How MRI Works

BY TODD A. GOULD, RT-(R)(MR)(ARRT) & MOLLY EDMONDS

Browse the article How MRI Works

MRI Image Gallery Dr. Raymond Damadian, a physician and

scientist, toiled for years trying to produce a
machine that could noninvasively scan the
body with the use of magnets. Along with some
graduate students, he constructed a
superconducting magnet and fashioned a coil
of antenna wires. Since no one wanted to be
the first one in this contraption, Damadian
volunteered to be the first patient.

When he climbed in, however, nothing

LESTER LEFKOWITZ/PHOTOGRAPHER'S CHOICE/GETTY happened. Damadian was looking at years
IMAGES wasted on a failed invention, but one of his
Into the abyss. See more MRI pictures. colleagues bravely suggested that he might be
too big for the machine. A svelte graduate
student volunteered to give it a try, and on July 3, 1977, the first MRI exam was performed on a
human being. It took almost five hours to produce one image, and that original machine, named the
"Indomitable," is now owned by the Smithsonian Institution.

In just a few decades, the use of magnetic resonance imaging (MRI) scanners has grown
tremendously. Doctors may order MRI scans to help diagnose multiple sclerosis, brain tumors, torn
ligaments, tendonitis, cancer and strokes, to name just a few. An MRI scan is the best way to see
inside the human body without cutting it open.
Learn More
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That may be little comfort to you when you're getting ready for an MRI exam. You're stripped of your
jewelry and credit cards and asked detailed questions about all the metallic instruments you might
have inside of you. You're put on a tiny slab and pushed into a hole that hardly seems large enough
for a person. You're subjected to loud noises, and you have to lie perfectly still, or they're going to do
this to you all over again. And with each minute, you can't help but wonder what's happening to your
body while it's in this machine. Could it really be that this ordeal is truly better than another imaging
technique, such as an X-ray or a CAT scan? What has Raymond Damadian wrought?

Let the magnets of this mighty machine draw you to the next page, and we'll take a look at what's
going on inside.

MRI Magnets: the Major Players

MRI scanners vary in size and shape, and
some newer models have a greater degree of
openness around the sides. Still, the basic
design is the same, and the patient is pushed
into a tube that's only about 24 inches (60
centimeters) in diameter [source: Hornak]. But
what's in there?

The biggest and most important component of

an MRI system is the magnet. There is a
horizontal tube -- the same one the patient
enters -- running through the magnet from front
to back. This tube is known as the bore. But
this isn't just any magnet -- we're dealing with
an incredibly strong system here, one capable
HOWSTUFFWORKS.COM
of producing a large, stable magnetic field.
The components of an MRI system
The strength of a magnet in an MRI system is rated using a unit of measure known as a tesla.
Another unit of measure commonly used with magnets is the gauss (1 tesla = 10,000 gauss). The
magnets in use today in MRI systems create a magnetic field of 0.5-tesla to 2.0-tesla, or 5,000 to
20,000 gauss. When you realize that the Earth's magnetic field measures 0.5 gauss, you can see
how powerful these magnets are.

Most MRI systems use a superconducting magnet, which consists of many coils or windings of
wire through which a current of electricity is passed, creating a magnetic field of up to 2.0 tesla.
Maintaining such a large magnetic field requires a good deal of energy, which is accomplished by
superconductivity, or reducing the resistance in the wires to almost zero. To do this, the wires are
continually bathed in liquid helium at 452.4 degrees below zero Fahrenheit (269.1 below zero
degrees Celsius) [source: Coyne]. This cold is insulated by a vacuum. While superconductive
magnets are expensive, the strong magnetic field allows for the highest-quality imaging, and
superconductivity keeps the system economical to operate.

The Other Parts of an MRI Machine

MRI Developments
MRI machines are evolving so that they're more patient-friendly. For example, many claustrophobic
people simply can't stand the cramped confines, and the bore may not accommodate obese
people. There are more open scanners, which allow for greater space, but these machines have
weaker magnetic fields, meaning it may be easier to miss abnormal tissue. Very small scanners for
imaging specific body parts are also being developed.

Other advancements are being made in the field of MRI. Functional MRI (fMRI), for example,
creates brain maps of nerve cell activity second by second and is helping researchers better
understand how the brain works. Magnetic resonance angiography (MRA) creates images of
flowing blood, arteries and veins in virtually any part of the body.

Two other magnets are used in MRI systems to a much lesser extent. Resistive magnets are
structurally like superconducting magnets, but they lack the liquid helium. This difference means
they require a huge amount of electricity, making it prohibitively expensive to operate above a 0.3
tesla level. Permanent magnets have a constant magnetic field, but they're so heavy that it would
be difficult to construct one that could sustain a large magnetic field.

There are also three gradient magnets inside the MRI machine. These magnets are much lower
strength compared to the main magnetic field; they may range in strength from 180 gauss to 270
gauss. While the main magnet creates an intense, stable magnetic field around the patient, the
gradient magnets create a variable field, which allows different parts of the body to be scanned.

Another part of the MRI system is a set of coils that transmit radiofrequency waves into the patient's
body. There are different coils for different parts of the body: knees, shoulders, wrists, heads, necks
and so on. These coils usually conform to the contour of the body part being imaged, or at least
reside very close to it during the exam. Other parts of the machine include a very powerful computer
system and a patient table, which slides the patient into the bore. Whether the patient goes in head
or feet first is determined by what part of the body needs examining. Once the body part to be
scanned is in the exact center, or isocenter, of the magnetic field, the scan can begin.

What goes on during a scan? Find out on the next page.

Hydrogen Atoms and Magnetic Moments

When patients slide into an MRI machine, they

take with them the billions of atoms that make
up the human body. For the purposes of an
MRI scan, we're only concerned with the
hydrogen atom, which is abundant since the
body is mostly made up of water and fat.
These atoms are randomly spinning, or
precessing, on their axis, like a child's top. All
of the atoms are going in various directions,
but when placed in a magnetic field, the atoms
line up in the direction of the field.

These hydrogen atoms have a strong

magnetic moment, which means that in a
magnetic field, they line up in the direction of
© 2008 HOWSTUFFWORKS.COM
the field. Since the magnetic field runs straight
The steps of an MRI
down the center of the machine, the hydrogen
protons line up so that they're pointing to either the patient's feet or the head. About half go each
way, so that the vast majority of the protons cancel each other out -- that is, for each atom lined up
toward the feet, one is lined up toward the head. Only a couple of protons out of every million aren't
canceled out. This doesn't sound like much, but the sheer number of hydrogen atoms in the body is
enough to create extremely detailed images. It's these unmatched atoms that we're concerned with
now.
What Else Is Going on in an MRI Scan?
Next, the MRI machine applies a radio frequency (RF) pulse that is specific only to hydrogen. The
system directs the pulse toward the area of the body we want to examine. When the pulse is
applied, the unmatched protons absorb the energy and spin again in a different direction. This is the
"resonance" part of MRI. The RF pulse forces them to spin at a particular frequency, in a particular
direction. The specific frequency of resonance is called the Larmour frequency and is calculated
based on the particular tissue being imaged and the strength of the main magnetic field.

At approximately the same time, the three gradient magnets jump into the act. They are arranged in
such a manner inside the main magnet that when they're turned on and off rapidly in a specific
manner, they alter the main magnetic field on a local level. What this means is that we can pick
exactly which area we want a picture of; this area is referred to as the "slice." Think of a loaf of
bread with slices as thin as a few millimeters -- the slices in MRI are that precise. Slices can be
taken of any part of the body in any direction, giving doctors a huge advantage over any other
imaging modality. That also means that you don't have to move for the machine to get an image
from a different direction -- the machine can manipulate everything with the gradient magnets.

But the machine makes a tremendous amount of noise during a scan, which sounds like a continual
rapid hammering. That's due to the rising electrical current in the wires of the gradient magnets
being opposed by the main magnetic field. The stronger the main field, the louder the gradient
noise. In most MRI centers, you can bring a music player to drown out the racket, and patients are
given earplugs.

When the RF pulse is turned off, the hydrogen protons slowly return to their natural alignment within
the magnetic field and release the energy absorbed from the RF pulses. When they do this, they
give off a signal that the coils pick up and send to the computer system. But how is this signal
converted into a picture that means anything?

MRI Images and How They're Made

The MRI scanner can pick out a very small point inside the patient's body and ask it, essentially,
"What type of tissue are you?" The system goes through the patient's body point by point, building
up a map of tissue types. It then integrates all of this information to create 2-D images or 3-D
models with a mathematical formula known as the Fourier transform. The computer receives the
signal from the spinning protons as mathematical data; the data is converted into a picture. That’s
the "imaging" part of MRI.

RON LEVINE/THE IMAGE BANK/GETTY IMAGES
Doctors examine the contrasts on an MRI scan.
doesn't, there might be an abnormality.
The MRI system uses injectable contrast, or
dyes, to alter the local magnetic field in the
tissue being examined. Normal and abnormal
tissue respond differently to this slight
alteration, giving us differing signals. These
signals are transferred to the images; an MRI
system can display more 250 shades of gray to
depict the varying tissue [source: Coyne]. The
images allow doctors to visualize different
types of tissue abnormalities better than they
could without the contrast. We know that when
we do "A," normal tissue will look like "B" -- if it

An X-ray is very effective for showing doctors a broken bone, but if they want a look at a patient's
soft tissue, including organs, ligaments and the circulatory system, then they'll likely want an MRI.
And, as we mentioned on the last page, another major advantage of MRI is its ability to image in any
plane. Computer tomography (CT), for example, is limited to one plane, the axial plane (in the loaf-
of-bread analogy, the axial plane would be how a loaf of bread is normally sliced). An MRI system
can create axial images as well as sagitall (slicing the bread side-to-side lengthwise) and coronal
(think of the layers in a layer cake) images, or any degree in between, without the patient ever
moving.

But for these high-quality images, the patient can't move very much at all. MRI scans require
patients to hold still for 20 to 90 minutes or more. Even very slight movement of the part being
scanned can cause distorted images that will have to be repeated. And there's a high cost to this
kind of quality; MRI systems are very expensive to purchase, and therefore the exams are also very
expensive.

But are there any other costs? What about the patient's safety?

MRI Safety Concerns

Maybe you're concerned about the long-term impact of having all your atoms mixed about, but once
you're out of the magnetic field, your body and its chemistry return to normal. There are no known
biological hazards to humans from being exposed to magnetic fields of the strength used in medical
imaging today. The fact that MRI systems don’t use ionizing radiation, as other imaging devices do,
is a comfort to many patients, as is the fact that MRI contrast materials have a very low incidence of
side effects. Most facilities prefer not to image pregnant women, due to limited research of the
 biological effects of magnetic fields on a
developing fetus. The decision of whether or
not to scan a pregnant patient is made on a
case-by-case basis with consultation between
the MRI radiologist and the patient's
obstetrician.

However, the MRI suite can be a very

dangerous place if strict precautions are not
observed. Credit cards or anything else with
magnetic encoding will be erased. Metal
PLUSH STUDIOS/BLEND IMAGES/GETTY IMAGES
This patient was cleared for take-off. objects can become dangerous projectiles if
they are taken into the scan room. For
example, paperclips, pens, keys, scissors, jewelry, stethoscopes and any other small objects can be
pulled out of pockets and off the body without warning, at which point they fly toward the opening of
the magnet at very high speeds.

Big objects pose a risk, too -- mop buckets, vacuum cleaners, IV poles, patient stretchers, heart
monitors and countless other objects have all been pulled into the magnetic fields of the MRI. In
2001, a young boy undergoing a scan was killed when an oxygen tank was pulled into the magnetic
bore [source: McNeil]. Once, a pistol flew out of a policeman's holster, the force causing the gun to
fire. No one was injured.

To ensure safety, patients and support staff should be thoroughly screened for metal objects prior to
entering the scan room. Often, however, patients have implants inside them that make it very
dangerous for them to be in the presence of a strong magnetic field. These include:

Metallic fragments in the eye, which are very dangerous as moving these fragments
could cause eye damage or blindness
Pacemakers, which may malfunction during a scan or even near the machine
Aneurysm clips in the brain, which could tear the very artery they were placed on to
repair if the magnet moves them
Dental implants, if magnetic

Most modern surgical implants, including staples, artificial joints and stents are made of non-
magnetic materials, and even if they're not, they may be approved for scanning. But let your doctor
know, as some orthopedic hardware in the area of a scan can cause distortions in the image.

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Sources

Berman, Phyllis. "How to Avoid That Buried Alive Feeling." Forbes. Feb. 28, 1994.
Coyne, Kristen Eliza. "MRI: A Guided Tour." National High Magnetic Field
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http://www.magnet.fsu.edu/education/tutorials/magnetacademy/mri/
Damadian, Raymond V. "The story of MRI." Saturday Evening Post. May/June 1994.
Hornak, Joseph P. "The Basics of MRI." 1996. (Aug. 6, 2008)
http://www.cis.rit.edu/people/faculty/hornak
Kirby, David. "Patients Embrace New Generation of Imaging Machines." New York
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http://query.nytimes.com/gst/fullpage.html?
res=9C0CE0DE163BF93BA35756C0A9679C8B63
McNeil, Donald G. Jr. "M.R.I.'s Strong Magnets Cited in Accidents." New York Times.
Aug. 19, 2005. (Aug. 6, 2008)
http://www.nytimes.com/2005/08/19/health/19magnet.html
Wakefield, Julie. "The 'Indomitable' MRI." Smithsonian. June 2000.
 Woodward, Peggy. "MRI for Technologists." McGraw-Hill Professional. 2000. (Aug.
6, 2008)
http://books.google.com/books?id=fR5u5u1hwFkC&printsec=frontcover