Automatic bolus detection is used to trigger the begin of the MRI scan with the time the contrast agent reaches the region of interest. The acquisition process is started once the signal is increased in this region.
There are similar methods used by the scanner manufacturer (see MRI Acronyms for Automatic Bolus Detection). After injection of the contrast agent the region of interest is monitored (e.g. with a spin echo or gradient echo sequence). When the signal increases the scan is automatically triggered or the operator is informed.
Brain imaging, magnetic resonance imaging of the head or skull, cranial magnetic resonance tomography (MRT), neurological MRI - they describe all the same radiological imaging technique for medical diagnostic. Magnetic resonance imaging of the human brain includes the anatomic description and the detection of lesions. Special techniques like diffusion weighted imaging, functional magnetic resonance imaging (fMRI) and spectroscopy provide also information about the function and chemical metabolites of the brain.
MRI provides detailed pictures of brain and nerve tissues in multiple planes without obstruction by overlying bones. Brain MRI is the procedure of choice for most brain disorders. It provides clear images of the brainstem and posterior brain, which are difficult to view on a CT scan. It is also useful for the diagnosis of demyelinating disorders (disorders such as multiple sclerosis (MS) that cause destruction of the myelin sheath of the nerve).
With this noninvasive procedure also the evaluation of blood flow and the flow of cerebrospinal fluid (CSF) is possible. Different MRAmethods, also without contrast agents can show a venous or arterial angiogram. MRI can distinguish tumors, inflammatory lesions, and other pathologies from the normal brain anatomy. However, MRI scans are also used instead other methods to avoid the dangers of interventional procedures like angiography (DSA - digital subtraction angiography) as well as of repeated exposure to radiation as required for computed tomography (CT) and other X-ray examinations.
A (birdcage) bird cage coil achieves uniform excitation and reception and is commonly used to study the brain. Usually a brain MRI procedure includes FLAIR, T2 weighted and T1 weightedsequences in two or three planes.
Contrast agent with a preferential intracellular distribution.
Intracellular agents (such as manganese derivatives and ultrasmall superparamagnetic iron oxide), exhibit a flow- and metabolism-dependent uptake. These properties may allow delayed imaging, similar to isotopic methods.
Phospholipid liposomes are rapidly sequestered by the cells in the reticuloendothelial system (RES), primarily in the liver. For imaging of the liver, liposomes may be labeled with MRcontrast medium, both positive (T1-shortening) paramagnetic media, and negative (T2-shortening) superparamagnetic media.
Several other nonliposome MRcontrast media are also taken up by the RES, e.g.:
Diffusion weighted imaging can be performed similar to the phase contrast angiography sequence. The gradients must be increased in amplitude to depict the much slower motions of molecular diffusion in the body.
While a T1 weightedMRIpulse sequence is diffusion sensitive, a quantitative diffusionpulse sequence was introduced by Steijskal and Tanner. Its characteristic features are two strong symmetrical gradient lobes placed on either side of the 180° refocusing pulse in a spin echosequence. These symmetrical gradient lobes have the sole purpose of enhancing dephasing of spins, thereby accelerating intravoxel incoherent motion (IVIM) signal loss.
Dephasing is proportional to the square of the time (diffusion time) during which the gradients are switched on and the strength of the applied gradient field. Therefore, the use of high field gradient systems with faster and more sensitive sequences, make diffusion weighting more feasible.
Areas in which the protons diffuse rapidly (swollen cells in early stroke, less restriction to diffusion) will show an increased signal when the echo is measured relative to areas in which diffusion is restricted.
For increased accuracy of diffusion measurement and image enhancement, useful motion correction techniques such as navigator echo and other methods should be used. In addition to this, applying the b-value calculated by the strength and duration of motion probing gradients with a high rate of accuracy is very important.