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MRI Resources 
Directories - MRI Reimbursement - Cochlear Implant - Shoulder MRI - IR - Societies
 
Fast Imaging with Steady PrecessionInfoSheet: - Sequences - 
Intro, 
Overview, 
Types of, 
etc.
 
(TrueFISP) True fast imaging with steady state precession is a coherent technique that uses a fully balanced gradient waveform. The image contrast with TrueFISP is determined by T2*//T1 properties and mostly depending on TR. The speed and relative motion insensitivity of acquisition help to make the technique reliable, even in patients who have difficulty with holding their breath.
Recent advances in gradient hardware have led to a decreased minimum TR. This combined with improved field shimming capabilities and signal to noise ratio, has allowed TrueFISP imaging to become practical for whole-body applications. There's mostly T2* weighting. With the used ultrashort TR-times T1 weighting is almost impossible. One such application is cardiac cine MR with high myocardium-blood contrast. Spatial and temporal resolution can be substantially improved with this technique, but contrast on the basis of the ratio of T2* to T1 is not sufficiently high in soft tissues. By providing T1 contrast, TrueFISP could then document the enhancement effects of T1 shortening contrast agents. These properties are useful for the anatomical delineation of brain tumors and normal structures. With an increase in SNR ratio with minimum TR, TrueFISP could also depict the enhancement effect in myoma uteri. True FSIP is a technique that is well suited for cardiac MR imaging. The imaging time is shorter and the contrast between the blood and myocardium is higher than that of FLASH.

See Steady State Free Precession.
 
Images, Movies, Sliders:
 Cardiac Infarct 4 Chamber Cine 1  Open this link in a new window
    
 
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Further Reading:
  Basics:
Accurate T1 Quantification Using a Breath-hold Inversion Recovery TrueFISP Sequence
2003   by rsna2003.rsna.org    
MRI Resources 
Coils - Patient Information - Abdominal Imaging - PACS - Guidance - Liver Imaging
 
Coherent Gradient EchoInfoSheet: - Sequences - 
Intro, 
Overview, 
Types of, 
etc.MRI Resource Directory:
 - Sequences -
 
Coherent gradient echo sequences can measure the free induction decay (FID), generated just after each excitation pulse or the echo formed prior to the next pulse. Coherent gradient echo sequences are very sensitive to magnetic field inhomogeneity. An alternative to spoiling is to incorporate residual transverse magnetization directly into the longitudinal steady state. These GRE sequences use a refocusing gradient in the phase encoding direction during the end module to maximize remaining transverse (xy) magnetization at the time when the next excitation is due, while the other two gradients are, in any case, balanced.
When the next excitation pulse is sent into the system with an opposed phase, it tilts the magnetization in the -a direction. As a result the z-magnetization is again partly tilted into the xy-plane, while the remaining xy-magnetization is tilted partly into the z-direction.
A fully refocused sequence with a properly selected and uniform f would yield higher signal, especially for tissues with long T2 relaxation times (high water content) so it is used in angiographic, myelographic or arthrographic examinations and is used for T2* weighting. The repetition time for this sequence has to be short. With short TR, coherent GE is also useable for breath hold and 3D technique. If the repetition time is about 200 msec there's no difference between spoiled or unspoiled GE. T1 weighting is better with spoiled techniques.
The common types include GRASS, FISP, FAST, and FFE.
The T2* component decreases with long TR and short TE. The T1 time is controlled by flip angle. The common TR is less than 50 ms and the common TE less than 15 ms
Other types have stronger T2 dependence but lower SNR. They include SSFP, CE-FAST, PSIF, and CE-FFE-T2.
Examples of fully refocused FID sequences are TrueFISP, bFFE and bTFE.
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• View the DATABASE results for 'Coherent Gradient Echo' (6).Open this link in a new window

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Contrast Enhanced Gradient Echo SequenceInfoSheet: - Sequences - 
Intro, 
Overview, 
Types of, 
etc.
 
Contrast enhanced GRE sequences provide T2 contrast but have a relatively poor SNR. Repetitive RF pulses with small flip angles together with appropriate gradient profiles lead to the superposition of two resonance signals.
The first signal is due to the free induction decay FID observed after the first and all ensuing RF excitations.
The second is a resonance signal obtained as a result of a spin echo generated by the second and all addicted RF-pulses.
Hence it is absent after the first excitation, it is a result of the free induction decay of the second to last RF-excitation and has a TE, which is almost 2TR. For this echo to occur the gradients have to be completely symmetrical relative to the half time between two RF-pulses, a condition that makes it difficult to integrate this pulse sequence into a multiple slice imaging technique. The second signal not only contains echo contributions from free induction decay, but obviously weakened by T2-decay. Since the echo is generated by a RF-pulse, it is truly T2 rather than T2* weighted. Correspondingly it is also less sensitive to susceptibility changes and field inhomogeneities.
Companies use different acronyms to describe certain techniques.
Different terms (see also acronyms) for these gradient echo pulse sequences:
CE-FAST Contrast Enhanced Fourier Acquired Steady State,
CE-FFE Contrast Enhanced Fast Field Echo,
CE-GRE Contrast Enhanced Gradient-Echo,
DE-FGR Driven Equilibrium FGR,
FADE FASE Acquisition Double Echo,
PSIF Reverse Fast Imaging with Steady State Precession,
SSFP Steady State Free Precession,
T2 FFE Contrast Enhanced Fast Field Echo (T2 weighted).

In this context, 'contrast enhanced' refers to the pulse sequence, it does not mean enhancement with a contrast agent.
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• View the DATABASE results for 'Contrast Enhanced Gradient Echo Sequence' (4).Open this link in a new window

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Liver ImagingForum -
related threadsMRI Resource Directory:
 - Liver Imaging -
 
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.
 
Images, Movies, Sliders:
 Anatomic Imaging of the Liver  Open this link in a new window
      

 MRI Liver T2 TSE  Open this link in a new window
    
 
Radiology-tip.comradAbdomen CT,  Biliary Contrast Agents
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Medical-Ultrasound-Imaging.comLiver Sonography,  Vascular Ultrasound Contrast Agents
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• View the DATABASE results for 'Liver Imaging' (13).Open this link in a new window


• View the NEWS results for 'Liver Imaging' (10).Open this link in a new window.
 
Further Reading:
  Basics:
Comparison of liver scintigraphy and the liver-spleen contrast in Gd-EOB-DTPA-enhanced MRI on liver function tests
Thursday, 18 November 2021   by www.nature.com    
Liver Imaging Today
Friday, 1 February 2013   by www.healthcare.siemens.it    
Elastography: A Useful Method in Depicting Liver Hardness
Thursday, 15 April 2010   by www.sciencedaily.com    
Iron overload: accuracy of in-phase and out-of-phase MRI as a quick method to evaluate liver iron load in haematological malignancies and chronic liver disease
Friday, 1 June 2012   by www.ncbi.nlm.nih.gov    
  News & More:
Utility and impact of magnetic resonance elastography in the clinical course and management of chronic liver disease
Saturday, 20 January 2024   by www.nature.com    
Even early forms of liver disease affect heart health, Cedars-Sinai study finds
Thursday, 8 December 2022   by www.eurekalert.org    
For monitoring purposes, AI-aided MRI does what liver biopsy does with less risk, lower cost
Wednesday, 28 September 2022   by radiologybusiness.com    
Perspectum: High Liver Fat (Hepatic Steatosis) Linked to Increased Risk of Hospitalization in COVID-19 Patients With Obesity
Monday, 29 March 2021   by www.businesswire.com    
EMA's final opinion confirms restrictions on use of linear gadolinium agents in body scans
Friday, 21 July 2017   by www.ema.europa.eu    
T2-Weighted Liver MRI Using the MultiVane Technique at 3T: Comparison with Conventional T2-Weighted MRI
Friday, 16 October 2015   by www.ncbi.nlm.nih.gov    
EORTC study aims to qualify ADC as predictive imaging biomarker in preoperative regimens
Monday, 4 January 2016   by www.eurekalert.org    
MRI effectively measures hemochromatosis iron burden
Saturday, 3 October 2015   by medicalxpress.com    
Total body iron balance: Liver MRI better than biopsy
Sunday, 15 March 2015   by www.eurekalert.org    
MRI Resources 
Health - Equipment - Pediatric and Fetal MRI - Journals - MR Guided Interventions - Coils
 
Blood Flow ImagingMRI Resource Directory:
 - Blood Flow Imaging -
 
MR imaging techniques capable to provide maps of cerebral activity. All these techniques are based on indirect assessment of local cerebral haemodynamics that have been demonstrated to be closely related to cerebral activity.
Two kinds of techniques have been developed:
based on the assessment of the decrease in the content of deoxyhaemoglobin in local activated tissue that can be revealed as an increase of signal on T2* and T2 weighted sequences in which deoxyhaemoglobin has low signal (see Blood Oxygenation Level Dependent Contrast)
based on the time of flight or flow-related enhancement that is revealed either directly with T1 weighted images or through the use of modified angiographic bolus tracking techniques.
 
Images, Movies, Sliders:
 Circle of Willis, Time of Flight, MIP  Open this link in a new window
    
SlidersSliders Overview

 
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• View the NEWS results for 'Blood Flow Imaging' (1).Open this link in a new window.
 
Further Reading:
  News & More:
Turbo-FLASH Based Arterial Spin Labeled Perfusion MRI at 7 T
Thursday, 20 June 2013   by www.plosone.org    
Non-invasive MRI technique distinguishes between Alzheimer's and frontotemporal dementia
Saturday, 18 June 2005   by www.eurekalert.org    
MRI Resources 
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