Quick Overview

Pulsatile cerebro spinal fluid flow produces ghost artifacts that are superimposed in the image.

Flow compensation should be used to reduce these artifacts. This applies an additional gradient to eliminate phase differences for both stationary and moving spins at the echo time. At TE no phase differences is measured. If flow compensation is applied and there are still flow artifacts, cardiac triggering is an additional option to reduce these artifacts.
See also Motion Artifact.

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 enhanced MRI is a commonly used procedure in magnetic resonance imaging. The need to more accurately characterize different types of lesions and to detect all malignant lesions is the main reason for the use of intravenous contrast agents.
Some methods are available to improve the contrast of different tissues. The focus of dynamic contrast enhanced MRI (DCE-MRI) is on contrast kinetics with demands for spatial resolution dependent on the application. DCE-MR imaging is used for diagnosis of cancer (see also liver imaging, abdominal imaging, breast MRI, dynamic scanning) as well as for diagnosis of cardiac infarction (see perfusion imaging, cardiac MRI). Quantitative DCE-MRI requires special data acquisition techniques and analysis software.
Contrast enhanced magnetic resonance angiography (CE-MRA) allows the visualization of vessels and the temporal resolution provides a separation of arteries and veins. These methods share the need for acquisition methods with high temporal and spatial resolution.
Double contrast administration (combined contrast enhanced (CCE) MRI) uses two contrast agents with complementary mechanisms e.g., superparamagnetic iron oxide to darken the background liver and gadolinium to brighten the vessels. A variety of different categories of contrast agents are currently available for clinical use.
Reasons for the use of contrast agents in MRI scans are:
Common Indications:
Brain MRI : Preoperative/pretreatment evaluation and postoperative evaluation of brain tumor therapy, CNS infections, noninfectious inflammatory disease and meningeal disease.
Spine MRI : Infection/inflammatory disease, primary tumors, drop metastases, initial evaluation of syrinx, postoperative evaluation of the lumbar spine: disk vs. scar.
Breast MRI : Detection of breast cancer in case of dense breasts, implants, malignant lymph nodes, or scarring after treatment for breast cancer, diagnosis of a suspicious breast lesion in order to avoid biopsy.

For Ultrasound Imaging (USI) see Contrast Enhanced Ultrasound at Medical-Ultrasound-Imaging.com. See also Blood Pool Agents, Myocardial Late Enhancement, Cardiovascular Imaging, Contrast Enhanced MR Venography, Contrast Resolution, Dynamic Scanning, Lung Imaging, Hepatobiliary Contrast Agents, Contrast Medium and MRI Guided Biopsy.

(DIR or DIRT1) Double inversion recovery T1 measurement is a T1 weighted black blood MRA sequence in which the signal from blood is suppressed. The inversion time to suppress blood is described as the duration between the initial inversion pulse and time point that the longitudinal magnetization of blood reaches the zero point. The readout starts at the blood suppression inversion time (BSP TI) and blood in the imaging slice gives no signal. This inversion time is around 650 ms with a 60 beat per minute heart rate at 1.5 T.
The TI can be decreased by using a wider receive bandwidth, shorter echo train length and/or narrow trigger window. Wide bandwidth also decreases the blurring caused by long echo trains at the expense of signal to noise ratio. In case of in plane or slow flow the suppression of the signal from blood may be incomplete. With increased TE or change of the image plane the blood suppression can be improved.
Double inversion recovery is a breath hold technique with one image per acquisition used in cardiovascular imaging. The patient is instructed to hold the breath in expiration (if not possible also inspiration can be taken), so that the end diastolic volume in the cardiac chambers would be the same during entire scanning. DIR provides fine details of the boundary between the lumen and the wall of the cardiac chambers and main vascular and heart structures, pericardium, and mediastinal tissues.

(TrueFISP) True fast imaging with steady state precession is a coherent technique that uses a fully balanced gradient waveform. The image contrast with TrueFISP is determined by T2*//T1 properties and mostly depending on TR. The speed and relative motion insensitivity of acquisition help to make the technique reliable, even in patients who have difficulty with holding their breath.
Recent advances in gradient hardware have led to a decreased minimum TR. This combined with improved field shimming capabilities and signal to noise ratio, has allowed TrueFISP imaging to become practical for whole-body applications. There's mostly T2* weighting. With the used ultrashort TR-times T1 weighting is almost impossible. One such application is cardiac cine MR with high myocardium-blood contrast. Spatial and temporal resolution can be substantially improved with this technique, but contrast on the basis of the ratio of T2* to T1 is not sufficiently high in soft tissues. By providing T1 contrast, TrueFISP could then document the enhancement effects of T1 shortening contrast agents. These properties are useful for the anatomical delineation of brain tumors and normal structures. With an increase in SNR ratio with minimum TR, TrueFISP could also depict the enhancement effect in myoma uteri. True FSIP is a technique that is well suited for cardiac MR imaging. The imaging time is shorter and the contrast between the blood and myocardium is higher than that of FLASH.

See Steady State Free Precession.