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Quantification relies on inflow effects or on spin phase effects and therefore on quantifying the phase shifts of moving tissues relative to stationary tissues.
With properly designed pulse sequences (see phase contrast sequence) the pixel by pixel phase represents a map of the velocities measured in the imaging plane. Spin phase effect-based flow quantification schemes use pulse sequences specifically designed so that the phase angle in a pixel obtained upon measuring the signal is proportional to the velocity. As the relation of the phase angle to the velocity is defined by the gradient amplitudes and the gradient switch-on times, which are known, velocity can be determined quantitatively on a pixel-by-pixel basis. Once, this velocity is known, the flow in a vessel can be determined by multiplying the pixel area with the pixel velocity. Summing this quantity for all pixels inside a vessel results in a flow volume, which is measured, e.g. in ml/sec.
Flow related enhancement-based flow quantification techniques (entry phenomena) work because spins in a section perpendicular to the vessel of interest are labeled with some radio frequency RF pulse. Positional readout of the tagged spins some time T later will show the distance D they have traveled.
For constant flow, the velocity v is obtained by dividing the distance D by the time T : v = D/T. Variations of this basic principle have been proposed to measure flow, but the standard methods to measure velocity and flow use the spin phase effect.
Cardiac MRI sequences are used to encode images with velocity information. These pulse sequences permit quantification of flow-related physiologic data, such as blood flow in the aorta or pulmonary arteries and the peak velocity across stenotic valves. | | | | | |
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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. | | | | | | • View the DATABASE results for 'Knee MRI' (4).
| | | • View the NEWS results for 'Knee MRI' (4).
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| | | | • View the DATABASE results for 'Spin Echo' (96).
| | | • View the NEWS results for 'Spin Echo' (1).
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Quick Overview
Materials with magnetic susceptibility cause this artifact. There are in general three kinds of materials with magnetic susceptibility: ferromagnetic materials (iron, nickel etc.) with a strong influence and paramagnetic/diamagnetic (aluminium, platinum etc./gold, water, most organic compounds etc.) materials with a minimal/non influence on magnetic fields. In MRI, susceptibility artifacts are caused for example by medical devices in or near the magnetic field or by implants of the patient. These materials with magnetic susceptibility distort the linear magnetic field gradients, which results in bright areas (misregistered signals) and dark areas (no signal) nearby the magnetic material.
Image Guidance
| | | | • View the DATABASE results for 'Susceptibility Artifact' (8).
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( BOLD) In MRI the changes in blood oxygenation level are visible. Oxyhaemoglobin (the principal haemoglobin in arterial blood) has no substantial magnetic properties, but deoxyhaemoglobin (present in the draining veins after the oxygen has been unloaded in the tissues) is strongly paramagnetic. It can thus serve as an intrinsic paramagnetic contrast agent in appropriately performed brain MRI. The concentration and relaxation properties of deoxyhaemoglobin make it a susceptibility , e.g. T2 relaxation effective contrast agent with little effect on T1 relaxation.
During activation of the brain, the oxygen consumption of the local tissue increase by approximately 5% with that the oxygen tension will decrease. As a con sequence, after a short period of time vasodilatation occurs, resulting in a local increase of blood volume and flow by 20 - 40%. The incommensurate change in local blood flow and oxygen extraction increases the local oxygen level.
By using T2 weighted gradient echo EPI sequences, which are highly susceptibility sensitive and fast enough to capture the three-dimensional nature of activated brain areas will show an increase in signal intensity as oxyhaemoglobin is diamagnetic and deoxyhaemoglobin is paramagnetic. Other MR pulse sequences, such as spoiled gradient echo pulse sequences are also used.
As the effects are subtle and of the order of 2% in 1.5 T MR imaging, sophisticated methodology, paradigms and data analysis techniques have to be used to consistently demonstrate the effect.
As the BOLD effect is due to the deoxygenated blood in the draining veins, the spatial localization of the region where there is increased blood flow resulting in decreased oxygen extraction is not as precisely defined as the morphological features in MRI. Rather there is a physiological blurring, and is estimated that the linear dimensions of the physiological spatial resolution of the BOLD phenomenon are around 3 mm at best. | | | | • View the DATABASE results for 'Blood Oxygenation Level Dependent Contrast' (6).
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