(PRESS) Point resolved spectroscopy is a multi echo single shot technique to obtain spectral data. PRESS is a 90°-180°-180° (slice selective pulses) sequence. The 90° radio frequency pulse rotates the spins in the yx-plane, followed by the first 180° pulse (spin rotation in the xz-plane) and the second 180° pulse (spin rotation in the xy-plane), which gives the signal.
With the long echo times used in PRESS, there is a better visualization of metabolites with longer relaxation times. Many of the metabolites depicted by stimulated echo technique are not seen on point resolved spectroscopy, but PRESS is less susceptible to motion, diffusion, and quantum effects and has a better SNR than stimulated echo acquisition mode (STEAM).

(PWI - Perfusion Weighted Imaging) Perfusion MRI techniques (e.g. PRESTO - Principles of Echo Shifting using a Train of Observations) are sensitive to microscopic levels of blood flow. Contrast enhanced relative cerebral blood volume (rCBV) is the most used perfusion imaging. Both, the ready availability and the T2* susceptibility effects of gadolinium, rather than the T1 shortening effects make gadolinium a suitable agent for use in perfusion imaging. Susceptibility here refers to the loss of MR signal, most marked on T2* (gradient echo)-weighted and T2 (spin echo)-weighted sequences, caused by the magnetic field-distorting effects of paramagnetic substances.
T2* perfusion uses dynamic sequences based on multi or single shot techniques. The T2* (T2) MRI signal drop within or across a brain region is caused by spin dephasing during the rapid passage of contrast agent through the capillary bed. The signal decrease is used to compute the relative perfusion to that region. The bolus through the tissue is only a few seconds, high temporal resolution imaging is required to obtain sequential images during the wash in and wash out of the contrast material and therefore, resolve the first pass of the tracer. Due to the high temporal resolution, processing and calculation of hemodynamic maps are available (including mean transit time (MTT), time to peak (TTP), time of arrival (T0), negative integral (N1) and index.
An important neuroradiological indication for MRI is the evaluation of incipient or acute stroke via perfusion and diffusion imaging. Diffusion imaging can demonstrate the central effect of a stroke on the brain, whereas perfusion imaging visualizes the larger 'second ring' delineating blood flow and blood volume. Qualitative and in some instances quantitative (e.g. quantitative imaging of perfusion using a single subtraction) maps of regional organ perfusion can thus be obtained.
Echo planar and potentially echo volume techniques together with appropriate computing power offer real time images of dynamic variations in water characteristics reflecting perfusion, diffusion, oxygenation (see also Oxygen Mapping) and flow.
Another type of perfusion MR imaging allows the evaluation of myocardial ischemia during pharmacologic stress. After e.g., adenosine infusion, multiple short axis views (see cardiac axes) of the heart are obtained during the administration of gadolinium contrast. Ischemic areas show up as areas of delayed and diminished enhancement. The MRI stress perfusion has been shown to be more accurate than nuclear SPECT exams. Myocardial late enhancement and stress perfusion imaging can also be performed during the same cardiac MRI examination.

(SENSE) A MRI technique for relevant scan time reduction. The spatial information related to the coils of a receiver array are utilized for reducing conventional Fourier encoding. In principle, SENSE can be applied to any imaging sequence and k-space trajectories. However, it is particularly feasible for Cartesian sampling schemes. In 2D Fourier imaging with common Cartesian sampling of k-space sensitivity encoding by means of a receiver array enables to reduce the number of Fourier encoding steps.
SENSE reconstruction without artifacts relies on accurate knowledge of the individual coil sensitivities. For sensitivity assessment, low-resolution, fully Fourier-encoded reference images are required, obtained with each array element and with a body coil.
The major negative point of parallel imaging techniques is that they diminish SNR in proportion to the numbers of reduction factors. R is the factor by which the number of k-space samples is reduced. In standard Fourier imaging reducing the sampling density results in the reduction of the FOV, causing aliasing. In fact, SENSE reconstruction in the Cartesian case is efficiently performed by first creating one such aliased image for each array element using discrete Fourier transformation (DFT).
The next step then is to create a full-FOV image from the set of intermediate images. To achieve this one must undo the signal superposition underlying the fold-over effect. That is, for each pixel in the reduced FOV the signal contributions from a number of positions in the full FOV need to be separated. These positions form a Cartesian grid corresponding to the size of the reduced FOV.
The advantages are especially true for contrast-enhanced MR imaging such as dynamic liver MRI (liver imaging) , 3 dimensional magnetic resonance angiography (3D MRA), and magnetic resonance cholangiopancreaticography (MRCP).
The excellent scan speed of SENSE allows for acquisition of two separate sets of hepatic MR images within the time regarded as the hepatic arterial-phase (double arterial-phase technique) as well as that of multidetector CT.
SENSE can also increase the time efficiency of spatial signal encoding in 3D MRA. With SENSE, even ultrafast (sub second) 4D MRA can be realized.
For MRCP acquisition, high-resolution 3D MRCP images can be constantly provided by SENSE. This is because SENSE resolves the presence of the severe motion artifacts due to longer acquisition time. Longer acquisition time, which results in diminishing image quality, is the greatest problem for 3D MRCP imaging.
In addition, SENSE reduces the train of gradient echoes in combination with a faster k-space traversal per unit time, thereby dramatically improving the image quality of single shot echo planar imaging (i.e. T2 weighted, diffusion weighted 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.

The definition of imaging is the visual representation of an object. Medical imaging began after the discovery of x-rays by Konrad Roentgen 1896. The first fifty years of radiological imaging, pictures have been created by focusing x-rays on the examined body part and direct depiction onto a single piece of film inside a special cassette. The next development involved the use of fluorescent screens and special glasses to see x-ray images in real time.
A major development was the application of contrast agents for a better image contrast and organ visualization. In the 1950s, first nuclear medicine studies showed the up-take of very low-level radioactive chemicals in organs, using special gamma cameras. This medical imaging technology allows information of biologic processes in vivo. Today, PET and SPECT play an important role in both clinical research and diagnosis of biochemical and physiologic processes. In 1955, the first x-ray image intensifier allowed the pick up and display of x-ray movies.
In the 1960s, the principals of sonar were applied to diagnostic imaging. Ultrasonic waves generated by a quartz crystal are reflected at the interfaces between different tissues, received by the ultrasound machine, and turned into pictures with the use of computers and reconstruction software. Ultrasound imaging is an important diagnostic tool, and there are great opportunities for its further development. Looking into the future, the grand challenges include targeted contrast agents, real-time 3D ultrasound imaging, and molecular imaging.
Digital imaging techniques were implemented in the 1970s into conventional fluoroscopic image intensifier and by Godfrey Hounsfield with the first computed tomography. Digital images are electronic snapshots sampled and mapped as a grid of dots or pixels. The introduction of x-ray CT revolutionised medical imaging with cross sectional images of the human body and high contrast between different types of soft tissue. These developments were made possible by analog to digital converters and computers. The multislice spiral CT technology has expands the clinical applications dramatically.
The first MRI devices were tested on clinical patients in 1980. The spread of CT machines is the spur to the rapid development of MRI imaging and the introduction of tomographic imaging techniques into diagnostic nuclear medicine. With technological improvements including higher field strength, more open MRI magnets, faster gradient systems, and novel data-acquisition techniques, MRI is a real-time interactive imaging modality that provides both detailed structural and functional information of the body.
Today, imaging in medicine has advanced to a stage that was inconceivable 100 years ago, with growing medical imaging modalities:
All this type of scans are an integral part of modern healthcare. Because of the rapid development of digital imaging modalities, the increasing need for an efficient management leads to the widening of radiology information systems (RIS) and archival of images in digital form in picture archiving and communication systems (PACS). In telemedicine, healthcare professionals are linked over a computer network. Using cutting-edge computing and communications technologies, in videoconferences, where audio and visual images are transmitted in real time, medical images of MRI scans, x-ray examinations, CT scans and other pictures are shareable.
See also Hybrid Imaging.

See also the related poll results: 'In 2010 your scanner will probably work with a field strength of', 'MRI will have replaced 50% of x-ray exams by'