or
longitudinal spin-spin order
Zz L. zingiber (ginger)
μ linear attenuation coefficient
μCi microcurie
μF microfarad
μg microgram
μGy microgray
μl microlitre
μs microsecond
609
μSv microsievert

610