Diamagnetism occurs only by a substance in the presence of an externally applied magnetic field. Diamagnetic contrast agents are complexes in which the metal ion (e.g., Zn, Bi and Ca) is diamagnetic.
Potential diamagnetic materials in gastrointestinal MRI:
A suspension of clay minerals (Kaopectate with kaolin, a common over the counter drug) can be used as a negative oral contrast agent caused by the diamagnetic properties. By using this preparation as a gastrointestinal contrast agent e.g., in pancreas MRI or MRCP, the absence of signal is clearly visible in the stomach and duodenum. Barium sulfate commonly used as an X-ray contrast agent has also been tested for use in abdominal imaging. The diamagnetic properties of the barium particles are caused by a susceptibility effect around them, the resulting signal loss is strengthening by a replacement of water protons with barium.

See also Diamagnetism.

(GRAPPA) GRAPPA is a parallel imaging technique to speed up MRI pulse sequences. The Fourier plane of the image is reconstructed from the frequency signals of each coil (reconstruction in the frequency domain).
Parallel imaging techniques like GRAPPA, auto-SMASH and VD-AUTO-SMASH are second and third generation algorithms using k-space undersampling. A model from a part of the center of k-space is acquired, to find the coefficients of the signals from each coil element, and to reconstruct the missing intermediary lines. The acquisition of these additional lines is a form of self-calibration, which lengthens the overall short scan time. The acquisition of these k-space lines provides mapping of the whole field as well as data for the image contrast.
Algorithms of the GRAPPA type work better than the SENSE type in heterogeneous body parts like thoracic or abdominal imaging, or in pulse sequences like echo planar imaging. This is caused by differences between the sensitivity map and the pulse sequence (e.g. artifacts) or an unreliable sensitivity map.

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.

(MP-GRE / MPRAGE / MP-RAGE) A fast 3D gradient echo pulse sequence using a magnetization preparation pulse like TurboFLASH. Only one segment or partition of a 3D data record is obtained per inversion preparation pulse. After the acquisition, for all rows a delay time (TD) is used to prevent saturation effects.
MPRAGE is designed for rapid acquisition with T1 weighted dominance. Fast gradient echoes are characterized by their rapid sampling time, high signal intensity and image contrast while approaching steady state (the echo is collected during the time when tissues are experiencing T1 relaxation). The rapid speed of the acquisition makes it an excellent alternative to breath-hold abdominal imaging, neuro, dynamic bolus, MR angiography and cardiac imaging.

See Gradient Echo Sequence.

In single shot techniques (used for EPI, TSE, FSE, RARE, HASTE), the entire raw data set is acquired with a single excitation pulse. The magnetization of a fully relaxed spin system is used. Each of the subsequent echoes is given a different phase encoding. For improved SNR, spatial resolution or FOV, the needed raw data are acquired over a number of sequence repetitions. Each repetition then collects a fraction of the complete raw data set. Only slightly more than a half of the raw data is acquired. The image is obtained through half Fourier reconstruction.
A single shot sequence is useful in cases where movement is to expect e.g. in abdominal Imaging or fetal MRI.

See also Half Fourier Acquisition Single Shot Turbo Spin Echo.