The authors identify eight areas of potential safety concern during clinical magnetic resonance (MR) imaging. These include (a) biologic effects of the static magnetic field; (b) ferromagnetic attractive "projectile" effects of the static magnetic field; (c) potential effects of the relatively slowly time-varying magnetic field gradients; (d) effects of the rapidly varying radio-frequency (RF) magnetic fields, including RF power deposition concerns; (e) auditory considerations from noise caused by the rapidly pulsed magnetic field gradients; (f) safety considerations concerning superconductive systems, including quenches, use of cryogens, and cryogen storage and handling; (g) psychological effects, such as claustrophobia and anxiety induced because of the examination; and (h) possible effects of the intravenous use of the MR contrast agent gadopentetate dimeglumine. The concerns in each of these categories are elaborated upon, and the available data are presented to clarify their status.

Recent in vivo MRI studies at 7.0 T have demonstrated extensive heterogeneity of T2* relaxation in white matter of the human brain. In order to study the origin of this heterogeneity, we performed T2* measurements at 1.5, 3.0, and 7.0 T in normal volunteers. Formalin-fixed brain tissue specimens were also studied using T2*-weighted MRI, histological staining, chemical analysis, and electron microscopy. We found that T2* relaxation rate (R2*=1/ T2*) in white matter in living human brain is linearly dependent on the main magnetic field strength and the T2* heterogeneity in white matter observed at 7.0 T can also be detected, albeit weaker, at 1.5 and 3.0 T. The T2* heterogeneity exists also in white matter of the formalin fixed brain tissue specimens, with prominent differences between the major fiber bundles such as the cingulum and the superior corona radiada. The white matter specimen with substantial difference in T2*have no significant difference in the total iron content as determined by chemical analysis. On the other hand, evidence from histological staining and electron microscopy demonstrate these tissue specimen have apparent difference in myelin content and microstructure.

No abstract

No abstract

Measurement of brain perfusion using arterial spin labeling (ASL) or dynamic susceptibility contrast (DSC) based MRI has many potential important clinical applications. However, the clinical application of perfusion MRI has been limited by a number of factors, including a relatively poor spatial resolution, limited volume coverage, and low signalto-noise ratio (SNR). It is difficult to improve any of these aspects because both ASL and DSC methods require rapid image acquisition. In this report, recent methodological developments are discussed that alleviate some of these limitations and make perfusion MRI more suitable for clinical application. In particular, the availability of high magnetic field strength systems, increased gradient performance, the use of RF coil arrays and parallel imaging, and increasing pulse sequence efficiency allow for increased image acquisition speed and improved SNR. The use of parallel imaging facilitates the trade-off of SNR for increases in spatial resolution. As a demonstration, we obtained DSC and ASL perfusion images at 3.0 T and 7.0 T with multichannel RF coils and parallel imaging, which allowed us to obtain high-quality images with in-plane voxel sizes of 1.5 ϫ 1.5 mm 2 . (2), and diagnosis, treatment planning, and outcome prediction for brain infarction (3). One of the main factors limiting the widespread clinical application of perfusion MRI is its relatively poor spatial resolution. The spatial resolution is primarily limited due to constraints on the signal-to-noise ratio (SNR). An additional constraint is that both arterial spin labeling (ASL) (4) and bolus tracking or dynamic susceptibility contrast (DSC) MRI (5) require rapid image acquisition (i.e., high temporal resolution). In the following we will show how recent methodological developments can increase the temporal and spatial resolution of perfusion MRI of the human brain by improving the SNR and image acquisition speed. SNRThe SNR of perfusion-based MRI is small compared to that achieved by other imaging techniques, such as T 1 /T 2 -weighted and proton density-weighted MRI. In ASL, this is because generally less than 1% of the spins in a given voxel are perfused per second. For an adequate SNR, therefore, ASL requires extensive signal averaging, which leads to long measurement times (typically on the order of 5-10 minutes). In DSC MRI, as a result of the enhancing effect of a contrast injection, a substantially large fraction of the spins contributes to the signal. However, because of the relatively rapid washout of contrast agent (5-10 seconds), SNR of DSC MRI is compromised due to the limited time available for signal averaging. Recent methodological and technical developments have improved the SNR of perfusion MRI in a number of ways, including increased magnetic field strength, the development of multichannel signal detectors, and the optimization of MRI pulse sequences.In MRI the intrinsic SNR scales approximately linearly with the field strength, while at the same time the labeling efficiency of ASL and...

To test if the radiofrequency fields of a magnetic resonance imager could cause focal heating, two cylindrical phantoms were made from a mixture of agar and saline. The first phantom was uniform; the second was nonuniform in that a narrow bridge of agar was produced. Both phantoms were exposed to high levels of radiofrequency power (140 W) at 63 MHz and the temperature rises were measured. In the uniform phantom, the temperature increased as the radius increased. In the bridge phantom, the narrow bridge heated three times greater than at the opposite uniform periphery, and over five times the average of the uniform phantom. This experiment demonstrates that the radiofrequency fields of magnetic resonance imagers can cause focal heating if the exposed object is nonuniform. Since nonuniformity is present in the human body, as the radiofrequency power of magnetic resonance imaging techniques increases, focal heating in patients is a concern.

Because conventional stereotactic angiography provides only two-dimensional information for dose planning, we studied the accuracy and usefulness of stereotactic magnetic resonance angiography (sMRA) for arteriovenous malformation (AVM) radiosurgery in 28 consecutive patients. We hypothesized that the multidimensional data set provided by sMRA and the opportunity to image both blood vessels and brain parenchyma would improve the accuracy of AVM irradiation and improve the safety of radiosurgery. Twenty-eight patients with AVMs in different brain locations and with a variety of AVM sizes (range, 15-31 mm mean diameter) had sMRA followed by stereotactic angiography. The sMRA images only were used to construct an initial radiosurgical plan. This plan was then used to outline the AVM volume defined by conventional angiography. In 24 patients, sMRA information equaled that of conventional angiography. In 3 patients, sMRA was better, because conventional angiography overestimated the size of the AVM nidus. In one patient, the conventional angiogram showed a second separate nidus (10-mm diameter) that was not as well defined on MRA. There were no complications with any procedure. In 16 patients (57%), sMRA provided critical information on AVM shape that was not provided by conventional angiography alone. Stereotactic MRA is a fast, noninvasive, inexpensive, multidimensional imaging method for AVM radiosurgery that provides information on vascular and parenchymal brain anatomy important for optimal dose planning. We believe that it can be used with confidence as the sole imaging method for medium-size, compact-nidus AVMs.

No abstract