Magnetic resonance imaging
Magnetic resonance imaging is a medical imaging technique used in radiology to generate pictures of the anatomy and the physiological processes inside the body. MRI scanners use strong magnetic fields, magnetic field gradients, and radio waves to form images of the organs in the body. MRI does not involve X-rays or the use of ionizing radiation, which distinguishes it from computed tomography and positron emission tomography scans. MRI is a medical application of nuclear magnetic resonance which can also be used for imaging in other NMR applications, such as NMR spectroscopy.
MRI is widely used in hospitals and clinics for medical diagnosis, staging and follow-up of disease. Compared to CT, MRI provides better contrast in images of soft tissues, e.g. in the brain or abdomen. However, it may be perceived as less comfortable by patients, due to the usually longer and louder measurements with the subject in a long, confining tube, although "open" MRI designs mostly relieve this. Additionally, implants and other non-removable metal in the body can pose a risk and may exclude some patients from undergoing an MRI examination safely.
MRI was originally called NMRI, but "nuclear" was dropped to avoid negative associations. Certain atomic nuclei are able to absorb radio frequency energy when placed in an external magnetic field; the resultant evolving spin polarization can induce an RF signal in a radio frequency coil and thereby be detected. In other words, the nuclear magnetic spin of protons in the hydrogen nuclei resonates with the RF incident waves and emit coherent radiation with compact direction, energy and phase. This coherent amplified radiation is then detected by RF antennas close to the subject being examined. It is a process similar to masers. In clinical and research MRI, hydrogen atoms are most often used to generate a macroscopic polarized radiation that is detected by the antennas. Hydrogen atoms are naturally abundant in humans and other biological organisms, particularly in water and fat. For this reason, most MRI scans essentially map the location of water and fat in the body. Pulses of radio waves excite the nuclear spin energy transition, and magnetic field gradients localize the polarization in space. By varying the parameters of the pulse sequence, different contrasts may be generated between tissues based on the relaxation properties of the hydrogen atoms therein.
Since its development in the 1970s and 1980s, MRI has proven to be a versatile imaging technique. While MRI is most prominently used in diagnostic medicine and biomedical research, it also may be used to form images of non-living objects, such as mummies. Diffusion MRI and functional MRI extend the utility of MRI to capture neuronal tracts and blood flow respectively in the nervous system, in addition to detailed spatial images. The sustained increase in demand for MRI within health systems has led to concerns about cost effectiveness and overdiagnosis.
Mechanism
Construction and physics
The major components of an MRI scanner are the main magnet, which polarizes the sample, the shim coils for correcting shifts in the homogeneity of the main magnetic field, the gradient system which is used to localize the region to be scanned and the RF system, which excites the sample and detects the resulting NMR signal. The whole system is controlled by one or more computers.In most medical applications, hydrogen nuclei, which consist solely of a proton, that are in tissues create a signal that is processed to form an image of the body in terms of the density of those nuclei in a specific region. Given that the protons are affected by fields from other atoms to which they are bonded, it is possible to separate responses from hydrogen in specific compounds. To perform a study, the person is positioned within an MRI scanner that forms a strong magnetic field around the area to be imaged. First, energy from an oscillating magnetic field is temporarily applied to the patient at the appropriate resonance frequency. Scanning with X and Y gradient coils causes a selected region of the patient to experience the exact magnetic field required for the energy to be absorbed. The atoms are excited by a RF pulse and the resultant signal is measured by one or more receiving coils. The RF signal may be processed to deduce position information by looking at the changes in RF level and phase caused by varying the local magnetic field using gradient coils. As these coils are rapidly switched during the excitation and response to perform a moving line scan, they create the characteristic repetitive noise of an MRI scan as the windings move slightly due to magnetostriction. The contrast between different tissues is determined by the rate at which excited atoms return to the equilibrium state. Exogenous contrast agents may be given to the person to make the image clearer.
MRI requires a magnetic field that is both strong and uniform to a few parts per million across the scan volume. The field strength of the magnet is measured in teslas – and while the majority of systems operate at 1.5 T, commercial systems are available between 0.2 and 7 T. 3T MRI systems, also called 3 Tesla MRIs, have stronger magnets than 1.5 systems and are considered better for images of organs and soft tissue. Whole-body MRI systems for research applications operate in e.g. 9.4T, 10.5T, 11.7T. Even higher field whole-body MRI systems e.g. 14 T and beyond are in conceptual proposal or in engineering design. Most clinical magnets are superconducting magnets, which require liquid helium to keep them at low temperatures. Lower field strengths can be achieved with permanent magnets, which are often used in "open" MRI scanners for claustrophobic patients. Lower field strengths are also used in a portable MRI scanner approved by the FDA in 2020. Recently, MRI has been demonstrated also at ultra-low fields, i.e., in the microtesla-to-millitesla range, where sufficient signal quality is made possible by prepolarization and by measuring the Larmor precession fields at about 100 microtesla with highly sensitive superconducting quantum interference devices.
T1 and T2
Each tissue returns to its equilibrium state after excitation by the independent relaxation processes of T1 and T2. To create a T1-weighted image, magnetization is allowed to recover before measuring the MR signal by changing the repetition time. This image weighting is useful for assessing the cerebral cortex, identifying fatty tissue, characterizing focal liver lesions, and in general, obtaining morphological information, as well as for post-contrast imaging.To create a T2-weighted image, magnetization is allowed to decay before measuring the MR signal by changing the echo time. This image weighting is useful for detecting edema and inflammation, revealing white matter lesions, and assessing zonal anatomy in the prostate and uterus.
The information from MRI scans comes in the form of image contrasts based on differences in the rate of relaxation of nuclear spins following their perturbation by an oscillating magnetic field. The relaxation rates are a measure of the time it takes for a signal to decay back to an equilibrium state from either the longitudinal or transverse plane.
Magnetization builds up along the z-axis in the presence of a magnetic field, B0, such that the magnetic dipoles in the sample will, on average, align with the z-axis summing to a total magnetization Mz. This magnetization along z is defined as the equilibrium magnetization; magnetization is defined as the sum of all magnetic dipoles in a sample. Following the equilibrium magnetization, a 90° radiofrequency pulse flips the direction of the magnetization vector in the xy-plane, and is then switched off. The initial magnetic field B0, however, is still applied. Thus, the spin magnetization vector will slowly return from the xy-plane back to the equilibrium state. The time it takes for the magnetization vector to return to its equilibrium value, Mz, is referred to as the longitudinal relaxation time, T1. Subsequently, the rate at which this happens is simply the reciprocal of the relaxation time:. Similarly, the time in which it takes for Mxy to return to zero is T2, with the rate. Magnetization as a function of time is defined by the Bloch equations.
T1 and T2 values are dependent on the chemical environment of the sample; hence their utility in MRI. Soft tissue and muscle tissue relax at different rates, yielding the image contrast in a typical scan.
The standard display of MR images is to represent fluid characteristics in black-and-white images, where different tissues turn out as follows:
| Signal | T1-weighted | T2-weighted |
| High |
| |
| Intermediate | ||
| Low |