Knee MRI, with its high soft tissue contrast is one of the main imaging tools to depict knee joint pathology. MRI allows accurate imaging of intra-articular structures such as ligaments, cartilage, menisci, bone marrow, synovium, and adjacent soft tissue.
Knee exams require a dedicated extremity coil, providing a homogenous imaging volume and high SNR to ensure best signal coverage. A complete knee MR examination includes for example sagittal and coronal T1 weighted, and proton density weighted pulse sequences +/- fat saturation, or STIR sequences. For high spatial resolution, maximal 4 mm thick slices with at least an in plane resolution of 0.75 mm and small gap are recommended. To depict the anterior cruciate ligament clearly, the sagittal plane has to be rotated 10 - 20° externally (parallel to the medial border of the femoral condyle). Retropatellar cartilage can bee seen for example in axial T2 weighted gradient echo sequences with Fatsat. However, the choice of the pulse sequences is depended of the diagnostic question, the used scanner, and preference of the operator.
Diagnostic quality in knee imaging is possible with field strengths ranging from 0.2 to 3T. With low field strengths more signal averages must be measured, resulting in increased scan times to provide equivalent quality as high field strengths.
More diagnostic information of meniscal tears and chondral defects can be obtained by direct magnetic resonance arthrography, which is done by introducing a dilute solution of gadolinium in saline (1:1000) into the joint capsule. The knee is then scanned in all three planes using T1W sequences with fat suppression. For indirect arthrography, the contrast is given i.v. and similar scans are started 20 min. after injection and exercise of the knee.
Frequent indications of MRI scans in musculoskeletal knee diseases are:
e.g., meniscal degeneration and tears, ligament injuries, osteochondral fractures, osteochondritis dissecans, avascular bone necrosis and rheumatoid arthritis.

See also Imaging of the Extremities and STIR.

Liver imaging can be performed with sonography, computed tomography (CT) and magnetic resonance imaging (MRI). Ultrasound is, caused by the easy access, still the first-line imaging method of choice; CT and MRI are applied whenever ultrasound imaging yields vague results. Indications are the characterization of metastases and primary liver tumors e.g., benign lesions such as focal nodular hyperplasia (FNH), adenoma, hemangioma and malignant lesions (cancer) such as hepatocellular carcinomas (HCC). The decision, which medical imaging modality is more suitable, MRI or CT, is dependent on the different factors. CT is less costly and more widely available; modern multislice scanners provide high spatial resolution and short scan times but has the disadvantage of radiation exposure.
With the introduction of high performance MR systems and advanced sequences the image quality of MRI for the liver has gained substantially. Fast spin echo or single shot techniques, often combined with fat suppression, are the most common T2 weighted sequences used in liver MRI procedures. Spoiled gradient echo sequences are used as ideal T1 weighted sequences for evaluating of the liver. The repetition time (TR) can be sufficiently long to acquire enough sections covering the entire liver in one pass, and to provide good signal to noise. The TE should be the shortest in phase echo time (TE), which provides strong T1 weighting, minimizes magnetic susceptibility effects, and permits acquisition within one breath hold to cover the whole liver. A flip angle of 80° provides good T1 weighting and less of power deposition and tissue saturation than a larger flip angle that would provide comparable T1 weighting.
Liver MRI is very dependent on the administration of contrast agents, especially when detection and characterization of focal lesions are the issues. Liver MRI combined with MRCP is useful to evaluate patients with hepatic and biliary disease.
Gadolinium chelates are typical non-specific extracellular agents diffusing rapidly to the extravascular space of tissues being cleared by glomerular filtration at the kidney. These characteristics are somewhat problematic when a large organ with a huge interstitial space like the liver is imaged. These agents provide a small temporal imaging window (seconds), after which they begin to diffuse to the interstitial space not only of healthy liver cells but also of lesions, reducing the contrast gradient necessary for easy lesion detection. Dynamic MRI with multiple phases after i.v. contrast media (Gd chelates), with arterial, portal and late phase images (similar to CT) provides additional information.
An additional advantage of MRI is the availability of liver-specific contrast agents (see also Hepatobiliary Contrast Agents). Gd-EOB-DTPA (gadoxetate disodium, Gadolinium ethoxybenzyl dimeglumine, EOVIST Injection, brand name in other countries is Primovist) is a gadolinium-based MRI contrast agent approved by the FDA for the detection and characterization of known or suspected focal liver lesions.
Gd-EOB-DTPA provides dynamic phases after intravenous injection, similarly to non-specific gadolinium chelates, and distributes into the hepatocytes and bile ducts during the hepatobiliary phase. It has up to 50% hepatobiliary excretion in the normal liver.
Since ferumoxides are not eliminated by the kidney, they possess long plasmatic half-lives, allowing circulation for several minutes in the vascular space. The uptake process is dependent on the total size of the particle being quicker for larger particles with a size of the range of 150 nm (called superparamagnetic iron oxide). The smaller ones, possessing a total particle size in the order of 30 nm, are called ultrasmall superparamagnetic iron oxide particles and they suffer a slower uptake by RES cells. Intracellular contrast agents used in liver MRI are primarily targeted to the normal liver parenchyma and not to pathological cells. Currently, iron oxide based MRI contrast agents are not marketed.
Beyond contrast enhanced MRI, the detection of fatty liver disease and iron overload has clinical significance due to the potential for evolution into cirrhosis and hepatocellular carcinoma. Imaging-based liver fat quantification (see also Dixon) provides noninvasively information about fat metabolism; chemical shift imaging or T2*-weighted imaging allow the quantification of hepatic iron concentration.

See also Abdominal Imaging, Primovistâ„¢, Liver Acquisition with Volume Acquisition (LAVA), T1W High Resolution Isotropic Volume Examination (THRIVE) and Bolus Injection.

For Ultrasound Imaging (USI) see Liver Sonography at Medical-Ultrasound-Imaging.com.

From ONI Medical Systems, Inc.;
MSK-Extremeâ„¢MRI system is a dedicated high field extremity imaging device, designed to provide orthopedic surgeons and other physicians with detailed diagnostic images of the foot, ankle, knee, hand, wrist and elbow, all with the clinical confidence and advantages derived from high field, whole body MRI units. The light weight (less than 650 kg) of the OrthOne System performs rapid patient studies, is easy to operate, has a patient friendly open environment and can be installed in a practice office or hospital, all at a cost similar to a low field extremity machine.
New features include a more powerful operating system that offers increased scan speed as well as a 160-mm knee coil with higher signal to noise ratio, and the option of a CD burner.

Forces can result from the interaction of magnetic fields. Pulsed magnetic field gradients can interact with the main magnetic field during the MRI scan, to produce acoustic noise through the gradient coil.
Magnetic fields attract ferromagnetic objects with forces, which can be a lethal danger if one is hit by an unrestrained object in flight. One could also be trapped between the magnet and a large unrestrained ferromagnetic object or the object could damage the MRI machine.
Access control and personnel awareness are the best preventions of such accidents. The attraction mechanism for ferromagnetic objects is that the magnetic field magnetizes the iron. This induced magnetization reacts with the gradient of the magnetic field to produce an attraction toward the strongest area of the field. The details of this interaction are very dependent on the shape and composition of the attracted object. There is a very rapid increase of force as one approaches a magnet. There is also a torque or twisting force on objects, e.g. a long cylinder (such as a pen or an intracranial aneurysm clip) will tend to align along the magnet's field lines. The torque increases with field strength while the attraction increases with field gradient.
Depending on the magnetic saturation of the object, attraction is roughly proportional to object mass. Motion of conducting objects in magnetic fields can induce eddy currents that can have the effect of opposing the motion.

See also Duty Cycle.

See also the related poll result: 'Most outages of your scanning system are caused by failure of'

(MP-GRE / MPRAGE / MP-RAGE) A fast 3D gradient echo pulse sequence using a magnetization preparation pulse like TurboFLASH. Only one segment or partition of a 3D data record is obtained per inversion preparation pulse. After the acquisition, for all rows a delay time (TD) is used to prevent saturation effects.
MPRAGE is designed for rapid acquisition with T1 weighted dominance. Fast gradient echoes are characterized by their rapid sampling time, high signal intensity and image contrast while approaching steady state (the echo is collected during the time when tissues are experiencing T1 relaxation). The rapid speed of the acquisition makes it an excellent alternative to breath-hold abdominal imaging, neuro, dynamic bolus, MR angiography and cardiac imaging.

See Gradient Echo Sequence.