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Digestive Diseases and Sciences
Published in: Digestive Diseases and Sciences 5/2018

01-05-2018 | Paradigm Shifts in Perspective

Contributions of Magnetic Resonance Imaging to Gastroenterological Practice: MRIs for GIs

Authors: Christopher G. Roth, Dina Halegoua-De Marzio, Flavius F. Guglielmo

Published in: Digestive Diseases and Sciences | Issue 5/2018

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Abstract

MRI has transformed from the theoretical, investigative realm to mainstream clinical medicine over the past four decades and has become a core component of the diagnostic toolbox in the practice of gastroenterology (GI). Its success is attributable to exquisite contrast and the ability to isolate specific proton species through the use of different pulse sequences (i.e., T1-weighted, T2-weighted, diffusion-weighted) and exploiting extracellular and hepatobiliary contrast agents. Consequently, MRI has gained preeminence in various GI clinical applications: liver and pancreatic lesion evaluation and detection, liver transplantation evaluation, pancreatitis evaluation, Crohn’s disease evaluation (using MR enterography) rectal cancer staging and perianal fistula evaluation. MR elastography, in concert with technical innovations allowing for fat and iron quantification, provides a noninvasive approach, or “MRI virtual liver biopsy” for diagnosis and management of chronic liver diseases. In the future, the arrival of ultra-high-field MR systems (7 T) and the ability to perform magnetic resonance spectroscopy in the abdomen promise even greater diagnostic insight into chronic liver disease.
Footnotes
1
T1- and T2-weighted imaging in MRI refers to two different strategies that exploit the unique behavior of different proton species reacting to electromagnetic energy, or radiofrequency pulses, in a strong magnetic field. T1-weighting is accomplished by repeating radiofrequency pulses either very rapidly and/or with high intensity to selectively isolate those protons that rapidly realign their nuclear spin with the main magnetic field (defined as having a low T1 value, which refers to the time elapsed for a proton to achieve 63% realignment with the main magnetic field). T1-weighting favors signal from protons with short T1 values, such as gadolinium and methemoglobin (blood). T2-weighting is accomplished by prolonging the acquisition of data, or the reception of the emitted radiofrequency energy from protons following an radiofrequency pulse to selectively isolate the received signal from proton species retaining relatively greater transverse, or coherent, magnetization as a function of their proton-specific T2 value (which is the time elapsed for 63% of transverse magnetization to decay following excitation by a radiofrequency energy pulse). T2-weighting favors signal from protons with long T2 values, such as water protons.
 
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Metadata
Title
Contributions of Magnetic Resonance Imaging to Gastroenterological Practice: MRIs for GIs
Authors
Christopher G. Roth
Dina Halegoua-De Marzio
Flavius F. Guglielmo
Publication date
01-05-2018
Publisher
Springer US
Published in
Digestive Diseases and Sciences / Issue 5/2018
Print ISSN: 0163-2116
Electronic ISSN: 1573-2568
DOI
https://doi.org/10.1007/s10620-018-4991-x

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