Magnetic resonance imaging

Magnetic resonance imaging is a medical imaging technique used in radiology to

Magnetic resonance
form pictures of the anatomy and the physiological processes of the body in both
imaging
health and disease. MRI scanners use strong magnetic fields, electric field gradients,
and radio waves to generate images of the organs in the body. MRI does not involve Medical diagnostics
X-rays and the use of ionizing radiation, which distinguishes it from CT or CAT
scans. Magnetic resonance imaging is a medical application of nuclear magnetic
resonance (NMR). NMR can also be used for imaging in other NMR applications
such as NMR spectroscopy.

While the hazards of X-rays are now well-controlled in most medical contexts, MRI
may still be seen as a better choice than CT. MRI is widely used in hospitals and
clinics for medical diagnosis, staging of disease and follow-up without exposing the
body to radiation. However, MRI may often yield different diagnostic information
compared with CT. There may be risks and discomfort associated with MRI scans.
Compared with CT scans, MRI scans typically take longer and are louder, and they
usually need the subject to enter a narrow, confining tube. In addition, people with Play media
some medical implants or other non-removable metal inside the body may be unable Para-sagittal MRI of the head, with
to undergo an MRI examination safely. aliasing artifacts (nose and forehead
appear at the back of the head)
MRI was originally called 'NMRI' (nuclear magnetic resonance imaging) and is a
Synonyms nuclear magnetic
form of NMR, though the use of 'nuclear' in the acronym was dropped to avoid
resonance imaging
negative associations with the word.[1] Certain atomic nuclei are able to absorb and
(NMRI), magnetic
emit radio frequency energy when placed in an external magnetic field. In clinical
resonance
and research MRI, hydrogen atoms are most often used to generate a detectable
tomography (MRT)
radio-frequency signal that is received by antennas in close proximity to the anatomy
ICD-9-CM 88.91
being examined. Hydrogen atoms exist naturally in people and other biological
organisms in abundance, particularly in water and fat. For this reason, most MRI MeSH D008279
scans essentially map the location of water and fat in the body. Pulses of radio waves MedlinePlus 003335
excite the nuclear spin energy transition, and magnetic field gradients localize the
signal 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 highly 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. MRI
scans are capable of producing a variety of chemical and physical data, in addition to detailed spatial images. The sustained increase
in demand for MRI withinhealth systems has led to concerns aboutcost effectiveness and overdiagnosis.[2][3]

Contents
Mechanism
Construction and physics
T1 and T2
Diagnostics
Usage by organ or system
Neuroimaging
 Cardiovascular
Musculoskeletal
Liver and gastrointestinal
Angiography
Contrast agents
Sequences
Overview table
Other specialized configurations
Magnetic resonance spectroscopy
Real-time MRI
Interventional MRI
Magnetic resonance guided focused ultrasound
Multinuclear imaging
Molecular imaging by MRI

Economics
Safety
Overuse
Artifacts
Non-medical use
History
See also
References
Further reading
External links

Mechanism

Construction and physics

To perform a study, the person is positioned within an MRI
scanner that forms a strong magnetic field around the area to be
imaged. In most medical applications, protons (hydrogen
atoms) in tissues containing water molecules create a signal
that is processed to form an image of the body. First, energy
from an oscillating magnetic field temporarily is applied to the
patient at the appropriate resonance frequency. The excited
hydrogen atoms emit a radio frequency signal, which is
measured by a receiving coil. The radio signal may be made to
encode position information by varying the main magnetic field
using gradient coils. As these coils are rapidly switched on and
off they create the characteristic repetitive noise of an MRI
scan. 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.[4]
Schematic of construction of a cylindrical
superconducting MR scanner.
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 MR signal and the
RF system, which excites the sample and detects the resulting NMR signal. The whole system is controlled by one or more
computers.

MRI requires a magnetic field that is both strong and uniform. 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. Most clinical magnets are
superconducting magnets, which require liquid helium. Lower field strengths can be achieved with permanent magnets, which are
often used in "open" MRI scanners for claustrophobic patients.[5] Recently, MRI has been demonstrated also at ultra-low fields, i.e.,
in the microtesla-to-millitesla range, where sufficient signal quality is made possible by prepolarization (on the order of 10-100 mT)
and by measuring the Larmor precession fields at about 100 microtesla with highly sensitive superconducting quantum interference
devices (SQUIDs).[6][7][8]

T1 and T2
Each tissue returns to its equilibrium state after excitation by the independent
relaxation processes of T1 (spin-lattice; that is, magnetization in the same direction
as the static magnetic field) and T2 (spin-spin; transverse to the static magnetic
field). To create a T1-weighted image, magnetization is allowed to recover before
measuring the MR signal by changing the repetition time (TR). This image
weighting is useful for assessing the cerebral cortex, identifying fatty tissue,
characterizing focal liver lesions and in general for obtaining morphological Effects of TR and TE on MR signal
information, as well as for post-contrast imaging. To create a T2-weighted image,
magnetization is allowed to decay before measuring the MR signal by changing the
echo time (TE). This image weighting is useful for detecting edema and
inflammation, revealing white matter lesions and assessing zonal anatomy in the
prostate and uterus.

The standard display of MRI images is to represent fluid characteristics in black and
white images, where different tissues turn out as follows: Examples of T1 weighted, T2
weighted and PD weighted MRI
Signal T1-weighted T2-weighted scans

Fat[9][10]
Subacute
hemorrhage[10]
Melanin[10] More water content,[9] as
in edema, tumor,
Protein-rich fluid[10] infarction, inflammation
High Slowly flowing blood[10] and infection[10]
Paramagnetic Extracellularly located
substances, such as methemoglobin in
gadolinium, manganese, subacute hemorrhage[10]
copper[10]
Cortical pseudolaminar
necrosis[10]

Inter- Gray matter darker than White matter darker than grey
mediate white matter[11] matter[11]
Low
Bone[9] Bone[9]
Urine Air[9]
CSF Fat[9]
Air[9] Low proton density, as in
More water content,[9] as calcification and
in edema, tumor, fibrosis[10]
infarction, inflammation,
infection, hyperacute or
 infection, hyperacute or
chronic hemorrhage[10]
Low proton density as in
calcification[10]
Paramagnetic material,
such as
deoxyhemoglobin,
intracelullar
methemoglobin, iron,
ferritin, hemosiderin,
melanin[10]
Protein-rich fluid[10]

Diagnostics

Usage by organ or system

MRI has a wide range of applications in medical diagnosis and more than 25,000
scanners are estimated to be in use worldwide.[12] MRI affects diagnosis and
treatment in many specialties although the effect on improved health outcomes is
uncertain.[13]

MRI is the investigation of choice in the preoperative staging of rectal and prostate
[14]
cancer and, has a role in the diagnosis, staging, and follow-up of other tumors.

Patient being positioned for MR

Neuroimaging study of the head and abdomen.

MRI is the investigative tool of choice for neurological cancers, as it has better
resolution than CT and offers better visualization of the posterior fossa. The contrast
provided between grey and white matter makes MRI the best choice for many
conditions of the central nervous system, including demyelinating diseases,
dementia, cerebrovascular disease, infectious diseases, and epilepsy.[15] Since many
images are taken milliseconds apart, it shows how the brain responds to different
stimuli, enabling researchers to study both the functional and structural brain
abnormalities in psychological disorders.[16] MRI also is used in guided stereotactic
surgery and radiosurgery for treatment of intracranial tumors, arteriovenous
malformations, and other surgically treatable conditions using a device known as the
N-localizer.[17][18][19]

Cardiovascular
Cardiac MRI is complementary to other imaging techniques, such as
echocardiography, cardiac CT, and nuclear medicine. Its applications include
assessment of myocardial ischemia and viability, cardiomyopathies, myocarditis,
MRI image of white matter tracts
iron overload, vascular diseases, andcongenital heart disease.[20]

Musculoskeletal
Applications in the musculoskeletal system includespinal imaging, assessment of joint disease, and soft tissue tumors.[21]

Liver and gastrointestinal

Hepatobiliary MR is used to detect and characterize lesions of the liver, pancreas, and bile ducts. Focal or diffuse disorders of the
liver may be evaluated using diffusion-weighted, opposed-phase imaging, and dynamic contrast enhancement sequences.
Extracellular contrast agents are used widely in liver MRI and newer hepatobiliary contrast agents also provide the opportunity to
perform functional biliary imaging. Anatomical imaging of the bile ducts is achieved by using a heavily T2-weighted sequence in
magnetic resonance cholangiopancreatography (MRCP). Functional imaging of the
pancreas is performed following administration of secretin. MR enterography
provides non-invasive assessment of inflammatory bowel disease and small bowel
tumors. MR-colonography may play a role in the detection of large polyps in
.[22][23][24][25]
patients at increased risk of colorectal cancer

Angiography
Magnetic resonance angiography (MRA) generates pictures of the arteries to
evaluate them for stenosis (abnormal narrowing) or aneurysms (vessel wall MR angiogram in congenital heart
disease
dilatations, at risk of rupture). MRA is often used to evaluate the arteries of the neck
and brain, the thoracic and abdominal aorta, the renal arteries, and the legs (called a
"run-off"). A variety of techniques can be used to generate the pictures, such as
administration of a paramagnetic contrast agent (gadolinium) or using a technique
known as "flow-related enhancement" (e.g., 2D and 3D time-of-flight sequences),
where most of the signal on an image is due to blood that recently moved into that
plane (see also FLASH MRI). Techniques involving phase accumulation (known as
phase contrast angiography) can also be used to generate flow velocity maps easily
and accurately. Magnetic resonance venography (MRV) is a similar procedure that is
used to image veins. In this method, the tissue is now excited inferiorly, while the
signal is gathered in the plane immediately superior to the excitation plane—thus
[26]
imaging the venous blood that recently moved from the excited plane.

Magnetic resonance angiography

Contrast agents
MRI for imaging anatomical structures or blood flow do not require contrast agents
as the varying properties of the tissues or blood provide natural contrasts. However, for more specific types of imaging, exogenous
contrast agents may be given intravenously, orally, or intra-articularly.[4] The most commonly used intravenous contrast agents are
based on chelates of gadolinium.[27] In general, these agents have proved safer than the iodinated contrast agents used in X-ray
radiography or CT. Anaphylactoid reactionsare rare, occurring in approx. 0.03–0.1%.[28] Of particular interest is the lower incidence
of nephrotoxicity, compared with iodinated agents, when given at usual doses—this has made contrast-enhanced MRI scanning an
go contrast-enhanced CT.[29]
option for patients with renal impairment, who would otherwise not be able to under

Although gadolinium agents have proved useful for patients with renal impairment, in patients with severe renal failure requiring
dialysis there is a risk of a rare but serious illness, nephrogenic systemic fibrosis, which may be linked to the use of certain
gadolinium-containing agents. The most frequently linked is gadodiamide, but other agents have been linked too.[30] Although a
causal link has not been definitively established, current guidelines in the United States are that dialysis patients should only receive
gadolinium agents where essential, and that dialysis should be performed as soon as possible after the scan to remove the agent from
the body promptly.[31][32] In Europe, where more gadolinium-containing agents are available, a classification of agents according to
potential risks has been released.[33][34] Recently, a new contrast agent named gadoxetate, brand name Eovist (US) or Primovist
[35]
(EU), was approved for diagnostic use: this has the theoretical benefit of a dual excretion path.

Sequences
An MRI sequence is a particular setting of radiofrequency pulses and gradients, resulting in a particular image appearance.[36] The
T1 and T2 weighting can also be described as MRI sequences.

Overview table

This table does not includeuncommon and experimental sequences.

 Group Sequence Abbr. Physics Main clinical distinctions Example

Lower signal for more

water content, [9]as in
edema, tumor,
infarction, inflammation,
infection, hyperacute or
chronic hemorrhage [10]
Measuring spin–lattice High signal for fat[9][10]
relaxation by using a
T1 weighted T1 High signal for
short repetition time
paramagnetic
(TR) and echo time (TE)
substances, such as
MRI contrast agents[10]
Standard foundation and
comparison for other
sequences.

Spin echo
Higher signal for more
water content.[9]
Low signal for fat.[9]
Low signal for
Measuring spin–spin
paramagnetic
T2 weighted T2 relaxation by using long
TR and TE times. substances.[10]
Standard foundation and
comparison for other
sequences.

Joint disease and injury.[38]

Proton Long TR (to reduce T1)
density PD and short TE (to High signal from
weighted minimize T2)[37] meniscus tears[39]
(pictured)

Maintenance of a
Steady-state steady, residual
Gradient Creation of cardiac MRI
free SSFP transverse
echo
precession magnetisation over videos (pictured).[40]
successive cycles.[40]

Inversion
recovery
Fat suppression by High signal in edema, such
Short tau setting an inversion time as in more severe stress
inversion STIR where the signal of fat is fracture.[42] Shin splints
recovery
zero.[41] pictured:

High signal in lacunar

Fluid
Fluid suppression by infarction, multiple sclerosis
attenuated
FLAIR setting an inversion time (MS) plaques, subarachnoid
inversion
that nulls fluids. haemorrhage and
recovery
meningitis (pictured).[43]

Double DIR Simultaneous High signal of multiple

inversion suppression of sclerosis plaques
recovery cerebrospinal fluid and (pictured).[44]
 white matter by two
inversion times.[44]

Measure of Brownian High signal within minutes

Conventional DWI motion of water of cerebral infarction
molecules.[45] (pictured).[46]

Reduced T2 weighting
by taking multiple
Apparent conventional DWI Low signal minutes after
Diffusion diffusion ADC images with different cerebral infarction
weighted coefficient DWI weighting, and the (pictured).[48]
(DWI) change corresponds to
diffusion.[47]

Mainly tractography Evaluating white matter

(pictured) by an overall deformation by
Diffusion greater Brownian motion tumors[49]
DTI
tensor of water molecules in
Reduced fractional
the directions of nerve
anisotropy may indicate
fibers.[49]
dementia[50]

Gadolinium contrast is
injected, and rapid
repeated imaging
Dynamic
(generally gradient-echo
susceptibility DSC
echo-planar T2
contrast
weighted) quantifies
susceptibility-induced
signal loss.[51]
Measuring shortening of In cerebral infarction, the
Perfusion the spin–lattice
Dynamic infarcted core and the
weighted relaxation (T1) induced
contrast DCE penumbra have decreased
(PWI) by a gadolinium contrast
enhanced perfusion (pictured).[52]
bolus.[53]
Magnetic labeling of
arterial blood below the
imaging slab, which
Arterial spin subsequently enters the
ASL
labelling
region of interest.[54] It
does not need
gadolinium contrast.[55]

Changes in oxygen
Blood- saturation-dependent Localizing highly active
Functional oxygen-level magnetism of brain areas before
BOLD
MRI (fMRI) dependent hemoglobin reflects surgery.[57]
imaging
tissue activity.[56]

Magnetic Time-of-flight TOF Blood entering the Detection of aneurysm,

resonance imaged area is not yet stenosis or dissection.[58]
angiography magnetically saturated,
 (MRA) and giving it a much higher
venography signal when using short
echo time and flow
compensation.

Two gradients with

equal magnitude but
Phase- opposite direction are Detection of aneurysm,
PC- used to encode a phase stenosis or dissection
contrast
MRA
MRA shift, which is (pictured).[58]
proportional to the
velocity of spins.[59] (VIPR)
Sensitive for blood and
calcium, by a fully flow
compensated, long Detecting small amounts of
echo, gradient recalled hemorrhage (diffuse axonal
Susceptibility weighted SWI echo (GRE) pulse injury pictured) or
sequence to exploit
calcium.[60]
magnetic susceptibility
differences between
tissues.

Other specialized configurations

Magnetic resonance spectroscopy

Magnetic resonance spectroscopy (MRS) is used to measure the levels of different metabolites in body tissues. The MR signal
produces a spectrum of resonances that corresponds to different molecular arrangements of the isotope being "excited". This
fecting the brain,[61] and to provide information on tumor
signature is used to diagnose certain metabolic disorders, especially those af
metabolism.[62]

Magnetic resonance spectroscopic imaging (MRSI) combines both spectroscopic and imaging methods to produce spatially localized
spectra from within the sample or patient. The spatial resolution is much lower (limited by the available SNR), but the spectra in each
voxel contains information about many metabolites. Because the available signal is used to encode spatial and spectral information,
MRSI requires high SNR achievable only at higher field strengths (3 T and above).

Real-time MRI
Real-time MRI refers to the continuous monitoring ("filming") of moving objects in real time. While many different strategies have
been developed since the early 2000s, a recent development reported a real-time MRI technique based on radial FLASH and iterative
reconstruction that yields a temporal resolution of 20 to 30 milliseconds for images with an in-plane resolution of 1.5 to 2.0 mm. The
new method promises to add important information about diseases of the joints and the heart. In many cases MRI examinations may
become easier and more comfortable for patients.[63]

Interventional MRI
The lack of harmful effects on the patient and the operator make MRI well-suited for interventional radiology, where the images
produced by an MRI scanner guide minimally invasive procedures. Such procedures must be done with no ferromagnetic
instruments.

A specialized growing subset of interventional MRI is intraoperative MRI, in which doctors use an MRI in surgery. Some specialized
MRI systems allow imaging concurrent with the surgical procedure. More typical, however, is that the surgical procedure is
temporarily interrupted so that MRI can verify the success of the procedure or guide subsequent sur
gical work.
Magnetic resonance guided focused ultrasound
In MRgFUS therapy, ultrasound beams are focused on a tissue—guided and
controlled using MR thermal imaging—and due to the significant energy deposition
at the focus, temperature within the tissue rises to more than 65 °C (150 °F),
completely destroying it. This technology can achieve precise ablation of diseased
tissue. MR imaging provides a three-dimensional view of the target tissue, allowing
for precise focusing of ultrasound energy. The MR imaging provides quantitative,
real-time, thermal images of the treated area. This allows the physician to ensure that
the temperature generated during each cycle of ultrasound energy is sufficient to
cause thermal ablation within the desired tissue and if not, to adapt the parameters to
ensure effective treatment.[64]
Play media
Real-time MRI of a human heart at a
Multinuclear imaging resolution of 50 ms
Hydrogen is the most frequently imaged nucleus in MRI because it is present in
biological tissues in great abundance, and because its high gyromagnetic ratio gives
a strong signal. However, any nucleus with a net nuclear spin could potentially be imaged with MRI. Such nuclei include helium-3,
lithium-7, carbon-13, fluorine-19, oxygen-17, sodium-23, phosphorus-31 and xenon-129. 23Na and 31P are naturally abundant in the
body, so can be imaged directly. Gaseous isotopes such as 3He or 129 Xe must be hyperpolarized and then inhaled as their nuclear
density is too low to yield a useful signal under normal conditions. 17O and 19F can be administered in sufficient quantities in liquid
form (e.g. 17 O-water) that hyperpolarization is not a necessity. Using helium or xenon has the advantage of reduced background
[65]
noise, and therefore increased contrast for the image itself, because these elements are not normally present in biological tissues.

Moreover, the nucleus of any atom that has a net nuclear spin and that is bonded to a hydrogen atom could potentially be imaged via
heteronuclear magnetization transfer MRI that would image the high-gyromagnetic-ratio hydrogen nucleus instead of the low-
[66] In principle, hetereonuclear magnetization transfer MRI could be
gyromagnetic-ratio nucleus that is bonded to the hydrogen atom.
[67][68]
used to detect the presence or absence of specific chemical bonds.

Multinuclear imaging is primarily a research technique at present. However, potential applications include functional imaging and
imaging of organs poorly seen on 1H MRI (e.g., lungs and bones) or as alternative contrast agents. Inhaled hyperpolarized 3He can be
used to image the distribution of air spaces within the lungs. Injectable solutions containing 13 C or stabilized bubbles of
hyperpolarized 129 Xe have been studied as contrast agents for angiography and perfusion imaging. 31 P can potentially provide
information on bone density and structure, as well as functional imaging of the brain. Multinuclear imaging holds the potential to
chart the distribution of lithium in the human brain, this element finding use as an important drug for those with conditions such as
bipolar disorder.

Molecular imaging by MRI

MRI has the advantages of having very high spatial resolution and is very adept at morphological imaging and functional imaging.
MRI does have several disadvantages though. First, MRI has a sensitivity of around 10−3 mol/L to 10−5 mol/L, which, compared to
other types of imaging, can be very limiting. This problem stems from the fact that the population dif
ference between the nuclear spin
states is very small at room temperature. For example, at 1.5 teslas, a typical field strength for clinical MRI, the difference between
high and low energy states is approximately 9 molecules per 2 million. Improvements to increase MR sensitivity include increasing
magnetic field strength, andhyperpolarization via optical pumping or dynamic nuclear polarization. There are also a variety of signal
amplification schemes based on chemical exchange that increase sensitivity
.

To achieve molecular imaging of disease biomarkers using MRI, targeted MRI contrast agents with high specificity and high
relaxivity (sensitivity) are required. To date, many studies have been devoted to developing targeted-MRI contrast agents to achieve
molecular imaging by MRI. Commonly, peptides, antibodies, or small ligands, and small protein domains, such as HER-2 affibodies,
have been applied to achieve targeting. To enhance the sensitivity of the contrast agents, these targeting moieties are usually linked to
[69] A new class of gene targeting MR contrast agents
high payload MRI contrast agents or MRI contrast agents with high relaxivities.
(CA) has been introduced to show gene action of unique mRNA and gene transcription factor proteins.[70][71] This new CA can trace
cells with unique mRNA, microRNA and virus; tissue response to inflammation in living brains.[72] The MR reports change in gene
.[73]
expression with positive correlation to TaqMan analysis, optical and electron microscopy

Economics
In the UK, the price of a clinical 1.5-tesla MRI scanner is around £920,000/US$1.4 million, with the lifetime maintenance cost
broadly similar to the purchase cost.[74] In the Netherlands, the average MRI scanner costs around €1 million,[75] with a 7-T MRI
having been taken in use by the UMC Utrecht in December 2007, costing €7 million.[76] Construction of MRI suites could cost up to
US$500,000/€370.000 or more, depending on project scope. Pre-polarizing MRI (PMRI) systems using resistive electromagnets have
shown promise as a low-cost alternative and have specific advantages for joint imaging near metal implants, however they are likely
[77][78]
unsuitable for routine whole-body or neuroimaging applications.

MRI scanners have become significant sources of revenue for healthcare providers
in the US. This is because of favorable reimbursement rates from insurers and
federal government programs. Insurance reimbursement is provided in two
components, an equipment charge for the actual performance and operation of the
MRI scan and a professional charge for the radiologist's review of the images and/or
data. In the US Northeast, an equipment charge might be $3,500/€2,600 and a
professional charge might be $350/€260,[79] although the actual fees received by the
equipment owner and interpreting physician are often significantly less and depend
on the rates negotiated with insurance companies or determined by the Medicare fee
A 3 tesla clinical MRI scanner.
schedule. For example, an orthopedic surgery group in Illinois billed a charge of
$1,116/€825 for a knee MRI in 2007, but the Medicare reimbursement in 2007 was
only $470.91/€350.[80] Many insurance companies require advance approval of an MRI procedure as a condition for coverage.

In the US, the Deficit Reduction Act of 2005 significantly reduced reimbursement rates paid by federal insurance programs for the
equipment component of many scans, shifting the economic landscape. Many private insurers have followed suit.

In the United States, an MRI of the brain with and without contrast billed to Medicare Part B entails, on average, a technical payment
of US$403/€300 and a separate payment to the radiologist of US$93/€70.[81] In France, the cost of an MRI exam is approximately
€150/US$205. This covers three basic scans including one with an intravenous contrast agent as well as a consultation with the
technician and a written report to the patient's physician.[82] In Japan, the cost of an MRI examination (excluding the cost of contrast
material and films) ranges from US$155/€115 to US$180/€133, with an additional radiologist professional fee of US$17/€12.50.[83]
In India, the cost of an MRI examination including the fee for the radiologist's opinion comes to around Rs 3000–4000 (€37–
49/US$50–60), excluding the cost of contrast material. In the UK the retail price for an MRI scan privately ranges between £350 and
£700 (€405–810).[84]

Safety
MRI is in general a safe technique, although injuries may occur as a result of failed safety procedures or human error.[85]
Contraindications to MRI include most cochlear implants and cardiac pacemakers, shrapnel, and metallic foreign bodies in the eyes.
The safety of MRI during the first trimester of pregnancy is uncertain, but it may be preferable to other options.[86] Since MRI does
not use any ionizing radiation, its use is generally favored in preference to CT when either modality could yield the same
information.[87] In certain cases, MRI is not preferred as it may be more expensive, time-consuming, and claustrophobia-
exacerbating.

MRI uses powerful magnets and can therefore cause magnetic materials to move at great speeds posing risk. Deaths have
occurred.[88]
Overuse
Medical societies issue guidelines for when physicians should use MRI on patients and recommend against overuse. MRI can detect
health problems or confirm a diagnosis, but medical societies often recommend that MRI not be the first procedure for creating a plan
to diagnose or manage a patient's complaint. A common case is to use MRI to seek a cause of low back pain; the American College
[89][90]
of Physicians, for example, recommends against this procedure as unlikely to result in a positive outcome for the patient.

Artifacts
An MRI artifact is a visual artifact, that is, an anomaly during visual representation.
Many different artifacts can occur during magnetic resonance imaging (MRI), some
affecting the diagnostic quality, while others may be confused with pathology.
Artifacts can be classified as patient-related, signal processing-dependent and
hardware (machine)-related.[91] Artifacts remain a problematic in magnetic
resonance imaging (MRI). Some affect the quality of the examination, while others
may be confused with pathology.[91]

Non-medical use
MRI is used industrially mainly for routine analysis of chemicals. The nuclear Motion artifact (T1 coronal study of
magnetic resonance technique is also used, for example, to measure the ratio lumbar vertebrae).[91]
between water and fat in foods, monitoring of flow of corrosive fluids in pipes, or to
study molecular structures such as catalysts.[92]

History
In the late 1970s, physicists Dr. Peter Mansfield and Dr. Paul Lauterbur, developed MRI-related techniques, like the echo-planar
imaging (EPI) technique.[93] Mansfield and Lauterbur were awarded the 2003 Nobel Prize in Physiology or Medicine for their
"discoveries concerning magnetic resonance imaging".

See also
Earth's field NMR
Electron paramagnetic resonance
High-definition fiber tracking
History of neuroimaging
International Society of Magnetic Resonance in Medicine
Jemris
List of neuroimaging software
Magnetic immunoassay
Magnetic particle imaging
Magnetic resonance elastography
Magnetic Resonance Imaging(journal)
Magnetic resonance microscopy
Nobel Prize controversies
Rabi cycle
Robinson oscillator
Sodium MRI
Virtopsy

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91. Erasmus, L.J.; Hurter, D.; Naude, M.; Kritzinger, H.G.; Acho, S. (2004). "A short overview of MRI artifacts".South
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Magnetic Resonance (11 ed.). 2017. Retrieved 2017-12-18.
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doi:10.1103/physrevb.12.3618(https://doi.org/10.1103%2Fphysrevb.12.3618) .

Further reading
TRTF/EMRF: The history of MRI (Peter A. Rinck, ed). url = http://www.magnetic-resonance.org/ch/20-01.html
Guadalupe Portal; Aliosvi Rodriguez Whole body magnetic resonance imaging in early diagnosis inrinidad
T BMJ
(2010) ISSN 1756-1833 url = http://www.bmj.com/rapid-response/2011/12/19/re-whole-body-magnetic-resonance-
imaging
Ian L. Pykett (May 1, 1982)."NMR Imaging in Medicine"(PDF). Scientific American. 246 (5): 78–88.
Bibcode:1982SciAm.246e..78P. doi:10.1038/scientificamerican0582-78. Archived from the original (PDF) on March
10, 2016.
Simon, Merrill; Mattson, James S (1996).The pioneers of NMR and magnetic resonance in medicine: The story of
MRI. Ramat Gan, Israel: Bar-Ilan University Press.ISBN 0-9619243-1-4.
Haacke, E Mark; Brown, Robert F; Thompson, Michael; e Vnkatesan, Ramesh (1999).Magnetic resonance imaging:
Physical principles and sequence design. New York: J. Wiley & Sons. ISBN 0-471-35128-8.
Lee SC; Kim K; Kim J; Lee S; Han Yi J; Kim SW; Ha KS; Cheong C (June 2001). "One micrometer resolution NMR
microscopy". J. Magn. Reson. 150 (2): 207–13. Bibcode:2001JMagR.150..207L. doi:10.1006/jmre.2001.2319.
PMID 11384182.
Perry Sprawls (2000). Magnetic Resonance ImagingPrinciples, Methods, and Techniques. Medical Physics
Publishing. ISBN 9780944838976.
P Mansfield (1982). NMR Imaging in Biomedicine: Supplement 2 Advances in Magnetic Resonance
. Elsevier.
ISBN 9780323154062.
Eiichi Fukushima (1989).NMR in Biomedicine: The Physical Basis. Springer Science & Business Media.
ISBN 9780883186091.
Bernhard Blümich; Winfried Kuhn (1992).Magnetic Resonance Microscopy: Methods and Applications in Materials
Science, Agriculture and Biomedicine. Wiley. ISBN 9783527284030.
Peter Blümer (1998). Peter Blümler; Bernhard Blümich; Robert E. Botto; Eiichi Fukushima, eds.
Spatially Resolved
Magnetic Resonance: Methods, Materials, Medicine, Biology
, Rheology, Geology, Ecology, Hardware. Wiley-VCH.
ISBN 9783527296378.
Zhi-Pei Liang; Paul C. Lauterbur (1999).Principles of Magnetic Resonance Imaging: A Signal Processing
Perspective. Wiley. ISBN 9780780347236.
Franz Schmitt; Michael K. Stehling; Robert T
urner (1998). Echo-Planar Imaging: Theory, Technique and Application.
Springer Berlin Heidelberg.ISBN 9783540631941.
Vadim Kuperman (2000).Magnetic Resonance Imaging: Physical Principles and Applications
. Academic Press.
ISBN 9780080535708.
Bernhard Blümich (2000).NMR Imaging of Materials. Clarendon Press. ISBN 9780198506836.
Jianming Jin (1998). Electromagnetic Analysis and Design in Magnetic Resonance Imaging
. CRC Press.
ISBN 9780849396939.
Imad Akil Farhat; P. S. Belton; Graham Alan Webb; Royal Society of Chemistry (Great Britain) (2007).Magnetic
Resonance in Food Science: From Molecules to Man . Royal Society of Chemistry. ISBN 9780854043408.

External links
MRI: A Peer-Reviewed, Critical Introduction. European Magnetic Resonance Forum (EMRF)/The Round able T
Foundation (TRTF); Peter A. Rinck (editor)
A Guided Tour of MRI: An introduction for laypeople National High Magnetic Field Laboratory
The Basics of MRI. Underlying physics and technical aspects.
Video: What to Expect During Your MRI Exam from the Institute for Magnetic Resonance Safety , Education, and
Research (IMRSER)
Royal Institution Lecture – MRI: A Window on the Human Body
A SHORT HISTORY OF MAGNETIC RESONANCE IMAGING FROM A EUROPEAN POINT OF VIEW
 Animal Imaging Database (AIDB)
How MRI works explained simply using diagrams
Real-time MRI videos: Biomedizinische NMR Forschungs GmbH
.

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