MRI Made Easy ® (for Beginners) Govind B Chavhan
Page numbers followed by f refer to figure and t refer to table.
coronal images of 44f
postcontrast axial image of 89f
vibe image of 112f
Abscess 147, 148f, 173
Acquired immunodeficiency syndrome 173
Air 98
Alanine 169
Alexander disease 172
Alzheimer's dementia 172
Alzheimer's disease 166f
American College of Radiology 79, 92, 93
Amino acids 169
Amyloidosis 208
Analog-to-digital converter 76
Aneurysm 83
Angiomyolipoma 44f
ascending 127
descending 127
Apparent diffusion coefficient 141144, 146148, 150, 157
Arachnoid cyst 147
Arch of aorta 206
Array spatial sensitivity encoding technique 45
Arrhythmogenic right ventricular dysplasia 202, 208f
Arterial spin labeling technique 152, 160, 161f, 214
Arthritis, enthesitis-related 190
Artificial sphincters 84
Atrial septal defect 206
Balanced steady state free precession 62, 212
Bandwidth 18
Bankart's lesion 192
Basal ganglion calcifications, bilateral 65f
Bile duct, cystic diseases of 183
Black blood imaging 126, 127f
Bladder imaging 118f
Blood 100
oxygen level-dependent imaging 174, 175
pool agent 91, 93
Body imaging 95
magnetic resonance imaging techniques 180, 193
Bone 100
marrow imaging 57
axial localizer image of 74f
contrast-enhanced T1-weighted sagittal image of 95f
diffusion weighted axial image of 103f
gradient hemo axial image of 65f, 107f
axial image of 73f, 103f
postcontrast axial image of 104f, 106f
sagittal image of 101f
axial image of 76f, 109f
sagittal image of 71f, 78f
tumor 95f, 170
magnetic resonance perfusion in 157
imaging 127, 128f
technique 203
Bronchial atresia 212f
Calcifications 98
Canavan's disease 168f, 172
Cardiac implantable electronic devices 84
Cardiac magnetic resonance 202
imaging 202
clinical applications of 206
Cardiac mass 210f
Cardiac motion, electrocardiogram gating for 69
Cardiomyopathy 207
hypertrophic 207
restrictive 207
Cardiovascular imaging 96
delayed gadolinium-enhanced magnetic resonance imaging of 201
sensitive sequences 65
Cell membrane 140f
Central nervous system 148
infection 94, 103
neoplasm 94
vasculitis 159
Cerebellopontine 64
angle lesions 105
artery, anterior 146
flow 156
volume 104f, 156, 158f, 160f
hemisphere 160f
Cerebrospinal fluid 14, 15, 39, 47, 59, 60, 64, 117, 117f, 124, 143, 147, 174, 178
flow study 176
Cerebrovascular reactivity 174, 178
Cervical spine
cerebrospinal fluid 72
medic axial image of 66f
Chemical shift
imaging 164
related artifacts 70
Cholangitis, primary sclerosing 184, 185f
Choledochal cyst 183f
Choledocholithiasis 184
Chondroblastoma 115f
Circle of Willis 126
Colloid 99, 99f
Common bile duct 183, 184
Common hepatic duct 183f
Computed tomography 213
Computer system 21
Congenital anomalies 183
Connective tissue disorders 208
lung perfusion 214
magnetic resonance angiography 48, 134, 135f
Coronary artery assessment 209
Corpus callosum 107f, 150f
Crohn's disease 186f
Cryostat 24
Dark-blood technique 203
Dental devices and materials 84
Diamagnetism 21
Diffuse axonal injury 107
Diffusion 139
kurtosis imaging 145
tensor imaging 139, 149, 150f
evaluation of 149
weighted imaging 139, 140, 146148
clinical applications of 145
Dixon method 44, 44f
Double spin-echo sequence 32
Down syndrome 172
Dowson's finger 106, 107f
Dual spin-echo sequence 32
Duodenal papilla 183f
Dynamic contrast-enhanced magnetic resonance lymphangiography 190
Dynamic susceptibility contrast 88, 179
magnetic resonance perfusion, technique of 154
perfusion 152
Echo planar imaging 31, 37, 40, 58, 154
Electrocardiograph-gated fast spin-echo magnetic resonance angiography 133
Electromagnet 23
Encephalopathy, hypoxic-ischemic 108
Endometrium 119f
Endoscopic retrograde cholangiography 182
Epidermoid 147
Epilepsy 105, 105f, 172
European Medicines Agency 92
Extracellular volume 198
Extrahepatic biliary tree 184f
Faraday cage 26
Fast field echo 40, 65, 67, 115, 116
Fast low angle shot 53, 55
Fast spin-echo 113, 180, 185, 187
sequence 32
Fat 98
quantification 197f, 198f
saturation 42f
signal fraction 196
suppression 41
techniques 42t
infiltration 53
liver 197
Femur, medial condyle of 60f
Ferromagnetism 22
Fever, rheumatic 207
direction map 150
tractography map 150
Fibrous tissue 100, 100f
Field of view 18, 20, 42, 69, 72, 80, 124, 131
Flight magnetic resonance angiography, time of 128, 130f
Flip angle 18
Fluid-attenuated inversion recovery 39, 51, 58, 61, 107f, 148
Foley catheters 82
Four-chamber view 205
Fourier decomposition 214
Fractional anisotropy 149
Free water protons 47
selective fat suppression 41
wrap 70
Functional magnetic resonance imaging 174
Gadolinium 88
based contrast agent 85, 88, 89, 90t, 91, 93, 115, 131, 135, 152, 154, 201, 210
injection 102
chelates 89
deposition 92
Gallbladder 183
Gamma-amino-butyric acid 165
Glenoid labrum ovoid mass 192
Global shimming 165
Glutamate 166f
Glutamine 166f
Glycosaminoglycan 200
field 7, 80
moment rephasing 47, 128
strength 26
Gradient-echo 30, 5355, 113, 115, 127, 182, 186, 208
sequence 13, 30, 34, 34f, 73
sequences, types of 34
Great arteries, transposition of 206
Half-Fourier acquisition single-shot turbo spin-echo 59
Heart disease
acquired 202
congenital 202, 206, 206f
Hematoma, subacute 148
Hemochromatosis 208
Hemorrhage 65f
Hemostatic clips 83
Hepatic encephalopathy 173
Hepatic fat quantification 196
Hepatic veins 208
Hepatobiliary agents 91
High-grade glioma 158f, 170f
Hip joint arthrogram 192
Horizontal long-axis 204
Human immunodeficiency virus 173
Hybrid chess and inversion recovery techniques 41
Hydrogen ions 97
Hyperpolarized gas ventilation 215f
Implantable cardioverter defibrillator 82
Infection 103
Inferior vena cava 133, 133f, 208
Inflow enhancement 128
Internal carotid artery 146
International electrotechnical commission 80
International Society of Magnetic Resonance in Medicine 92
Intrahepatic bile ducts 183f, 185f
Intravoxel incoherent motion model 143, 144
Inversion recovery sequence 31, 36, 36f
types of 37
overload imaging 195, 196f
oxide 93
Ischemic central nervous system diseases 94
Joint imaging 116
Key hole imaging 49
K-space 16, 16f
filling methods 17f
Langerhans cell histiocytosis 189
Left atrium 63, 205, 207, 208
Left renal pelvicalyceal system 62
Left ventricle 59, 63, 205, 208
Leigh's disease 172, 172f
Leukoencephalopathy, progressive multifocal 173
Ligamentum flavum, hypertrophy of 110f
acquisition 40
focal nodular hyperplasia 54f
Longitudinal magnetization 4, 6, 11, 14
Longitudinal relaxation time 9, 10f, 11, 15
Look-Locker inversion recovery sequence, modified 198
Low-grade glioma 158f
imaging sequences 211
magnetic resonance imaging
clinical applications of 215
techniques 211
parenchyma 213f
perfusion 214f
magnetic resonance imaging 214
ventilation magnetic resonance imaging 214
Lymphoma 148f, 173, 189
Macromolecules 140
Magnetic field 23f
homogeneity 25, 163
strength 22
Magnetic resonance 6, 21, 31, 32, 36, 63, 72, 83, 102, 103, 135, 154
angiography 49, 125f, 126, 134, 146
reformation of 129
types of 126
arthrogram 190
arthrography 190
cholangiopancreatography 94, 117, 125, 180, 181, 185
components 79
contrast enhancement, mechanism of 88
elastography 193
enterography 185
imaging 3, 9, 30, 41, 68, 79, 81f, 87, 94, 97, 113, 123, 126, 148, 162, 174, 175, 180, 188, 189, 193, 211, 213, 214
acquisition 30f
application of 211
artifacts 68
basics of 1
contrast media 87
formation 6f
perfusion 152
safety 79, 81
techniques 121
instrumentation 21
lymphangiography 190, 191f
perfusion 152
imaging methods 153t
signal 5
spectroscopic imaging 164, 171
spectroscopy 70, 162, 163, 170, 196
acquisition 165
clinical uses of 170
non-neurological applications of 173
urography 186, 187
Magnetic susceptibility
artifact 73
effect 75f
Magnetism 21
prepared rapid gradient echo 56
transfer 41, 47, 48f
diagram 48f
pulse 48
Main pancreatic duct 183f
Main pulmonary artery 127
Matrix 17
Maximum intensity projection 62, 135, 181, 185, 187
Mean transit time 156
Meconium 99
Melanin 99, 99f
Metabolic disorder 172, 172f
Metastatic diseases 189
Middle cerebral artery 146
Minimum intensity projection 176
Mitochondrial encephalopathy lactic acidosis 172
Mitral stenosis 207f
Molecules, crystalline lattice of 9
Moyamoya disease 159, 160f
Mucin 100
Multi echo data image combination 65, 66
Multifocal marrow edema 189f
Multivoxel spectroscopy technique 164
Muscle 97
tissue 97
Musculoskeletal neoplasms 114
Myelin 98
Myocardial perfusion 209
Myocardial perfusion study 209
Myocardium 63f
Myometrium 119f
N-acetylaspartate 162, 167, 168
Navigator technique 46
Neonatal hypoxia 172
Neoplasm 208
Neoplastic lesions 184
Nephrogenic systemic fibrosis 91, 93, 126
Net magnetization vector 9, 38, 39, 77
Neural foramen 66f
Neurofibromatosis 19f
Neuroimaging magnetic resonance imaging techniques 174
Non-contrast magnetic resonance angiography techniques 127
Non-gadolinium magnetic resonance contrast agents 93
Normal pressure hydrocephalus 177, 178f
Ocular implants 84
Optic glioma 19
Oral contrast agents 94
Orthopedic implants 84
Osteoarthritis 60f, 66f
chronic nonbacterial 189f
chronic recurrent multifocal 189, 189f
Osteophytes 66f
Otologic implants 84
Pacemakers 84
Pancreas divisum 183f
Pancreatic duct 62f, 183, 185f
Pancreatitis, chronic 184
Parallel imaging artifacts 78
Paramagnetic agents 87
Pediatric brain, magnetic resonance imaging in 108
Pelvic imaging 117
Penile implants 84
Pericardial disease 210
Pericardial masses 209
Pericarditis, constrictive 207, 208, 208f
flow quantification 132
magnetic resonance angiography 130
Positive relaxation agents 87
Positron emission tomography 149, 161
Postcardiac surgery 208
Posterior cerebral artery 103
Posterior circulation stroke 103f
Posterior cranial fossa 64f
Post-excitation refocused steady-state sequences 35
Pre-excitation refocused steady-state sequences 35
Prosthetic heart valves 84
Protein 99
Proton-density 9, 32, 51
fat fraction method 197, 198f
image 15, 15f
Pulmonary artery 59
Pulse sequences 30
Quadrature coil 27
Quench 25
Radiation necrosis 171f
Radiofrequency 3, 7, 24, 3134, 36, 38, 77, 123, 124, 127
coils 27
excitation 9
magnetic field 80
pulse 9, 30
Radiotherapy 208
Renal failure 208
Respiratory compensation techniques 46, 46f, 69
Right atrium 63, 205208
Right internal auditory canal 106
Right pulmonary artery stenosis 206f
Right ventricle 63, 205, 207, 208
Right ventricular outflow tract 205, 206f
Sacroiliitis 114f
Salvageable tissue, penumbra of 157
Sarcoidosis 208
Saturation band 49, 69
Scleroderma 208
Sclerosis, multiple 107f, 172
Secretin magnetic resonance cholangiopancreatography 182
Short tau inversion recovery 38, 39, 4143, 57, 58, 60, 114, 188, 189
images 112
sequence 37
Short-axis plane 204
Shoulder, magnetic resonance arthrogram of 191f
Signal intensity pattern 101, 111, 143t
Signal-to-noise ratio 18, 19, 19f, 20, 42, 45, 58f, 125, 161
Single-photon emission computed tomography 216
Single-shot fast spin-echo 57, 59, 63
sequence 33, 33f
Spherical volume, diameter of 25
Spine 95
imaging 108
T1-weighted axial image of 110f
T2-weighted sagittal image of 109f
Spin-echo 30
sequence 12f, 13, 30, 31, 31f
modifications of 31
Splenic parenchyma 196f
Steady-state free precession 35, 40, 113, 124, 127, 134, 180, 186
Stejskal-Tanner sequence 140f
Stimulated echo acquisition method 163
Stroke 145, 146f, 172
imaging 102
magnetic resonance perfusion in 155
Superior vena cava 59, 127, 208
Superparamagnetic iron oxides 88
Susceptibility-weighted imaging 175, 176, 176f
Swan-Ganz catheters 82
Synthetic magnetic resonance imaging 51
high resolution isotropic volume examination 40, 52, 100, 182, 186
three-dimensional gradient echo 52
fast spin-echo sequences 61
image 14
three-dimensional sequences 60
Tesla magnetic resonance imaging 123
Tetralogy of Fallot 206f
Thalassemia 196
Tibia, medial condyle of 60f
Time-resolved contrast-enhanced magnetic resonance angiography 136, 137
Tissue suppression 37
Toxoplasma 173
Transverse magnetization 5, 5f, 6, 11, 11f, 15, 27
formation of 10f
vector, precession of 6
Transverse relaxation time 10, 11, 11f, 12, 15
Trauma 106
Truncation artifact 70, 73f
Tuberculomas 95f
Tumefactive demyelinating lesion 157
Tumor vascularity 104f
Turbo spin-echo 53, 58, 59, 63
Ultrasonography 184
Urinary bladder 118f
Uterine imaging 119f
Valvular heart disease 206
Vascular access ports 85
Vasculitis 125f
Ventricular function 209
Ventricular septal defect 206
Vertebral arteries 130f
Vertical long-axis plane 204
Volume coil 28
Volumetric interpolated breath-hold examination 40, 53, 54, 56, 112
Water 98
excitation 45
selective excitation 45
White matter diseases 172
Whole-body magnetic resonance imaging 188
X-axis 7
Y-axis 7
Z-axis 4, 7
Zipper artifact 75, 76f
Chapter Notes

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MRI Made Easy® (for Beginners)
MRI Made Easy® (for Beginners)
Third Edition
Govind B Chavhan MBBS MD DNB DABR Staff Pediatric Radiologist The Hospital for Sick Children Professor of Radiology University of Toronto Ontario, Canada
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Medical knowledge and practice change constantly. This book is designed to provide accurate, authoritative information about the subject matter in question. However, readers are advised to check the most current information available on procedures included and check information from the manufacturer of each product to be administered, to verify the recommended dose, formula, method and duration of administration, adverse effects and contraindications. It is the responsibility of the practitioner to take all appropriate safety precautions. Neither the publisher nor the author(s)/editor(s) assume any liability for any injury and/or damage to persons or property arising from or related to use of material in this book.
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MRI Made Easy® (for Beginners) / Govind B Chavhan
First Edition: 2006
Third Edition: 2022
Printed at:
Ravi Sir (Professor Ravi Ramakantan)
The teacher par excellence
unchallengeable Radiologist
“Niswarth Karmayogi” relentlessly working toward
the benefit of thousands of poor patients
the great igniter of minds
this is for you
Preface to the Third Edition
Similar to other fields in medicine, MRI is ever advancing field. Many new techniques have been added in clinical practice since second edition. MRI is rapidly moving from qualitative to quantitative techniques regularly applied in patient management. Nephrogenic systemic fibrosis suddenly surfaced and changed the practice of contrast administration. As NSF cases became rare, concerns over gadolinium deposition in various body tissues started emerging. This little book has become a staple for radiology students and trainees beginning to learn MRI, selling over 1,000 copies yearly in the last decade. Third edition is an attempt to update this book with new advances and knowledge in the field.
The third edition of MRI Made Easy remains superficial overview of the subject explaining the basic fundamentals in simple language. This work is done keeping in mind needs of the person beginning to learn MR, especially radiology residents. As before, in attempt to simplify the subject, many complex things have been purposely omitted. This book is by no means complete source of the subject. This should serve as an appetizer for further reading of this interesting subject.
The book is still divided into two sections. First section deals with basic principles, instrumentation of MR system, sequences, and artifacts. Many new sequences and modifications are added in the chapters on sequences. The chapter on contrast media has up to date discussion on current issues. Also discussed in the section I are basic principles of MR interpretations with addition of a new chapter on normal signal intensity on MRI. Section II is on higher applications of MRI and has many new chapters covering new and upcoming MRI techniques including quantitative techniques.
Best Wishes and Happy Reading!
Govind B Chavhan
Preface to the First Edition
Radiology is the fastest advancing branch of medical sciences. It is moving from evaluation of anatomy to physiology, structural to functional, morphological to tissue diagnosis and biochemical information. MR takes the lead in this rapid march of advancement of radiology. No other modality has developed so much as MR in the last 20 years. MR has emerged as strong modality, which gives final answer in many conditions in all body systems.
This short introductory book is the superficial overview of the subject explaining the basic fundamentals. This work is done keeping in mind needs of the person beginning to learn MR, especially radiology residents. In attempt to simplify the subject, many complex things have purposely been omitted. This book is by no means complete source of the subject. This should serve as an appetizer for further reading of this interesting subject.
This book is divided into two sections. First section deals with basic principles, instrumentation of MR system, sequences and artifacts. Also discussed are few basic principles of MR interpretations. Section two has some advances and higher applications of MR. Following are few things to remember while reading this book:
Govind B Chavhan
High-quality radiology work done by my idols Dr Bhavin Jankharia and Dr Meher Ursekar inspired me to write MRI Made Easy. Their work and teaching still inspire me. I am grateful to them for their continued support and love. Most of the images of the first edition are retained in this third edition. These images are courtesy of Jankharia Imaging, Mumbai, Maharashtra, India.
I was fortunate to have excellent teachers and guides at every step of my carrier. It started with Professor Ravi Ramakantan in King Edward Memorial (KEM) Hospital, University of Mumbai who instilled ability, confidence and values for patient care. Dr Malini Nadkarni introduced me to pediatric imaging. MRI learning was with Dr Jankharia and Dr Ursekar in Mumbai. This was followed by support and guidance from Dr Manohar Shroff and Dr Paul Babyn in Toronto. I am ever grateful to Dr Babyn for mentoring me in the exciting field of pediatric body MRI.
Thank you to my all colleagues in the department at The Hospital for Sick Children, Toronto. I am fortunate to be working with such brilliant minds and nice human beings. Thank you to constant flow of trainees including residents and fellows to our department. Learning from them and teaching them is one of the greatest joys of my life.
Thank you to my friends Drs Pradeep Krishnan, Kushaljit Singh Sodhi and Giles Santyr for providing some images of their valuable work in the field for this book.
I take this opportunity to thank all the readers who commented, criticized, and made suggestions on Amazon website. My sincere and heartfelt thank you to those who reached me directly by email and pointed out some mistakes in the second edition. This has helped to improve the third edition.
My sincere thanks to Shri Jitendar P Vij (Group Chairman), Mr Ankit Vij (Managing Director), Mr MS Mani (Group President) of M/s Jaypee Brothers Medical Publishers (P) Ltd, New Delhi, India, for publishing the book. Special thank you to Dr Richa Saxena (Associate Director-Professional Publishing), Ms Pooja Bhandari (Production Head), Ms Nedup Denka Bhutia (Development Editor), of M/s Jaypee Brothers Medical Publishers (P) Ltd, New Delhi, India.
Last but not the least, pillars of my existence, creativity, and joy—my family, my wife Barakha and my sons Yash and Raj. Thank you for your love and bearing with me.
Few Commonly Used Short Forms
Analog to Digital Converter
Contrast Enhanced Magnetic Resonance Angiography
Field of View
Fourier Transformation
Gradient Moment Rephasing
Gradient Moment Nulling
Gradient Echo
Inversion Recovery
Longitudinal Magnetization
Magnetization Transfer Contrast
Number of Excitation (Averages of Acquisition)
Net Magnetization Vector
Proton Density
Specific Absorption Rate
Spin Echo
Signal to Noise ratio
Time to Echo
Time to Invert (Inversion Time)
Transverse Magnetization
Time to Repeat
Velocity Encoding
Summary of Sequences
GE *
Spin Echo Sequences
  • Conventional SE (90–180° RF pulses)
  • Double SE (90° followed by two 180° RF pulses)
  • Multi-SE (90° followed by multiple 180° RF pulses)
Turbo SE
Fast SE
Turbo SE
  • Multi-SE with flip-back 90° pulse
  • Single-shot Multi-SE (Multi-SE with half k-space filling)
Single Shot
  • 3D versions of T2-weighted Fast spin-echo sequence
  • Fast spin-echo with radial k-space filling
Gradient Echo Sequences
A. Incoherent spoiled TM
  • 3D versions
  • 3D versions with radial/stack of star k-space filling
B. Coherent/Rephased TM
  • Post-excitation refocused (FID sampled)
  • Pre-excitation refocused (Spin echo sampled)
  • Fully refocused (both FID and spin echo sampled)
Inversion Recovery Sequences
  • Short TI (80–150 ms), e.g., STIR
  • Medium TI (200–1,200 ms), e.g., MPRAGE
  • Long TI (1,500–2,500 ms), e.g., FLAIR
  • Combination of SE and GRE
  • Single shot
  • Multishot-segmented
* Vendor nomenclatures for sequences are taken from References:1. Nitz WR. MR Imaging: Acronyms and clinical applications. Eur Radiol. 1999;9(5):979-97.2. Brown MA, Semelka RC. MR Imaging Abbreviations, Definitions, and Descriptions: a review. Radiology. 1999;213(3):647-62.3. accessed on January 1, 2021.
(EPI: echo planar imaging; FAME: fast acquisition with multiphase enhanced fast 3D GRE; FLASH: fast low-angle shot; FFE: fast field echo; FISP: fast imaging with steady-state precession; GRASS: gradient-recalled acquisition in the steady state; LAVA: liver acquisition with volume acquisition; SPGR: spoiled gradient-recalled; SSFP: steady-state free precession; THRIVE: T1-weighted high-resolution isotropic volume examination; VIBE: volumetric interpolated breath-hold examination)