Cardiovascular MR imaging includes the complete anatomical display of the heart with CINE imaging of all phases of the heartbeat. Ultrafast techniques make breath hold three-dimensional coverage of the heart in different cardiac axes feasible. Cardiac MRI provides reliable anatomical and functional assessment of the heart and evaluation of myocardial viability and coronary artery disease by a noninvasive diagnostic imaging technique.
Cardiovascular MRI offers potential advantages over radioisotopic techniques because it provides superior spatial resolution, does not use ionizing radiation, has no imaging orientations constraints and contrast resolution better than echocardiography. It also offers direct visualization and characterization of atherosclerotic plaques and diseased vessel walls and surrounding tissues in cardiovascular research.
MRI perfusion approaches measure the alteration of regional myocardial magnetic properties after the intravenous injection of contrast agents and assess the extent of injury after a myocardial infarction and the presence of myocardial viability with a technique based on late enhancement. Extracellular MRI contrast agents, like Gd-DTPA, accumulate only in irreversibly damaged myocardium after a time period of at least 10 minutes.
This type of patients may also have an implanted cardiac stent, bypass or a cardiac pacemaker and special caution should be observed on the MRI safety and the contraindications. While a number of coronary stents have been tested and reported to be MRI compatible, coronary stents must be assessed on an individual basis, with the medical team weighing the risks and benefits of the MRI procedure.

Cardiac MRI overview:

Cardiovascular MRI has become one of the most effective noninvasive imaging techniques for almost all groups of heart and vascular disease.

(DWI) Magnetic resonance imaging is sensitive to diffusion, because the diffusion of water molecules along a field gradient reduces the MR signal. In areas of lower diffusion the signal loss is less intense and the display from this areas is brighter. The use of a bipolar gradient pulse and suitable pulse sequences permits the acquisition of diffusion weighted images (images in which areas of rapid proton diffusion can be distinguished from areas with slow diffusion).
Based on echo planar imaging, multislice DWI is today a standard for imaging brain infarction. With enhanced gradients, the whole brain can be scanned within seconds. The degree of diffusion weighting correlates with the strength of the diffusion gradients, characterized by the b-value, which is a function of the gradient related parameters: strength, duration, and the period between diffusion gradients.
Certain illnesses show restrictions of diffusion, for example demyelinization and cytotoxic edema. Areas of cerebral infarction have decreased apparent diffusion, which results in increased signal intensity on diffusion weighted MRI scans. DWI has been demonstrated to be more sensitive for the early detection of stroke than standard pulse sequences and is closely related to temperature mapping.
DWIBS is a new diffusion weighted imaging technique for the whole body that produces PET-like images. The DWIBS sequence has been developed with the aim to detect lymph nodes and to differentiate normal and hyperplastic from metastatic lymph nodes. This may be possible caused by alterations in microcirculation and water diffusivity within cancer metastases in lymph nodes.

See also Diffusion Weighted Sequence, Perfusion Imaging, ADC Map, Apparent Diffusion Coefficient, and Diffusion Tensor Imaging.

The company is a leading manufacturer and developer of magnetic resonance imaging (MRI) scanners. The Patient Friendly MRI Company, formed in 1978, is engaged in the business of inventing, manufacturing, selling and servicing magnetic resonance imaging (MRI) scanners. FONAR is the oldest MRI company in the world. After receiving hundreds of millions in a windfall from protecting their MRI patents, they made a MRI scanner that no other MRI manufacturer has. One that the patient stands in and they call Indomitable, the Stand-Up MRI. Patients like it because it is the least claustrophobic, most comfortable MRI on the market. Doctors like it because of its superior image quality and for the first time, the patient can be scanned in the weight-bearing position, or the position of pain or symptom. In October of 2004, the company changed the product name of the Stand-Up MRI to the Upright MRI. Fonar introduced the first "open" MRI scanner in 1980 and is the originator of the iron-core nonsuperconductive and permanent magnet technology.

MRI Scanners:

- 0.6T:

Ferrioxamines are potential iron oxide-based intravascular contrast agents. Ferrioxamine methanesulfonate, ferrioxamine-B, and hydroxyethyl-starch-ferrioxamine have been tested as MRI contrast agents, partly in clinical trials.
Ferrioxamine methanesulfonate was tested as a paramagnetic agent for the imaging of the kidney and the urogenital system. Hydroxyethyl-starch-ferrioxamine has the potential to provide information regarding myocardial vascular flow and ferrioxamine-B derivatives may be used as hepatobiliary contrast agents.

See also Superparamagnetic Iron Oxide, Hepatobiliary Contrast Agents.

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.