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Chapter

Magnetic Resonance Basics:

Magnetic Fields, Nuclear
Magnetic Characteristics, Tissue
Contrast, Image Acquisition
Nuclear magnetic resonance (NMR) is the spectroscopic study of the magnetic
properties of the nucleus of the atom. The protons and neutrons of the nucleus
have a magnetic field associated with their nuclear spin and charge distribution.
Resonance is an energy coupling that causes the individual nuclei, when placed
in a strong external magnetic field, to selectively absorb, and later release, energy
unique to those nuclei and their surrounding environment. The detection and
analysis of the NMR signal has been extensively studied since the 1940s as an
analytic tool in chemistry and biochemistry research. NMR is not an imaging tech-
nique but rather a method to provide spectroscopic data concerning a sample
placed in a small volume, high field strength magnetic device. In the early 1970s,
it was realized that magnetic field gradients could be used to localize the NMR sig-
nal and to generate images that display magnetic properties of the proton, reflect-
ing clinically relevant information, coupled with technological advances and
development of “body-size” magnets. As clinical imaging applications increased
in the mid-1980s, the “nuclear” connotation was dropped, and magnetic reso-
nance imaging (MRI), with a plethora of associated acronyms, became commonly
accepted in the medical community.
MR applications continue to expand clinical relevance with higher field strength
magnets, improved anatomic, physiologic, and spectroscopic studies. The high
Copyright © 2011. Wolters Kluwer Health. All rights reserved.

contrast sensitivity to soft tissue differences and the inherent safety to the patient
resulting from the use of nonionizing radiation have been key reasons why MRI
has supplanted many CT and projection radiography methods. With continuous
improvements in image quality, acquisition methods, and equipment design, MRI is
often the modality of choice to examine anatomic and physiologic properties of the
patient. There are drawbacks, however, including high equipment and siting costs,
scan acquisition complexity, relatively long imaging times, significant image artifacts,
patient claustrophobia, and MR safety concerns.
This chapter reviews the basic properties of magnetism, concepts of resonance,
tissue magnetization and relaxation events, generation of image contrast, and
basic methods of acquiring image data. Advanced pulse sequences, illustration of
image characteristics/artifacts, MR spectroscopy, MR safety, and biologic effects, are
discussed in Chapter 13.

402
Bushberg, Jerrold T., et al. Essential Physics of Medical Imaging, Wolters Kluwer Health, 2011. ProQuest Ebook Central,
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Created from pitt-ebooks on 2019-05-13 10:22:38.
Chapter 12 • Magnetic Resonance Basics 403

12.1 Magnetism, Magnetic Fields, and Magnets

Magnetism
Magnetism is a fundamental property of matter; it is generated by moving charges,
usually electrons. Magnetic properties of materials result from the organization and
motion of the electrons in either a random or a nonrandom alignment of magnetic
“domains,” which are the smallest entities of magnetism. Atoms and molecules have
electron orbitals that can be paired (an even number of electrons cancels the mag-
netic field) or unpaired (the magnetic field is present). Most materials do not exhibit
overt magnetic properties, but one notable exception is the permanent magnet, in
which the individual magnetic domains are aligned in one direction.
Unlike the monopole electric charges from which they are derived, magnetic
fields exist as dipoles, where the north pole is the origin of the magnetic field lines
and the south pole is the return (Fig. 12-1A). One pole cannot exist without the
other. As with electric charges, “like” magnetic poles repel and “opposite” poles
attract. Magnetic field strength, B (also called the magnetic flux density), can be con-
ceptualized as the number of magnetic lines of force per unit area, which decreases
roughly as the inverse square of the distance from the source. The SI unit for B is the
Tesla (T). As a benchmark, the earth’s magnetic field is about 1/20,000 5 0.00005
T 5 0.05 mT. An alternate (historical) unit is the gauss (G), where 1 T 5 10,000 G.

Magnetic Fields
Magnetic fields can be induced by a moving charge in a wire (e.g., see the sec-
tion on transformers in Chapter 6). The direction of the magnetic field depends
on the sign and the direction of the charge in the wire, as described by the “right
hand rule”: The fingers point in the direction of the magnetic field when the thumb
points in the direction of a moving positive charge (i.e., opposite to the direction
of electron movement). Wrapping the current-carrying wire many times in a coil
causes a superimposition of the magnetic fields, augmenting the overall strength of

A Bar magnet B Current-carrying coiled wire

e-
N

S
e-

Dipole magnetic field

■■FIGURE 12-1 A. The magnetic field has two poles with magnetic field lines emerging from the north pole
(N), and returning to the south pole (S), as illustrated by a simple bar magnet. B. A coiled wire carrying an
electric current produces a magnetic field with characteristics similar to a bar magnet. Magnetic field strength
and field density are dependent on the amplitude of the current and the number of coil turns.

Bushberg, Jerrold T., et al. Essential Physics of Medical Imaging, Wolters Kluwer Health, 2011. ProQuest Ebook Central,
http://ebookcentral.proquest.com/lib/pitt-ebooks/detail.action?docID=2031899.
Created from pitt-ebooks on 2019-05-13 10:22:38.
404 Section II • Diagnostic Radiology

the magnetic field inside the coil, with a rapid falloff of field strength outside the coil
(see Fig. 12-1B). Amplitude of the current in the coil determines the overall magni-
tude of the magnetic field strength. The magnetic field lines extending beyond the
concentrated field are known as fringe fields.

Magnets
The magnet is the heart of the MR system. For any particular magnet type, performance
criteria include field strength, temporal stability, and field homogeneity. These param-
eters are affected by the magnet design. Air core magnets are made of wire-wrapped
cylinders of approximately 1-m diameter and greater, over a cylindrical length of 2 to
3 m, where the magnetic field is produced by an electric current in the wires. When
the wires are energized, the magnetic field produced is parallel to the long axis of the
cylinder. In most clinically designed systems, the magnetic field is horizontal and
runs along the cranial–caudal axis of the patient lying supine (Fig. 12-2A). Solid core
magnets are constructed from permanent magnets, a wire-wrapped iron core “electro-
magnet,” or a hybrid combination. In these solid core designs, the magnetic field runs
between the poles of the magnet, most often in a vertical direction (Fig. 12-2B). Mag-
netic fringe fields extend well beyond the volume of the cylinder in air core designs.
Fringe fields are a potential hazard, and are discussed further in Chapter 13.
To achieve a high magnetic field strength (greater than 1 T) requires the electro-
magnet core wires to be superconductive. Superconductivity is a characteristic of cer-
tain metals (e.g., niobium–titanium alloys) that when maintained at extremely low
temperatures (liquid helium; less than 4°K) exhibit no resistance to electric current.

A Air Core Magnet

Y
B0
Z
Copyright © 2011. Wolters Kluwer Health. All rights reserved.

Fringe Fields Extensive

B Solid Core Magnet

X
Y B0

Fringe Fields Contained

■■FIGURE 12-2 A. Air core magnets typically have a horizontal main field produced in the bore of the electri-
cal windings, with the z-axis (B0) along the bore axis. Fringe fields for the air core systems are extensive and
are increased for larger bore diameters and higher field strengths. B. The solid core magnet has a vertical field,
produced between the metal poles of a permanent or wire-wrapped electromagnet. Fringe fields are confined
with this design. In both types, the main field is parallel to the z-axis of the Cartesian coordinate system.

Superconductivity allows the closed-circuit electromagnet to be energized and

ramped up to the desired current and magnetic field strength by an external elec-
tric source. Replenishment of the liquid helium must occur continuously, because if
the temperature rises above a critical value, the loss of superconductivity will occur
and resistance heating of the wires will boil the helium, resulting in a “quench.”
Superconductive magnets with field strengths of 1.5 to 3 T are common for clini-
cal systems, and 4 to 7 T clinical large bore magnets are currently used for research
applications, with possible future clinical use.
A cross section of the internal superconducting magnet components shows inte-
gral parts of the magnet system including the wire coils and cryogenic liquid contain-
ment vessel (Fig. 12-3). In addition to the main magnet system, other components
are also necessary. Shim coils interact with the main magnetic field to improve homo-
geneity (minimal variation of the magnetic flux density) over the volume used for
patient imaging. Radiofrequency (RF) coils exist within the main bore of the magnet
to transmit energy to the patient as well as to receive returning signals. Gradient coils
are contained within the main bore to produce a linear variation of magnetic field
strength across the useful magnet volume.
A magnetic field gradient is obtained by superimposing the magnetic fields
of two or more coils carrying a direct current of specific amplitude and direction
with a precisely defined geometry (Fig. 12-4). The bipolar gradient field varies
over a predefined field of view (FOV), and when superimposed upon B0, a small,
continuous variation in the field strength occurs from the center to the periph-
ery with distance from the center point (the “null”). Interacting with the much,
much stronger main magnetic field, the subtle linear variations are on the order of
0.005 T/m (5 mT/m) and are essential for localizing signals generated during the
operation of the MR system.

Shim Leads Main Leads

Instrumentation
Coldhead
Recondenser
Liquid Helium Superconducting Coils
Thermal
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Shield
Active Shims
Shim Coils
Helium Main Coils
Vessel
Vacuum Gradient
Vessel Coils

Passive Specification
Shims Volume
RF Coils

Imaging
Volume
RF coils
Main Switch Vacuum
Insulation

■■FIGURE 12-3 Internal components of a superconducting air-core magnet are shown. On the left is a cross
section through the long axis of the magnet illustrating relative locations of the components, and on the right
is a simplified cross section across the diameter.

Coil Coil
current + Coil pair current -

Magnetic field Magnetic field

Magnetic field
variation

Distance along coil axis

Superimposed
Gradient: linear change
magnetic fields
in magnetic field

Center of coil pair

■■FIGURE 12-4 Gradients are produced inside the main magnet with coil pairs. Individual conducting wire
coils are separately energized with currents of opposite direction to produce magnetic fields of opposite
polarity. Magnetic field strength decreases with distance from the center of each coil. When combined, the
magnetic field variations form a linear change between the coils, producing a linear magnetic field gradient,
as shown in the lower graph.

The MR System
The MR system is comprised of several components including those described above,
orchestrated by many processors and control subsystems, as shown in Figure 12-5.
Detail of the individual components, methods of acquiring the MR signals and recon-
struction of images are described in the following sections. But first, characteristics
of the magnetic properties of tissues, the resonance phenomenon, and geometric
considerations are explained.

Components
Shim Power Data
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Supply Storage

Magnet

RF Transmitter Digitizer &

& Receiver Image
Processor
Patient
Table
Clock

Pulse Program Host

Measurement Computer
Gradient & Control
Pulse Program

Gradient
Power Supply Operating
Console

■■FIGURE 12-5 The MR system is shown (lower left), the operators display (upper left), and the various
subsystems that generate, detect, and capture the MR signals used for imaging and spectroscopy.

Magnetic Properties of Materials

Magnetic susceptibility describes the extent to which a material becomes magnetized
when placed in a magnetic field. Induced internal magnetization opposes the exter-
nal magnetic field and lowers the local magnetic field surrounding the material. On
the other hand, the internal magnetization can form in the same direction as the
applied magnetic field, and increase the local magnetic field. Three categories of sus-
ceptibility are defined: diamagnetic, paramagnetic, and ferromagnetic, based upon the
arrangement of electrons in the atomic or molecular structure. Diamagnetic elements
and materials have slightly negative susceptibility and oppose the applied magnetic
field, because of paired electrons in the surrounding electron orbitals. Examples of
diamagnetic materials are calcium, water, and most organic materials (chiefly owing
to the diamagnetic characteristics of carbon and hydrogen). Paramagnetic materials,
with unpaired electrons, have slightly positive susceptibility and enhance the local
magnetic field, but they have no measurable self-magnetism. Examples of paramag-
netic materials are molecular oxygen (O2), deoxyhemoglobin, some blood degrada-
tion products such as methemoglobin, and gadolinium-based contrast agents. Locally,
these diamagnetic and paramagnetic agents will deplete or augment the local mag-
netic field (Fig. 12-6), affecting MR images in known, unknown, and sometimes
unexpected ways. Ferromagnetic materials are “superparamagnetic”—that is, they
augment the external magnetic field substantially. These materials, containing iron,
cobalt, and nickel, exhibit “self-magnetism” in many cases, and can significantly dis-
tort the acquired signals.

Magnetic Characteristics of the Nucleus

The nucleus, comprising protons and neutrons with characteristics listed in Table 12-1,
exhibits magnetic characteristics on a much smaller scale than for atoms/molecules and
their associated electron distributions. Magnetic properties are influenced by spin and
charge distributions intrinsic to the proton and neutron. A magnetic dipole is created
for the proton, with a positive charge equal to the electron charge but of opposite sign,
due to nuclear “spin.” Overall, the neutron is electrically uncharged, but subnuclear
charge inhomogeneities and an associated nuclear spin result in a magnetic field of
opposite direction and approximately the same strength as the proton. Magnetic char-
acteristics of the nucleus are described by the nuclear magnetic moment, represented as
Copyright © 2011. Wolters Kluwer Health. All rights reserved.

Diamagnetic: Paramagnetic:
Paired electron spins Unpaired electron spins

magnetic field lines water molecule

■■FIGURE 12-6 The local magnetic field can be changed in the presence of diamagnetic (depletion) and para-
magnetic (augmentation) materials, with an impact on the signals generated from nearby signal sources such
as the hydrogen atoms in water molecules.

TABLE 12-1 PROPERTIES OF THE NEUTRON AND PROTON

CHARACTERISTIC NEUTRON PROTON
Mass(kg) 1.674 3 10−27 1.672 3 10−27
Charge (coulomb) 0 1.602 3 10−19
Spin quantum number ½ ½
Magnetic moment (J/T) −9.66 3 10 −27
1.41 3 10−26
Magnetic moment (nuclear magneton) −1.91 2.79

a vector indicating magnitude and direction. For a given nucleus, the nuclear magnetic
moment is determined through the pairing of the constituent protons and neutrons.
If the sum of the number of protons (P) and number of neutrons (N) in the nucleus
is even, the nuclear magnetic moment is essentially zero. However, if N is even and
P is odd, or N is odd and P is even, the resultant noninteger nuclear spin generates a
nuclear magnetic moment. A single nucleus does not generate a large enough nuclear
magnetic moment to be observable, but the conglomeration of large numbers of nuclei
(,1015) arranged in a nonrandom orientation generates an observable nuclear mag-
netic moment of the sample, from which the MRI signals are derived.

Nuclear Magnetic Characteristics of the Elements

Biologically relevant elements that are candidates for producing MR signals are
listed in Table 12-2. Key features include the strength of the nuclear magnetic
moment, the physiologic concentration, and the isotopic abundance. Hydrogen,
having the largest magnetic moment and greatest abundance, chiefly in water
and fat, is by far the best element for general clinical utility. Other elements
are orders of magnitude less sensitive. Of these, 23Na and 31P have been used
for imaging in limited situations, despite their relatively low sensitivity. There-
fore, the nucleus of the hydrogen atom, the proton, is the principal focus for
generating MR signals.
Copyright © 2011. Wolters Kluwer Health. All rights reserved.

TABLE 12-2 MAGNETIC RESONANCE PROPERTIES OF MEDICALLY USEFUL

NUCLEI
SPIN QUANTUM % ISOTOPIC MAGNETIC % RELATIVE ELEMENTAL RELATIVE
NUCLEUS NUMBER ABUNDANCE MOMENTb ABUNDANCEa SENSITIVITY
1
H ½ 99.98 2.79 10 1
3
He ½ 0.00014 22.13 0 –
13
C 2½ 0.011 0.70 18 –
17
O 5
/2 0.04 21.89 65 9 3 1026
19
F ½ 100 2.63 ,0.01 3 3 1028
23
Na 3
/2 100 2.22 0.1 1 3 1024
31
P ½ 100 1.13 1.2 6 3 1025

a
moment in nuclear magneton units = 5.05 3 10227 J T21.
b
Note: by mass in the human body (all isotopes).

A No magnetic field B External magnetic field

Antiparallel spins
Higher energy

DE Net magnetic
moment
B0
Parallel spins
Lower energy

■■FIGURE 12-7 Simplified distributions of “free” protons without and with an external magnetic field are
shown. A. Without an external magnetic field, a group of protons assumes a random orientation of magnetic
moments, producing an overall magnetic moment of zero. B. Under the influence of an applied external mag-
netic field, B0, the protons assume a nonrandom alignment in two possible orientations: parallel and antiparal-
lel to the applied magnetic field. A slightly greater number of protons exist in the parallel direction, resulting
in a measurable net magnetic moment in the direction of B0.

Magnetic Characteristics of the Proton

The spinning proton or “spin” (spin and proton are used synonymously herein) is
classically considered to be a tiny bar magnet with north and south poles, even
though the magnetic moment of a single proton is undetectable. Large numbers
of unbound hydrogen atoms in water and fat, those unconstrained by molecular
bonds in complex macromolecules within tissues, have a random orientation of
their protons (nuclear magnetic moments) due to thermal energy. As a result, there
is no observable magnetization of the sample (Fig. 12-7A). However, when placed
in a strong static magnetic field, B0, magnetic forces cause the protons to align with
the applied field in parallel and antiparallel directions at two discrete energy levels
(Fig. 12-7B). Thermal energy within the sample causes the protons to be distrib-
uted in this way, and at equilibrium, a slight majority exists in the low-energy,
parallel direction. A stronger magnetic field increases the energy separation of the
low- and high-energy levels and the number of excess protons in the low-energy
state. At 1.0 T, the number of excess protons in the low-energy state is approxi-
mately 3 protons per million (3 3 1026) at physiologic temperatures. Although
this number seems insignificant, for a typical voxel volume in MRI, there are
Copyright © 2011. Wolters Kluwer Health. All rights reserved.

about 1021 protons, so there are 3 3 1026 3 1021, or approximately 3 3 1015

more protons in the low-energy state! This number of excess protons produces an
observable “sample” nuclear magnetic moment, initially aligned with the direc-
tion of the applied magnetic field.
In addition to energy separation of the parallel and antiparallel spin states, the
protons also experience a torque in a perpendicular direction from the applied
magnetic field that causes precession, much the same way that a spinning top wobbles
due to the force of gravity (Fig. 12-8). The precession occurs at an angular frequency
(number of rotations/sec about an axis of rotation) that is proportional to the mag-
netic field strength B0. The Larmor equation describes the dependence between the
magnetic field, B0, and the angular precessional frequency, 0:
0 5  B0
where g is the gyromagnetic ratio unique to each element. This is expressed in terms
of linear frequency as

■■FIGURE 12-8 A single proton pre-

cesses about its axis with an angular w0 radians/s
frequency, , proportional to the exter-
nally applied magnetic field strength,
according to the Larmor equation. A
well-known example of precession is
the motion a spinning top makes as it
interacts with the force of gravity as
it slows.
B0 Gravity

Proton Spinning top

Precessional frequency

γ
f0 = B0
2π
where  5 2pf and g/2p is the gyromagnetic ratio, with values expressed in millions
of cycles per second (MHz) per Tesla, or MHz/T.
Each element with a nonzero nuclear magnetic moment has a unique gyromag-
netic ratio, as listed in Table 12-3.

Energy Absorption and Emission

The protons precessing in the parallel and antiparallel directions result in a
quantized distribution (two discrete energies) with the net magnetic moment of
the sample at equilibrium equal to the vector sum of the individual magnetic
moments in the direction of B0 as shown in Figure 12-9. The magnetic field vec-
tor components of the sample in the perpendicular direction are randomly dis-
tributed and sum to zero. Briefly irradiating the sample with an electromagnetic
RF energy pulse tuned to the Larmor (resonance) frequency promotes protons
from the low-energy, parallel direction to the higher energy, antiparallel direc-
tion, and the magnetization along the direction of the applied magnetic field
shrinks. Subsequently, the more energetic sample returns to equilibrium condi-
Copyright © 2011. Wolters Kluwer Health. All rights reserved.

tions when the protons revert to the parallel direction and release RF energy at the

TABLE 12-3 GYROMAGNETIC RATIO FOR USEFUL

ELEMENTS IN MAGNETIC RESONANCE
NUCLEUS g/2p (MHz/T)
1
H 42.58
13
C 10.7
17
O 5.8
19
F 40.0
23
Na 11.3
31
P 17.2

■■FIGURE 12-9 A group of protons

in the parallel and antiparallel energy
M0 states generates an equilibrium mag-
netization, M0, in the direction of the
applied magnetic field B0. The pro-
Parallel tons are distributed randomly over
the surface of the cone, and produce
B0 no magnetization in the perpendicu-
lar direction.

Anti-
Group of protons– net
Parallel
magnetized sample

same frequency. This energy emission is detected by highly sensitive antennas to

capture the basic MR signal.
Typical magnetic field strengths for MR systems range from 0.3 to 4.0 T. For pro-
tons, the precessional frequency is 42.58 MHz/T, and increases or decreases with an
increase or decrease in magnetic field strength, as calculated in the example below.
Accuracy of the precessional frequency is necessary to ensure that the RF energy
will be absorbed by the magnetized protons. Precision of the precessional frequency
must be on the order of cycles/s (Hz) out of millions of cycles/s (MHz) in order to
identify the location and spatial position of the emerging signals, as is described in
Section 12.6.

Example: What is the frequency of precession of 1H and 31P at 0.5 T? 1.5 T? 3.0 T?
The Larmor frequency is calculated as f0 = (/2)B0.
Field Strength

Element 0.5 T 1.5 T 3.0 T

1
H 42.58 3 0.5 = 21.29 MHz 42.58 3 1.5 = 63.87 MHz 42.58 3 3.0 = 127.74 MHz
Copyright © 2011. Wolters Kluwer Health. All rights reserved.

31
P 17.2 3 0.5 = 8.6 MHz 17.2 3 1.5 = 25.8 MHz 17.2 3 3 = 51.6 MHz

The differences in the gyromagnetic ratios and corresponding precessional frequen-

cies allow the selective excitation of one element from another in the same magnetic
field strength.

Geometric Orientation, Frame of Reference, and

Magnetization Vectors
By convention, the applied magnetic field B0 is directed parallel to the z-axis of the
three-dimensional Cartesian coordinate axis system and perpendicular to the x and y
axes. For convenience, two frames of reference are used: the laboratory frame and the
rotating frame. The laboratory frame (Fig. 12-10A) is a stationary reference frame from
the observer’s point of view. The sample magnetic moment vector precesses about the

A Laboratory Frame B Rotating Frame

z z
Precessing
moment is
stationary
B0

y y'

x x'

x – y axes stationary x’ – y’ axes rotate at Larmor frequency

■■FIGURE 12-10 A. The laboratory frame of reference uses stationary three-dimensional Cartesian coordi-
nates: x, y, z. The magnetic moment precesses around the z-axis at the Larmor frequency as the illustration
attempts to convey. B. The rotating frame of reference uses rotating Cartesian coordinate axes that rotate
about the z-axis at the Larmor precessional frequency, and the other axes are denoted: x and y. When pre-
cessing at the Larmor frequency, the sample magnetic moment is stationary.

z-axis in a circular geometry about the x-y plane. The rotating frame (Fig. 12-10B) is
a spinning axis system, whereby the x-y axes rotate at an angular frequency equal to
the Larmor frequency. In this frame, the sample magnetic moment vector appears to
be stationary when rotating at the resonance frequency. A slightly higher precessional
frequency is observed as a slow clockwise rotation, while a slightly lower precessional
frequency is observed as a slow counterclockwise rotation. The magnetic interactions
between precessional frequencies of the tissue magnetic moments with the externally
applied RF (depicted as a rotating magnetic field) can be described more clearly using
the rotating frame of reference, while the observed returning signal and its frequency
content is explained using the laboratory (stationary) frame of reference.
The net magnetization vector of the sample, M, is described by three compo-
nents. Longitudinal magnetization, Mz, along the z direction, is the component of the
magnetic moment parallel to the applied magnetic field, B0. At equilibrium, the lon-
gitudinal magnetization is maximal and is denoted as M0, the equilibrium magnetiza-
Copyright © 2011. Wolters Kluwer Health. All rights reserved.

tion. The component of the magnetic moment perpendicular to B0, Mxy, in the x-y
plane, is transverse magnetization. At equilibrium, Mxy is zero. When the protons in
the magnetized sample absorb energy, Mz is “tipped” into the transverse plane, and
Mxy generates the all-important MR signal. Figure 12-11 illustrates this geometry.

12.2 The Magnetic Resonance Signal

Application of RF energy synchronized to the precessional frequency of the protons

causes absorption of energy and displacement of the sample magnetic moment from
equilibrium conditions. The return to equilibrium results in the emission of energy
proportional to the number of excited protons in the volume. This occurs at a rate
that depends on the structural and magnetic characteristics of the sample. Excitation,
detection, and acquisition of the signals constitute the basic information necessary
for MRI and and MR spectroscopy (MRS).

M0
B0
Mz

Mxy
x

Mz: Longitudina l Magnetization: in z-axis direction

Mxy: Transverse Magnetization: in x-y plane
M0: Equilibrium Magnetization: maximum magnetization

■■FIGURE 12-11 Longitudinal magnetization, Mz, is the vector component of the magnetic moment in the z
direction. Transverse magnetization, Mxy, is the vector component of the magnetic moment in the x-y plane.
Equilibrium magnetization, M0, is the maximal longitudinal magnetization of the sample, and is shown dis-
placed from the z-axis in this illustration.

Resonance and Excitation

Displacement of the equilibrium magnetization occurs when the magnetic compo-
nent of the RF excitation pulse, known as the B1 field, is precisely matched to the
precessional frequency of the protons. The resonance frequency corresponds to the
energy separation between the protons in the parallel and antiparallel directions.
The quantum mechanics model considers the RF energy as photons (quanta)
instead of waves. Protons oriented parallel and antiparallel to the external magnetic
field, separated by an energy gap, DE, will transition from the low- to the high-
energy level only when the RF pulse is equal to the precessional frequency. The
number of protons that undergo an energy transition is dependent on the ampli-
tude and duration of the RF pulse. Mz changes from the maximal positive value at
equilibrium, through zero, to the maximal negative value (Fig. 12-12). Continued

z
Equilibrium – RF energy (B 1)
more spins applied to the
parallel than y system at the
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x
antiparallel Larmor Frequenc y
Mz positive

Equal numbers
Time of B 1 field
of parallel and
increasing
antiparallel spins
Mz = 0
B0
Excited spins
More antiparallel occupy anti-
than parallel parallel energy
levels
Mz negative
■■FIGURE 12-12 A simple quantum mechanics process depicts the discrete energy absorption and the time
change of the longitudinal magnetization vector as RF energy equal to the energy difference of the parallel
and antiparallel spins is applied to the sample (at the Larmor frequency). Discrete quanta absorption changes
the proton energy from parallel to antiparallel. With continued application of the RF energy at the Larmor
frequency, Mz is displaced from equilibrium, through zero, to the opposite direction (high energy state).
Bushberg, Jerrold T., et al. Essential Physics of Medical Imaging, Wolters Kluwer Health, 2011. ProQuest Ebook Central,
http://ebookcentral.proquest.com/lib/pitt-ebooks/detail.action?docID=2031899.
Created from pitt-ebooks on 2019-05-13 10:22:38.
414 Section II • Diagnostic Radiology

A Magnetic field variation of electromagnetic RF wave

Amplitude
Clockwise Counter-
rotating clockwise Time
vector rotating
vector

B B1 at Larmor Frequency C B 1 off resonance

z z
Mz B1
Mz B1
B1
y' y'
B1 B1
Direction of B1
x' torque on Mz x' B1 B1

■■FIGURE 12-13 A. A classical physics description of the magnetic field component of the RF pulse (the
electric field is not shown). Clockwise (solid) and counterclockwise (dotted) rotating magnetic vectors produce
the magnetic field variation by constructive and destructive interaction. At the Larmor frequency, one of the
magnetic field vectors rotates synchronously in the rotating frame and is therefore stationary (the other vector
rotates in the opposite direction and does not synchronize with the rotating frame). B. In the rotating frame,
the RF pulse (B1 field) is applied at the Larmor frequency and is stationary in the x-y plane. The B1 field inter-
acts at 90 degrees to the sample magnetic moment and produces a torque that displaces the magnetic vector
away from equilibrium. C. The B1 field is not tuned to the Larmor frequency and is not stationary in the rotating
frame. No interaction with the sample magnetic moment occurs.

irradiation can induce a return to equilibrium conditions, when an incoming RF

quantum of energy causes the reversion of a proton in the antiparallel direction
to the parallel direction with the energy-conserving spontaneous emission of two
excess quanta. While this model shows how energy absorption and emission occurs,
there is no clear description of how Mxy evolves, which is better understood using
Copyright © 2011. Wolters Kluwer Health. All rights reserved.

classical physics concepts.

In the classical physics model, the linear B1 field is described with two mag-
netic field vectors of equal magnitude, rotating in opposite directions, representing
the sinusoidal variation of the magnetic component of the electromagnetic RF wave
as shown in Figure 12-13. One of the two rotating vectors is synchronized to the
precessing protons in the magnetized sample, and in the rotating frame is station-
ary. If the RF energy is not applied at the precessional (Larmor) frequency, the B1
field will not interact with Mz. Another description is that of a circularly polarized
B1 transmit field from the body coil that rotates at the precessional frequency of the
magnetization.

Flip Angles
Flip angles represent the degree of Mz rotation by the B1 field as it is applied along
the x-axis (or the y-axis) perpendicular to Mz. A torque is applied on Mz, rotating it
from the longitudinal direction into the transverse plane. The rate of rotation occurs

A Small flip angle B Large flip angle

z z
DMz M0
DMz
Mz q q M0
Mz
y' y'
B1 Mxy B1 Mxy

x' x'

z C Common flip angles z

90° flip 180° flip

y' y'
B1 Mxy B1
-Mz
x' x'

■■FIGURE 12-14 Flip angles are the result of the angular displacement of the longitudinal magnetization
vector from the equilibrium position. The rotation angle of the magnetic moment vector is dependent on the
duration and amplitude of the B1 field at the Larmor frequency. Flip angles describe the rotation of Mz away
from the z-axis. A. Small flip angles (less than 45 degrees) and B. Large flip angles (75 to 90 degrees) produce
small and large transverse magnetization, respectively.

at an angular frequency equal to 1 5 gB1, as per the Larmor equation. Thus, for
an RF pulse (B1 field) applied over a time t, the magnetization vector displacement
angle, , is determined as  5 1 t 5 gB1t, and the product of the pulse time and B1
amplitude determines the displacement of Mz. This is illustrated in Figure 12-14.
Common flip angles are 90 degrees (p/2) and 180 degrees (p), although a variety of
smaller and larger angles are chosen to enhance tissue contrast in various ways. A 90-de-
gree angle provides the largest possible Mxy and detectable MR signal, and requires a
known B1 strength and time (on the order of a few to hundreds of ms). The displacement
angle of the sample magnetic moment is linearly related to the product of B1 field strength
and time: For a fixed B1 field strength, a 90-degree displacement takes half the time of a
180-degree displacement. With flip angles smaller than 90 degrees, less time is needed
to displace Mz, and a larger transverse magnetization per unit excitation time is achieved.
For instance, a 45-degree flip takes half the time of a 90 degrees yet creates 70% of the
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signal, as the magnitude of Mxy is equal to the sine of 45 degrees, or 0.707. With fast MRI
techniques, small displacement angles of 10 degrees and less are often used.

12.3 Magnetization Properties of Tissues

Free Induction Decay: T2 Relaxation

After a 90-degree RF pulse is applied to a magnetized sample at the Larmor frequency,
an initial phase coherence of the individual protons is established and maximum Mxy
is achieved. Rotating at the Larmor frequency, the transverse magnetic field of the
excited sample induces signal in the receiver antenna coil (in the laboratory frame of
reference). A damped sinusoidal electronic signal, known as the free induction decay
(FID), is produced (Fig. 12-15).
The FID amplitude decay is caused by loss of Mxy phase coherence due to intrinsic
micromagnetic inhomogeneities in the sample’s structure, whereby individual protons

z Rotating frame

y'
x'
Equilibrium 90° RF pulse Dephasing Dephased
Mxy = zero Mxy large Mxy decreasing Mxy = zero
Time
Laboratory frame
Rotating Mxy vector
z z induces signal in antenna

90° + FID
y y

-
x
x Time

■■FIGURE 12-15 Top. Conversion of longitudinal magnetization, Mz, into transverse magnetization, Mxy ,
results in an initial phase coherence of the individual spins of the sample. The magnetic moment vector pre-
cesses at the Larmor frequency (stationary in the rotating frame), and dephases with time. Bottom. In the
laboratory frame, Mxy precesses and induces a signal in an antenna receiver sensitive to transverse magnetiza-
tion. A FID signal is produced with positive and negative variations oscillating at the Larmor frequency, and
decaying with time due to the loss of phase coherence.

in the bulk water and hydration layer coupled to macromolecules precess at incremen-
tally different frequencies arising from the slight changes in local magnetic field strength.
Phase coherence is lost over time as an exponential decay. Elapsed time between the
peak transverse signal (e.g., directly after a 90-degree RF pulse) and 37% of the peak
level (1/e) is the T2 relaxation time (Fig. 12-16A). Mathematically, this is expressed as
Mxy (t) 5 M0e2t/T2
where Mxy(t) is the transverse magnetic moment at time t for a sample that
has M0 transverse magnetization at t 5 0. When t 5 T2, then e21 5 0.37 and
Mxy 5 0.37 M0.
The molecular structure of the magnetized sample and characteristics of the
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bound water protons strongly affects its T2 decay value. Amorphous structures (e.g.,
cerebral spinal fluid [CSF] or highly edematous tissues) contain mobile molecules
with fast and rapid molecular motion. Without structural constraint (e.g., lack of
a hydration layer), these tissues do not support intrinsic magnetic field inhomo-
geneities, and thus exhibit long T2 values. As molecular size increases for specific
tissues, constrained molecular motion and the presence of the hydration layer pro-
duce magnetic field domains within the structure and increase spin dephasing that
causes more rapid decay with the result of shorter T2 values. For large, nonmoving
structures, stationary magnetic inhomogeneities in the hydration layer result in these
types of tissues (e.g., bone) having a very short T2.
Extrinsic magnetic inhomogeneities, such as the imperfect main magnetic field,
B0, or susceptibility agents in the tissues (e.g., MR contrast materials, paramagnetic or
ferromagnetic objects), add to the loss of phase coherence from intrinsic inhomoge-
neities and further reduce the decay constant, known as T2* under these conditions
(Fig. 12-16B).

A B
Mxy Mxy Mxy
maximum decreasing zero

Mxy Mxy
100%
T2 decay

37% T2* decay

t=0 t=T2 Time Time

■■FIGURE 12-16 A. The loss of Mxy phase coherence occurs exponentially caused by intrinsic spin-spin inter-
actions in the tissues and extrinsic magnetic field inhomogeneities. The exponential decay constant, T2, is
the time over which the signal decays to 37% of the initial transverse magnetization (e.g., after a 90-degree
pulse). B. T2 is the decay time resulting from intrinsic magnetic properties of the sample. T2* is the decay time
resulting from both intrinsic and extrinsic magnetic field variations. T2 is always longer than T2*.

Return to Equilibrium: T1 Relaxation

Longitudinal magnetization begins to recover immediately after the B1 excitation
pulse, simultaneous with transverse decay; however, the return to equilibrium con-
ditions occurs over a longer time period. Spin-lattice relaxation is the term describing
the release of energy back to the lattice (the molecular arrangement and structure of
the hydration layer), and the regrowth of Mz. This occurs exponentially as
Mz (t) 5 M0(1 2 e−t/T1)
where Mz(t) is the longitudinal magnetization at time t and T1 is the time needed for the
recovery of 63% of Mz after a 90-degree pulse (at t 5 0, Mz 5 0, and at t 5 T1, Mz 5
0.63 M0), as shown in Figure 12-17. When t 5 3 3 T1, then Mz 5 0.95 M0, and for t .
5 3 T1, then Mz < M0, and full longitudinal magnetization equilibrium is established.
Since Mz does not generate an MR signal directly, determination of T1 for a spe-
cific tissue requires a specific “sequence,” as shown in Figure 12-18. At equilibrium,
a 90-degree pulse sets Mz 5 0. After a delay time, DT, the recovered Mz component
is converted to Mxy by a second 90-degree pulse, and the resulting peak amplitude
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Mz Mz

Mxy
90°
pulse
100%

63%
Mz

0%
t=0 t = T1 Time

■■FIGURE 12-17 After a 90-degree pulse, Mz is converted from a maximum value at equilibrium to Mz = 0.
Return of Mz to equilibrium occurs exponentially and is characterized by the spin-lattice T1 relaxation constant.
After an elapsed time equal to T1, 63% of the longitudinal magnetization is recovered. Spin-lattice recovery
takes longer than spin-spin decay (T2).
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418 Section II • Diagnostic Radiology

■■FIGURE 12-18 Spin-lattice relaxation for a sam- z

ple can be measured by using various delay times Equilibrium 100% Mz
y
between two 90-degree RF pulses. After an initial x
z
90-degree pulse, Mz = 0, another 90-degree pulse
separated by a known delay is applied, and the 90° pulse 0% Mz
y
longitudinal magnetization that has recovered dur- x
ing the delay is converted to transverse magnetiza- Delay time short medium long
z z z
tion. The maximum amplitude of the resultant FID Longitudinal
is recorded as a function of delay times between recovery y y y
initial pulse and readout (three different delay time x
z
x
z
x
z
experiments are shown in this example), and the 90° pulse
points are fit to an exponential recovery function (readout) y y y
x x x
to determine T1.
Resulting FID
100%
Mz recovery

0%
Delay time (s)

is recorded. By repeating the sequence from equilibrium conditions with different

delay times, DT between 90-degree pulses, data points that lie on the recovery curve
are fit to an exponential equation and T1 is estimated.
The T1 relaxation time depends on the rate of energy dissipation into the sur-
rounding molecular lattice and hydration layer and varies substantially for different
tissue structures and pathologies. This can be explained from a classical physics
perspective by considering the “tumbling” frequencies of the protons in bulk water
and the hydration layers present relative to the Larmor precessional frequency of the
protons. Energy transfer is most efficient when a maximal overlap of these frequen-
cies occurs. Small molecules and unbound, bulk water have tumbling frequencies
across a broad spectrum, with low-, intermediate-, and high-frequency components.
Large, slowly moving molecules have a very tight hydration layer and exhibit low
tumbling frequencies that concentrate in the lowest part of the frequency spectrum.
Moderately sized molecules (e.g., proteins) and viscous fluids have a moderately
bound hydration layer that produce molecular tumbling frequencies more closely
matched to the Larmor frequency. This is more fully described in the “Two Com-
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partment Fast Exchange Model” (Fullerton, et.al, 1982; Bottomley, et. al, 1984).
The water in the hydration layer and bulk water exchange rapidly (on the order of
100,000 transitions per second) so that a weighted average of the T1 is observed.
Therefore, the T1 time is strongly dependent on the physical characteristics of the
tissues and their associated hydration layers. Therefore for solid and slowly moving
structures, the hydration layer permits only low-frequency molecular tumbling fre-
quencies and consequently, there is almost no spectral overlap with the Larmor fre-
quency. For unstructured tissues and fluids in bulk water, there is also only a small
spectral overlap with the tumbling frequencies. In each of these situations, release of
energy is constrained and T1 relaxation time is long. For structured and moderately
sized proteins and fatty tissues, molecular tumbling frequencies are most conducive
to spin-lattice relaxation because of a larger overlap with the Larmor frequency and
result in a relatively short T1 relaxation time, as shown in Figure 12-19. Typical T1
values are in the range of 0.1 to 1 s for soft tissues, and 1 to 4 s in aqueous tissues
(e.g., CSF).
As the main magnetic field strength increases, a corresponding increase in the
Larmor precessional frequency causes a decrease in the overlap with the molecu-
lar tumbling frequencies and a longer T1 recovery time. Gadolinium chelated with
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Chapter 12 • Magnetic Resonance Basics 419

B0 Higher B0
w0 w0
Medium, viscous:

Relative Amplitude
Short T1

Small, aqueous:
Long T1

Large, stationary:
Longest T1

Low Frequency High

Molecular vibration frequency spectrum

■■FIGURE 12-19 A classical physics explanation of spin-lattice relaxation is based upon the tumbling frequency
of the protons in water molecules of a sample material and its frequency spectrum. Large, stationary struc-
tures have water protons with tight hydration layers that exhibit little tumbling motion and a low-frequency
spectrum (aqua curve). Bulk water and small-sized, aqueous materials have frequencies distributed over a
broad range (purple curve). Medium-sized, proteinacious materials have a hydration layer that slows down
the tumbling frequency of protons sufficiently to allow tumbling at the Larmor frequency (black curve). The
overlap of the Larmor precessional frequency (vertical bar) with the molecular vibration spectrum indicates
the likelihood of spin-lattice relaxation. With higher field strengths, the T1 relaxation becomes longer as the
tumbling frequency spectrum overlap is decreased.

c omplex macromolecules are effective in decreasing T1 relaxation time of local

tissues by creating a hydration layer that forms a spin-lattice energy sink and results
in a rapid return to equilibrium.

Comparison of T1 and T2
T1 is on the order of 5 to 10 times longer than T2. Molecular motion, size, and
interactions influence T1 and T2 relaxation (Fig. 12-20). Because most tissues of
interest for clinical MR applications are intermediate to small-sized molecules, tissues

Long

T1
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T2
Relaxation
time

Short

Molecular motion: slow intermediate fast

Molecular size: large intermediate small

Molecular interactions: bound intermediate free

■■FIGURE 12-20 Factors affecting T1 and T2 relaxation times of different tissues are generally based on
molecular motion, size, and interactions that have an impact on the local magnetic field variations (T2 decay)
and structure with intrinsic tumbling frequencies coupling to the Larmor frequency (T1 recovery). The relax-
ation times (vertical axis) are different for T1 and T2.
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420 Section II • Diagnostic Radiology

TABLE 12-4 T1 AND T2 RELAXATION CONSTANTS FOR SEVERAL TISSUESa

TISSUE T1, 0.5 T (ms) T1, 1.5 T (ms) T2 (ms)
Fat 210 260 80
Liver 350 500 40
Muscle 550 870 45
White matter 500 780 90
Gray matter 650 900 100
Cerebrospinal fluid 1,800 2,400 160

a
Estimates only, as reported values for T1 and T2 span a wide range.

with a longer T1 usually have a longer T2, and those with a shorter T1 usually have
a shorter T2. In Table 12-4, a comparison of T1 and T2 values for various tissues
is listed. Depending on the main magnetic field strength, measurement methods,
and biological variation, these relaxation values vary widely. Agents that disrupt the
local magnetic field environment, such as paramagnetic blood degradation prod-
ucts, elements with unpaired electron spins (e.g., gadolinium), or any ferromagnetic
materials, cause a significant decrease in T2*. In situations where a macromolecule
binds free water into a hydration layer, T1 is also significantly decreased.
To summarize, T1 . T2 . T2*, and the specific relaxation times are a character-
istic of the tissues. T1 values are longer for higher field strength magnets, while T2
values are unaffected. Thus, the T1, T2, and T2* decay constants, as well as proton
density are fundamental properties of tissues, and can be exploited by machine-de-
pendent acquisition techniques in MRI and MRS to aid in the diagnosis of pathologic
conditions such as cancer, multiple sclerosis, or hematoma.

12.4 Basic Acquisition Parameters

Emphasizing the differences of T1 and T2, relaxation time constants, and proton
density of the tissues is the key to the exquisite contrast sensitivity of MR images, but
at the same time, the need to spatially localize the tissues is also required. First, basic
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machine-based parameters are described.

Time of Repetition
Acquiring an MR image relies on the repetition of a sequence of events in order to
sample the volume of interest and periodically build the complete dataset over time.
The time of repetition (TR) is the period between B1 excitation pulses. During the
TR interval, T2 decay and T1 recovery occur in the tissues. TR values range from
extremely short (millisecond) to extremely long (10,000 ms) time periods, deter-
mined by the type of sequence employed.

Time of Echo
Excitation of protons with the B1 RF pulse creates the Mxy FID signal. To separate
the RF energy deposition and returning signal, an “echo” is induced to appear at a
later time, with the application of a 180-degree RF inversion pulse. This can also be
achieved with a gradient field and subsequent polarity reversal. The time of echo (TE)
is the time between the excitation pulse and the appearance of the peak amplitude of
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Chapter 12 • Magnetic Resonance Basics 421

an induced echo, which is determined by applying a 180-degree RF inversion pulse

or gradient polarity reversal at a time equal to TE/2.

Time of Inversion
The TI is the time between an initial inversion/excitation (180 degrees) RF pulse that
produces maximum tissue saturation, and a 90-degree readout pulse. During the TI,
Mz recovery occurs. The readout pulse converts the recovered Mz into Mxy, which is
then measured with the formation of an echo at time TE as discussed above.

Partial Saturation
Saturation is a state of tissue magnetization from equilibrium conditions. At equi-
librium, the protons in a material are unsaturated, with full Mz amplitude. The first
excitation (B1) pulse in the sequence produces the largest transverse magnetization,
and recovery of the longitudinal magnetization occurs at the T1 time constant over
the TR interval. However, because the TR is less than at least five times the T1 of the
sample, Mz recovery is incomplete. Consequently, less Mxy amplitude is generated
in the second excitation pulse. After the third pulse, a “steady-state” equilibrium is
reached, where the amount of Mz recovery and Mxy signal amplitude are constant,
and the tissues achieve a state of partial saturation (Fig. 12-21). Tissues with short
T1 have relatively less saturation than tissues with long T1. Partial saturation has an
impact on tissue contrast, and explains certain findings such as unsaturated protons
in blood outside of the volume moving into the volume and generating a bright
vascular signal on entry slices into the volume.

12.5 Basic Pulse Sequences

Three major pulse sequences perform the bulk of data acquisition (DAQ) for imaging:
spin echo (SE), inversion recovery (IR), and gradient echo (GE). When used in con-
junction with spatial localization methods, “contrast-weighted” images are obtained.
In the following sections, the salient points and considerations of generating tissue
contrast are discussed.

Mz
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unsaturated
unsaturated

partially
saturated
Short T1 Long T1

partially
saturated

…………
TR TR TR TR TR
90° 90° 90° 90° 90° 90°

■■FIGURE 12-21 Partial saturation of tissues occurs because the repetition time between excitation pulses does
not allow for full return to equilibrium, and the Mz amplitude for the next RF pulse is reduced. After the third
excitation pulse, a steady-state equilibrium is reached, where the amount of longitudinal magnetization is the
same from pulse to pulse, as is the transverse magnetization for a tissue with a specific T1 decay constant. Tissues
with long T1 experience a greater partial saturation than do tissues with short T1 as shown above. Partial satura-
tion is important in understanding contrast mechanisms and signal from unsaturated and saturated tissues.
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422 Section II • Diagnostic Radiology

Spin Echo
SE describes the excitation of the magnetized protons in a sample with a 90-degree
RF pulse and production of a FID, followed by a refocusing 180-degree RF pulse to
produce an echo. The 90-degree pulse converts Mz into Mxy , and creates the largest
phase coherent transverse magnetization that immediately begins to decay at a rate
described by T2* relaxation. The 180-degree RF pulse, applied at TE/2, inverts the
spin system and induces phase coherence at TE, as depicted in the rotating frame in
Figure 12-22. Inversion of the spin system causes the protons to experience external
magnetic field variations opposite of that prior to TE/2, resulting in the cancellation
of the extrinsic inhomogeneities and associated dephasing effects. In the rotating
frame of reference, the echo magnetization vector reforms in the opposite direction
from the initial transverse magnetization vector.
Subsequent 180-degree RF pulses during the TR interval (Fig. 12-23) produce
corresponding echoes with peak amplitudes that are reduced by intrinsic T2 decay
of the tissues, and are immune from extrinsic inhomogeneities. Digital sampling and
acquisition of the signal occurs in a time window symmetric about TE, during the
evolution and decay of each echo.

Spin Echo Contrast Weighting

Contrast is proportional to the difference in signal intensity between adjacent pixels
in an image, corresponding to different voxels in the patient. The details of signal
localization and image acquisition in MRI are discussed in Section 12.6. Here, the
signal intensity variations for different tissues based upon TR and TE settings are
described without consideration of spatial localization.
Ignoring the signal due to moving protons (e.g., blood flow), the signal intensity
produced by an MR system for a specific tissue using a SE sequence is
S  rH [1 2 eTR/T1] e−TE/T2

Excitation Echo
TE
90°
180°
TE / 2
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Rotating frame
M xy

After 180° pulse, echo

reforms at same rate

FID signal gradually decays Spin echo peak amplitude

with rate constant T2* depends on T2

■■FIGURE 12-22 The SE pulse sequence starts with a 90-degree pulse and produces an FID that decays
according to T2* relaxation. After a delay time TE/2, a 180-degree RF pulse inverts the spins that re-establishes
phase coherence and produces an echo at a time TE. Inhomogeneities of external magnetic fields are canceled,
and the peak amplitude of the echo is determined by T2 decay. The rotating frame shows the evolution of the
echo vector in the opposite direction of the FID. The sequence is repeated for each repetition period, TR.

90° 180° 180° 180°

pulse pulse pulse pulse
T2 decay

T2* decay
■■FIGURE 12-23 “True” T2 decay is determined from multiple 180-degree refocusing pulses acquired during
the repetition period. While the FID envelope decays with the T2* decay constant, the peak amplitudes of
subsequent echoes decay exponentially according to the T2 decay constant, as extrinsic magnetic field inho-
mogeneities are cancelled.

where rH is the proton density, T1 and T2 are physical properties of tissue, and TR
and TE are pulse sequence timing parameters. For the same pulse sequence, different
values of T1, T2, and rH change the signal intensity S, and generate contrast amongst
different tissues. Importantly, by changing the pulse sequence parameters TR and TE,
the contrast dependence can be weighted toward T1, proton density, or T2 charac-
teristics of the tissues.

T1 Weighting
A “T1-weighted” SE sequence is designed to produce contrast chiefly based on the T1
characteristics of tissues, with de-emphasis of T2 and proton density contributions to
the signal. This is achieved by using a relatively short TR to maximize the differences
in longitudinal magnetization recovery during the return to equilibrium, and a short
TE to minimize T2 decay during signal acquisition. In Figure 12-24, on the left is the
graph of longitudinal recovery in steady-state partial saturation after a 90-degree RF
excitation at time t 5 0, depicting four tissues (CSF, gray matter, white matter, and
fat). The next 90-degree RF pulse occurs at the selected TR interval, chosen to create
the largest signal difference between the tissues based upon their respective T1 recov-
ery values, which is shown to be about 600 ms (the red vertical line). At this instant
in time, all Mz recovered for each tissue is converted to Mxy, with respective signal
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amplitudes projected over to the transverse magnetization graph on the right. Decay
immediately occurs, t 5 0, at a rate based upon respective T2 values of the tissues.
To minimize T2 decay and to maintain the differences in signal amplitude due to T1
recovery, the TE time is kept short (red vertical line). Horizontal projections from
the TE intersection with each of the curves graphically illustrate the relative signal
amplitudes acquired according to tissue type. Fat, with a short T1, has a large signal,
because there is greater recovery of the Mz vector over the TR period. White and gray
matter have intermediate T1 values with intermediate signal amplitude, and CSF,
with a long T1, has the lowest signal amplitude. A short TE preserves the T1 signal
differences by not allowing any significant transverse (T2) decay.
T1-weighted SE contrast therefore requires a short TR and a short TE.
A T1-weighted axial image of the brain acquired with TR 5 500 ms and TE 5 8 ms
is illustrated in Figure 12-25. Fat is the most intense signal, followed by white matter,
gray matter, and CSF. Typical SE T1-weighting machine parameters are TR 5 400 to
600 ms and TE 5 3 to 10 ms.

Longitudinal recovery (T1) Transverse decay (T2) Signal

intensity

Relative Signal Recovery

1
0.9
0.8
0.7 Fat Fat
0.6 White
0.5 Gray White
0.4 Gray
0.3 CSF CSF
0.2
0.1
0
0 1000 2000 3000 4000 5000 0 100 200 300 400 500
TR Time (ms) TE Time (ms)

■■FIGURE 12-24 T1-weighted contrast: Longitudinal recovery (left) and transverse decay (right) diagrams
(note the values of the x-axis time scales) show four brain tissues and T1 and T2 relaxation constants.
T1-weighted contrast requires the selection of a TR that emphasizes the differences in the T1 characteristics
of the tissues (e.g., TR = , 500 ms), and reduces the T2 characteristics by using a short TE so that transverse
decay is reduced (e.g., TE  15 ms).

Proton Density Weighting

Proton density contrast weighting relies mainly on differences in the number of mag-
netized protons per unit volume of tissue. At equilibrium, tissues with a large pro-
ton density, such as lipids, fats, and CSF, have a corresponding large Mz compared
to other soft tissues. Contrast based on proton density differences is achieved by
reducing the contributions of T1 recovery and T2 decay. T1 differences are reduced
by selecting a long TR value to allow substantial recovery of Mz. T2 differences of
the tissues are reduced by selecting a short TE value. Longitudinal recovery and
transverse decay graphs for proton density weighting, using a long TR and a short
TE, are illustrated in Figure 12-26. Contrast is generated from variations in proton
density (CSF . fat . gray matter . white matter). Figure 12-27 shows a proton

■■FIGURE 12-25 T1 contrast weighting, TR=500 ms,

TE=8 ms. Short TR (400 to 600 ms) generates T1 relaxation-
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dependent signals. Signals with short T1 have high signal

intensity (fat and white matter), while signals with long T1
have low signal intensity (CSF). Short TE (less than 15 ms)
preserves the T1 tissue differences by not allowing signifi-
cant T2 decay to occur.

Longitudinal recovery (T1) Transverse decay (T2) Signal

intensity
1

Relative Signal Intensity

0.9 CSF
0.8 Fat Gray
0.7 White Fat
Gray White
0.6
CSF
0.5
0.4
0.3
0.2
0.1
0
0 1000 2000 3000 4000 5000 0 100 200 300 400 500
TR Time (ms) TE Time (ms)

■■FIGURE 12-26 Proton density weighting: Proton (spin) density weighted contrast requires the use of a long
TR (e.g., greater than 2,000 ms) to reduce T1 effects, and a short TE (e.g., less than 35 ms) to reduce T2 influ-
ence in the acquired signals. Note that the average overall signal intensity is higher.

density-weighted image with TR 5 2,400 ms and TE 5 30 ms. Fat and CSF display
as a relatively bright signal, and a slight contrast inversion between white and gray
matter occurs. A typical proton density-weighted image has a TR between 2,000 and
4,000 ms (see footnote in Table 12.5) and a TE between 3 and 30 ms. The proton
density SE sequence achieves the highest overall signal intensity and the largest sig-
nal-to-noise ratio (SNR); however, the image contrast is relatively low, and therefore
the contrast-to-noise ratio is not necessarily larger than achievable with T1 or T2
contrast weighting.

T2 Weighting
T2 contrast weighting follows directly from the proton density-weighting sequence:
reduce T1 differences in tissues with a long TR, and emphasize T2 differences with
a long TE. The T2-weighted signal is generated from the second echo produced by a

■■FIGURE 12-27 Proton density contrast weighting,

TR=2400 ms, TE=30 ms.. Long TR minimizes T1 relaxation
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differences of the tissues. Signals with large proton den-

sity have higher signal intensity (CSF). Short TE preserves
the proton density differences without allowing significant
T2 decay. This sequence produces a high peak SNR, even
though the contrast differences are less than a T2-weighted
image.

Longitudinal recovery (T1) Transverse decay (T2) Signal

intensity
1

Relative Signal Intensity

0.9
0.8 FatWhite
0.7 CSF
0.6 Gray
CSF
0.5
0.4 Gray
0.3 White
0.2 Fat
0.1
0
0 1000 2000 3000 4000 5000 0 100 200 300 400 500
TR Time (ms) TE Time (ms)

■■FIGURE 12-28 T2 weighted contrast requires the use of a long TR (e.g., greater than 2,000 ms) to reduce
T1 influences, and a long TE (e.g., greater than 80 ms) to allow for T2 decay to evolve. Compared to the proton
density weighting, the difference is with longer TE.

second 180-degree pulse of a long TR spin echo pulse sequence, where the first echo
is proton density weighted, with short TE. T2 contrast differences are manifested by
allowing Mxy signal decay as shown in Figure 12-28. Compared with a T1-weighted
image, inversion of tissue contrast occurs in the image where CSF is bright, and gray
and white matter are reversed in intensity.
A T2-weighted image (Fig. 12-29) demonstrates high tissue contrast, compared
with either the T1-weighted or proton density-weighted images. As TE is increased,
more T2-weighted contrast is achieved, but at the expense of less Mxy signal and
greater image noise. However, even with low signal amplitudes, image processing
with window width and window level adjustments can remap the signals over the full
range of the display, so that the overall average brightness is similar for all images.
The typical T2-weighted sequence uses a TR of approximately 2,000 to 4,000 ms and
a TE of 80 to 120 ms.
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■■FIGURE 12-29 T2 contrast weighting. Long TR minimizes

T1 relaxation differences of the tissues. Long TE allows T2
decay differences to be manifested. A second echo provides
time for T2 decay to occur, so a T2 W image is typically
acquired in concert with a PD W image. While this sequence
has high contrast, the signal decay reduces the overall signal
and therefore the SNR.

TABLE 12-5 SE PULSE SEQUENCE CONTRAST WEIGHTING PARAMETERS

PARAMETER T1 CONTRAST PROTON DENSITY CONTRASTa T2 CONTRAST
TR (ms) 400–600 2,000–4,000 2,000–4,000
TE (ms) 5–30 5–30 60–150

a
Strictly speaking, SE images with TR less than 3,000 ms are not proton density with respect to the CSF;
because of its long T1, only 70% of the CSF magnetization recovery will have occurred and will not appear
as bright as for a true PD image. True PD image intensities can be obtained with fast spin echo methods
(Chapter 13) with longer TR (e.g., 8,000 ms).
TE, time of echo; TR, time of repetition.

Spin Echo Parameters

Table 12-5 lists typical contrast-weighting values of TR and TE for SE imaging. For
conventional SE sequences, both proton density and T2-weighted contrast signals
are acquired during each TR by acquiring two echoes with a short TE and a long TE
(Fig. 12-30).

Inversion Recovery
IR emphasizes T1 relaxation times of the tissues by extending the amplitude of the lon-
gitudinal recovery by a factor of two. An initial 180-degree RF pulse inverts Mz to 2Mz.
After a programmed delay, the time of inversion—TI, a 90-degree RF (readout) pulse
rotates the recovered fraction of Mz into the transverse plane to generate the FID.
A second 180-degree pulse (or gradient polarity reversal, see next section, GE) at
TE/2 produces an echo at TE (Fig. 12-31); in this situation, the sequence is called
inversion recovery spin echo (IR SE). The TR for IR is the time between 180-degree
initiation pulses. Partial saturation of the protons and steady-state equilibrium of
the longitudinal magnetization is achieved after the first three excitations in the
sequence. The echo amplitude associated with a given tissue depends on TI, TE, TR,
and magnitude (positive or negative) of Mz.
The signal intensity at a location (x,y) in the image matrix for an IR SE acquisition
with nonmoving anatomy is approximated as
S  rH (1 2 2e2TI/T1) (1 2e2(TR2TI)/T1) (e2TE/T2)
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0 10 ms 45 ms TR 2500 ms

90° 180° 180° 90°

TE1= 20 ms
TE2 = 90 ms

1st echo 2nd echo

■■FIGURE 12-30 SE with two 180-degree refocusing pulses after the initial 90-degree excitation pulse.
The early echo contains information related to proton density of the tissues, and the longer echo provides
T2 weighting. This double echo method is used for providing proton density content and T2 weighted content
independently during the same TR interval, and used to fill two separate k-space repositories that are used in
producing the final proton density and T2 weighted images.

TR
TI TE

180° 90° 180° 180°

excitation readout refocusing pulse excitation

RF pulses TE/2

Signal out

■■FIGURE 12-31 Inversion-recovery SE sequence is shown. The initial 180-degree excitation pulse inverts
the longitudinal magnetization, and thus requires a factor of two times recovery of the longitudinal
magnetization over time. The “inversion time” (TI) is the delay between the excitation pulse and conver-
sion to transverse magnetization of the recovered longitudinal magnetization. Subsequently, a second
180-degree pulse is applied at TE/2, which refocuses the transverse magnetization as an echo at time
TE. The signal strength is chiefly a function of the T1 characteristics of the tissues, as the TE values are
kept short.

where the factor of 2 in the first part of the equation arises from the longitudinal
magnetization recovery from 2Mz to Mz, and all other parameters are as previously
described. For the TI to control contrast between tissues, it follows that TR must be
relatively long and TE short. The RF sequence is shown in Figure 12-31.
The IR sequence produces “negative” longitudinal magnetization that results in
negative (in phase) or positive (out of phase) transverse magnetization when short
TI is used. The actual signals are acquired as magnitude (absolute values) such that
Mz values are positive.

Short Tau Inversion Recovery

Short Tau Inversion Recovery, or STIR, is a pulse sequence that uses a very short TI and
magnitude signal processing, where Mz signal amplitude is always positive (Fig. 12-32).

Inversion Recovery (T1) Transverse decay (T2) Image

intensity
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Fat Fat
White White
Gray
Gray
CSF CSF

Time (ms) Time (ms))

Signal intensity is dependent on T1 (with short TE)

T1 relaxation range is doubled
TI Contrast is dependent on TI
-M z RF energy depos ition is relatively high
180°° 90°°
pulse pulse

■■FIGURE 12-32 The IR longitudinal recovery diagram shows the 2 3 Mz range provided by the 180-degree
excitation pulse. A 90-degree readout pulse at a time TI and a 180-degree refocusing pulse at a time TE/2 from
the readout pulse forms the echo at time TE. The time scale is not explicitly indicated on the x-axis. A short TE
is used to reduce T2 contrast characteristics.

Magnitude of Mz (T1) Transverse decay (T2) Image

Mz Mxy intensity
CSF CSF

Gray Gray

Fat Fat
Time (ms)) Time (ms))

bounce point
TI STIR TE

■■FIGURE 12-33 IR longitudinal magnetization as a function of time, with magnitude signal processing. All
tissues go through a null (the bounce point) at a time dependent on T1. The inversion time (TI) is adjusted to
select a time to null a certain tissue type. Shown above is the STIR (Short Tau IR) used for suppressing the signal
due to fat tissues, achieved with TI = approximately 150 ms (0.693 3 260 ms).

In this situation, materials with short T1 have a lower signal intensity (the reverse of
a standard T1-weighted image), and all tissues at some point during recovery have
Mz 5 0. This is known as the bounce point or tissue null. Selection of an appropriate
TI can thus suppress tissue signals (e.g., fats/lipids, CSF) depending on their
T1 relaxation times. The signal null (Mz 5 0) occurs at TI 5 ln(2) 3 T1, where ln is
the natural log and ln(2) 5 0.693. Since T1 for fat at 1.5T is approximately 260 ms,
TI is selected as 0.693 3 260 ms 5 180 ms. A typical STIR sequence uses TI of 140
to 180 ms and TR of approximately 2,500 ms. Compared with a T1-weighted exami-
nation, STIR reduces distracting fat signals (Fig. 12-33) and chemical shift artifacts
(explained in Chapter 13) (Fig. 12-34).

Fluid Attenuated Inversion Recovery

The signal levels of CSF and other tissues with long T1 relaxation constants can be
overwhelming in the magnitude IR image. Fluid attenuated IR, the FLAIR sequence,
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T1 STIR

■■FIGURE 12-34 SE T1-weighting versus STIR technique. Left. T1 W with TR = 750 ms, TE = 13 ms. Right.
STIR with TR = 5,520 ms, TI = 150 ms, TE = 8 ms. The fat is uniformly suppressed in the STIR image, providing
details of nonfat structures otherwise difficult to discern.

Magnitude of Mz (T1) Transverse decay (T2) Image

intensity
Mz M xy
Fat

Gray
Fat
Gray
CSF CSF
Time (ms)) Time (ms))

bounce point

TI FLAIR TE

■■FIGURE 12-35 Shown above is the FLAIR acquisition, with the TI set to the null of CSF, which reduces the
large CSF signals and allows the visualization of subtle details otherwise hidden. TE is short to not allow T2
“contamination” of the signals.

reduces CSF signal and other water-bound anatomy in the MR image by using a
TI selected at or near the bounce point of CSF to permit better evaluation of
the surrounding anatomy as shown in Figure 12-35. Reducing the CSF signal
(T1 < 2,500 ms @ 1.5 T) requires TI 5 0.693 3 2,500 ms, or < 1,700 ms. A
comparison of T1, T2, and FLAIR sequences demonstrates the contrast differ-
ences achievable by reducing signals of one tissue to be able to visualize another
(see Fig. 12-36).

Summary, Spin Echo Sequences

MR contrast schemes for clinical imaging use the SE or an IR variant of the SE pulse
sequences for many examinations. SE and IR SE sequences are less sensitive to mag-
netic field inhomogeneities, magnetic susceptibilities, and generally give high SNR
and CNR. The downsides are the relatively long TR and corresponding long acquisi-
tion times.

Gradient Echo
The GE technique uses a magnetic field gradient applied in one direction and
then reversed to induce the formation of an echo, instead of the 180-degree
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T1 T2 FLAIR

■■FIGURE 12-36 Left. T1-weighted spin-echo axial brain image (TR = 549 ms, TE = 11 ms); Middle: T2 weighted
spin-echo image (TR = 2,400 ms, TE = 90 ms); Right. FLAIR image (TR = 10,000 ms, TI = 2,400 ms, TE = 150 ms).

inversion pulse. For a FID signal generated under a linear gradient, the transverse
magnetization dephases rapidly as the gradient is applied. After a predetermined
time, the nearly instantaneous reversal of the GE polarity will rephase the pro-
tons and produce a GE that occurs when the opposite gradient polarity of equal
strength has been applied for the same time as the initial gradient. The induced
GE signal is acquired just before and after the peak amplitude, as illustrated in
Figure 12-37.
The GE is not a true SE but a purposeful dephasing and rephasing of the FID.
Magnetic field (B0) inhomogeneities and tissue susceptibilities caused by para-
magnetic or diamagnetic tissues or contrast agents are emphasized in GE imaging.
This is because the dephasing and rephasing of the FID signals occur in the same
direction relative to the main magnetic field. In this situation, unlike a 180-degree
refocusing RF pulse, the external magnetic field variations are not cancelled. Com-
pare Figures 12-22 and 12-37 and the direction of the Mxy vector in the rotating
frame. For SE techniques, the FID and echo vectors form in opposite directions,
whereas with GE, the FID and echo form in the same direction. Significant sen-
sitivity to field nonuniformity and magnetic susceptibility agents thus occurs, as
Mxy decay is a strong function of T2*, which is much shorter than the “true” T2
achieved in SE sequences. Timing of the gradient echo is controlled either by
inserting a time delay between the negative and positive gradients or by reducing
the amplitude of the reversed gradient, thereby extending the time for the rephas-
ing process to occur.
A major variable determining tissue contrast in GE sequences is the flip angle.
Depending on the desired image contrast, flip angles of a few degrees to more than
90 degrees are used, a majority of which are small angles much less than 60 degrees.
In the realm of very short TR, smaller flip angles require less time and create more
transverse magnetization compared to larger flip angles. A plot of Mxy signal ampli-
tude versus TR as a function of flip angle (Fig. 12-38) shows that smaller flip angles
produce more Mxy signal than larger flip angles when TR is less than 200 ms.

Excitation Gradient Echo

<60 Gradient Equal area, opposite polarity
+
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-
TE
Mxy TE/2 Rotating frame

Mxy reforms in
same direction

Gradient dephasing Gradient rephasing

■■FIGURE 12-37 A magnetic field gradient induces the formation of an “echo” (instead of a 180-degree RF
pulse). Transverse magnetization spins are dephased with an applied gradient of one polarity and rephased
with the gradient reversed in polarity; this produces a “gradient echo.” Note that the rotating frame depicts
the magnetic moment vector of the echo in the same direction as the FID relative to the main magnetic field,
and therefore extrinsic inhomogeneities are not cancelled.

1.0 Flip angle

Flip angle 30° 50° 90°

Normalized signal amplitude:

0.2

Transverse magnetization
0.8 90°
20°
50°
0.6 10°

30° 0.1
0.4

20°
0.2
10°
0.0 0.0
0.0 0.5 1.0 1.5 2.0 2.5 3.0 0.0 0.25
TR (sec) TR (sec)

■■FIGURE 12-38 Transverse magnetization as a function of TR and the flip angle is shown. For small flip
angles and very short TR, the transverse magnetization is higher for small flip angles compared to larger flip
angles. Detail is shown on the right.

ltimately, tissue contrast in GE pulse sequences depends on TR, TE, and flip angle
U
along with specialized manipulation of the acquisition sequence.

Gradient Echo Sequences with Long TR

For GE sequences with “long” TR (greater than 200 ms) and flip angles greater than
45 degrees, contrast behavior is similar to that of SE sequences. The major difference
is image contrast that is based on T2* rather than T2, because external magnetic field
inhomogeneities are not cancelled. As for clinical interpretation, the mechanisms
of contrast based on T2* are different from those based on T2, particularly for MRI
contrast agents. A relatively long TE tends to emphasize the differences between T2*
and T2, rather than improve T2 contrast, as would be expected in an SE sequence.
T1 weighting is achieved with a short TE (5 to 10 ms). In most situations, however,
GE imaging is not useful with long TR, except when contrast produced by magnetic
susceptibility differences is desired.

Gradient Echo Sequences with short TR, less than 50 ms

Reducing the repetition period below 50 ms does not allow for transverse decay
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(T2*) to fully occur, and a steady-state equilibrium of longitudinal and transverse

magnetization from pulse to pulse exists. The persistent transverse magnetization is
produced from previous RF excitations, and multiple signals are generated: (1) the
FID signal generated at the end of the current RF pulse, and once rephased, contains
T2* or T1 information depending on the TE; (2) a stimulated echo generated from
the previous RF pulse acting on the persistent transverse magnetization accruing
from the RF pulse twice displaced. The stimulated echo contains T2 and T2* weight-
ing. This is schematically shown in Figure 12-39 for a train of RF pulses and the
generated signals.
Given the nature of the overlapping signals, there are generic GE acquisitions
termed coherent, incoherent, and steady-state free precession (SSFP) that provide
differential tissue contrast weighting.

Coherent GE
The coherent GE sequence is shown in Figure 12-40, indicating the timing of the
RF pulse with the dephasing and rephasing implemented by reversal of gradient

RF 1 TR RF 2 RF 3 RF 4

FID 1 FID 2 FID 3 FID 4

SE 1 SE 2

■■FIGURE 12-39 GE acquisition with short TR less than 50 ms and flip angles upto 45 degrees produces two
signals: (1) the FID from the current RF pulse and (2) stimulated echo from the previous RF pulse resulting from
persistent transverse magnetization. These signals overlap, but are shown distinct in the illustration for clarity.
Resultant image contrast is due to the ratio of T1 to T2 in a tissue because of the mixed signals generated by
the combined FID (chiefly T1 and T2* contrast) and SE (chiefly T2 and T2* contrast) in the digitized signal. With
the train of RF excitation pulses, RF pulse 2 stimulates the echo formation of the FID produced from RF pulse 1,
which appears during RF pulse 3 and superimposes on the current (RF pulse 3) FID. While this is a conceptual
illustration, in fact, the actual situation is much more complicated, as there are many higher order stimulated
and gradient echoes that contribute to the observed signal.

polarity to generate an echo at a selectable time TE for the frequency encode gradi-
ent (FEG), where identification of proton position based upon frequency is per-
formed. (Note: the various encoding gradients used to localize the protons are
discussed in the next section of this chapter.) Also involved in this sequence is the
phase encode gradient (PEG), which is applied and incrementally changed for each
TR to identify proton position in the direction perpendicular to the FEG based
upon phase changes of the protons after the PEG is turned off. A “rewinder PEG”
of the same strength but opposite polarity is applied after the echo to realign the
phase prior to the next RF pulse. The combined FID and simulated echo signals
are generated during the GE, and produce tissue contrast dependent on flip angle,
TR, and TE. With moderate flip angles of 30 to 60 degrees, the differences in tis-
sue contrast are primarily based upon T2/T1 ratios. Since most tissues with a long
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TR
RF

PEG rewinder

FEG rephase
dephase
FID

SE
Gradient Echo + Stimulated Echo
TE

■■FIGURE 12-40 Coherent GE: Multiple gradients are used for localizing the protons, including the PEG and
the FEG. In addition to localizing protons, these gradients are intrinsic to the manipulation of the signals in
the coherent GE acquisition. As shown above, the PEG is applied after the RF pulse but prior to the FEG, to
determine location in one direction by adding a known phase to the protons based on location per TR interval.
Subsequently, a rewinder gradient of the same strength but opposite polarity resets the phase prior to the
next TR excitation. The FEG is the gradient that generates the echo from the FID plus the stimulated echo from
the previous RF pulse.

TABLE 12-6 GRADIENT RECALLED ECHO WEIGHTING (STEADY-STATE)

PARAMETER T1 T2/T1 T2 T2* PROTON DENSITY
Flip angle 45–90 30–50 5–15 5–15 5–30
(degrees)
TR (ms) 200–400 10–50 200–400 100–300 100–300
TE (ms) 3–15 3–15 30–50 10–20 5–15

T2 also have a long T1 and vice versa, there is very little tissue contrast generated.
In certain applications such as MR angiography, this is a good outcome, so that ana-
tomical contrast differences that would otherwise compete with the bright blood
when displayed by image processing techniques (described in Chapter 13) would
reduce the image quality.
This acquisition technique is described by the acronyms GRASS (gradient
recalled acquisition in the steady state), FISP (fast imaging with steady-state
precession), FAST (Fourier acquired steady state), and other acronyms coined by
MRI equipment manufacturers. Table 12-6 indicates typical parameter values for
contrast desired in steady-state and GE acquisitions. The steady-state sequences
with coherent echoes produce T2* and proton density contrast. A GRASS/FISP
sequence using TR 5 35 ms, TE 5 3 ms, and flip angle 5 20 degrees shows unre-
markable contrast, but blood flow shows up as a bright signal (Fig. 12-41). This
technique enhances vascular contrast, from which MR angiography sequences can
be reconstructed.

Incoherent, “Spoiled” Gradient Echo Techniques

With very short TR steady-state acquisitions, T1 weighting cannot be achieved to
any great extent, owing to either a small difference in longitudinal magnetization
with small flip angles or dominance of the T2* effects for larger flip angles produced
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TR=35 ms, TE=3 ms, flip angle=20

■■FIGURE 12-41 A steady-state gradient recalled echo (GRASS) sequence (TR = 24 ms, TE = 4.7 ms, flip
angle = 50 degrees) of two slices out of a volume acquisition is shown. Contrast is unremarkable for white
and gray matter because of a T2-/T1-weighting dependence. Blood flow appears as a relatively bright signal.
MR angiography (see Chapter 13) depends on pulse sequences such as these to reduce the contrast of the
anatomy relative to the vasculature.

RF 1, phase 0° RF 2, phase 45° RF 3, phase 90° RF 4, phase 135°

FID 1, phase 0° FID 2, phase 45° FID 3, phase 90° FID 4, phase 135°

SE 1, Phase 0° SE 2, phase 45°

■■FIGURE 12-42 Incoherent (spoiled) GE acquisition: Persistent transverse magnetization is dephased by each
RF pulse; the superposition of the FID from the current RF pulse with a stimulated-echo from the previous RF
pulse is separable, because of differences in the phase of the generated signals. In an actual sequence with TR
of 5 to 6 ms, several of stimulated echoes will contribute to the signal, along with the FID. Particular angles
of phase increment (typically 117 or 123 degrees) have been determined empirically to cause cancellation by
destructive interference of the magnetization from the different coherence pathways to eliminate the signal,
leaving only the signal from the FID. T1 contrast can be preferentially generated without contamination of the
signals due to the T2 characteristics of the tissues.

by persistent residual transverse magnetization created by stimulated echoes. The

T2* influence can be reduced by using a long TR (usually not an option), or by
“spoiling” the steady-state transverse magnetization by introducing incoherent
phase differences from pulse to pulse. The latter is achieved by adding a phase
shift to successive RF pulses during the excitation of protons. Both the RF transmit-
ter and RF receiver are phase locked, so that the receiver discriminates the phase
of the GE from the SE generated by the previous RF pulse, now out of phase, as
shown in Figure 12-42. Mostly, T1-weighted contrast is obtained, with short TR,
short TE, and moderate to large flip angle. Spoiled transverse magnetization gradi-
ent recalled echo (SPGR) is often used in three-dimensional volume acquisitions
because of the extremely short acquisition time allowed by the short TR of the GE
sequence and the good contrast rendition of the anatomy provided by T1 weight-
ing (Fig. 12-43).
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TR=8 ms, TE=1.9 ms, flip angle=20°

Note T1 contrast and high blood vessel signal
■■FIGURE 12-43 Incoherent (spoiled) GE images. The ability to achieve T1 contrast weighting is extremely
useful for rapid three-dimensional volume imaging. Bright blood (lower portion of each image) and magnetic
susceptibility artifacts are characteristic of this sequence. TR = 8 ms, TE = 1.9 ms, flip angle = 20 degrees.

MR contrast agents (e.g., gadolinium) produce greater contrast with T1-weighted

SPGR than with a comparable T1-weighted SE sequence because of the greater sen-
sitivity to magnetic susceptibility. The downsides of spoiled GE techniques are the
increased sensitivity to other artifacts such as chemical shift and magnetic field inho-
mogeneities, as well as lower SNR.

Steady-State Free Precession

In GE sequences with short TR (less than 50 ms), the TE is not long enough to gen-
erate any T2 contrast, and GE rephasing is inefficient and dominated by T2* effects.
The SSFP sequence emphasizes acquisition of only the stimulated echo, which arises
from the previous RF pulse and appears during the next RF pulse at a time equal to
2 3 TR (see Fig. 12-39). To reposition the stimulated echo to an earlier time in the
TR interval for signal acquisition, a rewinder gradient is applied, which speeds up the
rephasing process initiated by the RF pulse, so that it reforms and decays just before
the next RF pulse. In the SSFP sequence, there are two TE values: one is the actual
TE, the time between the peak stimulated echo amplitude and the next excitation
pulse, and the other is the effective TE, the time from the echo and the RF pulse that
created its FID. The effective TE is thus longer than the TR and is calculated as: effec-
tive TE 5 2 3 TR-actual TE. So for TR 5 50 ms and TE 5 5 ms, the effective TE is
95 ms, which means that the stimulated echo has had 95 ms to manifest T2 weight-
ing. SSFP sequences provide true T2 contrast weighting, are useful for brain and
joint imaging, and can be used with three-dimensional volumetric acquisitions (as
discussed in Chapter 13) (Figs. 12-44 and 12-45). “Balanced” SSFP sequences gen-
erate accumulated gradient echo (FID) and stimulated echo signals with the use of
symmetrical gradients in 3 spatial directions, which null phase shifts induced by
flow. Balanced SSFP provides T2/T1 contrast and high speed acquisitions, particu-
larly useful for cardiac imaging (Chavan, et.al., 2008).

Summary, Gradient Echo contrast

For GE acquisition in the realm of short TR, persistent transverse magnetization
produces two signals: (1) the FID produced from the RF pulse just applied and

RF 1 RF 2 RF 3 RF 4
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Rewind 1
FID 1 SE 1

Rewind 2
FID 2 SE 2

Rewind 3
ID 3 SE 3

FID 4
Effective TE
Actual
TE

■■FIGURE 12-44 SSFP uses a rewinder gradient to position each stimulated echo so that it appears just before
the next excitation pulse, and is acquired separately from the FID. Since rephasing of the stimulated echo is
initiated by an RF pulse rather than a gradient, more T2 rather than T2* weighting occurs. The actual TE is the
time from the peak echo amplitude to the center of the next RF pulse. The effective TE is 2  TR2actual TE
(This is shown in the lower left of the figure).

■■FIGURE 12-45 Three abdominal post gadolinium contrast axial images are part of a breath-hold dataset
using a “balanced SSFP” acquisition, which simultaneously accumulates the FID and the stimulated echo
with contrast varying according to the T2/T1 ratio (TR: 3.34 ms, TE: 1.2 milliseconds, Flip angle 70 degrees,
matrix size 192 × 320). Each image is acquired in approximately 700 milliseconds, making this sequence
useful for reducing voluntary and involuntary patient motion in contrast enhanced abdominal and cardiac
imaging.

(2) the stimulated echo from the residual transverse magnetization. From these two
generated signals, coherent, incoherent, or SSFP sequences are used in order to gen-
erate different contrast-weighting schemes. Coherent GE uses the combined FID and
SE signals and produces contrast mainly depending on the ratio of T2/T1 or T2*/T1;
incoherent (or spoiled) GE produces contrast mainly based on T1, and SSFP samples
the SE signal only, thus producing signals that are more T2 weighted. Figure 12-46
shows the signals and the timing of acquisition for these three scenarios. Note that
these are generic, not fully inclusive, and do not include specific sequences imple-
mented by the major manufacturers that do not fit into this simplified categorization.
Additionally the term SSFP is used differently by the manufacturers. One should
consult the specific applications manuals and descriptions of the specific models and
pulse sequence implementations for more detailed information (Also see Chapter
13, Table 1 for a brief comparison of GE sequences). Details of GE techniques are
reviewed in an article by Chavhan, et.al. (2008).

RF ■■FIGURE 12-46 A schematic summary of the three major GE

pulse FID + SE sequences (RF, RadioFrequency; FID, Free Induction Decay; GE,
Coherent FID Gradient Echo; SE, Stimulated or Spin Echo; TE, Time of Echo) are
Copyright © 2011. Wolters Kluwer Health. All rights reserved.

GE shown. Coherent GE uses signals from the FID and the SE to pro-
SE duce the image, typically with contrast dependent on T2/T1 weight-
ing, and low contrast. Incoherent GE eliminates the detection of
TE the SE, thus, providing a means to generate T1-weighted contrast
from the FID signal. SSFP uses the SE signal, which provides mainly
RF T2-weighted contrast. Balanced SSFP uses both the gradient and
pulse
Incoherent, stimulated echo to produce a T2/T1 weighting with symmetrically
FID
spoiled applied gradients in three dimensions.
GE

TE
RF
pulse
FID
SSFP
SE

■■FIGURE 12-47 The gradient magnetic field Lower Higher

creates a net positive and negative magnetic magnetic Null magnetic
environment that adds to and subtracts from field field
the main magnetic field. Associated with the
local change in magnetic field is a positionally
- +
dependent change in precessional frequencies,
per the Larmor equation. The precessional fre-
quencies directly vary across the field in pro-
Lower Higher
portion to the applied gradient strength.
precessional precessional
frequency frequency

12.6 MR Signal Localization

Spatial localization is essential for creating MR images and determining the

location of discrete sample volumes for MR spectroscopy. This is achieved by
superimposing linear magnetic field variations on the main (B0) field to generate cor-
responding position-dependent variations in precessional frequency of the protons
(Fig. 12-47). Simultaneous application of an RF excitation (B1 pulse) excites only
those protons in resonance within the frequency bandwidth (BW) of the B1 RF
pulse by absorbing energy.

Magnetic Field Gradients

Inside the magnet bore, three sets of gradients reside along the logical coordinate
axes—x, y, and z—and produce a magnetic field variation determined by the mag-
nitude of the applied current in each coil set (Fig. 12-48). When independently
energized, the three coils (x, y, z) can produce a linearly variable magnetic field in

Individual gradients Superimposed gradients

X
Copyright © 2011. Wolters Kluwer Health. All rights reserved.

X -axis
Z

Y-axis
Net gradient = G2x + G2y + G2z

Z -axis

■■FIGURE 12-48 Within the large stationary magnetic field, field gradients are produced by three separate
coil pairs placed within the central core of the magnet, along the x, y, or z directions. In modern systems, the
current loops are distributed across the cylinders for the x-, y- and z- gradients, which generates a lower, but
more uniform gradient field. Magnetic field gradients of arbitrary direction are produced by the vector addition
of the individual gradients turned on simultaneously. Any gradient direction is possible by superimposition of
magnetic fields generated by the three-axis gradient system.

any direction, where the net gradient is equal to G2x  G2y  G2z . Gradient polar-
ity reversals (positive to negative and negative to positive changes in magnetic field
strength) are achieved by reversing the current direction in the gradient coils.
Two important properties of magnetic gradients are: (1) The gradient field strength
is determined by its peak amplitude and slope (change over distance), and typically
ranges from 1 to 50 mT/m. (2) The slew rate is the time to achieve the peak magnetic
field amplitude. Typical slew rates of gradient fields are from 5 to 250 mT/m/ms. As
the gradient field is turned on, eddy currents are induced in nearby conductors such
as adjacent RF coils and the patient, which produce magnetic fields that oppose the
gradient field and limit the achievable slew rate. Actively shielded gradient coils and
compensation circuits can reduce problems caused by eddy currents.
In a gradient magnetic field, protons maintain precessional frequen-
cies corresponding to local magnetic field strength. At the middle of the gra-
dient, called the null, there is no change in the field strength or precessional
frequency. With a linear gradient, the magnetic field increases and decreases
linearly from the null, as does the precessional frequency (Fig. 12-47 and
Table 12-7). In the rotating frame of reference, incremental changes of fre-
quency occur symmetrically about the null, and the positions of protons are
encoded by frequency and phase. The frequency BW is the range of frequen-
cies over the FOV, and the frequency BW per pixel is the BW divided by the
number of discrete samples. Gradient amplitude can also be expressed in fre-
quency per distance. For instance, a 10-mT/m gradient can be expressed as
10 mT/m 3 42.58 MHz/T 3 1 T/1,000 mT 5 0.4258 MHz/m, which is equiva-
lent to 425.8 kHz/m or 425.8 Hz/mm. The relationship of gradient strength
and frequency BW across the FOV is independent of the main magnet field
strength.
Localization of protons in the three-dimensional volume requires the application
of three distinct gradients during the pulse sequence: slice select, frequency encode,
and phase encode. These gradients are sequenced in a specific order, depending on
the pulse sequences employed. Often, the three gradients overlap partially or com-
pletely during the scan to achieve a desired spin state, or to leave protons in their
original phase state after the application of the gradient(s).
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TABLE 12-7 PRECESSIONAL FREQUENCY VARIATION AT 1.5 T ALONG

AN APPLIED GRADIENT
Gradient field strength 3 mT/m 5 127.74 Hz/mm
Main magnetic field strength 1.5 T
FOV 0.15 m 5 150 mm
Linear gradient amplitude over FOV 0.45 mT; from 20.225 mT to 10.225 mT
Maximum magnetic field (frequency) 1.500225 T (63.8795805 MHz)
Unchanged magnetic field at null 1.500000 T (63.8700000 MHz)
Minimum magnetic field 1.499775 T (63.8604195 MHz)
Net frequency range across FOV a
0.019161 MHz 5 19.2 kHz 5 19,161 Hz
Frequency range across FOV (1,278 Hz/cm)b 127.74 Hz/mm 3 150 mm 5 19,161 Hz
Frequency BW per pixel (256 samples) 19,161 Hz/256 5 74.85 Hz/pixel

a
Calculated using the absolute precessional frequency range: 63.8796−63.8604 MHz.
b
Calculated using the gradient strength expressed in Hz/mm.

Slice Select Gradient

RF transmitters cannot spatially direct the RF energy to a specific region in the body;
rather the RF pulse, when turned on during the application of the slice select gradi-
ent (SSG), determines the slice location of protons in the tissues that absorb energy.
For axial MR images, the SSG is applied along the long (cranial-caudal) axis of the
body. Under the influence of the gradient field, the proton precessional frequencies
in the volume are incrementally increased or decreased dependent on their distance
from the null. A selective, narrow band RF frequency pulse of a known duration
and amplitude delivers energy to the total volume, but only those protons with pre-
cessional frequencies matching the RF BW frequencies will absorb energy within a
defined slice of tissues as shown in Figure 12-49 (red vertical line indicates energy
absorbed due to resonance). If the center frequency of the RF pulse is increased, then
a different slab of protons absorbs energy (blue vertical line).
Slice thickness is chiefly determined by the frequency BW of the RF pulse and
the gradient strength across the FOV. For a fixed gradient strength, the RF pulse with
a narrow BW excites protons within a thin slice, and a wide BW excites a thick slice
(Fig. 12-50A). For a fixed RF BW, a high gradient strength produces a large range of
frequencies across the FOV and decreases the slice thickness, whereas a low gradient
strength produces a small range of frequencies and produces an increase in the slice
thickness (Fig. 12-50B).
A combination of a narrow BW and a low gradient strength or a wide BW and a high
gradient strength can result in the same slice thickness. Decisions depend chiefly on the
SNR and the propensity for “chemical shift” artifacts. SNR is inversely proportional to
1
the receiver BW: SNR ∝ ; therefore narrow BW and low gradient strength are
BW
preferred; however, artifacts due to chemical shift (see Chapter 13, Section 13.5, Chemi-
cal Shift Artifacts) can be problematic. Consequently, trade-offs in image quality must be
considered when determining the optimal RF BW and SSG field strength combinations.
After the SSG is turned off, the protons revert to the precessional frequency of
the main magnetic field, but phase coherence is lost. To reestablish the original phase
of all stationary protons, a gradient of opposite polarity equal to one-half of the
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Lower frequenc y
Narrow -band RF:
Higher frequency
Slice -select gradient

y
z
Gradient coils x

■■FIGURE 12-49 The SSG disperses the precessional frequencies of the protons in a known way along the gradi-
ent. A narrow band RF pulse excites only a selected volume (slice) of tissues, determined by frequency, BW, and SSG
strength. In the example above, two narrow-band RF pulses with different center frequencies irradiate the whole
body during the application of the gradient, and only those protons at the same frequencies as the RF pulses will
absorb energy. Note that the higher frequency slice is shifted towards the positive pole of the applied gradient.

A Variable RF Bandwidth B Fixed RF Bandwi dth,

Fixed Gradient Variable Gradient

Bandwidth Gradient Strength

RF Frequency
Narrow Wide fixed High
gradient Low
0
fixed 0

Large Large

Small Small

Slice Thickness, z Slice Thickness, z

Narrow bandwidth Small z High gradient Small z
Wide bandwidth Large z Low gradient Large z

■■FIGURE 12-50 Slice thickness is dependent on RF BW and gradient strength. A. For a fixed gradient
strength, the RF BW determines the slice thickness. B. For a fixed RF BW, gradient strength determines the
slice thickness.

area of the original SSG is applied (Fig. 12-51). For 180-degree RF excitations, the
rephasing gradient is not necessary, as all protons maintain their phase relationships
because of the symmetry of the RF pulse and spin inversion.
To summarize, the SSG is applied simultaneously with a RF pulse of a known
BW to create proton excitation in a single plane with a known slice thickness, and
to localize signals orthogonal to the gradient. It is the first of three gradients applied
to the volume.

Frequency Encode Gradient

The FEG, also known as the readout gradient, is applied in a direction perpendicu-
lar to the SSG, along the “logical” x-axis, during the evolution and decay of the
induced echo. Net changes in precessional frequencies are distributed symmetrically
from 0 at the null to 1fmax and 2fmax at the edges of the FOV (Fig. 12-52) under
the applied FEG. The composite signal is amplified, digitized, and processed by the
Fourier transform to convert frequency into spatial position (Fig. 12-53). A spatial
Copyright © 2011. Wolters Kluwer Health. All rights reserved.

“projection” is created by integrating the resultant Fourier transformed signal ampli-

tudes perpendicular to the direction of the applied gradient at corresponding spatial
positions.
The SSG in concert with an incremental rotation of the FEG direction about
the object can produce data projections through the object as a function of angle,
as shown in Figure 12-54. With a sufficient number of projections, filtered back-
projection can be used for reconstructing a tomographic image (see Chapter 11 on

RF pulse ■■FIGURE 12-51 SSG rephasing. At the peak of the RF

pulse, all protons in the slice are in phase, but the SSG
Rephasing
causes the spins to become dephased after the gradient
SSG Gradient
is turned off. To reestablish phase coherence, a reverse
polarity gradient is applied equal to one-half the area of
Equal area
out of phase the original SSG. At the next pulse, the relative phase
will be identical.
in phase in phase
Relative
phase

Body cross -section Frequency Encode Gradient (FEG)

determined by SSG applied during echo formation
y +
Net frequency at
x gradient location
- Composite
frequency
amplitude signal

Receiver coil
signal

Digitization
- f max 0 + f max
Spatial position Fourier Transform
Line integral of signal amplitude (position decoder)

■■FIGURE 12-52 The FEG is applied in an orthogonal direction to the SSG, and confers a spatially dependent
variation in the precessional frequencies of the protons. Acting only on those protons in a slice determined
by the SSG excitation, the composite signal is acquired, digitized, demodulated (Larmor frequency removed),
and Fourier transformed into frequency and amplitude information. A one-dimensional array represents a
projection of the slice of tissue (amplitude and position) at a specific angle. (Demodulation into net frequencies
occurs after detection by the receiver coil; this is shown in the figure for clarity only.)

CT Reconstruction). In fact, this is how some of the first MR images were recon-
structed from individual projections, using a rotating FEG. However, inefficient
acquisition and data handling, in addition to motion artifacts, has led to near-univer-
sal acquisition with phase encoding techniques.

Demodulated MR Signal Corresponding Fourier Transformation

2
1.5
1.0
1 cycle/cm
1
0.5
0 0.5
-0.5
-1
Amplitude: 1.0
-1.5
-2
-5 -4 -3 -2 -1 0 1 2 3 4 5
2
1.5
1
1.0
0.5
0
2 cycles/cm
cycles/
Amplitude: 0.75
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-0.5 0.5
-1
Amplitude

-1.5
-2
180°° phase shift
180
-5 -4 -3 -2 -1 0 1 2 3 4 5
2
1.5
1
0.5
1.0
0 3 cycles/cm
cycles/
-0.5 0.5
-1
-1.5
Amplitude: 0.5
-2

-5 -4 -3 -2 -1 0 1 2 3 4 5
2
1.5
1 1.0
0.5
0 Composite
0.5
-0.5
-1 waveform
-1.5
-2

-5 -4 -3 -2 -1 0 1 2 3 4 5
0 1.0

Frequency (cm-1) Position, cm

■■FIGURE 12-53 Spatial frequency signals (cycles/cm) and their Fourier transforms (spatial position) are shown
for three simple sinusoidal waveforms with a specific amplitude and phase. The Fourier transform decodes
the frequency, phase and amplitude variations in the spatial frequency domain into a corresponding position
and amplitude in the spatial domain. A 180-degree phase shift (second from the top) is shifted in the negative
direction from the origin. The composite waveform (a summation of all waveforms, lower left) is decoded by
Fourier transformation into the corresponding positions and amplitudes (lower right).

■■FIGURE 12-54 A rotating FEG in the x-y plane

3 allows the acquisition of individual projections as
a function of angle, by repeating the SSG − FEG
2 sequence with incremental change of the FEG
1 direction. This example shows eight projections;
5 to have sampling sufficient for high SNR and
4 6
resolution would require hundreds of projections
4 about the object.
.... 3 7

2 8
1

Phase Encode Gradient

Position of the protons in the third orthogonal dimension is determined with a PEG,
which is applied after the SSG but before the FEG, along the third orthogonal axis. Phase
in this context represents a linear variation in the starting point of sinusoidal waves that
precess at the same frequency. Phase changes are purposefully introduced by the appli-
cation of a short duration PEG within each data acquisition (DAQ) interval. Prior to the
PEG, all protons have the same phase, and turning on the PEG introduces a linear varia-
tion in the precessional frequency of the protons according to their position along the
gradient. After a brief interval, the PEG is turned off, all protons revert to the Larmor fre-
quency, and linear phase shifts are manifested by a specific gradient strength and polarity.
Incremental positive phase change is introduced for protons under the positive pole,
negative phase change under the negative pole, and no phase change occurs for protons
at the null of the PEG. Throughout the acquisition sequence, the PEG strength and polar-
ity is incrementally changed to introduce specific known phase changes as a function of
position across the FOV for each acquisition interval (Fig. 12-55). Spatial encoding is
determined by the amount of phase shift that has occurred. Protons located at the center

PEG Phase shift in TR interval

strength after gradient removed
+ - y
#1
x
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#60

#128

#188

#256

■■FIGURE 12-55 The PEG is applied before the FEG and after the SSG. The PEG produces a spatially dependent
variation in angular frequency of the excited spins for a brief duration, and generates a spatially dependent
variation in phase when the spins return to the Larmor frequency. Incremental changes in the PEG strength for
each TR interval spatially encodes the phase variations: protons at the null of the PEG do not experience any
phase change, while protons in the periphery experience a large phase change dependent on their distance
from the null. The incremental variation of the PEG strength can be thought of as providing specific “views”
of the volume because the SSG and FEG remain fixed throughout the acquisition.
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444 Section II • Diagnostic Radiology

TR
90° 180 ° 90°

RF Excite protons

SSG Fat Localize (z)

PEG Localize (y)

FEG Localize (x)

Echo Generate echo

DAQ Acquire data

■■FIGURE 12-56 A typical spin-echo pulse sequence diagram indicates the timing of the SSG, PEG, and FEG
during the repetition time (TR) interval, synchronized with the RF pulses and the DAQ when the echo appears.
Each TR interval is repeated with a different PEG strength (this appears as multiple lines in the illustration, but
only one PEG strength is applied per TR as indicated by the bold line in this figure).

of the FOV, the PEG null, do not exhibit a phase shift. Protons located at the edges of the
FOV exhibit the largest positive to negative (or negative to positive) phase shifts. Protons
located at intermediate distances from the null experience intermediate phase shifts (pos-
itive or negative). Each location along the phase encode axis is spatially encoded by the
amount of phase shifts experienced by the protons. For sequential acquisition sequences,
each sample in the PEG direction is separated in time by the TR interval.

Gradient Sequencing
An acquisition of an SE pulse sequence is illustrated in Figure 12-56, showing the
timing of the SSG in conjunction with the 90-degree RF excitation pulse, the applica-
tion of a short duration PEG at a known strength, followed by a 180-degree refocus-
ing RF pulse at TE/2, and the echo envelope with the peak amplitude occurring at
TE. This sequence is repeated with slight incremental changes in the PEG strength to
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define the three dimensions in the image over the acquisition time.

12.7 “K-Space” Data Acquisition and Image Reconstruction

MR data are initially stored in the k-space matrix, the “frequency domain” reposi-
tory (Fig. 12-57). K-space describes a two-dimensional matrix of positive and nega-
tive spatial frequency values, encoded as complex numbers (e.g., a 1 bi, i 5 −1 ).
The matrix is divided into four quadrants, with the origin at the center representing
frequency 5 0. Frequency domain data are encoded in the kx direction by the FEG,
and in the ky direction by the PEG in most image sequences. The lowest spatial
frequency increment (the fundamental frequency) is the BW across each pixel (see
Table 12-7). The maximum useful frequency (the Nyquist frequency) is equal to
½ frequency range across the kx or ky directions, as the frequencies are encoded
from 2fmax to 1 fmax. The periodic nature of the frequency domain has a built-in sym-
metry described by “symmetric” and “antisymmetric” functions (e.g., cosine and sine
waves). “Real,” “imaginary,” and “magnitude” describe specific phase and amplitude
characteristics of the composite MR frequency waveforms. Partial acquisitions are
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Chapter 12 • Magnetic Resonance Basics 445

■■FIGURE 12-57 The k-space matrix is the reposi-

+f max,y
tory for spatial frequency signals acquired during
the evolution and decay of the echo. The kx axis
(along the rows) and the ky axis (along the col-
Phase variations umns) have units of cycles/unit distance. Each axis
is symmetric about the center of k-space, rang-
ing from −fmax to +fmax along the rows and the
ky 0 columns. The matrix is filled one row at a time in
a conventional acquisition with the FEG induced
frequency variations mapped along the kx axis and
the PEG induced phase variations mapped along
the ky axis.
-f max, y
Frequenc y variations
-f max, x 0 +f max, x
kx
possible (e.g., one-half of the k-space matrix plus one line) with complex conjugate
symmetry filling the remainder (See Chapter 13, Section 1, “Data Synthesis”).

Two-Dimensional Data Acquisition

MR data are acquired as a complex, composite frequency waveform. With methodical
variations of the PEG during each excitation, the k-space matrix is filled to produce
the desired variations across the frequency and phase encode directions as shown in
Figure 12-58.
128 ´ 128 acquisition matrix Repeat with different PEG for each TR
90° 180 °
RF pulses
Slice select gradient
Phase encode gradient
Frequency encode gradient
MR signal
Data acquisition
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z
64 0
2-D Fourier
0 y
ky
Transform

-63 127
-63 0 64 0 127
kx x
Frequency Domain k-space Spatial Domain image space

■■FIGURE 12-58 MR data are acquired into k-space matrix, where each row in k-space represents spatially
dependent frequency variations under a fixed FEG strength, and each column represents spatially dependent
phase shift variations under an incrementally varied PEG strength. Data are placed in a specific row determined
by the PEG strength for each TR interval. The grayscale image is constructed from the two-dimensional Fourier
transformation of the k-space matrix by sequential application of one-dimensional transforms along each row,
and then along each column of the intermediate transformed data. The output image matrix is arranged with
the image coordinate pair, x = 0, y = 0 at the upper left of the image matrix.

A summary description of the two-dimensional spin-echo image acquisition

steps follows.
1. A narrow band RF excitation pulse simultaneously applied with the SSG causes
a specific slab of tissues with protons at the same frequency to absorb energy.
Transverse magnetization, Mxy, is produced with amplitude dependent on the sat-
uration of the protons and the angle of excitation. A 90-degree flip angle produces
the largest Mxy.
2. A PEG is applied for a brief duration, which introduces a phase difference among
the protons along the phase encode direction to produce a specific “view” of the
data along the ky axis, corresponding to the strength of the PEG,
3. A refocusing 180-degree RF pulse is delivered at TE/2 to invert and reestablish the
phase coherence of the transverse magnetization at time TE.
4. During the evolution and decay of the echo signal, the FEG is applied orthogonal
to both the SSG and PEG directions, generating spatially dependent changes in
the precessional frequencies of the protons.
5. Data sampling and acquisition of the complex signal occurs simultaneous to the
FEG. A one-dimensional inverse Fourier transform converts the digital data into
discrete frequency values and corresponding amplitudes to determine position
along the kx (readout) direction.
6. Data are deposited in the k-space matrix at a row location specifically deter-
mined by the strength of the PEG. For each TR, an incremental variation of the
PEG strength sequentially fills each row. In some sequences, the phase encode
data are acquired in nonsequential order to fill portions of k-space more per-
tinent to the requirements of the exam (e.g., in the low-frequency, central
area of k-space). Once filled, the k-space matrix columns contain positionally
dependent variations in phase change along the ky (phase encode) direction.
7. After all rows are filled, an inverse Fourier transform decodes the frequency
domain variations in phase for each of the columns of k-space to produce the
spatial domain representation.
8. The final image is scaled and adjusted to represent the proton density, T1, T2,
and flow characteristics of the tissues using a grayscale range, where each pixel
represents a voxel.
The bulk of image information representing the lower spatial frequencies is con-
tained in the center of k-space, whereas the higher spatial frequencies are contained
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in the periphery, as shown in Figure 12-59, representing a grayscale rendition

of k-space for a sagittal slice of a brain MR image acquisition. The innermost
areas represent the bulk of the anatomy, while the outer areas of k-space contain
the detail and resolution components of the anatomy, as shown by reconstructed
images.

Two-Dimensional Multiplanar Acquisition

Direct axial, coronal, sagittal, or oblique planes can be obtained by energizing the
appropriate gradient coils during the image acquisition, as shown in Figure 12-60.
The SSG determines the orientation of the slices: axial uses z-axis coils; coronal uses
y-axis coils; and sagittal uses x-axis coils for selection of the slice orientation. Oblique
plane acquisition depends on a combination of the x-, y-, and z-axis coils energized
simultaneously. SSG, PEG, and FEG applications are perpendicular to each other,
and acquisition of data into the k-space matrix remains the same, with the FEG along
the kx axis and the PEG along the ky axis.

Full k -space Central area Peripheral area

Low & high frequenc ies Low frequenc ies High frequencies
128

A C E

-127
-127 0 128
0 255
0

B D F

255
Spatial domain images reconstructed by 2D Fouri er Transform

■■FIGURE 12-59 A. Image representations of k-space segmentation show a concentration of information

around the origin (the k-space images are logarithmically amplified for display of the lowest amplitude signals).
B. Inverse two-dimensional Fourier transformation converts the data into a visible image. C. Segmenting a
radius of 25 pixels out of 128 in the central area and zeroing out the periphery extracts a majority of the low-
frequency information. D. The corresponding image demonstrates the majority of the image content is in the
center of k-space. E. Zeroing out the central portion and leaving the peripheral areas isolates the higher spatial
frequency signals. F. The resulting image is chiefly comprised of high frequency detail and resolution. Ringing
that is visible in the image is due to the sharp masking transition from the image data to zero.

12.8 Summary

The basics of magnetic resonance are covered in this chapter, including the simplest
descriptions of magnetism, magnetic characteristics of the elements, and magnetiza-
tion of tissue samples. Important is the description of the intrinsic decay constants
T1, T2, T2*, and proton density in terms of tissue-specific structures and variation
Copyright © 2011. Wolters Kluwer Health. All rights reserved.

in the intrinsic and extrinsic local magnetic fields. Contrast between tissues is deter-
mined by pulse sequences including SE, IR, GE, and their associated parameters

Axial Coronal Sagittal

■■FIGURE 12-60 Direct acquisitions of axial, coronal, and sagittal tomographic images are possible by elec-
tronically energizing the magnetic field gradients in a different order without moving the patient. Oblique
planes can also be obtained. PEG (ky axis) and FEG (kx axis) are perpendicular to the SSG.

TR, TE, TI, and flip angle. In addition to generating contrast, the ability to spatially
localize the protons and create a two-dimensional image is as important, so that the
differences can be appreciated in a grayscale rendition of the anatomy. The concepts
of the frequency domain description of the signals and the k-space acquisition matrix
are integral to the discussion, as well as the Fourier transform and the conversion of
frequency to spatial domain representations of the data, necessary for visualization.
In the next chapter, more details are given for image acquisition time, various pulse
sequence designs, how image acquisition time is shortened, and characteristics of
the image in terms of SNR, CNR, and artifacts. Unique capabilities for noninvasive
“biopsy” of tissues, quality control, equipment, MR safety, and biological effects are
also discussed.

REFERENCES AND Suggested Readings

Bottomley PA, Foster TH, Argersinger RE, Pfeifer LM. A review of normal tissue hydrogen NMR relaxation
mechanisms from 1-100 MHz: dependence on tissue type, NMR frequency, temperature, species,
excision, and age. Med Phys 1984;11:425–448.
Chavhan GB, Babyn PS, Jankharia BG, Cheng HM,Shroff MM. Steady-State MR Imaging Sequences:
Physics, Classification, and Clinical Applications. Radiographics 2008;28:1147–1160.
Fullerton GD, Potter JL, Dornbluth NC. NMR relaxation of protons in tissues and other macromolecular
water solutions. Magn Reson Imaging 1982; 1:209–228.
NessAiver M. All you really need to know about MRI physics. Baltimore, MD: Simply Physics, 1997.
Pooley RA. AAPM/RSNA physics tutorial for residents: fundamental Physics of MR imaging. Radiographics
2005;25:1087–1099.
Westbrook C, Kaut-Roth C, Talbot J. MRI in practice. 3rd ed. Malden, MA: Blackwell Publishing, 2005.
Copyright © 2011. Wolters Kluwer Health. All rights reserved.

Magnetic Resonance
Imaging: Advanced Image
Acquisition Methods, Artifacts,
Spectroscopy, Quality Control,
Siting, Bioeffects, and Safety

The essence of magnetic resonance imaging (MRI) in medicine is the acquisition,

manipulation, display, and archive of datasets that have clinical relevance in the
context of making a diagnosis or performing research for new applications and
opportunities. There are many advantages and limitations of MRI and MR spectros-
copy (MRS) as a solution to a clinical problem. Certainly, as described previously
(note that this chapter assumes a working knowledge of Chapter 12 content), the
great advantages of MR are the ability to generate images with outstanding tissue
contrast and good resolution, without resorting to ionizing radiation. Capabilities of
MR extend far beyond those basics, into fast acquisition sequences, perfusion and
diffusion imaging, MR angiography (MRA), tractography, spectroscopy, and a host of
other useful or potentially useful clinical applications. Major limitations of MR are
also noteworthy, including extended acquisition times, MR artifacts, patient claustro-
phobia, tissue heating, and acoustic noise to name a few. MR safety, often ignored, is
also of huge concern to the safety of the patient.
In this second of two MR chapters, advanced pulse sequences and fast image
acquisition methods, dedicated radiofrequency (RF) coils, methods for perfusion,
diffusion, and angiography imaging, image quality metrics, common artifacts, spec-
Copyright © 2011. Wolters Kluwer Health. All rights reserved.

troscopy, MR equipment and siting, as well as MR safety issues are described and
discussed with respect to the underlying physics.
The concepts of image acquisition and timing issues for standard and advanced
pulse sequences into k-space is discussed first, with several methods that can be used
to reduce acquisition times and many of the trade-offs that must be considered.

13.1 Image Acquisition Time

A defining character of MRI is the tremendous range of acquisition time needed to

image a patient volume. Times ranging from as low as 50 ms to tens of minutes are
commonly required depending on the study, pulse sequence, number of images in
the dataset, and desired image quality. When MR was initially considered to be a
potential diagnostic imaging modality in the late 1970s, the prevailing conventional
wisdom gave no chance for widespread applicability because of the extremely long
times required to generate a single slice from a sequentially acquired dataset, which
449
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450 Section II • Diagnostic Radiology

required several minutes or more per slice. Breakthroughs in technology, equip-

ment design, RF coils, the unique attributes of the k-space matrix, and methods of
acquiring data drastically shortened acquisition times (or effective acquisition times)
quickly, and propelled the rapid adoption of MRI in the mid-1980s. By the early
1990s, MRI established its clinical value that continues to expand today.

Acquisition Time, Two-Dimensional Fourier Transform Spin

Echo Imaging
The time to acquire an image is determined by the data needed to fill the fraction
of k-space that allows the image to be reconstructed by Fourier transform methods.
For a standard spin echo sequence, the relevant parameters are the TR, number of
phase encoding steps, and number of excitations (NEX) used for averaging identical
repeat cycles, as
Acquisition time  TR  # PEG Steps  NEX
Even though there may be multiple echoes as illustrated in Figure 13-1, there is
also the same number of k-space repositories to capture the data in a specific, single
row of k-space defined by the strength of the PEG, as shown for the first echo
with proton density weighting and second echo with T2 weighting for this double
echo acquisition. Thus, effective imaging time can be reduced by producing two
(or more) images of the same slice within the TR interval. In addition, the matrix
size that defines k-space is often not square (e.g., 256  256, 128  128), but

90° 180° 180° 90°

RF
SSG

PEG
FEG
Echo

DAQ
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ky ky

kx kx
st nd
1 echo, proton density weighted 2 echo, T2 weighted

■■FIGURE 13-1 Standard spin echo pulse sequence is shown with two echoes per TR interval to encode
proton density contrast (short TE, first echo), and T2 contrast (long TE, second echo). In this acquisition, two
separate images are acquired independently by storing in a designated k-space matrix according to echo time.
A single PEG strength is momentarily applied to induce phase variations to encode the row to be filled in each
of the matrices (see the red PEG encoding for the last row in k-space, for instance). The full k-space matrix
requires the sequence to be repeated with incremental variations in the PEG strength until each k-space row is
fully populated. If averaging is desired, then an identical sequence (without incrementing the PEG) is repeated
and averaged in the same row.

r ectangular (e.g., 256  192, 256  128) where the small matrix dimension is most
frequently along the phase encode direction to minimize the number of incremental
PEG strength applications during the acquisition. A 256  192 image matrix and
two averages (NEX) per phase encode step with a TR  600 ms (for T1 weighting)
requires imaging time of 0.6 s  192  2  230.4 s  3.84 min for a single slice!
For a proton density and T2-weighted double echo sequence with TR  2,500 ms
(Fig. 13-1), this increases to 16 min, although two images are created in that time.
Of course, a simple first-order method would be to eliminate the number of aver-
ages (NEX), which reduces the time by a factor of 2; however, the downsides are an
increase in the statistical variability of the data, which decreases the image signal-to-
noise ratio (SNR) and makes the image appear “noisy.” Methods to reduce acquisi-
tion time and/or time per slice are crucial to making MR exam times reasonable, as
described by various methods below.

Multislice Data Acquisition

The average acquisition time per reconstructed image slice in a single-slice spin echo
sequence is clinically unacceptable. However, the average time per slice is significantly
reduced using multislice acquisition methods, where several slices within the tissue
volume are selectively excited in a sequential timing scheme during the TR interval
to fully utilize the dead time waiting for longitudinal recovery in an adjacent slice,
as shown in Figure 13-2. This requires cycling all of the gradients and tuning the RF
excitation pulse many times during the TR interval. The total number of slices that
can be acquired simultaneously is a function of TR, TE, and machine limitations:
Total Number of Slices  TR/(TE  C),
where C is a constant dependent on the MR equipment capabilities (computer speed;
gradient capabilities; sequence options; additional pulses, e.g., spoiling pulses in
standard SE; use of spatial saturation; and chemical shift, among others). Each slice
and each echo, if multiecho, requires its own k-space repository to store data as it is
acquired. Long TR acquisitions such as proton density and T2-weighted sequences

TR
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TE Repeat

#6
# slices = TR / (TE+C)

■■FIGURE 13-2 Multislice two-dimensional image acquisition is accomplished by discretely exciting different
slabs of tissue during the TR period; appropriate changes of the RF excitation bandwidth, SSG, PEG, and FEG
parameters are necessary. Because of diffuse excitation profiles, RF irradiation of adjacent slices leads to partial
saturation and loss of contrast. The number of slices (volume) that can be obtained is a function of the TR, TE,
and C, the latter representing the capabilities of the MR system and type of pulse sequence.

can produce a greater number of slices over a given volume than T1-weighted
sequences with a short TR. The chief trade-off is a loss of tissue contrast due to cross-
excitation of adjacent slices due to nonsquare excitation profiles, causing undesired
proton saturation as explained in Section 13.5 on artifacts.

Data Synthesis
Data “synthesis” takes advantage of the symmetry and redundant characteristics of
the frequency domain signals in k-space. The acquisition of as little as one-half the
data plus one row of k-space allows the mirroring of “complex conjugate” data to fill
the remainder of the matrix (Fig. 13-3). In the phase encode direction, “half Fourier,”
“½ NEX,” or “phase conjugate symmetry” (vendor-specific names) techniques effec-
tively reduce the number of required TR intervals by one-half plus one line, and thus
can reduce the acquisition time by nearly one-half. In the frequency encode direc-
tion, “fractional echo” or “read conjugate symmetry” refers to reading a fraction of
the echo. While there is no scan time reduction when all the phase encode steps are
acquired, there is a significant echo time reduction, which can reduce motion-related
artifacts, such as dephasing of blood. However, the penalty for either half Fourier or
fractional echo techniques is a reduction in the SNR (caused by a reduced NEX or

Fractional NEX: Fractional Echo:

Acquired data = ½ matrix + 1 line minimum TE reduced
kx peak
min TE

peak
FEG min TE

ky
ky
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Synthesized mirror image data from Mirror kx Data

opposite quadrants image extracted

■■FIGURE 13-3 Fractional NEX and Fractional Echo. Left. Data synthesis uses the redundant characteristics
of the frequency domain. This is an example of phase conjugate symmetry, in which ½ of the PEG views 1
extra are acquired, and the complex conjugate of the data is reflected in the symmetric quadrants. Acquisition
( )
time is thus reduced by approximately 2 ~ 40% , although image noise is increased by approximately 2.
Right: Fractional echo acquisition is performed when only part of the echo is read during the application of the
FEG. Usually, the peak of the echo is centered in the middle of the readout gradient, and the echo signals prior
to the peak are identical mirror images after the peak. With fractional echo, the echo is no longer centered,
and the sampling window is shifted such that only the peak echo and the dephasing part of the echo are
sampled. As the peak of the echo is closer to the RF excitation pulse, TE can be reduced, which can improve
T1 and proton density weighting contrast. A larger number of slices can also be obtained with a shorter TE in
a multislice acquisition (see Fig. 13-2).

data sampling in the volume) and the potential for artifacts if the approximations in
the complex conjugation of the signals are not accurate. Other inaccuracies result
from inhomogeneities of the magnetic field, imperfect linear gradient fields, and the
presence of magnetic susceptibility agents in the volume being imaged.

Fast Pulse Sequences

Fast Spin Echo (FSE) techniques use multiple PEG steps in conjunction with mul-
tiple 180-degree refocusing RF pulses to produce an echo train length (ETL) with
corresponding digital data acquisitions per TR interval, as illustrated in Figure 13-4.
Multiple k-space rows are filled during each TR equal to the ETL, which is also
the reduction factor for acquisition time. “Effective echo time” is determined when
the central views in k-space are acquired, which are usually the first echoes, and
subsequent echoes are usually spaced apart via increased PEG strength with the
same echo spacing time. “Phase re-ordering” optimizes SNR by acquiring the low-
frequency information with the early echoes (lowest amount of T2 decay), and the
high-frequency, peripheral information with late echoes, where the impact on over-
all image SNR is lower. The FSE technique has the advantage of spin echo image
acquisition, namely immunity from external magnetic field inhomogeneities, with
4, 8, to 16 faster acquisition time. However, each echo experiences differ-
ent amounts of intrinsic T2 decay, which results in image contrast differences when
compared with conventional spin echo images of similar TR and TE. Lower sig-
nal levels in the later echoes produce less SNR, and fewer images can be acquired
in the image volume during the same acquisition. A T2-weighted spin echo image
(TR  2,000 ms, 256 phase encode steps, one average) requires approximately 8.5 min,
while a corresponding FSE with an ETL of 4 (Fig. 13-4) requires about 2.1 min.

TR
90 180 90

SSG

PEG Phase
encode
ordering
FEG
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16 ms 32 ms 48 ms 64 ms
Echo
Effective
TE

Echo train length (ETL) = 4 k-space

Effective TE = 16 ms

■■FIGURE 13-4 Conventional FSE uses multiple 180-degree refocusing RF pulses per TR interval with incre-
mental changes in the PEG to fill several views in k-space (the ETL). This example illustrates an ETL of four,
with an “effective” TE equal to 16 ms. Total time of the acquisition is reduced by the ETL factor. The reversed
polarity PEG steps reestablish coherent phase before the next gradient application. Slightly different PEG
strengths are applied to fill the center of k-space first, and then the periphery with later echoes, continuing
until all views are recorded. As shown, data can be mirrored using conjugate symmetry to reduce the overall
time by another factor of two.

Longer TR values allow for a greater ETL, which will offset the longer TR in terms of
overall acquisition time, and will also allow more proton density weighting. Specific
FSE sequences for T2 weighting and multiecho FSE are employed with variations
in phase reordering and data acquisition. FSE is also known as “turbo spin echo” or
“RARE” (rapid acquisition with refocused echoes).
A Gradient Echo (GE) Acquisition pulse sequence is similar to a standard
spin echo sequence with a readout gradient reversal substituting for the 180-degree
pulse (Fig. 13-5). Repetition of the acquisition sequence occurs for each PEG step
and with each average. With small flip angles and gradient reversals, a consider-
able reduction in TR and TE is possible for fast image acquisition; however, the
ability to acquire multiple slices is compromised. A PEG rewinder pulse of oppo-
site polarity is applied to maintain phase relationships from pulse to pulse in the
coherent image acquisition. Spoiler gradients are used to eliminate persistent trans-
verse magnetization from stimulated echoes for incoherent GE (see Chapter 12,
Section 12.5).
Acquisition times are calculated in the same way as spin echo; a GE sequence for
a 256  192 image matrix, two averages, and a TR  30 ms, results in an imaging
time equal to 192  2  0.03 s  15.5 s. A conventional spin echo requires 3.84
min for a TR  600 ms. Trade-offs for fast acquisition speed include SNR losses,
magnetic susceptibility artifacts, and less immunity from magnetic field inhomo-
geneities. There are several acronyms for GE sequences, including GRASS, FISP,
Spoiled GRASS, FLASH, SSFP, etc., depending on the manufacturer of the equip-
ment. Table 13-1 describes a partial list of the different GE sequences and their
method of data acquisition.
Echo Planar Image (EPI) Acquisition is a technique that provides extremely
fast imaging time. Spin Echo (SE-EPI) and Gradient Echo (GE-EPI) are two methods
used for acquiring data, and a third is a hybrid of the two, GRASE (Gradient and Spin
Echo). Single-shot (all of the image information is acquired within 1 TR interval) or
multishot EPI has been implemented with these methods. For single-shot SE-EPI,

RF
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SSG
Rewinder gradient

PEG

FEG

Echo

TE
■■FIGURE 13-5 Coherent GE pulse sequence uses a small flip angle (30 to 40 degrees) RF pulse simultaneous
to the SSG. Phase and frequency encode gradients are applied shortly afterward (with a TE of less than 3 ms
in certain sequences). A PEG “rewinder” (reverse polarity) reestablishes the phase conditions prior to the next
pulse, simultaneous with the extended FEG duration.

TABLE 13-1 COMPARISON OF MANUFACTURER-NAMED ACRONYMS FOR

GE SEQUENCES
SEQUENCE GENERAL ELECTRIC PHILIPS SIEMENS TOSHIBA
Coherent GE GRASS, FGR FMPGR FFE FISP Field echo
Incoherent GE SPGR, FSPGR T1 FFE Field echo
(RF spoiled)
Incoherent GE MPGR FLASH Field echo
(Gradient spoiled)
Steady-state free SSFP, DE FGR T2 FFE PSIF
precession
SSFP: balanced FIESTA Balanced FFE True FISP True SSFP
sequence / true FISP

Note: Not all manufacturers are listed in this table, nor are all GE sequences. (Blank areas indicate particular
sequence is not performed (at time of publication).

image acquisition typically begins with a standard 90-degree flip, then a PEG/FEG
gradient application to initiate the acquisition of data in the periphery of the k-space,
followed by a 180-degree echo-producing RF pulse. Immediately after, an oscillating
readout gradient and phase encode gradient “blips” are continuously applied to stimu-
late echo formation and rapidly fill k-space in a stepped “zig-zag” pattern (Fig. 13-6).
The “effective” echo time occurs at a time TE, when the maximum amplitude of
the induced GEs occurs. Acquisition of the data must proceed in a period less than
T2* (around 50 ms), placing high demands on the sampling rate, the gradient coils
(shielded coils are required, with low induced “eddy currents”), the RF transmitter/
receiver, and RF energy deposition limitations. For GE-EPI, a similar acquisition strat-
egy is implemented but without a 180 degrees refocusing RF pulse, allowing for faster
acquisition time. SE-EPI is generally longer, but better image quality is achieved; on
the other hand, larger RF energy deposition to the patient occurs. EPI acquisition can

Effective TE ■■FIGURE 13-6 Single shot Echo

Planar Spin Echo image (SE-EPI)
acquisition sequence. Data is
90˚ 180˚
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RF deposited in k-space, initially posi-

tioned by a simultaneous PEG and
SSG FEG application to locate the initial
PEG “blips” row and column position (in this
PEG example, the upper left), followed
by phase encode gradient “blips”
FEG simultaneous to FEG oscillations,
to fill k-space line by line by intro-
Gradient ducing 1-row phase changes in
Echo a zig-zag pattern. Image matrix
sizes of 64  64 and 128  64
are common.

k-space

be preceded with any type of RF pulse, for instance FLAIR (EPI-FLAIR), which will
produce images much faster than the corresponding conventional FLAIR sequence.
The GRASE (Gradient and Spin Echo) sequence combines the initial spin echo
with a series of GEs, followed by an RF rephasing (180 degrees) pulse, and the pat-
tern is repeated until k-space is filled. This hybrid sequence achieves the benefits
of both types of rephasing: the speed of the gradient and the ability of the RF pulse
to compensate for T2* effects, providing significant improvements in image quality
compared to the standard EPI methods. A trade-off is a longer acquisition time (e.g.,
greater than 100 ms) and much greater energy deposition from the multiple 180
degrees RF pulses.
EPI acquisitions typically have poor SNR, low resolution (matrices of 64  64 or
128  64 are typical), and many artifacts, particularly of chemical shift and magnetic
susceptibility origin. Nevertheless, EPI offers real-time “snapshot” image capability
with 50 ms total acquisition time. EPI is emerging as a clinical tool for studying time-
dependent physiologic processes and functional imaging. Concerns of safety with
EPI, chiefly related to the rapid switching of gradients and possible nerve stimulation
of the patient, the associated acoustic noise, image artifacts, distortion, and chemical
shift are components that will limit use for many imaging procedures.

Other K-Space Filling Methods

Methods to fill k-space in a nonsequential way can enhance signal, contrast, and
achieve rapid scan times as shown in Figure 13-7. Centric k-space filling has been
discussed with FSE imaging (above), where the lower strength phase encode gradi-

Outer rows filled last

A Centric filling Central rows filled first

Outer rows filled last

Outer rows filled first

B Keyhole filling Central rows filled with

appearance of contrast

Outer rows filled first

Equal DT between points

C Spiral filling k-space re-binning of spiral
data is required before
image reconstruction

■■FIGURE 13-7 Alternate methods of filling k-space. A. Centric filling applies the lower strength PEG’s first to
maximize signal and contrast from the earliest echoes of a FSE or GE sequence. B. Keyhole filling applies PEG’s
of higher strength first to fill the outer portions of k-space, and the central lines are filled only during a certain
part of the sequence, such as with arrival of contrast signal. C. Spiral data acquisition occurs with sinusoidal
oscillation of the X and Y gradients 90 degrees out of phase with each other, with samples beginning in the
center of k-space and spiraling out to the periphery. Interpolating the data into the kx, ky matrix is required in
order to apply 2DFT image reconstruction.

ents are applied first, filling the center of k-space when the echoes have their highest
amplitude. This type of filling is also important for fast GE techniques, where the
image contrast and the SNR fall quickly with time from the initial excitation pulse.
Keyhole filling methods fill k-space similarly to centric filling, except the central
lines are filled when important events occur during the sequence, in situations such
as contrast-enhanced angiography. Outer areas of k-space are filled first, and when
gadolinium appears in the imaging volume, the center areas are filled. At the end of
the scan, the outer and central k-space regions are meshed to produce an image with
both good contrast and resolution.
Spiral filling is an alternate method of filling k-space radially, which involves
the simultaneous oscillation of equivalent encoding gradients to sample data points
during echo formation in a spiral, starting at the origin (the center of the k-space)
and spiraling outward to the periphery in the prescribed acquisition plane. The same
contrast mechanisms are available in spiral sequences (e.g., T1, T2, proton density
weighting), and spin or GEs can be obtained. After acquisition of the signals, an addi-
tional post-processing step, re-gridding, is necessary to convert the spiral data into
the rectilinear matrix for two-dimensional Fourier transform (2DFT). Spiral scanning
is an efficient method for acquiring data and sampling information in the center of
k-space, where the bulk of image information is contained.
A variant of radial sampling with enhanced filling of the center of k-space is known
generically as “blade” imaging, and commonly as propeller: Periodically Rotated
Overlapping Parallel Lines with Enhanced Reconstruction, where a rectangular block
of data is acquired and then rotated about the center of k-space. Redundant informa-
tion concentrated in the center of k-space is used for improvement of SNR or for the
identification of times during the scan in which the patient may have moved, so that
those blocks of data can be processed with a phase-shifting algorithm to eliminate the
movement effect on the data during the reconstruction process and to mitigate motion
artifacts to a great extent. Filling of k-space for this method is shown in Figure 13-8.

Parallel Imaging
Parallel imaging is a technique that fills k-space by using the response of multiple
receive RF coils that are coupled together with independent channels, so that data
can be acquired simultaneously. Specific hardware and software are necessary for the
electronic orchestration of this capability. Typically, 2, 4, 5, 7, 8, 16, 18 (or more)
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coils are arranged around the area to be imaged; if a 4-coil configuration is used,
then during each TR period, each coil acquires a view of the data as the acquisition
sequence proceeds. Lines in k-space are defined only after the processing of linear
combinations of the signals that are received by all of the coils. Since 4 views of the
data are acquired per TR interval, scan time can be decreased by a factor of 4 (known
as the reduction factor). However, the acquisition of the signals have gaps, and the
FOV in the phase direction is reduced to one-quarter of its original size. This results
in a known aliasing of the information (a wrapped image—see section on Artifacts),
that is rectified by using the measured sensitivity profile of each coil to calculate from
where the signal is coming. This sensitivity profile determines the position of the sig-
nal based on its amplitude, where the signal near the coil has a higher amplitude than
that farthest away. As a result of the process, commonly known as SENSE (SENSitiv-
ity Encoding—there are several acronyms coined by the manufacturers), the image
can be unwrapped and combined with the unwrapped images from each of the other
coils. A simple two-coil example is shown in Figure 13-9 for a breast image applica-
tion of SENSE, in which improved resolution is desired over reduced scan time.

Rectangular filling Propeller filling

“Blades”

Motion during
the acquisition

Blades with motion

are processed to
remove motion and
data reconstructed

■■FIGURE 13-8 The propeller data acquisition compared to a rectangular filling of k-space is shown above.
Instead of acquiring single lines of information to fill k-space consecutively as shown in the upper left and
middle left, a rectangular data acquisition at a specific angle (e.g., 0 degree) is acquired encompassing several
lines of k-space, which represents a “blade” of information. The partial acquisition is rotated about the center
of k-space at angular increments, which provides a dense sampling of data at the center of k-space and less in
the periphery as shown by the schematic (upper right illustration). If the patient moves during a portion of the
examination (lower left image), the blades in which the motion occurred can be identified, reprocessed, and
the image reconstructed without the motion artifacts (lower right image).
■■FIGURE 13-9 Parallel imaging with two RF Single coil
coils. Top. a single coil acquisition of a breast
MR exam over the full FOV. Middle. Individual
coils with every-other row of k-space being
filled represent ½ FOV, with image overlap
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caused by aliasing. Bottom. after SENSE pro-

cessing, images are combined to deliver twice
the spatial resolution in the left/right (Phase)
FOV
direction, with the same imaging time.
Right coil Left coil

FOV/2
Unwrapped, combined

Parallel imaging can be used to either reduce scan times or improve resolution. It
also can be used with most pulse sequences. There are obvious benefits in terms of
scan times and/or resolution, but there is a slight loss of SNR due to the manipulation
of the signals, and chemical shift artifacts (explained in the Artifacts section) may
increase. Patient motion can also cause misalignment between the undersampled
data and the reference scans of the coils.

Three-Dimensional Fourier Transform Image Acquisition

Three-dimensional image acquisition (volume imaging) requires the use of a broad-
band, nonselective, or “slab-selective” RF pulse to excite a large volume of pro-
tons simultaneously. Two phase gradients are discretely applied in the slice encode
and phase encode directions, prior to the frequency encode (readout) gradient
(Fig. 13-10). The image acquisition time is equal to
TR 
# Phase Encode Steps (z-axis)  # Phase Encode Steps
(y-axis)  # Signal Averages
A three-dimensional Fourier transform (three one-dimensional Fourier transforms)
is applied for each column, row, and depth axis in the image matrix “cube.” Volumes
obtained can be either isotropic, the same size in all three directions, or anisotropic,
where at least one dimension is different in size. The advantage of the former is
equal resolution in all directions; reformations of images from the volume do not
suffer from degradations of larger sample size from other directions. After the spatial
domain data are obtained, individual two-dimensional slices in any arbitrary plane
are extracted by interpolation of the cube data.
When using a standard TR of 600 ms with one average for a T1-weighted exam, a
128  128  128 cube requires 163 min or about 2.7 h! Obviously, this is unaccept-
able for standard clinical imaging. GE pulse sequences with TR of 50 ms acquire the
same image volume in about 15 min. Another shortcut is with anisotropic voxels, where
the phase encode steps in one dimension are reduced, albeit with a loss of resolution.
A major benefit to isotropic three-dimensional acquisition is the uniform resolution

Isotropic Anisotropic
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Slice Encode
(phase #1)

Frequency Encode

■■FIGURE 13-10 Three-dimensional image acquisition requires the application of a broadband RF pulse to
excite all of the protons in the volume simultaneously, followed by a phase encode gradient along the slice
encode direction, a phase encode gradient along the phase encode direction, and a frequency encode gra-
dient in the readout direction. Spatial location is decoded sequentially by the Fourier transform along each
encode path, storing intermediate results in the three-dimensional k-space matrix.

in all directions when extracting any two-dimensional image from the matrix cube. In
addition, high SNR is achieved compared to a similar two-dimensional image, allowing
reconstruction of very thin slices with good detail (less partial volume averaging) and
high SNR. A downside is the increased probability of motion artifacts and increased
computer hardware requirements for data handling and storage.

13.2 MR Image Characteristics

Spatial Resolution and Contrast Sensitivity

Spatial resolution, contrast sensitivity, and SNR parameters form the basis for evalu-
ating the MR image characteristics. The spatial resolution is dependent on the FOV,
which determines pixel size, the gradient field strength, which determines the FOV,
the receiver coil characteristics (head coil, body coil, and various surface coil designs),
the sampling bandwidth, and the image matrix. Common image matrix sizes are 128
 128, 256  128, 256  192, and 256  256, with 512  256, 512  512, and
1,024  512 becoming prevalent. In general, MR provides spatial resolution approx-
imately equivalent to that of CT, with pixel dimensions on the order of 0.5 to 1.0
mm for a high-contrast object and a reasonably large FOV (greater than 250 mm).
A 250 mm FOV and a 256  256 matrix will have a pixel size on the order of 1
mm. In small FOV acquisitions with high gradient strengths and with surface coil
receivers, the effective pixel size can be smaller than 0.1 to 0.2 mm (of course, with
a limited FOV of 25 to 50 mm. Slice thickness in MRI is usually 5 to 10 mm and
represents the dimension that produces the most partial volume averaging.
Spatial resolution can be improved with higher field strength magnets due to a larger
SNR, which allows thinner slice acquisition, and/or higher sampling rates (smaller pix-
els) for a given acquisition. However, with higher B0, increased RF absorption, artifact
production, and a lengthening of T1 relaxation occur. The latter decreases T1 contrast
sensitivity because of increased saturation of the longitudinal m agnetization.
Contrast sensitivity is the major attribute of MR. The spectacular contrast sensitiv-
ity of MR enables the exquisite discrimination of soft tissues and contrast due to blood
flow. This sensitivity is achieved through differences in the T1, T2, proton density, and
flow velocity characteristics. Contrast, which is dependent upon these parameters, is
achieved through the proper application of pulse sequences, as discussed previously.
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MR contrast materials, usually susceptibility agents that disrupt the local magnetic field
to enhance T2 decay or provide a relaxation mechanism for shorter T1 recovery time
(e.g., bound water in hydration layers), are becoming important enhancement agents
for differentiation of normal and diseased tissues. The absolute contrast sensitivity of
the MR image is ultimately limited by the SNR and presence of image artifacts.

Signal-to-Noise Ratio, SNR

There are numerous dependencies on the ultimate SNR achievable by the MR system.
The intrinsic signal intensity based on T1, T2, and proton density parameters has
been discussed; to summarize, the TR, TE, and flip angle will have an impact on the
magnitude of the signal generated in the image. While there are many mitigating
factors, a long TR increases the longitudinal magnetization recovery and increases
the SNR; a long TE increases the transverse magnetization decay and reduces the
SNR; a smaller flip angle (reduced from 90 degrees) reduces the SNR. Therefore,
spin echo pulse sequences with large flip angle, long TR, short TE, coarse matrix,

large FOV, thick slices, and many averages will generate the best SNR; however, the
resultant image may not be clinically relevant or desirable. While SNR is important,
it’s not everything.
For a given pulse sequence (TR, TE, flip angle), the SNR of the MR image is
dependent on a number of variables, as shown in the equation below for a two-
dimensional image acquisition:
NEX
SNR ∝ I  voxel x, y, z   f(QF)  f(B)  f(slice gap)  f(reconstruction)
BW

where I is the intrinsic signal intensity based on pulse sequence, voxelx,y,z is the voxel
volume, determined by FOV, image matrix, and slice thickness, NEX is the number
of excitations, determined by the number (or fractional number) of repeated signal
acquisitions into the same voxels. BW is the frequency bandwidth of the RF receiver,
f(QF) is the function of the coil quality factor parameter (tuning the coil), f(B) is the
function of magnetic field strength, B, f(slice gap) is the function of interslice gap
effects, and f(reconstruction) is the function of the reconstruction algorithm.
Other factors in the above equation are explained briefly below.

Voxel Volume
The voxel volume is equal to
FOVx FOVy
Volume    Slice thickness, z
No. of pixels, x No. of pixels, y

SNR is linearly proportional to the voxel volume. Thus, by reducing the image matrix
size from 256  256 to 256  128 over the same FOV, the effective voxel size
increases by a factor of two, and therefore increases the SNR by a factor of two for the
same image acquisition time (e.g., 256 phase encodes with one average versus 128
phase encodes with two averages).

Signal Averages
Signal averaging (also known as number of excitations, NEX) is achieved by averag-
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ing sets of data acquired using an identical pulse sequence (same PEG strength). The
SNR is proportional to the square root of the number of signal averages. A 2-NEX
acquisition requires a doubling (100% increase) of the acquisition time for a 40%
( )
increase in the SNR 2 = 1.4 Doubling the SNR requires 4 NEX. In some cases,
less than 1 average (e.g., ½ or ¾ NEX) can be selected. Here, the number of phase
encode steps is reduced by ½ or ¼, and the missing data are synthesized in the
k-space matrix. Imaging time is therefore reduced by a similar amount; however, a
loss of SNR accompanies the shorter imaging times by the same square root factor.

RF Bandwidth
The receiver bandwidth defines the range of frequencies to which the detector is
tuned during the application of the readout gradient. A narrow bandwidth (a nar-
row spread of frequencies around the center frequency) provides a higher SNR,
1
proportional to BW . A twofold reduction in RF bandwidth—from 8 to 4 kHz,

for instance—increases the SNR by 1.4  (40% increase). This is mainly related
to the fact that the white noise, which is relatively constant across the bandwidth,
does not change, while the signal distribution changes with bandwidth. In the spa-
tial domain, bandwidth is inversely proportional to the sample dwell time, T to
sample the signal: BW  1/T. Therefore, a narrow bandwidth has a longer dwell
time, which increases the signal height (Fig. 13-11), compared to the shorter dwell
time for the broad bandwidth signal, thus spreading the signal over a larger range
of frequencies. The SNR is reduced by the square root of the dwell time. However,
any decrease in RF bandwidth must be coupled with a decrease in gradient strength
to maintain the sampling across the FOV, which might be unacceptable if chemi-
cal shift artifacts are of concern (see Artifacts, below). Narrower bandwidths also
require a longer time for sampling, and therefore affect the minimum TE time that
is possible for an imaging sequence. Clinical situations that can use narrow band-
widths are with T2-weighted images and long TEs that allow the echo to evolve over
an extended period, particularly in situations where fat saturation pulses are used to
reduce the effects of chemical shift in the acquired images. Use of broad bandwidth
settings is necessary when very short TEs are required, such as in fast GE imaging
to reduce the sampling time.

RF Coil Quality Factor

The coil quality factor is an indication of RF coil sensitivity to induced currents in
response to signals emanating from the patient. Coil losses that lead to lower SNR are
caused by patient “loading” effects and eddy currents, among other factor. Patient load-
ing refers to the electric impedance characteristics of the body, which to a certain extent
acts like an antenna. This effect causes a variation in the magnetic field that is different

Signal
Noise
broad (16 kHz)

DT
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(8 kHz)

narrow (4 kHz)

RF bandwidth =
1 / dwell time =
1 / DT DT
Sample dwell time
■■FIGURE 13-11 RF Receiver Bandwidth is determined by the FEG strength, the FOV, and sampling rate. This
figure illustrates the spatial domain view of SNR and corresponding sample dwell time. Evolution of the echo
in the broad bandwidth situation occurs rapidly with minimal dwell time, which might be needed in situations
where very short TE is required, even though the SNR is reduced. On the other hand, in T2 weighted images
requiring a long TE, narrow bandwidth can improve SNR.

for each patient, and must be measured and corrected for. Consequently, tuning the
receiver coil to the resonance frequency is mandatory before image acquisition. Eddy
currents are signals that are opposite of the induced current produced by transverse
magnetization in the RF coil, and reduce the overall signal. Quadrature coils increase the
SNR as two coils are used in the reception of the signal; phased array coils increase the
SNR even more when the data from several coils are added together (see Parallel Imag-
ing, Section 13.1). The proximity of the receiver coil to the volume of interest affects the
coil quality factor, but there are trade-offs with image uniformity. Positioning of the coil
with respect to the direction of the main magnetic field is also an issue that occurs with
air core (horizontal B0) to solid core (vertical B0) magnets. Body receiver coils positioned
in the bore of the magnet have a moderate quality factor, whereas surface coils have a
high quality factor. With the body coil, the signal is relatively uniform across the FOV;
however, with surface coils, the signal falls off abruptly near the edges of the field, limit-
ing the useful imaging depth and resulting in nonuniform brightness across the image.

Magnetic Field Strength

Magnetic field strength influences the SNR of the image by a factor of B1.0 to B1.5.
Thus, one would expect a three- to fivefold improvement in SNR with a 1.5 T magnet
over a 0.5 T magnet. Although the gains in the SNR are real, other considerations
mitigate the SNR improvement in the clinical environment, including longer T1
relaxation times and greater RF absorption, as discussed previously.

Cross-Excitation
Cross-excitation occurs from the nonrectangular RF excitation profiles in the spatial
domain and the resultant overlap of adjacent slices in multislice image acquisition
sequences. This saturates the protons and reduces contrast and the contrast-to-noise
ratio. To avoid cross-excitation, interslice gaps or interleaving procedures are neces-
sary (see Artifacts section, below).

Image Acquisition and Reconstruction Algorithms

Image acquisition and reconstruction algorithms have a profound effect on SNR. The
various acquisition/reconstruction methods that have been used in the past and those
Copyright © 2011. Wolters Kluwer Health. All rights reserved.

used today are, in order of increasing SNR, point acquisition methods, line acquisition
methods, two-dimensional Fourier transform acquisition methods, and three-dimen-
sional Fourier transform volume acquisition methods. In each of these techniques,
the volume of tissue that is excited is the major contributing factor to improving the
SNR and image quality. Reconstruction filters and image processing algorithms will
also affect the SNR. High-pass filtration methods that increase edge definition will
generally decrease the SNR, while low-pass filtration methods that smooth the image
data will generally increase the SNR at the cost of reduced resolution.

Summary, Image Quality

The best possible image quality is always desirable, but not always achievable because
of the trade-off between SNR, scan speed, and spatial resolution. To increase one of
these three components of image quality involves the consideration of reducing one
or both of the other two. It is thus a balancing act that is chosen by the operator, the
protocol, and the patient in order to acquire images with the best diagnostic yield.

MR parameters that may be changed include TR, TE, TI, ETL, Matrix Size, Slice
Thickness, Field of view, and NEX. Working with these parameters in the optimiza-
tion of acquisition protocols to achieve high image quality is essential.

13.3 Signal from Flow

The appearance of moving fluid (vascular and cerebrospinal fluid [CSF]) in MR images
is complicated by many factors, including flow velocity, vessel orientation, laminar
versus turbulent flow patterns, pulse sequences, and image acquisition modes. Flow-
related mechanisms combine with image acquisition parameters to alter contrast.
Signal due to flow covers the entire gray scale of MR signal intensities, from “black
blood” to “bright blood” levels, and flow can be a source of artifacts. The signal from
flow can also be exploited to produce MR angiographic images.
Low signal intensities (flow voids) are often a result of high-velocity signal loss
(HVSL), in which protons in the flowing blood move out of the slice during echo ref-
ormation, causing a lower signal. Flow turbulence can also cause flow voids, by causing
a dephasing of protons in the blood with a resulting loss of the tissue magetization in
the area of turbulence. With HVSL, the amount of signal loss depends on the velocity
of the moving fluid. Pulse sequences to produce “black blood” in images can be very
useful in cardiac and vascular imaging. A typical black blood pulse sequence uses a
“double inversion recovery” method, whereby a nonselective 180-degree RF pulse
is initially applied, inverting all protons in the body, and is followed by a selective
180-degree RF pulse that restores the magnetization in the selected slice. During the
inversion time, blood outside of the excited slice with inverted protons flows into the
slice, producing no signal; therefore, the blood appears dark.

Flow-Related Enhancement
Flow-related enhancement is a process that causes increased signal intensity due to
flowing protons; it occurs during imaging of a volume of tissues. Even-echo rephas-
ing is a phenomenon that causes flow to exhibit increased signal on even echoes in
a multiple-echo image acquisition. Flowing protons that experience two subsequent
180-degree pulses (even echoes) generate higher signal intensity due to a construc-
tive rephasing of protons during echo formation. This effect is prominent in slow
Copyright © 2011. Wolters Kluwer Health. All rights reserved.

laminar flow (e.g., veins show up as bright structures on even-echo images).

Flow enhancement in GE images is pronounced for both venous and arterial
structures, as well as CSF. The high intensity is caused by the wash-in (between
subsequent RF excitations) of fully unsaturated protons into a volume of partially
saturated protons due to the short TR used with gradient imaging. During the next
excitation, the signal amplitude resulting from the moving unsaturated protons is
about 10 times greater than that of the nonmoving saturated protons. With GE tech-
niques, the degree of enhancement depends on the velocity of the blood, the slice
or volume thickness, and the TR. As blood velocity increases, unsaturated blood
exhibits the greatest signal. Similarly, a thinner slice or decreased repetition time
results in higher flow enhancement. In arterial imaging of high-velocity flow, it is
possible to have bright blood throughout the imaging volume of a three-dimensional
acquisition if unsaturated blood can penetrate into the volume prior to experiencing
an RF pulse.
Signal from blood is dependent on the relative saturation of the surrounding
tissues and the incoming blood flow in the vasculature. In a multislice volume,

Imaging volume ■■FIGURE 13-12 The repeated RF excitation within

an imaging volume produces partial saturation of
the tissue magnetization (top figure, gray area).
Unsaturated protons flowing into the volume gener-
ate a large signal difference that is bright relative to
the surrounding tissues. Bright blood effects can be
Unsaturated spins: high signal reduced by applying pre-saturation RF pulses adjacent
to the imaging volume, so that protons in inflowing
Flow-Related Enhancement blood will have a similar partial saturation (bottom
Presaturation figure; note no blood signal).
RF pulses outside
imaging volume

Pre-saturated spins: equal signal

Flow presaturation

repeated excitation of the tissues and blood causes a partial saturation of the protons,
dependent on the T1 characteristics and the TR of the pulse sequence. Blood out-
side of the imaged volume does not interact with the RF excitations, and therefore
these unsaturated protons may enter the imaged volume and produce a large signal
compared to the blood within the volume. This is known as flow-related enhance-
ment. As the pulse sequence continues, the unsaturated blood becomes partially
saturated and the protons of the blood produce a similar signal to the tissues in the
inner slices of the volume (Fig. 13-12). In some situations, flow-related enhance-
ment is undesirable and is eliminated with the use of “presaturation” pulses applied
to volumes just above and below the imaging volume. These same saturation pulses
are also helpful in reducing motion artifacts caused by adjacent tissues outside the
imaging volume.

MR Angiography
Exploitation of blood flow enhancement is the basis for MRA. Two techniques to create
images of vascular anatomy include time-of-flight and phase contrast a ngiography.
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Time-of-Flight Angiography
The time-of-flight technique relies on the tagging of blood in one region of the body
and detecting it in another. This differentiates moving blood from the surround station-
ary tissues. Tagging is accomplished by proton saturation, inversion, or relaxation to
change the longitudinal magnetization of moving blood. The penetration of the tagged
blood into a volume depends on the T1, velocity, and direction of the blood. Since the
detectable range is limited by the eventual saturation of the tagged blood, long vessels
are difficult to visualize simultaneously in a three-dimensional volume. For these rea-
sons, a two-dimensional stack of slices is typically acquired, where even slowly mov-
ing blood can penetrate the region of RF excitation in thin slices (Fig. 13-13). Each
slice is acquired separately, and blood moving in one direction (north or south, e.g.,
arteries versus veins) can be selected by delivering a presaturation pulse on an adja-
cent slab superior or inferior to the slab of data acquisition. Thin slices are also help-
ful in preserving resolution of the flow pattern. Often used for the two-dimensional

■■FIGURE 13-13 The time of flight MRA acquisition collects each slice separately with a sequence to enhance
blood flow. Exploitation of blood flow is achieved by detecting unsaturated protons moving into the volume,
producing a bright signal. A coherent GE image acquisition pulse sequence is shown, TR  24 ms, TE  3.1
ms, Flip Angle  20 degrees. Every 10th image in the stack is displayed above, from left to right and top to
bottom.

image acquisition is a “GRASS” or “FISP” GE technique that produces relatively poor

anatomic contrast, yet provides a high-contrast “bright blood” signal. Magnetization
transfer contrast sequences (see below) are also employed to increase the contrast of
the signals due to blood by reducing the background anatomic contrast.
Two-dimensional TOF MRA images are obtained by projecting the content of the
stack of slices at a specific angle through the volume. A maximum intensity projec-
tion (MIP) algorithm detects the largest signal along a given ray through the volume
and places this value in the image (Fig. 13-14). The superimposition of residual
Copyright © 2011. Wolters Kluwer Health. All rights reserved.

■■FIGURE 13-14 A simple illustration shows Projections are cast through the image stack (volume)
how the MIP algorithm extracts the highest The maximum signal along each line is projected
(maximum) signals in the two-dimensional
stack of images along a specific direction in
the volume, and produces projection images
with maximum intensity variations as a func- MIP images
tion of angle.

Projection angles Volume of 2D Images

stationary anatomy often requires further data manipulation to suppress undesirable

signals. This is achieved in a variety of ways, the simplest of which is setting a win-
dow threshold. Another method is to acquire a dataset without contrast, and subtract
the noncontrast MIP from the contrast MIP to reduce background signals. Clini-
cal MRA images show the three-dimensional characteristics of the vascular anatomy
from several angles around the volume stack (Fig. 13-15) with some residual signals
from the stationary anatomy. Time-of-flight angiography often produces variation in
vessel intensity dependent on orientation with respect to the image plane, a situation
that is less than optimal.

Phase Contrast Angiography

Phase contrast imaging relies on the phase change that occurs in moving protons
such as blood. One method of inducing a phase change is dependent on the applica-
tion of a bipolar gradient (one gradient with positive polarity followed by a second
gradient with negative polarity, separated by a delay time T). In a second acquisi-
tion of the same view of the data (same PEG), the polarity of the bipolar gradients is
reversed, and moving protons are encoded with negative phase, while the stationary
protons exhibit no phase change (Fig. 13-16). Subtracting the second excitation from
the first cancels the magnetization due to stationary protons but enhances magne-
tization due to moving protons. Alternating the bipolar gradient polarity for each
subsequent excitation during the acquisition provides phase contrast image informa-
tion. The degree of phase shift is directly related to the velocity encoding (VENC)
time, T, between the positive and negative lobes of the bipolar gradients and the
velocity of the protons within the excited volume. Proper selection of the VENC time

2D Projection
Angiograms from MIP

■■FIGURE 13-15 A volume stack of bright blood images (left) is used with MIP processing to create a series
of projection angiograms at regular intervals; the three-dimensional perspective is appreciated in a stack view,
with virtual rotation of the vasculature.

bipolar gradient encoding

T T
Excitation Excitation
#1 #2

Excitation #1 - Excitation #2 = net residual phase

- Stationary spins:
=
net phase shift = 0

Moving spins, low

velocity, forward direction:
net phase shift is small;
- =
Backward direction, high
flow, net phase shift is
large, opposite

■■FIGURE 13-16 Phase Contrast Angiography uses consecutive excitations that have a bipolar gradient
encoding with the polarity reversed between the first and second excitation, as shown in the top row. Mag-
netization vectors (lower two rows) illustrate the effect of the bipolar gradients on stationary and moving
spins for the first and second excitations. Subtracting the two will cancel stationary tissue magnetization and
enhance phase differences caused by the velocity of moving blood.

is necessary to avoid phase wrap error (exceeding 180-degree phase change) and to
ensure an optimal phase shift range for the velocities encountered. Intensity varia-
tions are dependent on the amount of phase shift, where the brightest pixel values
represent the largest forward (or backward) velocity, a mid-scale value represents 0
velocity, and the darkest pixel values represent the largest backward (or forward)
velocity. Figure 13-17 shows a representative magnitude and phase contrast image of
the cardiac vasculature. Unlike the time-of-flight methods, the phase contrast image
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Magnitude Image Phase Image

■■FIGURE 13-17 Magnitude (left) and phase (right) images provide contrast of flowing blood. Magnitude
images are sensitive to flow, but not to direction; phase images provide direction and velocity information.
The blood flow from the heart shows forward flow in the ascending aorta (dark area) and forward flow in the
descending aorta at this point in the heart cycle for the phase image. Some bright flow patterns in the ascend-
ing aorta represent backward flow to the coronary arteries. Grayscale amplitude is proportional to velocity,
where intermediate grayscale is 0 velocity.
Bushberg, Jerrold T., et al. Essential Physics of Medical Imaging, Wolters Kluwer Health, 2011. ProQuest Ebook Central,
http://ebookcentral.proquest.com/lib/pitt-ebooks/detail.action?docID=2031899.
Created from pitt-ebooks on 2019-05-13 10:22:38.
Chapter 13 • Magnetic Resonance Imaging 469

is inherently quantitative, and when calibrated carefully, provides an estimate of the

mean blood flow velocity and direction. Two- and three-dimensional phase contrast
image acquisitions for MRA are possible.

Gradient Moment Nulling

In spin echo and gradient recalled echo imaging, the slice select and readout gradients are
balanced, so that the uniform dephasing with the initial gradient application is rephased
by an opposite polarity gradient of equal area. However, when moving protons are sub-
jected to the gradients, the amount of phase dispersion is not compensated (Fig. 13-18).
This phase dispersal can cause ghosting (faint, displaced copies of the anatomy) in images.
It is possible, however, to rephase the protons by a gradient moment nulling technique.
With constant velocity flow (first-order motion), all protons can be rephased using the
application of a gradient triplet. In this technique, an initial positive gradient of unit area
is followed by a negative gradient of twice the area, which creates phase changes that are
compensated by a third positive gradient of unit area. The velocity compensated gradi-
ent (right graph in Fig. 13-18) depicts the evolution of the proton phase back to zero
for both stationary and moving protons. Note that the overall applied gradient has a net
area of zero—equal to the sum of the positive and negative areas. Higher order correc-
tions such as second- or third-order moment nulling to correct for acceleration and other
motions are possible, but these techniques require more complicated gradient switching.
Gradient moment nulling can be applied to both the slice select and readout gradients to
correct for problems such as motion ghosting as elicited by CSF pulsatile flow.

13.3 Perfusion and Diffusion Contrast Imaging

Perfusion of tissues via the capillary bed permits the delivery of oxygen and nutrients
to the cells and removal of waste (e.g., CO2) from the cells. Conventional perfusion
measurements are based on the uptake and wash-out of radioactive tracers or other
exogenous tracers that can be quantified from image sequences using well-characterized
imaging equipment and calibration procedures. For MR perfusion images, exogenous

Net area = 0
Slice
Select

Stationary
Relative
spins
phase
change Stationary
Moving
and moving
spins
spins

■■FIGURE 13-18 Left. Phase dispersion of stationary and moving spins under the influence of an applied
gradient (no flow compensation) as the gradient is inverted is shown. The stationary spins return to the original
phase state, whereas the moving spins do not. Right. Gradient moment nulling of first order linear velocity
(flow compensation) requires a doubling of the negative gradient amplitude followed by a positive gradient
such that the total summed area is equal to zero. This will return both the stationary spins and the moving
spins back to their original phase state.

and endogenous tracer methods are used. Freely diffusible tracers using nuclei such
as 2H (deuterium), 3He, 17O, and 19F are employed in experimental procedures to
produce differential contrast in the tissues. More clinically relevant are intravascular
blood pool agents such as gadolinium–diethylenetriaminepentaacetic acid, which
modify the relaxation of protons in the blood in addition to producing a shorter T2*.
This produces signal changes that can be visualized in pre and post contrast images
(Fig. 13-19). Endogenous tracer methods do not use externally added agents, but
instead depend on the ability to generate contrast from specific excitation or diffusion
mechanisms. For example, labeling of inflowing protons (“black blood” perfusion)
uses protons in the blood as the contrast agent. Tagged (labeled) protons outside of
the imaging volume perfuse into the tissues, resulting in a drop in signal intensity, a
time course of events that can be monitored by quantitative measurements.
Functional MRI (fMRI) is based on the increase in blood flow to the local vascu-
lature that accompanies neural activity in the specific areas of the brain, resulting in a
local reduction of deoxyhemoglobin because the increase in blood flow occurs without
an increase in oxygen extraction. As deoxyhemoglobin is a paramagnetic agent, it alters
the T2*-weighted MRI image signal. Thus, this endogenous contrast enhancing agent
serves as the signal for fMRI. Area voxels (represented by x-y coordinates and z slice
thickness) of high metabolic activity resulting from a task-induced stimulus produce a
correlated signal for Blood Oxygen Level Dependent (BOLD) acquisition techniques. A
BOLD sequence produces multiple T2*-weighted images of the head before the appli-
cation of the stimulus. The patient is repeatedly subjected to the stimulus and multiple
BOLD images are acquired. Because the BOLD sequence produces images that are
highly dependent on blood oxygen levels, areas of high metabolic activity will dem-
onstrate a change in signal when the prestimulus image data set is subtracted, voxel
by voxel, from post-stimulus image data set. Voxel locations defined by significant
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■■FIGURE 13-19 Pre (top row) and post (bottom row) gadolinium contrast T1-weighted MR axial images
of the brain illustrate the signal change that occurs with the appearance of gadolinium by shortening the T1
time of the perfused tissues.

signal changes indicate regions of the brain activated by a specific task. Stimuli in fMRI
experiments can be physical (finger movement), sensory (light flashes or sounds), or
cognitive (repetition of “good” or “bad” word sequences, complex problem solving),
among others. To improve the SNR in the fMRI images, a stimulus is typically applied
in a repetitive, periodic sequence, and BOLD images are acquired continuously, tagged
with the timing of the stimulus. Regions in the brain that demonstrate time-dependent
activity and correlate with the time-dependent application of the stimulus are sta-
tistically analyzed, and coded using a color scale, while voxels that do not show a
significant intensity change are not colored. The resultant color map is overlaid onto a
grayscale image of the brain for anatomic reference, as shown in Figure 13-20.
High-speed imaging and T2* weighting necessary for fMRI is typically achieved
with EPI acquisition techniques that can be acquired in as little as 50 ms for a 64 
64 acquisition matrix. Gradient Recalled Echo acquisitions using standard sequences
are also employed with multiple contiguous slices (e.g., 16 slices, slice thickness 5
mm, TR  3 s, TE  60 ms, 90-degree flip angle) at 1.5 T, with 25 to 30 complete
head acquisitions. The latter acquisition techniques provide better spatial resolution
but rely on very cooperative subjects and a much longer exam time.

Diffusion Weighted Imaging

Diffusion relates to the random motion of water molecules in tissues. Interaction of
the local cellular structure with the movement of water molecules produces aniso-
tropic, directionally dependent diffusion (e.g., in the white matter of brain tissues).

Bilateral finger tapping paradigm r=0.729

r=0.668

■■FIGURE 13-20 Functional MR image bilateral finger tapping paradigm shows the areas of the brain acti-
vated by this repeated activity. The paradigm was a right finger tap alternated by a left finger tap (time
sequence on the right side of the figure) and the correlated BOLD signals (black traces) derived from the echo
planar image sequence. A voxel-by-voxel correlation of the periodic stimulus and MR signal is performed, and
when exceeding a correlation threshold, a color overlay is added to the grayscale image. In this example, red
indicates the right finger tap that excites the left motor cortex, which appears on the right side of the image,
and blue the left finger tap. (Figure compliments of MH Buonocore, MD, PhD University of California Davis.)

■■FIGURE 13-21 The basic elements of a DWI 90° 180°

pulse sequence are shown. The diffusion weight-
ing gradients are of amplitude G, duration of the RF
gradients  and time between gradients is . SSG
d
DWI G
gradients
D
PEG
FEG
Signal

Freely diffusing water Restricted diffusion

Normal Tissue Ischemic Injury / Stroke

Diffusion sequences use strong MR gradients applied symmetrically about the refo-
cusing pulse to produce signal differences based on the mobility and directionality of
water diffusion, as shown in Figure 13-21. Tissues with more water mobility (normal)
have a greater signal loss than those of lesser water mobility (injury) under the influ-
ence of the diffusion weighted imaging (DWI) gradients.
The in vivo structural integrity of certain tissues (healthy, diseased, or injured) can
be measured by the use of DWI, in which water diffusion characteristics are deter-
mined through the generation of apparent diffusion coefficient (ADC) maps. This
requires two or more acquisitions with different DWI parameters. A low ADC cor-
responds to high signal intensity on a calculated image, which represents restricted
diffusion (Fig. 13-22). ADC maps of the brain and the spinal cord have shown prom-
Copyright © 2011. Wolters Kluwer Health. All rights reserved.

■■FIGURE 13-22 Left. Diffusion weighted image. Right. Calculated ADC image, showing an area of increased
brightness related to restricted mobility of water molecules.

ise in predicting and evaluating pathophysiology before it is visible on conventional

T1- or T2-weighted images. DWI is also a sensitive indicator for early detection
of ischemic injury. Areas of acute stroke show a drastic reduction in the diffusion
coefficient compared with nonischemic tissues. Diagnosis of multiple sclerosis is a
potential application, based on the measurements of the diffusion coefficients in three-
dimensional space.
Various acquisition techniques are used to generate diffusion-weighted contrast.
Standard spin echo and EPI pulse sequences with applied diffusion gradients of high
strength are used. Challenges for DWI are the extreme sensitivity to motion of the
head and brain, which is chiefly caused by the large pulsed gradients required for the
diffusion preparation. Eddy currents are also an issue, which reduce the effectiveness
of the gradient fields, so compensated gradient coils are necessary. Several strategies
have been devised to overcome the motion sensitivity problem, including common
electrocardiographic gating and motion compensation methods.

13.4 Magnetization Transfer Contrast

Magnetization transfer contrast is the result of selective observation of the interaction

between protons in free water molecules and protons contained in the macromolecules
of a protein. Magnetization exchange occurs between the two proton groups because
of coupling or chemical exchange. Because the protons exist in slightly different mag-
netic environments, the selective saturation of the protons in the macromolecule can
be excited separately from the bulk water by using narrow-band RF pulses (because the
Larmor frequencies are different). A transfer of the magnetization from the protons in
the macromolecule partially saturates the protons in bulk water, even though these pro-
tons have not experienced an RF excitation pulse (Fig. 13-23). Reduced signal from the

H H
H H
NH3 O O
H H H H
H HO O
O H H H H H H H H
H H O O
O O
O H H
H H O H H H H
O H H H H O O
H H O O
Protons bound to O

macromolecule

RF Excitation Protons of
(off-resonance pulse) bulk water

~1.5 kHz shift Frequency Spectrum

■■FIGURE 13-23 Magnetization transfer contrast is implemented with an off-resonance RF pulse of about
1,500 Hz from the Larmor frequency. Excitation of hydrogen atoms on macromolecules is transferred via the
hydration layer to adjacent “free-water” hydrogen atoms. A partial saturation of the tissues reduces the sig-
nals that would otherwise compete with signals from blood flow, making this useful for time-of-flight MRA.

adjacent free water protons by the saturation “label” affects only those protons having a
chemical exchange with the macromolecules and improves local image contrast in many
situations by decreasing the otherwise large signal generated by the protons in the bulk
water. This technique is used for anatomic MRI of the heart, the eye, multiple sclerosis,
knee cartilage, and general MRA. Tissue characterization is also possible, because the
image contrast in part is caused by the surface chemistry of the macromolecule and the
tissue-specific factors that affect the magnetization transfer characteristics.
Magnetization transfer contrast pulse sequences are often used in conjunction
with MRA time-of-flight methods. Hydrogen atoms constitute a large fraction of mac-
romolecules in proteins, are tightly bound to these macromolecules, and have a very
short T2 decay with a broad range of resonance frequencies compared to protons in
free water. Selective excitation of these protons is achieved with an off-resonance RF
pulse of approximately 1,500 Hz from the Larmor frequency, causing their satura-
tion. The protons in the hydration layer bound to these molecules are affected by
the magnetization and become partially saturated themselves. MR signals from these
tissues are suppressed, with an impact of reducing the contrast variation of the anat-
omy. As a result, the differential contrast of the flow-enhanced signals is increased,
with overall better image quality angiographic sequence.

13.5 MR Artifacts

Artifacts manifest as positive or negative signal intensities that do not accurately rep-
resent the imaged anatomy. Although some artifacts are relatively insignificant and
are easily identified, others can limit the diagnostic potential of the exam by obscur-
ing or mimicking pathologic processes or anatomy. One must realize the impact
of MR acquisition protocols and understand the etiology of artifact production to
exploit the information they convey.
To minimize the impact of MR artifacts, a working knowledge of MR physics as
well as image acquisition techniques is required. On the one hand, there are many
variables and options available that complicate the decision-making process for MR
image acquisition. On the other, the wealth of choices enhances the goal of achieving
diagnostically accurate images. MR artifacts are classified into three broad areas—
those based on the machine, on the patient, and on signal processing.
Copyright © 2011. Wolters Kluwer Health. All rights reserved.

Machine-Dependent Artifacts
Magnetic field inhomogeneities are either global or focal field perturbations that lead
to the mismapping of tissues within the image, and cause more rapid T2 relaxation.
Distortion or misplacement of anatomy occurs when the magnetic field is not com-
pletely homogeneous. Proper site planning, self-shielded magnets, automatic shim-
ming, and preventive maintenance procedures help to reduce inhomogeneities.
Focal field inhomogeneities arise from many causes. Ferromagnetic objects in or
on the patient (e.g., makeup, metallic implants, prostheses, surgical clips, dentures)
produce field distortions and cause protons to precess at frequencies different from
the Larmor frequency in the local area. Incorrect proton mapping, displacement, and
appearance as a signal void with a peripherally enhanced rim of increased signal are
common findings. Geometric distortion of surrounding tissue is also usually evi-
dent. Even nonferromagnetic conducting materials (e.g., aluminum) produce field
distortions that disturb the local magnetic environment. Partial compensation by
the spin echo (180-degree RF) pulse sequence reduces these artifacts; on the other

hand, the gradient-refocused echo sequence accentuates distortions, since the protons
always experience the same direction of the focal magnetic inhomogeneities within
the patient.

Susceptibility Artifacts
Magnetic susceptibility is the ratio of the induced internal magnetization in a tissue
to the external magnetic field. As long as the magnetic susceptibility of the tissues
being imaged is relatively unchanged across the field of view, then the magnetic field
will remain uniform. Any drastic changes in the magnetic susceptibility will distort
the magnetic field. The most common susceptibility changes occur at tissue-air inter-
faces (e.g., lungs and sinuses), which cause a signal loss due to more rapid dephasing
(T2*) at the tissue-air interface (Fig. 13-24). Any metal (ferrous or not) may have
a significant effect on the adjacent local tissues due to changes in susceptibility and
the resultant magnetic field distortions. Paramagnetic agents exhibit a weak magne-
tization and increase the local magnetic field causing an artifactual reduction in the
surrounding T2* relaxation.
Magnetic susceptibility can be quite helpful in some diagnoses. Most notable is the
ability to diagnose the age of a hemorrhage based on the signal characteristics of the
blood degradation products, which are different in the acute, subacute, and chronic
phases. Some of the iron-containing compounds (deoxyhemoglobin, methemoglobin,
hemosiderin, and ferritin) can dramatically shorten T1 and T2 relaxation of nearby pro-
tons. The amount of associated free water, the type and structure of the iron-containing
molecules, the distribution (intracellular versus extracellular), and the magnetic field
strength all influence the degree of relaxation effect that may be seen. For example,
in the acute stage, T2 shortening occurs due to the paramagnetic susceptibility of the
organized deoxyhemoglobin in the local area, without any large effect on the T1 relax-
ation time. When red blood cells lyse during the subacute stage, the hemoglobin is
altered into methemoglobin, and spin-lattice relaxation is enhanced with the formation
of a hydration layer, which shortens T1 relaxation, leading to a much stronger signal
Copyright © 2011. Wolters Kluwer Health. All rights reserved.

■■FIGURE 13-24 Susceptibility artifacts due to dental fillings are shown in the same axial image slice. Left.
Axial T2-weighted fast spin echo image illustrates significant suppression of susceptibility artifacts with
180-degree refocusing pulse. Right. Axial T2*-weighted gradient echo image illustrates significant image void
exacerbated by the gradient echo, where external inhomogeneities are not canceled in the reformed echo.

on T1-weighted images. Increased signal intensity on T1-weighted images not found

in the acute stage of hemorrhage identifies the subacute stage. In the chronic stage,
hemosiderin, found in the phagocytic cells in sites of previous hemorrhage, disrupts
the local magnetic homogeneity, causes loss of signal intensity, and leads to signal void,
producing a characteristic dark rim around the hemorrhage site.
Gadolinium-based contrast agents (paramagnetic characteristics shorten T2 and
hydration layer interactions shorten T1) are widely used in MRI. Tissues that uptake
gadolinium contrast agents exhibit shortened T1 relaxation and demonstrate increased
signal on T1-weighted images. Although focal inhomogeneities are generally consid-
ered problematic, there are certain physiologic and anatomic manifestations that can
be identified and diagnostic information obtained.

Gradient Field Artifacts

Magnetic field gradients spatially encode the location of the signals emanating from
excited protons within the volume being imaged. Proper reconstruction requires lin-
ear, matched, and properly sequenced gradients. The slice select gradient defines the
volume (slice). Phase and frequency encoding gradients provide the spatial informa-
tion in the other two dimensions.
Since the reconstruction algorithm assumes ideal, linear gradients, any deviation
or temporal instability will be represented as a distortion. Gradient strength has a
tendency to fall off at the periphery of the FOV. Consequently, anatomic compres-
sion occurs, especially pronounced on coronal and sagittal images having a large
FOV, typically greater than 35 cm (Fig. 13-25). Minimizing the spatial distortion
entails either reducing the FOV by lowering the gradient field strength or by hold-
ing the gradient field strength and number of samples constant while decreasing the
frequency bandwidth. Of course, gradient calibration is part of a continuous quality
control (QC) checklist, and geometric accuracy must be periodically verified.
Anatomic proportions may simulate abnormalities, so verification of pixel dimen-
sions in the PEG and FEG directions are necessary. If the strength of the FEG and the
strength of the largest PEG are different, the height or width of the pixels can become dis-
torted and produce inaccurate measurements. Ideally, the phase and frequency encod-
ing gradients should be assigned to the smaller and larger dimensions of the object,
respectively, to preserve spatial resolution while limiting the number of phase encoding
steps. In practice, this is not always possible, because motion artifacts or high-intensity
Copyright © 2011. Wolters Kluwer Health. All rights reserved.

Accurate
geometry

Ideal
Actual
Distorted

FOV

■■FIGURE 13-25 Gradient nonlinearity causes image distortions by mis-mapping anatomy. In the above
examples, the strength of the gradient at the periphery is less than the ideal (orange line versus black line). This
results in a compression of the imaged anatomy, with inaccurate geometry (images with orange border). For
comparison, images acquired with linear corrections are shown above.

signals that need to be displaced away from important areas of interest after an initial
scan might require swapping the frequency and phase encode gradient directions.

RF Coil Artifacts
RF surface coils produce variations in uniformity across the image caused by RF
excitation variability, attenuation, mismatching, and sensitivity falloff with distance.
Proximal to the surface coil, receive signals are intense, and with distance, signal
intensity is attenuated, resulting in grayscale shading and loss of brightness in the
image. Nonuniform image intensities are the all-too-frequent result. Also, compensa-
tion for the disturbance of the magnetic field by the patient is typically compensated
by an automatic shimming calibration. When this is not performed, or performed
inadequately, a significant negative impact on image quality occurs. Examples of vari-
able response are shown in Figure 13-26.
Other common artifacts from RF coils occur with RF quadrature coils (coils that
simultaneously measure the signal from orthogonal views) that have two separate ampli-
fier and gain controls. If the amplifiers are imbalanced, a bright spot in the center of the
image, known as a center point artifact, arises as a “0 frequency” direct current offset.
Variations in gain between the quadrature coils can cause ghosting of objects diagonally
in the image. The bottom line for all RF coils is the need for continuous measurement
and consistent calibration of their response, so that artifacts are minimized.

RF Artifacts
RF pulses and precessional frequencies of MRI instruments occupy the same fre-
quencies of common RF sources, such as TV and radio broadcasts, electric motors,
fluorescent lights, and computers. Stray RF signals that propagate to the MRI antenna
can produce various artifacts in the image. Narrow-band noise creates noise pat-
terns perpendicular to the frequency encoding direction. The exact position and
spatial extent depends on the resonant frequency of the imager, applied gradient
field strength, and bandwidth of the noise. A narrow band pattern of black/white
Copyright © 2011. Wolters Kluwer Health. All rights reserved.

Coil close to skin Inadequate shimming for fat saturation

■■FIGURE 13-26 Signal intensity variations occur when surface RF receive coils are too close to the skin, as exem-
plified by the MR breast image on the left. With inadequate shimming calibration, saturation pulses for adipose
tissue in the breast is uneven, causing a significant variation in the uniformity of the reconstructed image. From
Hendrick RE, Breast MRI: fundamentals and technical aspects. New York, NY: Springer, 2007. By permission.

alternating noise produces a “zipper” artifact. Broadband RF noise disrupts the image
over a much larger area of the reconstructed image with diffuse, contrast-reducing
“herringbone” artifacts. Appropriate site planning and the use of properly installed RF
shielding materials (e.g., a Faraday cage) reduce stray RF interference to an accept-
ably low level. An example RF zipper artifact is shown in Figure 13-44.
RF energy received by adjacent slices during a multislice acquisition excite and
saturate protons in adjacent slices, chiefly due to RF pulses without sharp off/on/
off transitions. This is known as cross-excitation. On T2-weighted images, the slice-
to-slice interference degrades the SNR; on T1-weighted images, the extra partial
saturation reduces image contrast by reducing longitudinal recovery during the TR
interval. A typical truncated “sinc” RF profile and overlap areas in adjacent slices are
shown in Figure 13-27. Interslice gaps reduce the overlap of the profile tails, and
pseudo-rectangular RF pulse profiles reduce the spatial extent of the tails. Important
anatomic findings could exist within the gaps, so slice interleaving is a technique to
mitigate cross-excitation by reordering slices into two groups with gaps. During the
first half of the TR, the first slices are acquired (slices 1 to 5), followed by the second
group of slices that are positioned in the gap of the first group (slices 6 to 10). This
method reduces cross-excitation by separating the adjacent slice excitations in time.
The most effective method is to acquire two independent sets of gapped multislice
images, but the image time is doubled. The most appropriate solution is to devise RF
pulses that approximate a rectangular profile; however, the additional time necessary
for producing such an RF pulse can be prohibitive.

K-Space Errors
Errors in k-space encoding affect all areas of the reconstructed image, and cause
the artifactual superimposition of wave patterns across the FOV. Each individual
pixel value in k-space contributes to all pixel values in image space as a frequency
harmonic with a signal amplitude. One bad pixel introduces a significant artifact,
rendering the image suboptimal, as shown in Figure 13-28.

■■FIGURE 13-27 Top. Poor pulse pro- "sinc" “computer -optimized” "rectangular"
files are caused by truncated RF pulses, profile profile profile
and resulting profile overlap causes
unwanted partial saturation in adjacent
Copyright © 2011. Wolters Kluwer Health. All rights reserved.

slices, with a loss of SNR and CNR. Opti-

mized pulses are produced by consider-
ing the tradeoff of pulse duration versus
excitation profile. Bottom. Reduction of
cross-excitation is achieved with inter- overlapped area
slice gaps, but anatomy at the gap loca-
tion might be missed. An interleaving 1 2 3 4 5
technique acquires the first half of the
images with an interslice gap, and the
second half of the images are positioned Interslice gap
in the gaps of the first images. The sep-
aration in time reduces the amount of
contrast reducing saturation of the adja-
cent slices. 1 2 3 4 5
6 7 8 9 10

Interleaving

Bad pixel in k-space Resultant image

■■FIGURE 13-28 A single bad pixel in k-space causes a significant artifact in the reconstructed image. The
bad pixel is located at kx  2, ky  3, which produces a superimposed sinusoidal wave on the spatial domain
image as shown above.

Motion Artifacts
The most ubiquitous and noticeable artifacts in MRI arise with patient motion, including
voluntary and involuntary movement, and flow (blood, CSF). Although motion artifacts
are not unique to MRI, the long acquisition time of certain MRI sequences increases the
probability of motion blurring and contrast resolution losses. Motion artifacts occur
mostly along the phase encode direction, as adjacent phase encoding measurements in
k-space are separated by a TR interval that can last 3,000 ms or longer. Even very slight
motion can cause a change in the recorded phase variation across the FOV throughout
the MR acquisition sequence. Examples of motion artifacts are shown in Figure 13-29.
The frequency encode direction is less affected, especially by periodic motion, since the
evolution of the echo signal, frequency encoding, and sampling occur simultaneously
over several milliseconds. Ghost images, which are faint copies of the image displaced
along the phase encode direction, are the visual result of patient motion.
Several techniques can compensate for motion-related artifacts. The simplest
technique transposes the PEG and FEG to relocate the motion artifacts out of the
Copyright © 2011. Wolters Kluwer Health. All rights reserved.

FEG

PEG

PEG FEG
PEG
FEG

PEG PEG FEG FEG

■■FIGURE 13-29 Motion artifacts, particularly of flow patterns, are most always displayed in the phase encode
gradient direction. Slight changes in phase produce multiple ghost images of the anatomy, since the variation
in phase caused by motion can be substantial between excitations.

region of diagnostic interest with the same pulse sequences. This does not reduce the
magnitude of the artifacts, however, and often there is a mismatch when placing the
PEG along the long axis of a rectangular FOV (e.g., an exam of the thoracic spine)
in terms of longer examination times or a significant loss of spatial resolution or of
SNR.
There are other motion compensation methods:
1. Cardiac and respiratory gating—signal acquisition at a particular cyclic location
synchronizes the phase changes applied across the anatomy (Fig. 13-30).
2. Respiratory ordering of the phase encoding projections based on location within the
respiratory cycle. Mechanical or video devices provide signals to monitor the cycle.
3. Signal averaging to reduce artifacts of random motion by making displaced sig-
nals less conspicuous relative to stationary anatomy.
4. Short TE spin echo sequences (limited to proton density, T1-weighted scans, frac-
tional echo acquisition, Fig. 13-3). Note: Long TE scans (T2 weighting) are more
susceptible to motion.
5. Gradient moment nulling (additional gradient pulses for flow compensation) to
help rephase protons that are dephased due to motion. Most often, these techniques
require a longer TE and are more useful for T2-weighted scans (Fig. 13-18).
6. Presaturation pulses applied outside the imaging region to reduce flow artifacts
from inflowing protons, as well as other patient motions that occur in the periph-
ery (Fig. 13-12).
7. Multiple redundant sampling in the center of k-space (e.g., propeller) to identify
and remove those sequences contributing to motion, without deleteriously affect-
ing the image (Fig. 13-8).

Chemical Shift Artifacts of the First Kind

There are two types of chemical shift artifacts that affect the display of anatomy due
to the precessional frequency differences of protons in fat versus protons in water.
Chemical shift refers to the resonance frequency variations resulting from intrinsic

Non Gated

Velocity 5 6 1 2 3 4
4 3
1 6
1 2 3 4
2 3 4 5 5 6 1 2

ECG Gated

ECG Signal

3 3
Velocity 2 4 2 4 2 3
1 5 1 5 6 1
6

■■FIGURE 13-30 Motion artifacts occur when data is acquired without consideration of physiologic periodic-
ity. Top. The electrocardiogram measures the R-wave at each heartbeat, but data acquisition proceeds in a
linear fashion without regard to reproducibility. The result is a set of images degraded with motion artifact,
with diagnostic usefulness marginal, at best. Bottom. Acquisition of images proceeds with the detection of
the R-wave signal and synchronization of the collection of image data in a stepwise fashion over the period
between R-waves. A reduced number of images or extended acquisition time is required to collect the data.
Bushberg, Jerrold T., et al. Essential Physics of Medical Imaging, Wolters Kluwer Health, 2011. ProQuest Ebook Central,
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Chapter 13 • Magnetic Resonance Imaging 481

magnetic shielding of anatomic structures. Molecular structure and electron orbital

characteristics produce fields that shield the main magnetic field and give rise to dis-
tinct peaks in the MR spectrum. In the case of proton spectra, peaks correspond to
water and fat, and in the case of breast imaging, silicone material is another material
to consider. Lower frequencies of about 3.5 parts per million for protons in fat and
5.0 parts per million for protons in silicone occur, compared to the resonance frequency
of protons in water (Fig. 13-31). Since resonance frequency increases linearly with field
strength, the absolute difference between the fat and water resonance also increases,
making high field strength magnets more susceptible to chemical shift artifact.
Data acquisition methods cannot directly discriminate a frequency shift due to
the application of a frequency encode gradient or a chemical shift artifact. Water and
fat differences therefore cannot be distinguished by the frequency difference induced
by the gradient. The protons in fat resonate at a slightly lower frequency than the
corresponding protons in water, and cause a shift in the anatomy (misregistration of
water and fat moieties) along the frequency encode gradient direction.
A sample calculation in the example below demonstrates frequency variations in
fat and water for two different magnetic field and gradient field strengths:
Chemical shift artifact numerical calculation for field strength, with a 3.5-ppm
(3.5  106) variation in resonance frequency between fat and water results in the
following frequency differences:
1.5 T: 63.8  106 Hz  3.5  10− 6  223 Hz

3.0 T:127.7  106 Hz  3.5  10− 6  447 Hz

Thus, the chemical shift is more severe for higher field strength magnets.
Chemical shift artifact numerical calculation for gradient strength results in the
following numerical calculations for a 25-cm (0.25 m) FOV, 256  256 matrix:
Low gradient strength: 2.5 mT/m  0.25 m  0.000625 T variation, gives frequency
range of 0.000625 T  42.58 MHz/T  26.6 kHz across FOV and 26.6 kHz/256
pixels  104 Hz/pixel
High gradient strength: 10 mT/m  0.25 m  0.0025 T variation, gives frequency
range of 0.0025 T  42.58 MHz/T  106.5 kHz across FOV and 106.5 kHz/256
pixels  416 Hz/pixel.
Thus, a chemical shift occurrence is more severe for lower gradient strengths, since
Copyright © 2011. Wolters Kluwer Health. All rights reserved.

displacement will occur over a large number of pixels. With a higher gradient
strength, water and fat are more closely contained within the broader pixel boundary
bandwidths. Normal and low bandwidth images are illustrated in Figure 13-32.

silicone Chemical Shift ■■FIGURE 13-31 Chemical shift refers to

water the slightly different precessional frequen-
fat
3-4 ppm difference, fat cies of protons in different materials or tis-
~5 ppm difference, silicone sues. The shifts (in ppm) are referenced to
frequency water for fat and silicone. Fat chemical shift
artifacts are represented by a shift of water
and fat in the images of anatomical struc-
+ + ture, mainly in the frequency encode gradi-
water water ent direction. Swapping the PEG and the
FEG PEG FEG will cause a shift of the fat and water
fat fat components of the tissues in the image.

- -
+ - + -
PEG FEG
Bushberg, Jerrold T., et al. Essential Physics of Medical Imaging, Wolters Kluwer Health, 2011. ProQuest Ebook Central,
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482 Section II • Diagnostic Radiology

High Bandwidth Low Bandwidth

FEG

PEG
■■FIGURE 13-32 MR images of the breast, containing glandular and adipose tissue, are acquired under a high
bandwidth (32 kHz) and a low bandwidth (4 kHz), illustrating the more severe chemical shift with low readout
gradient strength and bandwidth. (Reprinted by permission, Hendrick RE. Breast MRI: fundamentals and tech-
nical aspects. New York, NY: Springer, 2007.)

RF bandwidth and gradient strength considerations can mitigate chemical shift arti-
facts. While higher gradient strength can confine the chemical shift of fat within the pixel
bandwidth boundaries, a significant SNR penalty occurs with the broad RF bandwidth
required to achieve a given slice thickness. A more widely used method is to use lower
gradient strengths and narrow bandwidths in combination with off-resonance “chemi-
cal presaturation” RF pulses to minimize the fat (or the silicone) signal in the image (Fig.
13-33). Another alternative is to use STIR techniques to eliminate the signals due to fat
at the “bounce point.” Swapping the phase and frequency gradient directions or chang-
ing the polarity of the frequency encode gradient can displace chemical shift artifacts
from a specific image region, even though the chemical shift displacement still exists.
Identification of fat in a specific anatomic region is easily discerned from the chemical
shift artifact displacement caused by changes in FEG/PEG gradient directions.

Chemical Shift Artifacts of the Second Kind

Chemical shift artifacts of the second kind occur with GE images, resulting from the rephas-
ing and dephasing of the echo in the same direction relative to the main magnetic field.
Signal appearance is dependent on the selection of TE. This happens because of construc-
Copyright © 2011. Wolters Kluwer Health. All rights reserved.

tive (in phase) or destructive (out of phase) transverse magnetization events that occur
periodically due to the difference in precessional frequencies. At 1.5 T, the chemical shift

■■FIGURE 13-33 The left image of the lumbar

spine is Spin Echo T1 weighted, TR  450 ms,
TE  14 ms. The right image is T1 weighted
with chemical fat saturation pulses, TR  667
ms, TE  8 ms. In both images, the FEG is verti- Water
cally oriented. Fat
FEG

2.5 Water & Fat In-Phase Every 4.4 ms

TE=
1.5
7 ms

1 Fat Water

0.5 TE =
9 ms
0
0 5 10 15 TE (ms)

Water & Fat Out-of-Phase at 2.2, 6.6, 11.0 ms, …

■■FIGURE 13-34 For GE image sequences, signal intensity of the transverse magnetization vector due to
the 220 Hz lower precessional frequency of fat protons, where in-phase magnetization occurs every 4.4 ms
(1/220 s−1), and out-of-phase magnetization occurs every 4.4 ms shifted by ½ cycle (2.2 ms). Signal intensity is
dependent on the selection of TE, as shown above.

is 220 Hz, and the periodicity of each peak (in phase) between water and fat occurs at 0,
4.5, 9.0, 13.5, …. ms, and each valley (out of phase) at 2.25, 6.75, 11.0, …. ms, as shown
in Figure 13-34. Thus, selection of TE at 9 ms will lead to a constructive addition of water
and fat, and TE at 7 ms will lead to a destructive addition of water and fat. The in-phase
timing will lead to a conventional chemical shift image of the first kind, while the out-of-
phase timing will lead to a chemical shift image of the second kind, manifesting a dark rim
around heterogeneous water and fat anatomical structures, shown in Figure 13-35.

Ringing Artifacts
Ringing artifact (also known as Gibbs phenomenon) occurs near sharp boundaries
and high-contrast transitions in the image, and appears as multiple, regularly spaced
parallel bands of alternating bright and dark signal that slowly fades with distance.

FEG
PEG

■■FIGURE 13-35 Breast MRI images show the effect of selecting a specific TE for a GE acquisition. On the left,
chemical shift of the “first kind” is shown with TE  9 ms and water and fat in phase for transverse magneti-
zation, shifted only due to the intrinsic chemical shift differences of fat and water. On the right, chemical shift
of the second kind is additionally manifested with TE  7 ms, due to fat and water being out of phase, creating
a lower signal at all fat-water interfaces, and resulting in reduced intensity. (Reprinted by permission, Hendrick
RE. Breast MRI: fundamentals and technical aspects. New York, NY: Springer, 2007.)
Bushberg, Jerrold T., et al. Essential Physics of Medical Imaging, Wolters Kluwer Health, 2011. ProQuest Ebook Central,
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484 Section II • Diagnostic Radiology

The cause is the insufficient sampling of high frequencies inherent at sharp disconti-
nuities in the signal. Images of objects can be reconstructed from a summation of sinu-
soidal waveforms of specific amplitudes and frequencies, as shown in Figure 13-36 for
a simple rectangular object. In the figure, the summation of frequency harmonics, each
with a particular amplitude and phase, approximates the distribution of the object, but
initially does very poorly, particularly at the sharp edges. As the number of higher fre-
quency harmonics increase, a better estimate is achieved, although an infinite number
of frequencies are theoretically necessary to reconstruct the sharp edge perfectly.
In the MR acquisition, the number of frequency samples is determined by the
number of pixels (frequency, kx, or phase, ky, increments) across the k-space matrix.
For 256 pixels, 128 discrete frequencies are depicted, and for 128 pixels, 64 discrete
frequencies are specified (the k-space matrix is symmetric in quadrants and dupli-
cated about its center). A lack of high-frequency signals causes the “ringing” at sharp
transitions described as a diminishing hyper- and hypointense signal oscillation from
the transition. Ringing artifacts are thus more likely for smaller digital matrix sizes
(Fig. 13-37, 256 versus 128 matrix). Ringing artifact commonly occurs at skull/brain
interfaces, where there is a large transition in signal amplitude.

A. 2
B. 2

1 1
Frequency Spatial
0 0
harmonics domain
-1 -1
1st rectangle
-2 -2
estimate
2 2

1 1

1st + 3rd 0 0

-1 -1

-2 -2

2 2

1 1

1st + 3rd + 5th 0 0

-1 -1

-2 -2

2 2

1 1

1st + 3rd + 5th + 7th 0 0

-2 -2

■■FIGURE 13-36 The synthesis of a spa- C. Sharp transition in MR image:

tial object occurs by the summation of
frequency harmonics in the MR image.
A. Left column: frequency harmonics that
estimate a rectangle function with progres-
sively higher frequencies and lower ampli- “Ringing”
tudes are shown. B. Middle column: As
higher frequency harmonics are included, n = 128
the summed result more faithfully rep- samples
resents the object shape, in this example
a rectangle with two vertical edges. The
number of frequencies encoded in the MR
image is dependent on the matrix size.
C. Right column: A sharp transition bound-
ary in an MR image is represented with 256 n=256
samples better than with128 samples (fre- samples
quency harmonics in k-space). The amount
of ringing caused by insufficient sampling is
reduced with a larger number of samples.
Bushberg, Jerrold T., et al. Essential Physics of Medical Imaging, Wolters Kluwer Health, 2011. ProQuest Ebook Central,
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Chapter 13 • Magnetic Resonance Imaging 485

256 (vertical) × 128 (horizontal) 256 × 256 ■■FIGURE 13-37 Example of ringing
artifacts caused by a sharp signal tran-
“ringing” sition at the skull in a brain image for
a 256  128 matrix (left) along the
short (horizontal) axis, and the elimi-
nation of the artifact in a 256  256
matrix (right). The short axis defines
the PEG direction.

Wraparound Artifacts
The wraparound artifact is a result of the mismapping of anatomy that lies out-
side of the FOV but within the slice volume. The anatomy is usually displaced to
the opposite side of the image. It is caused by nonlinear gradients or by under-
sampling of the frequencies contained within the returned signal envelope. For
the latter, the sampling rate must be twice the maximal frequency that occurs in
the object (the Nyquist sampling limit). Otherwise, the Fourier transform can-
not distinguish frequencies that are present in the data above the Nyquist fre-
quency limit, and instead assigns a lower frequency value to them (Fig. 13-38).
Frequency signals will “wraparound” to the opposite side of the image, masquer-
ading as low-frequency (aliased) signals.
In the frequency encode direction, a low-pass filter can be applied to the acquired
time domain signal to eliminate frequencies beyond the Nyquist frequency. In the
phase encode direction, aliasing artifacts can be reduced by increasing the number
of phase encode steps (the trade-off is increased image time). Another approach is to
move the region of anatomic interest to the center of the imaging volume to avoid the

+
FOV

A B C
-
A

Wrap-around
Sampling rate

■■FIGURE 13-38 Left. Wraparound artifacts are caused by aliasing. Shown is a fixed sampling rate and net pre-
cessional frequencies occurring at position A and position B within the FOV that have identical frequencies but dif-
ferent phase. If signal from position C is at twice the frequency of B and insufficiently sampled, the same frequency
and phase will be assigned to C as that assigned to A, and therefore will appear at that location. Right. A wrap-
around artifact example displaces anatomy from one side of the image (or outside of the FOV) to the other side.
Bushberg, Jerrold T., et al. Essential Physics of Medical Imaging, Wolters Kluwer Health, 2011. ProQuest Ebook Central,
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486 Section II • Diagnostic Radiology

overlapping anatomy, which usually occurs at the periphery of the FOV. An “antialias-
ing” saturation pulse just outside of the FOV is yet another method of eliminating
high-frequency signals that would otherwise be aliased into the lower frequency spec-
trum. This example of wrap-around artifact is easy to interpret. In some cases, the
artifact is not as well delineated (e.g., the top of the skull wrapping into the brain).

Partial Volume Artifacts

Partial volume artifacts arise from the finite size of the voxel over which the signal is
averaged. This results in a loss of detail and spatial resolution. Reduction of partial
volume artifacts is accomplished by using a smaller pixel size and/or a smaller slice
thickness. With a smaller voxel, the SNR is reduced for a similar imaging time, result-
ing in a noisier signal with less low-contrast sensitivity. Of course, with a greater NEX
(averages), the SNR can be maintained, at the cost of longer imaging time.

13.6 Magnetic Resonance Spectroscopy

Magnetic resonance spectroscopy (MRS) is a method to measure tissue chemistry (an

“electronic” biopsy) by recording and evaluating signals from metabolites by iden-
tifying metabolic peaks caused by frequency shifts (in parts per million, ppm) rela-
tive to a frequency standard. In vivo MRS can be performed with 1H (proton), 23Na
(sodium), and 31P (phosphorus) nuclei, but proton spectroscopy provides a much
higher SNR and can be included in a conventional MRI protocol with about 10 to 15
min extra exam time. Uses of MRS include serial evaluation of biochemical changes
in tumors, analyzing metabolic disorders, infections and diseases, as well as evalua-
tion of therapeutic oncology treatments for tumor recurrence versus radiation dam-
age. Early applications were dedicated to brain disorders, but now breast, liver, and
prostate MRS are also performed. Correlation of spectroscopy results and MR images
are always advised before making a final diagnosis.
In MRS, signals are derived from the amplitude of proton metabolites in targeted
tissues. In these metabolites, chemical shifts occur due to electron cloud shielding
of the nuclei, causing slightly different resonance frequencies, which exist in a fre-
quency range between water and fat. The very small signal amplitudes of the metabo-
lites require suppression of the extremely large (10,000 times higher) amplitudes
Copyright © 2011. Wolters Kluwer Health. All rights reserved.

due to bulk water and fat protons, as shown in Figure 13-39. This is achieved by
using specific chemical saturation techniques, such as CHESS (Chemical Shift-Selec-
tive) or STIR (see Chapter 12). In many cases, the areas evaluated are away from fat
structures, and only bulk water signal suppression is necessary; however, in organs
such as the liver and the breast, suppression of both fat and water are required. Once
the water and fat signals are suppressed, localization of the targeted area volume is
achieved by either a single voxel or multivoxel technique.
Single voxel MRS sampling areas, covering a volume of about 1 cm3 are delin-
eated by a STEAM (Stimulated echo acquisition mode) or a PRESS (Point Resolved
Spectroscopy) sequence. The STEAM method uses a 90-degree excitation pulse and
90-degree refocusing pulse to collect the signal in conjunction with gradients to
define each dimension of the voxel. The PRESS sequence uses a 90-degree excitation
and 180-degree refocusing pulse in each direction. STEAM achieves shorter echo
times and superior voxel boundaries, but with lower SNR. After the voxel data are col-
lected, a Fourier transform is applied to separate the composite signal into individual
frequencies, which are plotted as a trace for a normal brain spectrum (Fig. 13-40).
The resulting line widths are based on homogeneity of the main magnetic field as
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Chapter 13 • Magnetic Resonance Imaging 487

Water peak ■■FIGURE 13-39 MRS metabolites of

interest in comparison to the water and
fat peaks commonly used for imaging.
In order to isolate the very small signals,
Relative Amplitude

Metabolites
chemical saturation of the water (and fat
of interest
when present) signal is essential.

Fat peak

5 4 3 2 1 0
Frequency shift (ppm)

well as the magnetic field strength. Higher field strengths (e.g., 3.0 T) will improve
resolution of the peaks and corresponding SNR.
Multivoxel MRS uses a CSI (Chemical Shift Imaging) technique to delineate multiple
voxels of approximately 1 cm3 volume in 1, 2, or 3 planes over a rectangular block of sev-
eral centimeters, achievable with more sophisticated equipment and longer scan times.
This is followed by MRSI (Magnetic Resonance Spectroscopic Imaging) where the signal
intensity of a single metabolite in each voxel is color encoded for each voxel according
to concentration and the generated parameter maps superimposed on the anatomical
MR image. In practice, the single voxel technique is used to make the initial diagnosis
because the SNR is high and all metabolites are represented in the MRS trace. Then, a
multivoxel acquisition to assess the distribution of a specific metabolite is performed.
Proton MRS can be performed with short (20 to 40 ms), intermediate (135 to
145 ms), or long (270 to 290 ms) echo times. For short TE, numerous resonances
from metabolites of lesser importance (with shorter T2) can make the spectra more
difficult to interpret, and with long echo times, SNR losses are too severe. Therefore,
most MRS acquisitions use a TE of approximately 135 ms at 1.5 T. Metabolites of
interest for brain spectroscopy are listed in Table 13-2.
Applications of MRS are achieved through the interpretation of the spectra that
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are obtained from the lesion, from its surroundings, and presumably healthy tissue in
RadioGraphics 2006; 26:S173–S189

MR Spectrum from anaplastic oligoastrocytoma Choline / Creatine ratio map

■■FIGURE 13-40 Left: Intermediate echo (TE=135 ms) single voxel spectrum is shown, positioned over an anaplastic
oligoastrocytoma brain lesion. Note the elevated Choline peak and lowered Creatine and NAA peaks. Right: Multi-
voxel spectrum is color coded to the Choline / Creatine ratio, illustrating the regional variation of the metabolites cor-
responding to tumor. From Al-Okaili RN, Krejza J, Wang S, Woo JH, Melhem ER. Advanced MR Imaging Techniques
in the Diagnosis of Intraaxial Brain Tumors in Adults. Radiographics 2006; 26: S173-S189. By permission.
Bushberg, Jerrold T., et al. Essential Physics of Medical Imaging, Wolters Kluwer Health, 2011. ProQuest Ebook Central,
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488 Section II • Diagnostic Radiology

TABLE 13-2 METABOLITES IN MRS AT 1.5 T

PROPERTIES/SIGNIFICANCE
ABBREVIATION METABOLITE SHIFT (PPM) IN THE BRAIN
Cho Phosphocholine 3.22 Membrane turnover, cell
proliferation
Cr Creatine 3.02 and 3.93 Temporary store for
energy-rich phosphates
NAA N-acetyl-l-aspartate 2.01 Presence of intact glioneu-
ral structures
Lactate 1.33 (inverted) Anaerobic glycolysis
Lipids Free fatty acids 1.2–1.4 Necrosis

the same scan. Main criteria include the presence or absence of pathologic metabo-
lites (lactate or lipids) and the relationships between the concentrations of choline,
creatine, and NAA as ratios. Spectra are usually scaled to the highest peak, and y-axis
values will usually differ between measurements, so caution must be observed to
avoid potential misdiagnoses.
In a tumor, high cell turnover causes an increase in choline concentration along
with a corresponding depression of the NAA peak caused by the loss of healthy
glioneural structures. In addition, the creatine peak may also be reduced depending
on the energy status of the tumor; it is often used to serve as an internal reference
for calculating ratios of metabolites. When a lipid peak is observed, this is a sign of
hypoxia and the likelihood of a high-grade malignancy. Table 13-3 lists qualitative
findings for MRS spectroscopy in evaluating brain tumors for the ratios of NAA/Cr,
NAA/Cho, and Cho/Cr. Examples of single voxel and multivoxel spectra are shown
in Figure 13-40, illustrating the use of the spectral peaks for diagnostic interpretation
of the ratios, and a MRSI color-encoded graphic display of the spatial distribution
of findings. There is certainly much more than determining ratios, and differential
diagnoses are often clouded by indistinct peaks, poor SNR, and tumor heterogeneity,
among other causes. MRS at 3 T field strength enjoys much better SNR, improved
spectral resolution, and faster scans. Because of the higher spectral resolution, famil-
iar single target peaks at 1.5 T become a collection of peaks at 3 T.
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13.7 Ancillary Components

Ancillary components are necessary for the proper functioning of the MR system.
Shim coils are active or passive magnetic field devices that are used to adjust the main
magnetic field and to improve the homogeneity in the sensitive central volume of the

TABLE 13-3 RATIOS OF METABOLITE PEAKS IN

MRS INDICATING “NORMAL” AND
“ABNORMAL” STATUS
METABOLITE RATIO NORMAL ABNORMAL
NAA/Cr 2.0 1.6
NAA/Cho 1.6 1.2
Cho/Cr 1.2 .1.5

scanner. Gradient coils, as previously discussed, are wire conductors that produce a
linear superimposed gradient magnetic field on the main magnetic field. The gradient
coils are located inside the cylinder of the magnet, and are responsible for the banging
noise one hears during imaging. This noise is caused by the flexing and torque experi-
enced by the gradient coil from the rapidly changing magnetic fields when energized.

Radiofrequency Coils
A wide variety of transmit and receive coils complement a MR scanner. RF transmit-
ter coils create an oscillating secondary magnetic field formed by passing an alter-
nating current through a loop of wire. To accomplish excitation and resonance, the
created secondary B1 field must be arranged at right angles to the main magnetic field,
B0. In an air core design with a horizontal field, the RF coil secondary field should
be in the transverse or vertical axes, as the B1 field is created perpendicular to the
transmit coils themselves. RF transmitter coils are therefore oriented above, below, or
at the sides of the patient, and are usually cylindrical. In most systems, the body coil
contained within the bore of the magnet is most frequently used, but also transmitter
coils for the head, extremity, and some breast coils are coupled to a receiver coil.
Very often, transmit and receive functions are separated to handle the variety of
imaging situations that arise, and to maximize the SNR for an imaging sequence.
All RF receiver coils must resonate and efficiently store energy at the Larmor fre-
quency. This is determined by the inductance and capacitance properties of the coil.
RF transmit and receive coils need to be tuned prior to each acquisition and matched
to accommodate the different magnetic inductance of each patient. Receiver coils
must be properly placed to adequately detect the MR signal.
Proximity RF coils include volume or bird-cage coils, the design of choice for brain
imaging, the single-turn solenoid for imaging the extremities and the breasts, and the
saddle coil. These coils are typically operated as both a transmitter and receiver of RF
energy (Fig. 13-41). Volume coils encompass the total area of the anatomy of inter-
est and yield uniform excitation and SNR over the entire imaging volume. However,
because of their relatively large size, images are produced with lower SNR than other
types of coils. Enhanced performance is obtained with a process known as quadrature
excitation and detection, which enables the energy to be transmitted and the signals to
be received by two pairs of coils oriented at right angles, either electronically or physi-
cally. This detector manages two simultaneous channels known as the real (records
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MR information in phase with a reference signal) and the imaginary (records MR infor-
mation 90 degree out of phase with the reference signal) channels, and increases the
SNR up to a factor of 2 . If imbalances in the offset or gain of these detectors occur,
then artifacts will be manifested, such as a “center point” artifact.
Surface coils are used to achieve high SNR and high resolution when imaging
anatomy near the surface of the patient, such as the spine. They are typically receive-
only designs, and are usually small and shaped for a specific imaging exam and
for patient comfort. The received signal sensitivity, however, is limited to the vol-
ume located around the coil at a depth into the patient equal to the radius of the
coil, which causes a loss of signal with depth. There are now intracavitary coils for
endorectal, endovascular, endovaginal, esophageal, and urethral local imaging, and
can be used to receive signals from deep within the patient. In general, a body coil is
used to transmit the RF energy and the local coil is used to receive the MR signal.
Phased array coils consisting of multiple coils and receivers are made of several
overlapping loops, which extend the imaging FOV in one direction (Fig. 13-41). The

■■FIGURE 13-41 Radiofrequency surface coils improve image quality and SNR for specific examinations. Upper
left is a dedicated head and neck coil. Upper right is a dedicated head coil; the lower left and lower right images
illustrate the two components of an 8 channel phased array coil for body imaging.

small FOV of each individual coil provides excellent SNR and resolution, and each
is combined to produce a composite image with the advantages of the local surface
coil, so that all data can be acquired in a single sequence. Phased array coils for the
spine, pelvis, breast, cardiac, and temperomandibular joint applications are com-
monly purchased with an MR system for optimal image quality.
Multi-channel encoding coils with as many as N  32 elements allow for detection
and encoding based upon the detection of a sensitivity map of the signals near the coil.
These coils are used in parallel imaging to fill N multiple lines of k-space per TR interval,
by assigning certain coil responses to specific regions as the data are acquired simulta-
neously and using software to link them electronically. By filling k-space quicker, the
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scan time can be reduced by the number of elements in the coil. However, since each
line of k-space is encoded by separate coils, the gap between each line for a specific coil
is N times greater than if k-space had been filled normally. Since the FOV dimension
in the phase encode direction is inversely proportional to the spacing, the size of the
FOV is reduced to 1/N its original size, and as a result, aliasing of signals outside of the
FOV in the phase encode direction occurs, and each coil response produces a wrapped
image. To overcome the aliasing, the system uses the sensitivity profile of each coil to
calculate where the signal is coming from relative to the coil based on its amplitude—
the signal generated near the coil has a higher amplitude than the signal furthest away.
Using this process (called SENSE, ASSET, GRAPPA, iPAT by the various manufactur-
ers), the image is unwrapped and combined with the unwrapped images from the
other coils to form one summed image of the slice, with high SNR and resolution
(see Figure 13-9). Parallel imaging can be used to either reduce scan time or improve
resolution, in conjunction with most pulse sequences. Downsides include image mis-
alignment when combining images due to patient motion, and increase in chemical
shift artifacts, due to a range of frequencies mapped across each coil. Nevertheless,
multi-coil parallel imaging techniques are now common and increasing in use.
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Chapter 13 • Magnetic Resonance Imaging 491

RF coil safety requires regular inspection of the coil condition, including the con-
ductive wires leading to the coils from the connectors. These wires have the capacity
to transmit heat, which may burn the insulating material of the wires or burn the
patient. It is important to ensure that the coils are not looped and do not touch the
patient or the bore of the magnet. Damage to the insulation requires immediate repair,
as this could result in extreme heating, fire, and potential harm to the patient.

MR System Subcomponents
The control interfaces, RF source, detector, and amplifier, analog to digital converter
(digitizer), pulse programmer, computer system, gradient power supplies, and image
display are crucial components of the MR system. They integrate and synchronize the
tasks necessary to produce the MR image (Fig. 13-42).
The operator interface and computer systems vary with the manufacturer, but
most consist of a computer system, dedicated processor for Fourier transformation,
image processor to form the image, disk drives for storage of raw data and pulse
sequence parameters, and a power distribution system to distribute and filter the
direct and alternating current. The operator’s console is located outside of the scan
room, and provides the interface to the hardware and software for data acquisition.

13.8 Magnet Siting, Quality Control

Magnet Siting
Superconductive magnets produce extensive magnetic fringe fields, and create poten-
tially hazardous conditions in adjacent areas. In addition, extremely small signal
amplitudes generated by the protons in the body during an imaging procedure have
a frequency common to commercial FM broadcasts. Thus, two requirements must

MRI system components

Shim Power Data

Supply

RF Transmitter Digitizer &

Patient and Receiver Image
Table Processor

Clock

Gradient Pulse Prog Host

Pulse Prog Measurement Computer
Control

Gradient
Power Supply
Operating
Console

■■FIGURE 13-42 A block diagram of a typical MRI system shows the components and interfaces between
subsystems. Not shown is the Faraday cage that surrounds the magnet assembly to eliminate environ-
mental RF noise.
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492 Section II • Diagnostic Radiology

be considered for MR system siting: protect the local environment from the magnet
system and protect the magnet system from the local environment.
Fringe fields from a high field strength magnet can extend quite far—roughly equal
to B0, where  is a constant dependent on the magnet bore size and magnet configura-
tion. Fringe fields can potentially cause a disruption of electronic signals and sensitive
electronic devices. An unshielded 1.5-T magnet has a 1-mT fringe field at a distance of
approximately 9.3 m, a 0.5-mT field at 11.5 m, and a 0.3-mT field at 14.1 m from the
center of the magnet. Magnetic shielding is one way to reduce fringe field interactions in
adjacent areas. Passive (e.g., thick metal walls close to the magnet) and active (e.g., elec-
tromagnet systems strategically placed in the magnet housing) magnetic shielding sys-
tems permit a significant reduction in the extent of the fringe fields for high field strength,
air core magnets (Fig. 13-43). Patients with pacemakers or ferromagnetic aneurysm clips
must avoid fringe fields above 0.5 mT. Magnetically sensitive equipment such as image
intensifiers, gamma cameras, and color TVs are severely impacted by fringe fields of less
than 0.3 mT, as electromagnetic focusing in these devices is disrupted.
Administrative control for magnetic fringe fields is 0.5 mT, requiring controlled
access to areas that exceed this level. Magnetic fields below 0.5 mT are considered
safe for the patient population. Disruption of the fringe fields can reduce the homo-
geneity of the active imaging volume. Any large metallic object (elevator, automobile,
etc.) traveling through the fringe field can produce such an effect.
Environmental RF noise must be reduced to protect the extremely sensitive receiver
within the magnet from interfering signals. The typical approach for stray RF signal
protection is the construction of a Faraday cage, an internal enclosure consisting of RF
attenuating copper sheet and/or copper wire mesh. The room containing the MRI sys-
tem is typically lined with copper sheet (walls) and mesh (windows). This is a costly
construction item but provides effective protection from stray RF noise (Fig. 13-44).

Field Uniformity
In addition to magnetic field strength, field uniformity is an important characteristic,
expressed in parts per million (ppm) over a given volume, such as 40 cm3. This is
based upon the precessional frequency of the proton, which is determined from the

10 0.5

8 1 Unshielded
6 3
5
Radial distance (m)

4
20
2

2 4 6 8 10 12 14 Axial distance (m)

2 1
0.5
4
0.3
Shielded
6
0.1 mT
8

■■FIGURE 13-43 An unshielded (top half of diagram) and shielded (bottom half of diagram) 1.5 T magnet and
the magnetic fringe field strengths plotted with radial distance (vertical axis) and axial distance (horizontal axis).
Bushberg, Jerrold T., et al. Essential Physics of Medical Imaging, Wolters Kluwer Health, 2011. ProQuest Ebook Central,
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Chapter 13 • Magnetic Resonance Imaging 493

■■FIGURE 13-44 The MR scanner room requires protection from extraneous radiofrequency signals. This is
achieved with the installation of a “Faraday cage” comprised of copper sheet that lines the inner walls of
the room (left), copper mesh covering the operator viewing window (not shown), and a copper lined door
and doorjamb with an inflatable bladder conductor (note switch above the door handle) to seal the door
(middle and upper right). A leak in the Faraday cage will result in RF artifacts that will occur at specific
frequencies as streaks across the image, perpendicular to the FEG direction. (Lower right. FEG is vertical,
PEG is horizontal.)

proton gyromagnetic ratio. At 1.5 T, the precessional frequency is 1.5 T  42.58

MHz/T  63.8 MHz  63.8  106 cycles/s, and a specification of 2 ppm homogeneity
(2 × 10− 6 ) gives a frequency uniformity of about 128 cycles/s (Hz) over the volume.
Typical homogeneities range from less than 1 ppm for a small FOV (e.g. 150 mm)
to greater than 10 ppm for a large FOV (e.g., 400 mm). Field uniformity is achieved
by manipulating the main field peripherally with passive and active “shim” coils,
which exist in proximity to the main magnetic field. These coils interact with the
fringe fields and adjust the variation of the central magnetic field.
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Quality Control
Like any imaging system, the MRI scanner is only as good as the weakest link in the
imaging chain. The components of the MR system that must be periodically checked
include the magnetic field strength, magnetic field homogeneity, system field shim-
ming, gradient linearity, system RF tuning, receiver coil optimization, environmental
noise sources, power supplies, peripheral equipment, and control systems among
others. A QC program should be designed to assess the basic day-to-day functional-
ity of the scanner. A set of QC tests is listed in Table 13-4. Qualitative and quantita-
tive measurements of system performance should be obtained on a periodic basis,
with a test frequency dependent on the likelihood of detecting a change in the base-
line values outside of normal operating limits.
The American College of Radiology has an MRI accreditation program that specifies
requirements for system operation, QC, and the training requirements of technolo-
gists, radiologists, and physicists involved in scanner operation. The accreditation pro-
cess evaluates the qualifications of personnel, equipment performance, effectiveness
of QC procedures, and quality of clinical images—factors that are consistent with the
maintenance of a state-of-the-art facility.
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494 Section II • Diagnostic Radiology

TABLE 13-4 RECOMMENDED QC TESTS FOR MRI

SYSTEMS
High-contrast spatial resolution
Slice thickness accuracy
Slice position accuracy
RF center frequency tuning
Geometric accuracy and spatial uniformity
Signal uniformity
Low-contrast resolution (sensitivity)
Image artifact evaluation
Operational controls (e.g., table movement control and alignment
lighting checks)
Preventive maintenance logging and documentation
Review of system log book and operations

MRI phantoms are composed of materials that produce MR signals with carefully
defined relaxation times. Some materials are aqueous paramagnetic solutions; pure
gelatin, agar, silicone, or agarose; and organic doped gels, paramagnetic doped gels,
and others. Water is most frequently used, but it is necessary to adjust the T1 and T2
relaxation times of (doped) water, so that images can be acquired using pulse sequence
timing for patients (e.g., this is achieved by adding nickel, aqueous oxygen, aque-
ous manganese, or gadolinium). For example, the ACR MR Accreditation phantom
(Fig. 13-45) is a cylindrical phantom of 190 mm inside diameter and 148 mm inside
length. It is filled with a 10 millimolar solution of nickel chloride and 75 millimolar
sodium chloride. Inside the phantom are several structures that are used in a variety of
tests for scanner performance. In this phantom, seven quantitative tests are made by
scanning the phantom with specific instructions, and include geometric accuracy, high
contrast spatial resolution, slice thickness accuracy, slice position accuracy, image inten-
sity uniformity, percent signal ghosting, and low-contrast object detectability. Details
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MRI Accreditation
Phantom

■■FIGURE 13-45 The ACR accreditation phantom (upper left) and selected images scanned from the phan-
tom are shown above. Upper middle is the spatial resolution module, and just below is a magnification image
of the test targets. The upper right shows the geometric distortion module, the lower right is the low contrast
sensitivity module, and the lower left is the uniformity module. Not all images are shown; specific details are
described in the accreditation documentation available on the ACR website, http://www.acr.org.

on measurement analysis, recommended action criteria, and causes of failure/correc-

tive action are included in the guidance. Some phantoms have standards with known
T1, T2, and proton density values to evaluate the quantitative accuracy of the scanner,
and to determine the ability to achieve an expected contrast level for a given pulse
sequence. Homogeneity phantoms determine the spatial uniformity of transmit and
receive RF magnetic fields. Ideal performance is a spatially uniform excitation of the
protons and a spatially uniform sensitivity across the imaged object.

13.9 MR Bioeffects and Safety

Although ionizing radiation is not used with MRI and MRS, perception of the general
public is that MR is a very safe modality, safety aspects are often an afterthought,
particularly in terms of operational activities and training of personnel who work
in the area and around the magnet. There are very many important bioeffects and
safety issues to be considered for MR. These include the presence of strong magnetic
fields, RF energy, time-varying magnetic gradient fields, cryogenic liquids, a con-
fined imaging device (claustrophobia), and noisy operation (gradient coil activation
and deactivation, creating acoustic noise). Patients with implants, prostheses, aneu-
rysm clips, pacemakers, heart valves, etc., should be aware of considerable torque on
the devices which when placed in the magnetic field, could cause serious adverse
effects. Nonmetallic implant materials can also lead to significant heating under rap-
idly changing gradient fields. Consideration of the distortions and artifacts on the
acquired images and possibility of misdiagnosis are also a concern. Ferromagnetic
materials inadvertently brought into the imaging room (e.g., an IV pole) are attracted
to the magnetic field and can become a deadly projectile to the occupant within the
bore of the magnet. Many unfortunate deaths have been attributed to carelessness
and lack of a safety culture around an MR scanner. Signage exists in three categories
to help identify MR-compatible materials. “MR safe” is a square green sign, and is put
on materials and objects that are wholly nonmetallic; “not MR safe” is round red, and
is placed on all ferromagnetic and many conducting metals; “MR conditional” sig-
nage is triangular yellow, placed on objects that may or may not be safe until further
investigation is performed. These signs are shown in Figure 13-46.
In extreme emergencies, the superconducting magnet can be turned off by a
manually controlled “quench” procedure. Even under the best circumstances, the
Copyright © 2011. Wolters Kluwer Health. All rights reserved.

quench procedure subjects the magnet to a 260 degrees temperature difference in a

short period of time. If performed too quickly, major physical damage to the magnet

■■FIGURE 13-46 MR labeling includes on the left, MR safe materials that have been found not to interact
with the strong MR field or disrupt operation; in the middle, NOT MR safe labels that contraindicate bringing
materials with this designation past Zone 2 (see discussion later in this section; on the right, more consider-
ation required before bringing such labeled objects into the scan room).

TABLE 13-5 MRI SAFETY GUIDELINES

ISSUE PARAMETER VARIABLES SPECIFIED VALUE
Static magnetic field Magnetic field (B0) Maximum strength 3.0 T
Inadvertent exposure Maximum 0.0005 T
Changing magnetic Axial gradients  .120 μs ,20 T/s
field (dB/dt)
12 μs ,  ,120 μs ,2400/ (μs) T/s
 ,12 μs ,200 T/s
Transverse gradients ,3 axial
gradients
System ,6 T/s
RF power deposition Temperature Core of body ,18°C
Maximum head ,38°C
Maximum trunk ,39°C
Maximum extremities ,40°C
Specific absorption Whole body (average) ,4 W/kg
rate (SAR) Head (average) ,3 W/kg
Head or torso per gram ,8 W/kg
Extremities per gram ,12 W/kg
Acoustic noise levels Peak pressure 200 pascals
Average pressure 105 dBA

 rise time of gradients.

a
In some clinical applications, higher field strengths (e.g., 4.0 T) are allowed.

can occur. Because of risks to personnel, equipment, and physical facilities, manual
quenches should only be initiated after careful considerations and preparation.
Uncontrolled quenching is the result of a sudden loss of superconductivity in the
main magnet coils, which can result in the explosive conversion of liquid helium to
gas, and jeopardize the safety of those in the room and adjacent areas. In the event
of insufficient gas outflow, oxygen can be displaced and build up of pressure in the
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room can prevent the entry door from being easily opened.
MRI is considered “safe” when used within the regulatory guidelines required
of the manufacturers by the Food and Drug Administration (Table 13-5). Serious
bioeffects are demonstrated with static and varying magnetic fields at strengths
significantly higher (10 to 20 times greater) than those used for typical diagnostic
imaging.

Static Magnetic Fields

The long-term biologic effects of high magnetic field strengths are not well known. At
lower magnetic field strengths, there have not been any reports of deleterious or nonre-
versable biologic effects, either acute or chronic. With very high field strength magnets
(e.g., 4 T or higher), there has been anecdotal mention of dizziness and disorientation
of personnel and patients as they move through the field. With systems in excess of 20
T, enzyme kinetic changes have been documented, increased membrane permeability
shown, and altered biopotentials have been measured. These effects have not been dem-

onstrated in magnetic fields below 10 T. Effects on ECG traces have shown an increased
amplitude of the T wave, presumably due to the magneto-hemodynamic effect, caused
by conductive fluid such as blood moving across a magnetic field. When this occurs,
sometimes the elevated T wave will be mistaken for the desired R wave, creating an
insufficient gating situation. For this reason, it is recommended that ECG leads are not
used for patient monitoring, but rather an alternative such as pulse oximetry be used.

Varying Magnetic Field Effects

The time-varying magnetic fields encountered in the MRI system are due to the gra-
dient switching used for localization of the protons. Magnetic fields that vary their
strength with time are generally of greater concern than static fields because oscillat-
ing magnetic fields can induce electrical current flow in conductors. The maximum
allowed changing gradient fields depend on the rise times of the gradients, as listed
in Table 13-5. At extremely high levels of magnetic field variation, effects such as
visual phosphenes (the sensation of flashes of light being seen) can result because
of induced currents in the nerves or tissues. Other consequences such as bone heal-
ing and cardiac fibrillation have been suggested in the literature. The most common
bioeffect of MR systems is tissue heating caused by RF energy deposition and/or by
rapid switching of high strength gradients. RF coils and antennas can present burn
hazards when electrical currents and conductive loops are present, and must have
proper insulation—both electrical and thermal.

RF Exposure, Acoustic Noise Limits, Specific Absorption Rate

RF exposure causes heating of tissues. There are obvious effects of overheating, and
therefore a power deposition limit is imposed by governmental regulations on the
manufacturers for various aspects of MRI and MRS operation. Table 13-5 lists some
of the categories and the maximum values permitted for clinical use. The rationale for
imposing limits on static and varying magnetic fields is based on the ability of the rest-
ing body to dissipate heat buildup caused by the deposition and absorption of ther-
mal energy. Other indicators, such as acoustic noise levels and pressure amplitudes,
are determined from limits that are shown to have reversible (unaffected) outcomes
for clinically approved sequences. Hearing protection should always be available to
the patient. For research sequences and procedures that have not been approved by
Copyright © 2011. Wolters Kluwer Health. All rights reserved.

the FDA, patients or volunteers are to have hearing protection in place.

Pregnancy-related Issues and Pediatric Patient Concerns

Pregnant healthcare staff and physicians are permitted to work in and around the MR
environment throughout all stages of pregnancy and assist as needed in setting up
the patient and the exam. However, they are not to remain in the magnet scanning
room (Zone 4). Regarding the scanning of pregnant patients, current data have not
yielded any deleterious effects on the developing fetus with common examinations,
and no special considerations are warranted, as long as the benefit-risk-ratio of doing
the study is that for any other typical patient. Another consideration is the admin-
istration of contrast, which should not be routinely provided. A well-documented
consideration to administer contrast based on the overwhelming potential benefit to
the patient or fetus relative to the risk of exposing them to gadolinium-based agents
and potential deleterious effects of free gadolinium ions, as there are studies that have
documented that the agents do pass the placental barrier and do enter the fetus.

For pediatric patients, the largest issues are sedation and monitoring. Special
attention to sedation protocols, adherence to standards of care regarding sedation
guidelines, and monitoring patients during the scan with MR-safe temperature moni-
toring and isolation transport units are crucial to maintaining patient safety.

MR Personnel and MR Safety Zones

The American College of Radiology has published a white paper describing the rec-
ommendations for MR safety in general, and MR safety “zones” and MR personnel
definitions in particular in their 2007 publication (ACR white paper reference). MR
safety policies, procedures, and safe practices are suggested in the guidance. In an
effort to maintain a buffer zone around the “always on” magnet, MR safety zones
are categorized from Zone 1 to Zone 4. Zone 1 is the area freely accessible to the
general public, in essence everywhere outside of the MR magnet area and building.
Zone 2 represents the interface between Zone 1 and Zone 3—typically the reception
area, where patients are registered and MR screening questions take place. Zone 3
is a restricted area comprised of the MR control room and computer room that only
specific personnel can access, namely, those specifically trained as MR personnel
(described below) and appropriately screened patients and other individuals (nurses,
Copyright © 2011. Wolters Kluwer Health. All rights reserved.

■■FIGURE 13-47 Zoning concept for describing areas in an MR system environment include Zone 1, unre-
stricted access; Zone 2, interface between unrestricted and restricted areas; Zone 3, restricted area only allowed
for MR personnel and screened individuals; Zone 4, the area of the scanner and high magnetic field strength.
(Adapted from Kanal E., et.al. Guidance Document for Safe MR Practices: 2007.)

support staff). Zone 4 represents the MR magnet room, and is always located within
the confines of Zone 3. Demarcation of these zones should be clearly marked and
identified. Figure 13-47 illustrates the zoning concept.
Furthermore, there are personnel definitions describing criteria that must be
achieved before access can be granted to Zone 3 and Zone 4 areas. Non-MR personnel
are patients, visitors, for staff who do not have the appropriate education or training
that meet the criteria for Level 1 or Level 2 MR personnel. Level 1 MR personnel have
passed minimal safety and education training on MR safety issues and have a basic
understanding of the effects of MR magnets, dangers of projectiles, effects of strong
magnetic fields, etc. These individuals can work in Zone 3 and Zone 4 areas without
supervision or oversight; examples are MR office staff, patient aides, and custodial
staff. Level 2 MR personnel are more extensively trained in the broader aspects of MR
safety issues, for example, understanding the potential for thermal loading, burns,
neuromuscular excitation, and induced currents from gradients. These individuals
are the gatekeepers of access into Zone 4, and take the action and the leadership role
in the event of a patient code, ensuring that only properly screened support staff are
allowed access. Those responding to a code must be made aware of and comply with
MR safety protocols. Examples of personnel designated as Level 2 include MR tech-
nologists, MR medical physicists, radiologists, and department nursing staff.
Designated personnel are required to continuously maintain their safety creden-
tials, by acquiring continuous education credits throughout the year on MR safety
aspects, and taking an annual test and achieving a minimum passing score.

13.10 Summary

Meeting the needs of the MR exam and using the equipment safely and effectively
requires the understanding of the basic physics underpinnings described in Chapter
12, and the details of advanced acquisition methods, image characteristics, artifacts/
pitfalls, and MR safety/bioeffects covered in this chapter. The reader is encouraged to
keep up with the rapid developments of MRI and MRS by referring to recent litera-
ture and websites dedicated to MRI education and technological advances.

REFERENCES AND SUGGESTED READINGS

American College of Radiology MRI Accreditation Program, Phantom Test Guidance and other
documentation for the MRI accreditation program, available at http://www.acr.org/accreditation/mri/
mri_qc_forms.aspx, accessed May 30, 2011.
Hendrick RE. Breast MRI: fundamentals and technical aspects. New York, NY: Springer, 2007.
Kanal E, Barkovich AJ, Bell C, et.al. ACR guidance document for safe MR practices: 2007. AJR Am J
Roentgenol. 2007;188:1–27.
NessAiver M. All you really need to know about MRI physics. Baltimore, MD: Simply Physics, 1997.
Al-Okaili RN, Krejza J, Wang S, Woo JH, Melhem ER. Advanced MR Imaging Techniques in the Diagnosis of
Intraaxial Brain Tumors in Adults. Radiographics 2006; 26: S173-S189.
Westbrook C, Kaut-Roth C, Talbot J. MRI in practice. 3rd ed. Malden, MA: Blackwell Publishing, 2005.

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Chapter

Magnetic Resonance Basics:

12.1 Magnetism, Magnetic Fields, and Magnets

A Bar magnet B Current-carrying coiled wire

Dipole magnetic field

A Air Core Magnet

Fringe Fields Extensive

B Solid Core Magnet

Fringe Fields Contained

Superconductivity allows the closed-circuit electromagnet to be energized and

Shim Leads Main Leads

Magnetic field Magnetic field

Distance along coil axis

Center of coil pair

RF Transmitter Digitizer &

Pulse Program Host

Magnetic Properties of Materials

Magnetic Characteristics of the Nucleus

magnetic field lines water molecule

TABLE 12-1 PROPERTIES OF THE NEUTRON AND PROTON

Nuclear Magnetic Characteristics of the Elements

TABLE 12-2 MAGNETIC RESONANCE PROPERTIES OF MEDICALLY USEFUL

A No magnetic field B External magnetic field

Magnetic Characteristics of the Proton

about 1021 protons, so there are 3 3 1026 3 1021, or approximately 3 3 1015

■■FIGURE 12-8 A single proton pre-

Proton Spinning top

Energy Absorption and Emission

TABLE 12-3 GYROMAGNETIC RATIO FOR USEFUL

■■FIGURE 12-9 A group of protons

same ­frequency. This energy emission is detected by highly sensitive antennas to

Element 0.5 T 1.5 T 3.0 T

The differences in the gyromagnetic ratios and corresponding precessional frequen-

Geometric Orientation, Frame of Reference, and

A Laboratory Frame B Rotating Frame

x – y axes stationary x’ – y’ axes rotate at Larmor frequency

12.2 The Magnetic Resonance Signal

Application of RF energy synchronized to the precessional frequency of the protons

Mz: Longitudina l Magnetization: in z-axis direction

Resonance and Excitation

A Magnetic field variation of electromagnetic RF wave

B B1 at Larmor Frequency C B 1 off resonance

irradiation can induce a return to equilibrium conditions, when an incoming RF

classical physics concepts.

A Small flip angle B Large flip angle

z C Common flip angles z

12.3 Magnetization Properties of Tissues

Free Induction Decay: T2 Relaxation

37% T2* decay

t=0 t=T2 Time Time

Return to Equilibrium: T1 Relaxation

■■FIGURE 12-18 Spin-lattice relaxation for a sam- z

is recorded. By repeating the sequence from equilibrium conditions with different

Low Frequency High

c­ omplex macromolecules are effective in decreasing T1 relaxation time of local

Molecular motion: slow intermediate fast

Molecular size: large intermediate small

Molecular interactions: bound intermediate free

TABLE 12-4 T1 AND T2 RELAXATION CONSTANTS FOR SEVERAL TISSUESa

12.4 Basic Acquisition Parameters

machine-based parameters are described.

an induced echo, which is determined by applying a 180-degree RF inversion pulse

12.5 Basic Pulse Sequences

Spin Echo Contrast Weighting

After 180° pulse, echo

FID signal gradually decays Spin echo peak amplitude

90° 180° 180° 180°

Longitudinal recovery (T1) Transverse decay (T2) Signal

Relative Signal Recovery

Proton Density Weighting

■■FIGURE 12-25 T1 contrast weighting, TR=500 ms,

dependent signals. Signals with short T1 have high signal

Longitudinal recovery (T1) Transverse decay (T2) Signal

Relative Signal Intensity

■■FIGURE 12-27 Proton density contrast weighting,

differences of the tissues. Signals with large proton den-

TABLE 12-2 MAGNETIC RESONANCE PROPERTIES OF MEDICALLY USEFUL

TABLE 12-3 GYROMAGNETIC RATIO FOR USEFUL

same frequency. This energy emission is detected by highly sensitive antennas to

c omplex macromolecules are effective in decreasing T1 relaxation time of local

TABLE 12-7 PRECESSIONAL FREQUENCY VARIATION AT 1.5 T ALONG