From ISOL Technology

'Next generation MRI system 1.5T CHORUS developed by ISOL Technology is optimized for both clinical diagnostic imaging and for research development.
CHORUS offers the complete range of feature oriented advanced imaging techniques- for both clinical routine and research. The compact short bore magnet, the patient friendly design and the gradient technology make the innovation to new degree of perfection in magnetic resonance.'

A pacemaker is a device for internal or external battery-operated cardiac pacing to overcome cardiac arrhythmias or heart block. All implanted electronic devices are susceptible to the electromagnetic fields used in magnetic resonance imaging. Therefore, the main magnetic field, the gradient field, and the radio frequency (RF) field are potential hazards for cardiac pacemaker patients.
The pacemaker's susceptibility to static field and its critical role in life support have warranted special consideration. The static magnetic field applies force to magnetic materials. This force and torque effects rise linearly with the field strength of the MRI machines. Both, RF fields and pulsed gradients can induce voltages in circuits or on the pacing lead, which will heat up the tissue around e.g. the lead tip, with a potential risk of thermal injury.
Regulations for pacemakers provide that they have to switch to the magnet mode in static magnetic fields above 1.0 mT. In MR imaging, the gradient and RF fields may mimic signals from the heart with inhibition or fast pacing of the heart. In the magnet mode, most of the current pacemakers will pace with a fix pulse rate because they do not accept the heartsignals. However, the state of an implanted pacemaker will be unpredictable inside a strong magnetic field. Transcutaneous controller adjustment of pacing rate is a feature of many units. Some achieve this control using switches activated by the external application of a magnet to open/close the switch. Others use rotation of an external magnet to turn internal controls. The fringe field around the MRI magnet can activate such switches or controls. Such activations are a safety risk.
Areas with fields higher than 0.5 mT (5 Gauss Limit) commonly have restricted access and/or are posted as a safety risk to persons with pacemakers.

A Cardiac pacemaker is because the risks, under normal circumstances an absolute contraindication for MRI procedures.
Nevertheless, with special precaution the risks can be lowered. Reprogramming the pacemaker to an asynchronous mode with fix pacing rate or turning off will reduce the risk of fast pacing or inhibition. Reducing the SAR value reduces the potential MRI risks of heating. For MRI scans of the head and the lower extremities, tissue heating also seems to be a smaller problem. If a transmit receive coil is used to scan the head or the feet, the cardiac pacemaker is outside the sending coil and possible heating is very limited.

The MRI safety of cardiac stents is dependent of the material, the examined part of the body and the used field strength. A susceptibility artifact is expected also in low magnetic fields, but less.

Most of the used materials are non-magnetic, for this case there is no risk for movement caused through the magnetic field. If the cardiac stent is outside the region of the radio frequency pulse, also the risk of e.g. heating is low.

The principal contraindications of the MRI procedure are mostly related to the presence of metallic implants in a patient. The risks of MRI scans increase with the used field strength. In general, implants are becoming increasingly MR safe and an individual evaluation is carried out for each case.

Some patients should not be examined in MRI machines, or come closer than the 5 Gauss line to the system.

Absolute Contraindications for the MRI scan:
Patients with absolute contraindications should not be examined or only with special MRI safety precautions. Patients with an implanted cardiac pacemaker have been scanned on rare occasions, but pacemakers are generally considered an absolute contraindication. Relative contraindications may pose a relative hazard, and the type and location of an implant should be assessed prior to the MRI examination.

Relative Contraindications for the MRI scan:
Osteosynthesis material is usually anchored so well in the patients that no untoward effect will result. Another effect on metal parts in the patient's body is the heating of these parts through induction. In addition, image quality may be severely degraded. The presence of other metallic implants such as surgical clips etc. should be made known to the MRI operators. Most of these materials are non-magnetic, but if magnetic, they can pose a hazard.

See also MRI safety, Pregnancy, Claustrophobia and Tattoos.

Contrast is the relative difference of signal intensities in two adjacent regions of an image.
Due to the T1 and T2 relaxation properties in magnetic resonance imaging, differentiation between various tissues in the body is possible. Tissue contrast is affected by not only the T1 and T2 values of specific tissues, but also the differences in the magnetic field strength, temperature changes, and many other factors. Good tissue contrast relies on optimal selection of appropriate pulse sequences (spin echo, inversion recovery, gradient echo, turbo sequences and slice profile).
Important pulse sequence parameters are TR (repetition time), TE (time to echo or echo time), TI (time for inversion or inversion time) and flip angle. They are associated with such parameters as proton density and T1 or T2 relaxation times. The values of these parameters are influenced differently by different tissues and by healthy and diseased sections of the same tissue.
For the T1 weighting it is important to select a correct TR or TI. T2 weighted images depend on a correct choice of the TE. Tissues vary in their T1 and T2 times, which are manipulated in MRI by selection of TR, TI, and TE, respectively. Flip angles mainly affect the strength of the signal measured, but also affect the TR/TI/TE parameters.
Conditions necessary to produce different weighted images:
T1 Weighted Image: TR value equal or less than the tissue specific T1 time - TE value less than the tissue specific T2 time.
T2 Weighted Image: TR value much greater than the tissue specific T1 time - TE value greater or equal than the tissue specific T2 time.
Proton Density Weighted Image: TR value much greater than the tissue specific T1 time - TE value less than the tissue specific T2 time.

See also Image Contrast Characteristics, Contrast Reversal, Contrast Resolution, and Contrast to Noise Ratio.