Atlas of Magnetic Resonance Imaging Hariqbal Singh, Vikash Ojha, Santosh Konde
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1Atlas of Magnetic Resonance Imaging2
3Atlas of Magnetic Resonance Imaging
Editors Hariqbal Singh MD DMRD Professor and Head Department of Radiology Smt Kashibai Navale Medical College and General Hospital Pune, Maharashtra, India Vikash Ojha MD Consultant Department of Radiology Apollo Jehangir Hospital Pune, Maharashtra, India Santosh Konde MD Associate Professor Department of Radiology Smt Kashibai Navale Medical College and General Hospital Pune, Maharashtra, India
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© 2014, Jaypee Brothers Medical Publishers
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Atlas of Magnetic Resonance Imaging
First Edition: 2014
9789351521761
Printed at
5Dedicated to
Our dear wives
Arvind Babbal Hariqbal
Hariqbal Singh
Samta Singhania Ojha
Vikash Ojha
Leena Santosh Konde
Santosh Konde
Radiology is a kindergarten of logical rational coherent exploration and balanced learning and not dexterous adroit smugness or learning egotism cultivated by fake self-centeredness and egoism.
Hariqbal Singh
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7Contributors 9Preface
The advent of MR has revolutionized the field of medicine. This book provides a large bank of MR images. The importance of having a good knowledge of anatomy cannot be undermined. It has led us to include normal anatomy and a good range of MR imaging solutions routinely required. With these images in mind, it will help the residents, radiologists and practitioners to interpret the possible diagnosis during their routine practice. The intent has been to provide in-depth useful information material accounting for most of what is seen in clinical practice. It will be an ideal reference for anyone involved with MR image interpretation. The book, Atlas of Magnetic Resonance Imaging also includes a chapter on Assessment to make it more interest generating and gives the reader self-assessment to certain extend.
This book is meant for radiology residents, radiologists, general practitioners, other specialists, MR technical staff and those who have a special interest in MR imaging. It is meant for medical college and institutional libraries, departmental and MR stand-alone unit libraries.
Hariqbal Singh
Vikash Ojha
Santosh Konde
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11Acknowledgments
We thank Prof MN Navale, Founder President, Sinhgad Technical Education Society, Pune, Maharashtra, India, and Dr Arvind V Bhore, Dean, Smt Kashibai Navale Medical College and General Hospital, Pune, Maharashtra, India, for their kind acquiescence in this endeavor.
We profusely extend our gratefulness to the consultants Amit Ghawate, Yasmeen Khan, Shrikant Nagare, Anjali Sawant, Poonam Tambare, Swati Shah, Vikram Shende and Jarvis Pereira for their genuine help in building up this educational entity.
Our gratitude to Anna Bansode and Sachin Babar for their clerical help.
We are thankful to Musmade Bala, More Rahul, Demello Thomas, Gangoor Raghvendra, Shankar Gopale and Manjusha Chikhale for the plenteous help in data retrieval.
We express our thanks to the entire staff of M/s Jaypee Brothers Medical Publishers (P) Ltd., New Delhi, India, for their commitment to create highest standard of quality and state-of-the-art presentation with their excellence in publishing.
We are grateful to God Almighty and mankind who have allowed us to have this wonderful experience.
15Introduction
Magnetic resonance imaging (MRI) is the most important diagnostic imaging discovery in medicine since the discovery of X-ray in 1895 by Wilhelm Conrad Röntgen (also spelt as Roentgen). The first MRI was commercially available in 1980. Since then, its importance in the field of medicine continues to grow at a tremendous pace and is now established beyond doubt. Before beginning a study, it is important to know a brief history of MRI.
Sir Joseph Larmor (1857–1942) developed the equation that the angular frequency of precession of the nuclear spins being proportional to the strength of the magnetic field referred as Larmor relationship. In the 1930s, Isidor Isaac Rabi of Columbia University succeeded in detecting and measuring single states of rotation of atoms and molecules, and in determining the magnetic and mechanical moments of the nuclei.
Working independently, Felix Bloch of Stanford University and Edward Purcell of Harvard University made the first successful nuclear magnetic resonance experiment to study chemical compounds in 1946, thus magnetic resonance phenomenon was discovered. They developed instruments, which could measure the magnetic resonance in bulk material such as liquids and solids. In 1946, they came up with the idea to use magnets to take pictures of a living being and called it magnetic resonance. Both Felix Bloch and Edward Purcell were awarded the Nobel Prize in 1952.
In 1971, Raymond Damadian, a physician and scientist of State University of New York, demonstrated that there are different T1 relaxation times between normal and abnormal tissues of the same type, as well as between different types of normal tissues on Nuclear Magnetic Resonance (NMR) device. In the same year, he proved that magnetic resonance could be used to help detect diseases by the different nuclear magnetic relaxation times between tissues and tumors thus motivating scientists to consider magnetic resonance for the detection of disease.
In 1973, Paul Christian Lauterbur (6 May 1929 – 27 March 2007) of State University of New York described a new imaging technique that he termed Zeugmatography. By utilizing gradients in the magnetic field, this technique was able to produce a two-dimensional image. Magnetic resonance imaging was first demonstrated on small test tube samples. He used a back projection technique similar to that used in CT.
In 1975, Richard Ernst introduced two-dimensional NMR using phase and frequency encoding, and Fourier transformier instead of Paul Lauterbur's back-projection, he timely switched magnetic field gradients. This basic reconstruction method is the basis of current MRI techniques.
On 3 July 1977, the first MRI body examination was performed through a finger of a human being, this was a cross-sectional image. It took almost five hours to produce one image. This machine was named by Raymond Damadien as “Indomitable”. This machine is now in the Smithsonian Institution. Indomitable represents a milestone in the history of medical imaging (). Its story is a timeless one of a driven inventor who perseveres through every obstacle only to find that others are racing along similar paths, which in this case led to today's ubiquitous MRI machines.
Peter Mansfield further developed the utilization of gradients in the magnetic field and the mathematical analysis of these signals for a more useful imaging technique. In 1977, the first images taken of a cross section through a finger were presented by Peter Mansfield and Andrew Maudsley. Peter Mansfield also could present the first image through the abdomen. In the same year, Peter Mansfield developed the echo planar imaging (EPI) technique. This technique developed in later years to produce images at video rates (30 ms/image). Paul Lauterbur and Peter Mansfield were awarded the Nobel Prize in Medicine in 2003.
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Raymond Damadien in 1978 founded the FONAR Corporation, which manufactured the first commercial MRI scanner in 1980. As late as 1982, there were a handful of MRI scanners in the world. Today, there are a million or even more MR scanners world over, and images can be created in seconds what used to take hours. Current MRI scanners produce highly detailed two-dimensional and three-dimensional images. The technique was initially called nuclear magnetic resonance imaging (NMR or NMRI) but because of the negative connotations associated with the word nuclear it is called magnetic resonance imaging.
Fig. 1: “Indomitable” the first MRI machine invented by Raymond Damadian(Source: Jeff Goldberg/Esto)