Eleven steps to help patients avoid Claustrophobia in the MRI scanner

Claustrophobia ~an anxiety disorder that one experiences when they fear the inability to escape, which sometimes results in a panic attack of what “could” happen to them.  The “fear” is based on a fear of restriction or fear of suffocation. Claustrophobia is a direct result of the “fight or flight” response stimulated by the amygdala in the brain, which has evolved for human survival.   Humans are genetically predisposed to imagining what “could happen” to them, so with an MRI exam, a very small part of the fear experienced could be from the possible negative results of the MRI exam results, almost as much as from being inside the MRI scanner bore itself.  Large bore MRI  and open MRI scanners alleviate some of this anxiety, merely from the fact that the bore is a larger diameter, or the open line of sight which allows for the patient to visualize one’s escape from it.

Building respect and trust between the technologist and the patient is paramount for any radiology study, more even more important when you want to help patients avoid claustrophobia in the MRI scanner.  Below is a series of actions which might remedy the fear of claustrophobia that many patients experience.  These actions could also allow for many opportunities to create a better level of patient care than what your competitors are doing, which in turn will help build brand loyalty through your clientele, improve your reputation for having kind clinical staff, and ultimately improve your business through word of mouth.

Claustrophobia in MRI also has a great deal to do with the position of the patient for the exam ordered. For instance, it is unlikely a patient will experience claustrophobia for an MRI knee, ankle or foot exam when most of the body is outside the bore of the scanner, however, we have seen it happen.

MRI lumbar spines, MRI brains, MRI cervical spines, MRI shoulders, MRI abdomen or pelvis exams, and MRI chest exams should mostly be centered to the middle of the MRI bore (with exception to the Revo conditional pacemaker, and other conditional exclusions). It is often these exams where the patient is further inside the MRI gantry, that the patient experiences claustrophobia when they feel confined.

Below is a list of Eleven steps to help patients avoid claustrophobia in the MRI scanner:

1) Many MRI pre-screen appointment calls ask the question about patient claustrophobia. If you have a potential patient who might be claustrophobic, call those patients ahead of their appointment date, and discuss their MRI exam explaining what will happen during the exam.  Politely discuss the series of events, expectations, answer questions and let them know how they will get their results. Speak patiently and calmly to help alleviate some of the anxiety patients may experience prior to and during the exam.  Do not rush when talking with the patients. Through your conversation, allow them to feel that your attention is all about their comfort and well being. This will help build trust, which is an important part of a patient’s success.

2) Request that your patient avoid all stimulants prior to their scheduled exam, such as coffee, teas and high sugar items.

3)  If your patient’s appointment is within the next few days, ask them to perform a personal test for a claustrophobic exercise lying in the comfort of their bed at home.   Request they put a dry washcloth over their eyes, and lie there for a few minutes, imagining they are inside the MRI scanner.   Ask them to think about how they “feel” when they have this experience in the comfort of their own home.  Ask them to think about being in control of the situation, and through positive reinforcement, while visualizing that they can lie still inside an MRI scanner with a washcloth over their eyes, they can also remain in control of their body and mind.

4) Ask the patient to bring some of their favorite quiet music so they can listen to something familiar while inside the MRI scanner.  Most sites have headphones for music, along with CD and music systems. ( Confirm the study hardware will allow for use of the headphones during the MRI scan, as some cervical spine MRI hardware, and even some brain MRI hardware will not allow room for headphones to be worn during the exam. This will depend upon your MRI system and the hardware coils used for the patient study.)

5) Discuss with the patient that the MRI is much like a tanning bed, in which many clients actually pay to lie in and tan their skin. Discuss also that first time airline flying can also be like a claustrophobic environmental experience, that many frequent flyers overcome with practice. Reassure the patient that all possible will be done to create successful outcome.  If sedation is needed, then this will have to be arranged another time.

a) If sedation is needed based on this conversation, then arrangements should be made to get the sedation orders from the referring physician so the patient can pick it up at a pharmacy prior to their exam.  Be sure to explain the need for a driver to take the patient home after their exam.  Do not request the patient take the sedative until requested at the site, just in case the MRI schedule is running behind.

6) Invite the patient in for a table test run, prior to their scheduled time if tensions run extremely high.  Remind them that they will need to pass all MRI safety screening requirements prior to admittance into the MRI scan room.  Be patient and work with empathy toward the patient, understanding that claustrophobia is an uncontrollable anxiety condition that creates a flight or fight condition.

Very often, even when patients have never had an MRI experience before, they may experience claustrophobia for the first time going into the MRI scanner.  An experienced technologist will understand this and can adapt the situation to help a patient through this experience.  Some techs can sense which patients will experience an immediate claustrophobic reaction from their first MRI scanner entry based on the MRI screening discussion.

This is also done with claustrophobic patients, and I have seen it work successfully in many, many cases.

In order to get through the study completely, it is in the best interest of the patient for the technologist to coach the patient through a series of “dry runs” going into the scanner.

First -After the patient has passed MRI screening, help the patient onto the MRI table, and turn on the internal MRI bore fan and lights.  Explain to the patient that you are going to do a “test run” going into the scanner bore, and then bring them immediately back out.  Discuss how they felt in that short “test run” experience. If there is any hesitancy on the patient’s behalf, or they express to you any tension or troubling dialogue, either try the dry run again, or make a decision with the patient to discuss further sedation options with the ordering physician or healthcare provider.

Secondly- If the patient expresses some concern about their comfort with the first dry run, discuss further what they experienced.  Talk calmly to the patient, letting them know many others experience that first feeling of anxiety, but just as many absolve it each time they go into the scanner.  Like anything, it becomes easier with practice.  Likening the experience of going into an MRI bore for the first time to flying on an airplane for the first time.  Let them know that very often, people fall asleep inside the bore from the vibrations.   After more exchange and discussion, ask the patient again, if they will let you try another dry run.  The approval from the patient is a direct response from the patient trusting and feeling comfortable with the individual technologist.  Remind the patient they are in charge. Do not start moving them into the bore until after you get their permission.  If they agree, do so again without hardware, blankets, or any immobilization implements, and while explaining to the patient what you are doing, insert them into the position again with the promise of immediately bringing them back out.  Once you’ve placed them in the center location, then immediately bring them out again. (If they disagree, then you may need to defer them back to the ordering healthcare provider for an oral sedative prescription. )

Third – If necessary, take the time to work with the patient, moving them in and out of the MRI gantry bore on the table several times. If things seem to be getting easier for them, next explain to them you would like  to give them a washcloth over their eyes, which psychologically fools the brain, but they still know they are inside the scanner.  Do this without hardware, or immobilization.  If you get agreement from the patient, try this with a washcloth, and then using a calm collected voice, coach the patient while touching their hand or skin on their arm, letting them know you are immediately available.

Fourth – At some point of this experience, you will know whether your personal coaching is making a successful difference in getting the patient through their MRI exam.

7) Encourage a friend or family member to accompany the patient. The friend or family member accompanying the patient should also be thoroughly screened for MRI safety, just as one would the patient. It would be ideal if this friend or family member could accompany the patient into the MRI exam room and hold the hand (or the leg) of the patient while they are inside the MRI bore of the magnet.  It is also in the best interest of your images, that you coach the friend or family member to hold still and not move or change positions once the scanner has shimmed after the start of each sequence.

8) Always, always give the “call button” to the patient before and during the exam. Inform them that you are nearby at the operator’s console and immediately available should they squeeze the “call button”. (Never use the term “Panic ball” or “panic button” in referring to the call button when discussing this with the patient. The power of suggestion is strong, when emotions are heightened.)

9) Tell the patient that you will be talking to them between the sequences, each series of pictures, and ask them how they are doing between each set of images. Inform them of the time frame for next set of images, and remind them to hold as still as possible for the best in image quality. Ask them for permission to begin the next sequence, and when you get approval, do so.

10) Remind your patient when you give them the call button, that they are the one, always in control.  If they squeeze the call button, then tell them you will immediately remove them from inside the MRI scanner. And if they squeeze it, do as you promised!  (Never, ever leave the operators’ console to deal with changing the next patient or getting a cup of coffee from the break room with a patient inside the scanner. Your responsibility is to the immediate patient at hand, and not the next three on deck.)

11) If the above steps seem too difficult, or elaborate for you to do in helping a claustrophobic patient through an MRI exam, then it is suggested you change your field of employment.  These steps have worked in many circumstances when experience with Claustrophobic patients might be difficult.

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MRI closer to coronary artery diagnosis than ever before.

Many know that a beating heart is sometimes difficult to capture using MRI, but now MRI is closer to coronary artery diagnosis.

Typically, gating and capturing the heart are done using prospective or retrospective gating, with retrospective gating being the more commonly used technique today.

The black line under the QRS cycle indicates the time during which the MRI signal for cardiac imaging is acquired in multiple phases.

Fifteen years ago, prospective was the only way to acquire gated images with MRI, as retrospective was unavailable on most MRI systems.

The black line under the QRS cycle indicates the time during which the MRI signal for cardiac imaging is acquired in multiple phases.

Prior to many of the updated gating algorithms which discarded arrhythmias (abnormal heartbeats) during an acquisition, it could be quite difficult, and sometimes impossible to get accurate images with irregular beats.  If a patient has too irregular a heartbeat, an MRI may not be the best imaging modality.

One of the keys to determining the value of coronary artery imaging in MRI, is the possibility of calculating the amount of atherosclerotic placque inside the small arteries that feed the heart muscle.

It seems a team at NIH (National Institutes of Health) has created a technique which has gotten MRI closer to coronary artery diagnosis.

In a quote taken from a recent article, “Imaging the coronary arteries that supply the heart with blood is extremely difficult because they are very small and constantly in motion,” said lead researcher Khaled Z. Abd-Elmoniem, Ph.D., staff scientist in the Biomedical and Metabolic Imaging branch of NIH’s National Institute of Diabetes and Digestive and Kidney Diseases. “Obtaining a reliable and accurate image of these vessels is very important because thickening of the vessel wall is an early indicator of atherosclerosis.”

The thickening of coronary vessels were evaluated through use of a new time -resolved multi-frame acquisition technique in which five images are acquired in a very fast in order to capture an image free of motion and blurring.  The success rate of using this technique was ninety percent (90%) as opposed to seventy-six percent (76%) for a single frame imaging technique.

Additional studies will be necessary to validate this technique, and without much of the details on how this is being done, it may be as simple as using very fast MRI real-time fluoro technique to capture the coronary vessel in a cross section.    For the full article and source, go HERE.

The value of getting MRI closer to coronary artery diagnosis, is because with MRI there are no damaging x-rays or ionizing radiation used during the imaging process like there is in CT cardiac scoring.  Even with reduced dose CT scanners, there is still damaging x-ray needed to create the images for diagnosis. As long as the patient is safe to be scanned inside the MRI scanner and full safety protocols are utilized by the MRI site, the MRI is probably  safer.

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MARS MRI which is abbreviated for Metal Artifact Reduction Sequences are one of the recent trends in magnetic resonance imaging.

MARS sequences can be created by us, even if your think your scanner is impossible to get MARS sequences to work.   MARS are much easier to create on systems that are high field (1.5 Tesla) or even low to moderate field strength systems such as a 0.7T or a 0.35T, but on the ultra high field system (3.0Tesla) the MARS sequences can be difficult.   The 3T has a higher susceptibility to metal artifacts, plus the metal gets warmer faster from a physical factor known as SAR (Specific Absorption Rate.)

The benefit of MARS MRI sequences allow visualization of pathology and anatomy closer to the metal, where as on typical MRI sequences, there is so much distortion and signal theft, the radiologist is unable to determine if a diagnosis or pathology is present.

We know how to setup MARS MRI sequences on your MRI system, and can help you capture a market share, you would normally not find otherwise.

The 3T MRI system has four times (4X) the SAR that a 1.5T system has, even though it may have twice the signal to noise during the image acquisition phases.

MARS (metal artifact reduction sequence) for MRI.

Metal artifact reduction sequences are valuable especially if one is concerned about infection around a metal implant.  Harrington rods in the lumbar spine, metal hip replacements, shoulder pins, metal knees replacements, ankle screws, and other orthopedic rods, screws, metal parts and even braces when scanning the brain can all disrupt MRI signal and disguise pathology.

Settings can be altered on MARS MRI so that tissue closer to the metal will demonstrate signal where with the regularly run sequence, it could be very difficult to visualize any pathology at all near the metal.

If you would like to have MARS MRI sequences setup on your MRI system for some of the implants mentioned earlier on this page, then

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The improved GE lumbar spine image is on the right.

Which lumbar spine image would you rather have?  Would you believe the image on the left had also passed ACR accreditation? It did!

This is an example of an improved GE lumbar spine mri sequence that originally passed ACR accreditation, and then was improved immensely after MRI Optimize Consultants got to it.  We couldn’t help but optimized the sequence, and the entire study.  Ultimately, the entire scan quality was improved.

The radiologists reading the images on the left had no idea they could be improved until after we altered some of the MRI sequence parameters that improved the image quality.  This improved GE lumbar spine mri increased the overall reputation of this site, as they were initially losing cases from referrers and had no idea why.

The technologists at this site were experienced, but only at this site and one or two prior locations. They did not have the skills we have acquired from helping literally hundreds and hundreds of MRI locations.

We have taught physics for major vendors, coached physicists, radiologists, cardiologists, managers and technologists in the art and science of MRI.

If you were a radiologist, which image do you think would help you better diagnose the patient’s pathology and pain?

We KNOW we can make your images better.  Contact us HERE!

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NMR Beginning was the beginning of MRI spectroscopy and is at the origin of using magnetic resonance for human and animal imaging purposes.

Two pioneering researchers in the 1940′s, one at each end of the United States, were doing research on different chemical elements and how those chemical frequencies had a signal that registered in measurement pertaining to each chemical component.

Dr. Edward Purcell (at Harvard University in Cambridge, Massachusetts) observed H1 NMR in paraffin wax at 30MHz while Dr. Felix Bloch (at Stanford University in California) observed NMR in water at 8 MHz.  They both won the Nobel Prize for Physics in 1952.

From this discovery, came the idea for imaging hydrogen protons in biological tissue through use of this same technology, with the exception that using this technique on a human body, would have to be done significantly on a larger scale. Consequently, MRI spectroscopy, when done correctly, does not only isolate a single chemical type, but also multiples, depending upon the type of signal generated, the particular TE (echo time) used, among other factors.  The indication for cancerous signal can be determined in many instances without any biological invasiveness, such as with a needle biopsy requires.  Ten years ago, it was the preferred procedure at some pediatric institutions for determining whether children had a benign or malignant brain tumor, as this procedure done correctly, could sometimes avoid biopsying the child.

Initially, hydrogen MRI spectroscopy was predominantly used for brain tissue, but has expanded to use in many other parts of the body as Phosphorus 31 Spectroscopy or other types of signal measurement.  While an image is technically not gathered during the actual MRI spectroscopy process, data from the culmination of chemical types is gathered.  The particular peaks of certain chemicals indicate to MRI experts whether a tissue type could contain carcinogenic cells or not, as cancer has a particular chemical marker (namely Choline) that indicates when cells are in angiogenesis, the indication the cells are splitting and dividing while they are constantly growing.

In this image, the two peaks on the left are Choline and Creatine respectively, with NAA (N-Acetyl Alcohol) being the highest peak.

While CMS denied submitting any payable code for Medicare reimbursement, some centers (although rare) still utilize MRI Spectroscopy in the brain, breast and/or prostate to help determine tissue types for cancerous signal.

Performing MRI Spectroscopy has its many challenges, for consistency, successful dependable results, and an accurate outcome.

If you were to ask a patient if they would rather a signal that measures for tissue characterization, or an invasive needle biopsy, most would answer the non-invasive MRI Spectroscopy.  Unfortunately, due to the rareness with which this procedure is performed, and to the lack of  MRI technology skill sets in many locations that can perform this exam, it seems to be trending toward a lost practice.

NMR is the abbreviation for nuclear magnetic resonance.  The term “nuclear” can be easily misinterpreted by the general public, so for marketing purposes, the term MRI (magnetic resonance imaging) replaced NMR.

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MRI Shoulder aber view is designed to be in the sagittal plane, usually after the original shoulder MRI images have been completed.

A typical MRI of the shoulder is performed with the patient supine (on their back) and their affected arm along their side.  The patient is usually placed with their shoulder inside an MRI shoulder coil.  The arm should be along their side, with the thumb pointed outward to extend the glenohumeral ligament.  The MRI shoulder aber view is not performed at this time.

After the usual five or six MRI sequences are done, then the patient is positioned for the MRI shoulder aber view. This requires the patient lay on their back (supine) with the arm extended above their head and the antenna coil wrapped around the shoulder in the appropriate position to get the most signal.  It is often difficult for the patient to hold still in this position, but the MRI shoulder aber view is important to radiologists, so this should be explained to the patient prior to the study. If the patient is unable to get into this position, it would be wise not to force them to do so.

The MRI shoulder aber view (ABER- short for abduction external rotation) is a particular sequence usually preferred by specific radiology musculo-skeletal groups.  The sequence itself can be run as a T1 Fatsat sequence and is usually done post contrast via a shoulder mri arthrogram to demonstrate a labral tear when the shoulder joint is stressed.

The images used in this MRI shoulder aber view example shows that without a focus on excellent image quality, the diagnosis could have been quite difficult in this particular case.  Blood flow created motion artifact in the images, which obscured the area of interest on the shoulder images.

Are your MRI images the best they can be?

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This is about the possibility of getting 1.5T versus 3T MRI image quality.

MRI image quality makes or breaks a radiology business.  We have seen this time and time again. Some centers try to use new equipment or higher field strength as a differentiator, but ultimately, it is the value quality of the images that make the diagnosis easier or harder for the reading radiologist.  3T images are not always better than 1.5T MRI system images.

MRI image quality is created using around sixty to eighty different physics settings, depending upon the particular sequence used.

MRI Optimize Consultants uses their expertise with those factors to create the best image quality from your system, at any field strength.  In the example above, it is clearly demonstrated that the 1.5T versus 3T image quality can be equal or exceeded when the opportunity for a 1.5T system to get an image tune-up happens.

1.5T versus 3T MRI image quality 

Typically, a 3T system gets twice the signal to noise ratio during the mri scan, but it also puts out four times the heat in a factor known as SAR (specific absorption rate.) This can be a detriment to those with a 3T system.  Not all metal implants surgically implanted, can be scanned inside a 3T system, because of the contraindication.

Due to the heating limits mandated by the FDA on scanning humans, it is more difficult to run a moderate number of sequences in a row with a 3T than it is with a 1.5T MRI system without hitting the SAR limits.  When the SAR limits are reached with the 3T, it is possible to wait for the time necessary and allow the heat to dissipate before continuing to scan.   Images are data, so getting the right information helps the radiologist diagnosis the MRI exam images.

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MRA Carotid Flow Quantification is a technique in which MRI scanners use a specific sequence to help determine if the blood flow is going in the correct direction.  It may sound silly, but on some occasions this does not always happen.  Typically a carotid MRA, which stands for magnetic resonance angiography, a study of the blood vessels, requires a nominal amount of MRI contrast administered to the veins, while a timed MRA sequence captures the contrast in the carotid neck vessels.

MRA Carotid Flow Quantification

The arterial and venous blood vessels will fill with contrast, but this will not actually tell the reader the determination of the flow direction. On rare occasions, a patient may have a condition called sub-clavian steal syndrome (SSS, for short.) This condition can be discovered through a procedure called MRA carotid flow quantification of the carotid vessels. This is not a procedure that is always done with a carotid MRA study, so it needs to be specifically requested by the referring physician, the radiologist or vascular specialist.  Additionally, not all MRI locations are familiar with performing flow quantification on the blood vessels, but this is something easily taught.

Additionally, one should have flow quantification MRI software available to load the images, calculate blood flow and determine the flow directions, flow speeds and more.

Some of the patients present with vertigo (dizziness), positional vertigo (turning of the head), tinnitus (ringing in the ears), numbness of the upper left arm and sometimes occurs more often in patients who have had a CABG (coronary artery bypass graft), or open heart surgical procedure.  These episodes may occur (under exertion or not) when the sub-clavian artery “steals” blood flow from the left vertebral artery that feeds the base of the brain.

An oblique MRA carotid angio image showing the vertebral behind the carotid artery.

Phase contrast imaging is usually performed after the MR Angio study above is finished.

All of the arterial blood vessels fill up with an injection, so the blood flow speed and direction cannot be determined like they can using phase contrast flow quantification imaging.  The carotid arteries can be clearly defined and a cross-section of the bilateral vessels is selected for phase contrast imaging.  Phase contrast imaging works because the hydrogen protons line up North and South and are based on the Flow Quantification flow direction and Venc (Velocity Encoding) used at cc/cm (cc’s per centimeter).

The cross section usually includes both carotids and both vertebral arteries such as in the image below.  With the correct VENC and Flow Quantification direction setup, and an accurate slice prescription, the direction of the blood flow can be determined.  In the image below, a red and green ROI (region of interest) is placed on each of the carotid arteries, and underneath them inside the blue and yellow ROI’s are the vertebral arteries.

Cross sectional image of bilateral carotids and bilateral vertebrals measuring flow quantification of the arterial vessels.

A magnitude image is above with ROI (region of interest) on each carotid and vertebral vessel.  All vessels should show blood flow going to the top of the head to feed the brain, but in this example, one of the blood vessels, the blue ROI, shows blood flowing the opposite direction.

Below, the phase image showing the ROI and measurement of each vessel.

mra carotid flow quantification of arterial blood flow in the bilateral carotids and vertebral arteries.

The chart below corresponds in color to each blood vessel that shows the direction of blood flow.  It seems the blue vertebral artery, shows a reverse flow, showing sub-clavian steal syndrome in the right vertebral artery.

mra carotid flow quantification showing reverse flow in the right vertebral artery.

MRA carotid flow quantification showing reverse flow in the blue graph line, which correlates with the right vertebral artery in the cross-sectional image.  One might summarize that the flow is a result of right sub-clavian steal syndrome.

The blue line correlates with the blue ROI placed on the right vertebral artery, showing reverse flow during normal phase contrast gated imaging.

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MRI cardiac imaging can lead to better technologists and better imaging through understanding of the difficulties requiring the technicalities of catching a moving pathology.

MRI cardiac imaging requires a series of steps to get to the area of interest requested by the radiologist and referring physician.  The exam can be streamlined to specifics for finding answers to the exact information requested.

Whether it is a portion of the cardiac function, pulmonary valve function, aortic valve regurgitation (leaking), QP-QS (quantitative pulmonary flow ratio to quantitative systolic flow), flow quantification of a particular valve, or tissue characterization through other means, cardiac MRI is an exciting use of the MRI tool.  Techniques that create success are taught through practice, and repetition.  We can help teach your MRI team to be proficient at MRI cardiac imaging.

Whether the focus is to look for right heart disease, pulmonary disease, mitral valve regurgitation or Tetrology of Fallot, we can help your staff find the answers through cardiac MRI imaging. Each one of these requires a specific series of steps to get to the helpful diagnosis of each cardiac condition.  Catching a moving beating heart is not typical for MRI imaging. In most cases, the technologist has to encourage the patient to hold very still, and hold their breaths. In the case of MRI cardiac imaging, holding still is important, as well as holding the breath, but catching the heart while it’s moving is required in order to get cinematic cardiac imaging.

 MRI Cardiac Imaging

MRI cardiac imaging made a huge leap in popularity and success when the United Kingdom scientific report was released in December of 2011, stating that MRI was a better diagnosing tool than nuclear medicine spect testing. The link to the original report is just below.

 http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2811%2961335-4/abstract

We were early members of the SCMR (Society of Cardiac Magnetic Resonance) and have been the first to help introduce cardiac MRI imaging to many radiology centers at many states.

 Contact us to get your cardiac MRI program started now!

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MRI Spectroscopy is where the study of nuclear magnetic resonance, or updated to the name magnetic resonance imaging, originally developed from.

Dr. Edward Purcell

Dr. Felix Bloch won the Nobel Prize in 1952 for observing and reporting NMR in paraffin wax at 30 MHz (thirty Mega-Hertz) while he worked at Stanford University, sharing the award with Dr. Edward Purcell who worked out of Harvard with H1 (hydrogen). The work from these two scientists lead the way to discoveries of other physics principles and also created the possibility of imaging through the use of the hydrogen atom.

Dr. Felix Block

Nuclear Magnetic Resonance was and still is an elegant way of determining chemical structure and makeup of the properties of materials through the use of an electro-magnetic frequency.

MRI Spectroscopy

MRI spectroscopy displays an important feature of NMR.  That is the resonance frequency of a particular substance is directly proportional to the strength of the applied magnetic field.   This is the feature exploited in what started off as nuclear magnetic imaging techniques; the name change occurred after the term nuclear alarmed would be patients and practitioners. To desensitize the masses, magnetic resonance imaging became the new term of use for this imaging procedure.  The laws of mri spectroscopy state that if a sample is placed in a non-uniform magnetic field then the resonance frequencies of the sample’s nuclei depend on where in the field they are located. Since the resolution of the imaging technique depends on the magnitude of magnetic field gradient, many efforts are made to develop increased field strength, often using superconductive magnets.

Predominantly used with Hydrogen, Carbon 13 or Phosphorus 31 molecules, mri spectroscopy has been and is used for tissue characterization without any physical intervention.  In other words, measurement of these chemicals does not require any invasive-ness on behalf of the patient. Once the patient is cleared for MRI safety and access to the MRI exam scanner, then positioning and hardware placement can begin for imaging around the questionable anatomy.

Specific sequences are used to determine the make-up of the tissue after scanning. Critical steps must be taken, and done repeatedly for a sound spectroscopy program.

MRI spectroscopy can be performed on the brain, the breast, liver, heart, muscle, tumors, prostate or most body parts as long as the patient is able to hold very still.  MRI scanners must usually have the spectroscopy software to run the sequences and the post processing software to help radiologists and physicists determine the results.  The example below demonstrates 3D spectroscopy, also known as CSI (chemical shift imaging) of the bilateral hemispheres of the brain.  This is a safe painless process of imaging that acquires signal reflected back from the chemical makeup of the tissues. The patient merely has to lie very still in order for MRI spectroscopy of most anatomy to be successful.

This is an example of mri spectroscopy of the brain from a Phillips 1.5T system using TE144.

If you would like your MRI team to know more about MRI spectroscopy, please CALL US for a teaching engagement.

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