(IR) Inversion recovery is an MRI technique, which can be incorporated into MR imaging, wherein the nuclear magnetization is inverted at a time on the order of T1 before the regular imaging pulse-gradient sequences. The resulting partial relaxation of the spins in the different structures being imaged can be used to produce an image that depends strongly on T1. This may bring out differences in the appearance of structures with different T1 relaxation times. Note that this does not directly produce an image of T1. T1 in a given region can be calculated from the change in the MR signal from the region due to the inversion pulse compared to the signal with no inversion pulse or an inversion pulse with a different inversion time. This sequence involves successive 180° and 90° pulses. The inversion recovery sequence is specified in terms of three parameters, inversion time (TI), repetition time (TR) and echo time (TE).

See also Inversion Recovery Sequence and FLAIR.

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.

MR myelography is studying the spinal canal and subarachnoid space by high-resolution MRI with a technique in which a sequence with strong T2 weighting is used to provide high contrast between the "dark" spinal cord and its nerves and the surrounding "bright" cerebrospinal fluid. MR myelography as part of an entire MR examination has virtually replaced X-ray myelography. Used sequences are T2 weighted fast spin echo pulse sequences or a refocused gradient echo pulse sequence with strong T2 weighting.

See also the related poll result: 'MRI will have replaced 50% of x-ray exams by'

In MR, saturation is a nonequilibrium state with no net magnetization. The same amount of nuclear spins is aligned against and with the magnetic field. Saturation methods like FatSat, SPIR etc., work with a frequency selective saturation pulse for a specific chemical shift applied before the actual sequence starts. This saturation pulse adjusts the magnetization from tissue components to zero. The hydrogen nuclei of fat and water resonate at different frequencies, which makes it possible to excite just the fat with repeatedly applying RF pulses at the Larmor frequency with interpulse times compared to T1. The resulting signal is then destroyed with a gradient pulse (Spoiler Gradient Pulse). Fat is the chemical compound to be saturated at a fat saturation sequence. When the actual sequence follows, (e.g., a spin echo sequence) the unwanted suppressed component will not resonate.

See also Saturation Recovery.

(SR) Particular type of partial saturation pulse sequence in which the preceding pulses leave the spins in a state of saturation, so that recovery at the time of the next pulse has taken place from an initial condition of no magnetization. A rare used MRI pulse sequence that generates a predominantly proton density dependent signal, basically employing a 90° RF excitation pulse, with a very long repetition time. With this technique T1 times can be measured faster than with inversion recovery pulse sequences.
This saturation recovery sequence consists of multiple 90° radio frequency (RF) pulses with a short repetition time. A spoiler gradient pulse dephases the longitudinal magnetization that remains after the first 90° radio frequency pulse. A repetition time interval after the application of this spoiling gradient turns an additional 90° pulse the new developed longitudinal magnetization into the transverse plane, followed by recording a gradient echo.