How does an MRI scan work?

Most of the human body is made up of

water molecules, which consist of
hydrogen and oxygen atoms.

At the centre of each hydrogen atom is

an even smaller particle called a proton.
Protons are like tiny magnets and are
very sensitive to magnetic fields.

When you lie under the powerful scanner magnets, the protons in your body line up in the
same direction, in the same way that a magnet can pull the needle of a compass. You will not
be able to feel this.

Short bursts of radio waves are then sent to certain areas of the body, knocking the protons
out of alignment.

When the radio waves are turned off, the protons realign. This sends out radio signals, which
are picked up by receivers.

These signals provide information about the exact location of the protons in the body.

They also help to distinguish between

the various types of tissue in the body,
because the protons in different types
of tissue realign at different speeds and
produce distinct signals.

In the same way that millions of pixels

on a computer screen can create
complex pictures, the signals from the
millions of protons in the body are
combined to create a detailed image of
the inside of the body.

How does the procedure work?

Unlike x-ray and computed tomography (CT) exams, MRI does not use radiation. MRI uses a
high-power magnet to temporarily change the position of hydrogen atoms that naturally
exist within the body. This does not cause any long-term changes in your body. As the
hydrogen atoms return to their usual position, they emit different amounts of energy
depending on the type of tissue they are in. The scanner captures this energy, and a
computer creates a picture using this information.
Most MRI units produce the magnetic field by passing an electric current through wire coils.
Other coils are inside the machine and, in some cases, are placed around the part of the
body being imaged. These coils send and receive radio waves, producing signals that the
machine detects. The electric current does not come into contact with the patient.

MRI is often able to tell the difference between diseased tissue and normal tissue better
than x-ray, CT, and ultrasound.

What does an MRI show?

Nearly every part of the body may be studied with MRI. MRI gives very detailed pictures of
soft tissues like the brain. Air and hard bone do not give an MRI signal, so these areas appear
black. Bone marrow, spinal fluid, blood, and soft tissues vary in intensity from black to white,
depending on the amount of fat and water present in each tissue and the machine settings
used for the scan. The radiologist compares the size and distributions of these bright and
dark areas to determine whether a tissue is healthy.

Head and neck (Fig. 1). MRI can be used to detect brain tumors, traumatic brain injury,
developmental anomalies, multiple sclerosis, stroke, dementia, infection, and the causes
of headache.

Figure 1. MRI of the brain.

Arteries and veins (Fig. 2). MRA can detect aneurysms, blockages of the blood vessels,
carotid artery disease, and arteriovenous malformations.

Figure 2. MRA of the brain arteries.

Spine (Fig. 3). MRI is sensitive to changes in cartilage and bone structure resulting from
injury, disease, or aging. It can detect herniated discs, pinched nerves, spinal tumors,
spinal cord compression, and fractures.

Figure 3. MRI of the lumbar spine.

MRI machines use a combination of
radio waves, magnetic fields, and
powerful computer technology to
create vivid images of the interior
human body. During these tests,
patients lie down and are inserted into
a large tube that generates its own
magnetic field. The MRI technology
records how emitted radio waves
interact with the field and processes
those interactions with computer
technology to generate images of
inside the patient's body.

Patients can expect these tests to take

anywhere from 30 minutes to an hour.
They can eat, drink, and take
medications normally beforehand.
Your doctor and radiologist will walk
you through any further instructions
before or during your appointment.

Magnetic resonance imaging (MRI) is a

medical imaging technique that uses a
magnetic field and computer-generated
radio waves to create detailed images of
the organs and tissues in your body.

Most MRI machines are large, tube-shaped

magnets. When you lie inside
an MRI machine, the magnetic field inside
works with radio waves and hydrogen
atoms in your body to create cross-
sectional images — like slices in a loaf of
bread.

The MRI machine also can produce 3D

images that can be viewed from different
angles.
Brain Tumor MRI
Dean Booth explains the benefits and complexities of the MRI scanner

Magnetic resonance imaging (MRI) works with the basic elements of the human body by
taking advantage of the fact that water molecules in the human body react in a predictable
manner when magnetic fields and radio waves are applied to them.

Water molecules within the body have a slight magnetic polarity, with one end being slightly
positive and the other slightly negative. For an MRI scan, we first use a superconducting
magnet to align the water molecules in relation to the lines of magnetic force.

We then transmit radio waves through the area we want to scan. The energy in these waves
excites the water molecules, which disrupts their normal behavior and the levels of energy
they possess, causing them to jostle about. The critical part of the process begins after we
turn the radio transmitter off. It is while the molecules are relaxing back into their normal
state that the scanner’s sensors detect a signal they give off, and it is these signals that are
processed by computer to create the image we see. The crucial thing is that we are looking
at the change in the energy levels given off by the molecules, not just logging the energy
levels themselves.
Different types of tissue, such as fat, muscle or cartilage, will release different amounts of
energy in different ways. The scanner records these energy signals throughout the time the
molecules are calming down and each reading is given a number—so for example we could
have a range of numbers going from 0 to 10. These numbers are then used to create a
greyscale image, where black might be represented by 0 and white by 10, and everything in
between is a different shade of grey. The more accurate the recording, the more shades of
grey you can define and the more detailed your final image will be.

One of the great things about MRI is that while many other scans will give you a static
picture of an organ, an MRI can generate a moving image. This really comes into its own with
heart scans because a moving image allows you to assess the functionality as well as the
anatomy of the heart. The image resolution nowadays is wonderful and we can create a
virtual 3D model of what is going on inside the heart, from tiny vessels within the heart right
down to the structure of the muscle walls.

One of the things that makes MRI so powerful is that we can change the parameters used to
generate the image contrast in order to show us different things and focus in more closely on
a particular tissue or area if we need to. The incredible level of spatial resolution you can get
on an image allows you to manipulate the image to really narrow in on exactly what you
want to see.
MRI can be used to scan most parts of the body. As well as the heart, it is used extensively in
brain investigations to look for a wide range of diseases, including dementia. It is also very
good at physical structures such as the knee, where we can get detailed images of bone,
muscle, cartilage and blood vessels to build a complete picture.

The only real downside of MRI scanning is the time it takes. For example, some brain scans
can take over 20 minutes, and the longer the scanner is in use the more expensive it is to do
the test. One of the real advances in MRI scanning in recent years has been the speeding up
of how long a scan takes. It is better than it was five years ago, but this is always an ongoing
process.

As with any medical procedure, there are patient assessments you have to go through before
a scan. With MRI, most pacemakers, neurostimulators and ferrous metal implants can be
contraindicated. The strong magnetic field can interfere with the function of the implant, and
can disrupt, dislodge or heat up components with unfortunate effects. In itself, however, this
is a very safe technique. After over 20 years of use all over the world, we are pretty certain
that MRI scanning has no short or long term detrimental effects.

Imaging The process of creating visual representations of the interior of a body for clinical
analysis

Superconducting magnet an electromagnet made from coils of superconducting wire which

is cooled to below -150 °C during operation

Spatial resolution The number of pixels utilised in the construction of a digital image. The
higher the spatial resolution, the greater the number of pixels

Ferrous metals Metals that contain iron, and therefore have magnetic qualities

Neurostimulator An implant designed to modulate activity within the nervous system

Contraindication A factor that serves as a reason to withhold a medical treatment, due to

the possibility of the patient being harmed.
An MRI takes pictures of places in your body that contain water, and the detail in these
images comes from the ways that different tissues interfere with the electromagnetic waves
coming from water molecules. The idea of water releasing electromagnetic waves may seem
pretty exotic, but it turns out that most molecules do it all the time---the signals that they
emit are just so tiny that you’d only notice them if you went looking for them. An MRI is just
a device that first excites water molecules into releasing waves, and then records the
locations of those waves with high accuracy.
Your body is pretty much entirely made of water. Blood vessels, lymph nodes, and even solid
bones are soaked with water molecules, each of which contains two hydrogen atoms. At the
center of each hydrogen atom sits a nucleus consisting of a single proton, which can be
visualized as a tiny bar magnet with a “north” and “south” pole. Just like the “north” and
“south” poles of a needle on a compass tend to align with the magnetic poles of the earth, in
the presence of strong magnetic fields each proton in water twists its orientation so that it
aligns with the field. When health care providers first turn on the MRI machine, a very
strong, constant magnetic field forms that remains in place for the duration of the
measurement, and this super-strong field makes all the protons try to line up with the poles
of the field. This lining-up doesn’t mess up any of the chemical properties of the tissues, so
your body continues to function normally while the doctor makes the measurement.

But while this really strong constant magnetic field makes all the protons want to line up, the
MRI machine intentionally disrupts this field by sending a brief pulse of an additional, weaker
electromagnetic field. This weaker pulse points in a different direction than the constant
magnetic field, and so it disrupts the protons so that they become misaligned with the
constant field. After the pulse ends the protons are left askew, but then they gradually re-
align with the original constant field. You can think of it as the tiny jiggle that occurs in a
compass needle when a weak magnet passes by. The compass normally points north, but the
weak magnet causes the compass needle to jiggle slightly.

However, unlike the needle of a normal-sized compass, the direction that the protons can
align has single, well defined levels in a manner very similar to the different energy levels of
electrons around an atom’s nucleus. Just as electrons in atomic energy levels can absorb and
re-emit photons when changing energy levels, the gradual realignment of the nuclear
magnetic spin results in the emission of low-energy, radio frequency photons. The time and
amount of re-alignment changes based on the thickness and hardness of the tissue where
the water molecules are sitting, and so carefully monitoring of the arrival of re-emitted
photons in the MRI’s detectors allows the locations and shapes of different tissues to be
identified.

Because different places in the body contain different amounts of water, MRI detects the
electromagnetic fields of the atoms in water molecules and uses this to determine
differences in the density and shape of tissues throughout the body.
References

https://www.nhs.uk/conditions/mri-scan

https://www.radiologyinfo.org/en/info/bodymr
https://mayfieldclinic.com/pe-mri.htm

https://www.rwjbh.org/treatment-care/radiology-and-diagnostic-imaging/magnetic-
resonance-imaging-mri-/

https://www.mayoclinic.org/tests-procedures/mri/about/pac-20384768
https://www.harleystreetmedicalarea.com/news-features/how-does-it-work-mri-scanner

https://www.khanacademy.org/test-prep/mcat/physical-processes/proton-nuclear-
magnetic-resonance/a/magnetic-resonance-imaging-mri