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Cambridge University Press
978-1-107-64323-9 — MRI from Picture to Proton
Donald W. McRobbie , Elizabeth A. Moore , Martin J. Graves , Martin R. Prince
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MRI from Picture to Proton

Third Edition
© in this web service Cambridge University Press www.cambridge.org

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MRI from Picture to Proton

Third Edition
Donald W. McRobbie
South Australian Medical Imaging, Adelaide, Australia
Elizabeth A. Moore
Global MR R&D, Royal Philips, the Netherlands
Martin J. Graves
Cambridge University Hospitals, Cambridge, UK
Martin R. Prince
Weill Cornell Medical College, New York, USA

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University Printing House, Cambridge CB2 8BS, United Kingdom
Cambridge University Press is part of the University of Cambridge.

It furthers the University’s mission by disseminating knowledge
in the pursuit of education, learning and research at the highest
international levels of excellence.
www.cambridge.org
Information on this title: www.cambridge.org/9781107643239
DOI: 10.1017/9781107706958
© Donald W. McRobbie, Elizabeth A. Moore, Martin J. Graves and
Martin R. Prince 2003, 2007, 2017
This publication is in copyright. Subject to statutory exception
and to the provisions of relevant collective licensing agreements,
no reproduction of any part may take place without the written
permission of Cambridge University Press.
First published: 2003
Second edition 2007
Third edition 2017
Printed in the United Kingdom by Clays, St Ives plc
A catalogue record for this publication is available from the British
Library
Library of Congress Cataloguing in Publication data
Names: McRobbie, Donald W., 1958- , author. | Moore,
Elizabeth A. (Scientist), author. | Graves, Martin J., author.
Title: MRI from picture to proton / Donald W. McRobbie, Elizabeth
A. Moore, Martin J. Graves.
Description: 3rd edition. | Cambridge ; New York : University Printing
House, Cambridge University Press, 2016. | Preceded by MRI from
picture to proton / Donald W. McRobbie . . . [et al.]. 2nd ed. 2007. |
Includes bibliographical references and index.
Identifiers: LCCN 2016008139 | ISBN 9781107643239 (pbk.)
Subjects: | MESH: Magnetic Resonance Imaging
Classification: LCC RC78.7.N83 | NLM WN 185 | DDC 616.07/548–
dc23 LC record available at http://lccn.loc.gov/2016008139
ISBN 978-1-107-64323-9 Paperback
Cambridge University Press has no responsibility for the persistence
or accuracy of URLs for external or third-party internet websites
referred to in this publication, and does not guarantee that any
content on such websites is, or will remain, accurate or appropriate.
..................................................................
Every effort has been made in preparing this book to provide accurate
and up-to-date information which is in accord with accepted standards
and practice at the time of publication. Although case histories are
drawn from actual cases, every effort has been made to disguise the
identities of the individuals involved. Nevertheless, the authors, editors
and publishers can make no warranties that the information contained
herein is totally free from error, not least because clinical standards are
constantly changing through research and regulation. The authors,
editors and publishers therefore disclaim all liability for direct or
consequential damages resulting from the use of material contained in
this book. Readers are strongly advised to pay careful attention to
information provided by the manufacturer of any drugs or equipment
that they plan to use.

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I would like to acknowledge the following, with thanks: Dr Marc Agzarian, Gregory Brown, Patrick Revel,
Kathryn McClintock
DWMcR
Dedicated to inspirational friends throughout the MRI world (you know who you are).
EAM
To my family, friends and colleagues.
MJG
We could not have completed this without the support of CUP’s editorial staff, particularly Kirsten Bot
and the late Richard Marley.

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Contents
Glossary x
1 MR: What’s the Attraction? 1 5 The Devil’s in the Detail: Pixels, Matrices and
1.1 It’s not Rocket Science, but I Like It 1 Slices 55
1.2 A Brief History of Medical Imaging 1 5.1 Introduction 55
1.3 How to Use this Book 5 5.2 From Analogue Signal to
Digital Image 55
5.3 Matrices, Pixels and an Introduction to
Part I The Basic Stuff Resolution 58
5.4 Slices and Orientations 61
2 Early Daze: Your First Week in MR 11
5.5 Displaying Images 61
2.1 Introduction 11
5.6 What do the Pixels Represent? 63
2.2 Welcome to the MR Unit 11
5.7 From 2D to 3D 64
2.3 Safety First 14
2.4 Safety Second: Additional Practical 6 What You Set is What You Get: Basic Image
Guidelines 17 Optimization 67
2.5 The Patient’s Journey 21 6.1 Introduction 67
2.6 MRI Radiographer’s Blog . . . A Few 6.2 Looking on the Bright Side: What are we
Years On 23 Trying to Optimize? 67
6.3 Trading Places: Resolution, SNR and
3 Seeing is Believing: Introduction to Image
Scan Time 72
Contrast 26
6.4 Ever the Optimist: Practical Steps to
3.1 Introduction 26
Optimization 76
3.2 Introduction to the T-Words 27
3.3 T2-Weighted Images 27 7 Improving Your Image: How to Avoid
3.4 FLAIR Images 28 Artefacts 81
3.5 T1-Weighted Images 28 7.1 Introduction 81
3.6 T1w Images Post-Gd 29 7.2 Keep Still Please! Motion Artefacts 81
3.7 STIR Images 30 7.3 Lose the Fat! 88
3.8 PD-Weighted Images 32 7.4 Digital Imaging Artefacts 92
3.9 Gradient-Echo Images 35 7.5 Susceptibility and Metal Artefacts 96
3.10 More About Contrast Agents 37 7.6 Equipment Artefacts 98
3.11 Angiographic Images 38 7.7 What’s Causing this Artefact? 101
3.12 Diffusion-Weighted Images 39 8 Spaced Out: Spatial Encoding 102
4 Lost in the Pulse Sequence Jungle? 41 8.1 Introduction 102
4.1 Introduction 41 8.2 Anatomy of a Pulse Sequence 102
4.2 Anatomy of a Pulse Sequence 41 8.3 From Larmor to Fourier via
4.3 Take Me for a Spin (Echo) 43 Gradients 103
4.4 The Other Branch of the Tree: 8.4 Something to get Excited About:
Gradient Echo 49 The Image Slice 106
4.5 Echo Planar Imaging 54 8.5 In-Plane Localization 110
4.6 The Pulse Sequence Traveller 54 8.6 Consequences of Fourier Imaging 117 vii

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Contents
8.7 Speeding It Up 120 13.3 One Tree, Many Branches: FIDs, Echoes
8.8 3D FT 121 and Coherences 207
13.4 Ultra-Fast GE Imaging 218
9 Getting in Tune: Resonance and
Relaxation 124 14 The Parallel Universe: Parallel Imaging and
9.1 Introduction 124 Novel Acquisition Techniques 225
9.2 Spinning Nuclei 124 14.1 Introduction 225
9.3 Measuring the Magnetic Moment 127 14.2 Groundwork 225
9.4 Relaxation Times 129 14.3 Making SENSE: Parallel Imaging in
9.5 Creating Echoes 132 Image Space 227
9.6 Relaxation Time Mechanisms 135 14.4 SMASH Hits: Parallel Imaging in
9.7 Gadolinium-based Contrast Agents 141 k-Space 230
14.5 Undersampling by Simultaneous
10 Let’s Talk Technical: MR Equipment 144 Multi-Slice Excitation 236
10.1 Introduction 144 14.6 Image Quality in Parallel Imaging 237
10.2 Magnets 144 14.7 k-t BLAST 240
10.3 Gradient Subsystem 149 14.8 Non-Cartesian Acquisition
10.4 Radiofrequency Transmit Schemes 242
Subsystem 154 14.9 Compressed Sensing 248
10.5 RF Receiver Subsystem 158
10.6 Computer Systems 162 15 Go with the Flow: MR Angiography 251
10.7 Siting and Installation 163 15.1 Introduction 251
10.8 Other Types of MRI Systems 164 15.2 Effect of Flow in Conventional
Imaging 251
11 Ghosts in the Machine: Quality Control 166 15.3 Non-Contrast MR Angiography 255
11.1 Introduction 166 15.4 Contrast-Enhanced MRA 263
11.2 The Quality Cycle 166 15.5 Susceptibility-Weighted Imaging 267
11.3 Signal Parameters 169
11.4 Geometric Parameters 173 16 A Heart to Heart Discussion: Cardiac MRI 269
11.5 Relaxation Parameters 177 16.1 Introduction 269
11.6 Artefacts 178 16.2 Patient Set-up 269
11.7 Spectroscopic QA 179 16.3 Morphological Imaging 272
11.8 Temporal Stability 179 16.4 Functional Imaging 273
11.9 Other Specialist QA 181 16.5 Myocardial Perfusion 282
16.6 Myocardial Viability 284
16.7 Myocardial Tissue Characterization 286
Part II The Specialist Stuff 16.8 Coronary Artery Imaging 286
12 Acronyms Anonymous I: Spin Echo 185 17 It’s Not Just Squiggles: In Vivo
12.1 Introduction 185 Spectroscopy 288
12.2 Conventional Spin Echo 185 17.1 Introduction 288
12.3 RARING to Go: Fast Spin-Echo 17.2 Some Basic Chemistry 288
Techniques 186 17.3 Single-Voxel Spectroscopy 291
12.4 The Extended Family of TSE 191 17.4 Processing of Single-Voxel Spectra 295
12.5 Combining Gradient and Spin 17.5 Chemical Shift Imaging 297
Echoes 200
18 To BOLDly Go: fMRI, Perfusion and
13 Acronyms Anonymous II: Gradient Echo 207 Diffusion 303
13.1 Introduction 207 18.1 Introduction 303
viii 18.2 Diffusion Imaging 303
13.2 Image Formation in Gradient Echo 207

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Contents
18.3 Perfusion Imaging 311 20.3 Gradient Effects 347

18.4 Dynamic Contrast Enhancement: 20.4 Static Field Effects 351
Permeability Imaging 316 20.5 MR Exposures and Pregnancy 352
18.5 Brain Activation Mapping Using the 20.6 Occupational Exposure 352
BOLD Effect 319 20.7 Contrast Agent Safety 354
19 Making it Count: Quantitative MRI 326 20.8 So is MRI Safe? 356
19.1 Introduction 326 21 Where Are We Going Now? 358
19.2 Relaxation Times 326 21.1 Introduction 358
19.3 Diffusion Parameters 334 21.2 7 Tesla Systems 358
19.4 Tissue Perfusion and Permeability 335 21.3 Hyperpolarization 360
19.5 Fat Quantification 335 21.4 MR-PET 362
19.6 MR Elastography 338 21.5 MR-LINAC 363
19.7 Accuracy, Precision, and Diagnostic
Confidence 341
20 But is it Safe? Bio-effects 345
20.1 Introduction 345 Appendix: maths revision 365
20.2 Radiofrequency Effects 345 Index 369
ix

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Glossary
See also: Liney G (2011) MRI from A to Z, 2nd edition. London: Springer-Verlag.
Acronym/symbol Term Explanation

γ Gyromagnetic ratio A constant which relates the precessional
frequency of a nucleus to the external magnetic
field B0. For 1H γ = 2.68 × 108 radians s–1.
μ Magnetic moment Microscopic magnetic field originating from
nuclear spin.
α Flip angle The angle through which magnetization M is
tipped, or flipped, by an RF B1 pulse.
ω 0, f 0 Larmor frequency The precession frequency of the nuclear spins, or
the resonance frequency for nuclear magnetic
transitions.
ΔB Inhomogeneity Non-uniformity (of a magnetic field), expressed in
parts-per-million (ppm).
τc Correlation time The average time between molecular collisions,
part of the relaxation mechanism of protons.
χm Susceptibility Property determining the magnetization of a
material in an external magnetic field.
180° 180° pulse An RF (radiofrequency) pulse which flips the
magnetization through 180°. May be used either for
inversion or refocusing.
2D FT Two-Dimensional Fourier Transform The process whereby the data from frequency and
phase-encoded MR signals is converted to a two-
dimensional image.
3D FT Three-Dimensional Fourier Transform A volume-based Cartesian image acquisition which
utilizes two phase-encode directions.
4D-TRAK 4D-Time-Resolved Angiography using Method for time-resolved CE-MRA (Philips)
Keyhole
90° 90° pulse An RF (radiofrequency) pulse which flips the
magnetization through 90°. Usually used for
excitation, but can also act as a refocusing pulse.
ARC Auto-calibrating Reconstruction for A k-space-based parallel imaging method that uses
Cartesian sampling auto-calibration, related to GRAPPA (GE Healthcare).
ASL Arterial Spin Labelling A method to assess tissue perfusion using
x endogenous water as a contrast agent.

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Glossary
(cont.)

ASSET Array Spatial Sensitivity Encoding An image-based parallel imaging method related
Technique to SENSE (GE Healthcare).
B Magnetic field Magnetic flux density or induction, measured in
tesla (T).
B0 The main (static) magnetic field, e.g. 1.5 T.
B1 The alternating radiofrequency magnetic field used
to rotate the net magnetization.
BASG Balanced SARGE A fully rewound GE imaging sequence (Hitachi).
bFFE Balanced FFE A fully rewound GE imaging sequence (Philips).
BLADE BLADE A hybrid Cartesian/radial acquisition method that
can partly correct for patient motion (Siemens;
‘BLADE’ is not an acronym, it is a tradename). See
also PROPELLER.
BLAST Broad-use Linear Acquisition Speed-up A method for the acceleration of dynamic images
Technique (Philips).
BOLD Blood Oxygen Level Dependent Effect of deoxygenated blood on MR signals.
BRAVO BRAin VOlume imaging IR-prepared fast 3D gradient echo for isotropic
brain imaging (GE Healthcare).
BSI Blood Sensitive Imaging Method for non-contrast MR angiography based on
3D TSE (Hitachi).
bSSFP Balanced Steady-State-Free-Precession An alternative generic name for fully rewound GE
sequences.
b-TRANCE Balanced Triggered Angiography Non Method for non-contrast MR angiography based on
Contrast Enhanced fully rewound GE (Philips).
BW, RBW Bandwidth, receive bandwidth The range of frequencies contained in a pulse or
signal. The range of frequencies that may be
detected by the MR receiver.
CARE Bolus Combined Applications to Reduce Method for fluoro-triggered contrast-enhanced MR
Exposure Bolus angiography (Siemens).
CE-MRA Contrast Enhanced Magnetic Resonance Methods for acquiring MR angiograms using an
Angiography injection of gadolinium-based contrast agent.
CENTRA Contrast ENhanced Timing Robust Centric k-space method for time-resolved CE-MRA
Angiography (Philips).
CHESS CHEmical Shift Selective Chemical excitation or saturation of either water or
fat 1H nuclei based upon differences in the Larmor
frequency of each chemical species.
CIA Contrast Improved Angiography Method for non-contrast MR angiography based on
3D TSE (Toshiba).
CISS Constructive Interference in the Steady A fully rewound GE imaging sequence with two
State acquisitions and phase-cycling to reduce banding
artefacts (Siemens).
xi

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Glossary
(cont.)

CLEAR Constant LEvel AppeaRance Post-processing filter to reduce signal
inhomogeneities caused by coil sensitivity (Philips).
CP Carr–Purcell sequence Sequence containing a series of 90°–180°–180°–. . .
pulses, resulting in an echo train of length ETL.
CPMG Carr–Purcell–Meiboom–Gill sequence Similar to CP but with a 90° phase difference
between the excitation and refocusing pulses.
Even-numbered echoes are corrected for
inaccuracies in the refocusing pulses.
CS Compressed sensing Rapid image acquisition technique applicable to
sparse data sets.
CUBE 3D TSE sequence with variable refocusing flip
angles (GE Healthcare; Cube is not an acronym, it is
a tradename).
DCE Dynamic Contrast Enhanced A dynamic T1w method used to monitor the signal
changes as a contrast agent passes through tissue.
DESS Double Echo Steady State A form of GE imaging sequence that combines two
different types of gradient-echo signals to form one
image (Siemens).
DIET Delayed Interval Echo Train A TSE imaging sequence with an echo spacing
designed to maintain J-coupling, thus with reduced
fat signal compared to other TSE sequences
(Toshiba).
DIR Double Inversion Recovery Method to suppress the signal from flowing blood,
also known as black or dark-blood preparation.
Alternatively, a dual inversion prepulse used with
3D TSE to null two tissues, typically CSF and grey
matter in brain imaging.
Dixon TSE or GE techniques for producing separate water
and fat images, named after the inventor.
DRIVE DRIVen Equilibrium 90° RF pulse added to end of FSE echo train to
restore longitudinal magnetization (Philips).
DRKS Differential Rate K-space Sampling Centric k-space method for time-resolved CE-MRA
(Toshiba).
DSC Dynamic Susceptibility Contrast A dynamic T2*w method used to monitor the signal
changes as a contrast agent passes through tissue.
DSV Diameter Spherical Volume Spherical region with this diameter over which B0
uniformity is measured.
DTI Diffusion Tensor Imaging Method to determine the anisotropy of tissue
diffusion.
EPI Echo Planar Imaging A pulse sequence that allows rapid MR acquisition,
where k-space is collected following a single
excitation pulse.
xii ESP Echo SPacing The time interval between refocusing pulses in a
TSE sequence.

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Glossary
(cont.)

ETL Echo Train Length The number of echoes acquired following a single
initial excitation.
FASE Fast Advanced Spin Echo A multiple spin-echo sequence that uses a
segmented k-space (Toshiba). SuperFASE is a
variant with very short echo spacing. See also TSE.
FBI Fresh Blood Imaging Method for non-contrast MR angiography based on
3D TSE (Toshiba).
FE Frequency Encoding A process using a frequency encode gradient to
determine the position of MR signal during its
acquisition.
FFE, TFE Fast Field Echo, Turbo Field Echo A GE imaging sequence (Philips). See also T1-FFE,
bFFE, T2-FFE. TFE is a fast version of FFE.
FID Free Induction Decay MR signal following a single RF excitation pulse.
FIESTA Fast Imaging with Enhanced Steady A fully rewound GE imaging sequence (GE
sTate Acquisition Healthcare).
FIESTA-c Fast Imaging with Enhanced Steady A fully rewound GE imaging sequence with two
sTate Acquisition Cycled phases acquisitions and phase-cycling to reduce banding
artefacts (GE Healthcare). See also CISS.
FIR Fast Inversion Recovery A TSE imaging sequence with an inversion
prepulse, used for FLAIR or STIR (Hitachi).
FISP, TrueFISP Fast Imaging with Steady Precession A rewound GE imaging sequence (Siemens). The
fully rewound version is called TrueFISP.
FLAIR Fluid Attenuated Inversion Recovery An SE-based imaging sequence used to null the
signal from cerebrospinal fluid (CSF) based upon its
longitudinal relaxation time T1.
FLASH Fast Low Angle SHot A spoiled GE imaging sequence using RF spoiling
(Siemens). Turbo-FLASH is a fast version of FLASH.
FLUTE FLUoro TriggEred Method for fluoro-triggered contrast-enhanced MR
angiography (Hitachi).
fMRI Functional Magnetic Resonance Imaging Method to investigate signal changes based upon
the BOLD contrast mechanism.
fN Nyquist frequency The minimum frequency required to accurately
sample (digitize) a signal.
FOV Field Of View The size of the region to be imaged.
FSBB Flow Sensitive Black Blood Method for susceptibility-weighted imaging
(Toshiba).
FSE Fast Spin Echo A multiple spin-echo sequence that uses a
segmented k-space. See also TSE.
FWHM Full Width at Half Maximum A measure of slice width or thickness.
GE Gradient Echo A pulse sequence which creates a signal at time TE
by refocusing using gradients. Alternatively, the
signal itself at time TE. xiii

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Glossary
(cont.)

GMN Gradient Moment Nulling A method to eliminate the phase shifts due to
moving spins. Also known as flow or velocity
compensation.
GRAPPA GeneRalized Auto-calibrating Partial A k-space-based parallel imaging method that uses
Parallel Acquisition auto-calibration (Siemens).
GRASE Gradient and Spin Echo A pulse sequence that acquires both spin and
gradient echoes within a single TSE-type readout.
GRE Gradient Recalled Echo A rewound GE imaging sequence (GE Healthcare).
Gx, Gy, Gz Gradients Magnetic field gradients, or linear variations in Bz
along orthogonal directions x, y and z, measured in
mT m–1.
HASTE Half-Fourier Acquired Single shot Turbo A single shot TSE imaging sequence that also uses
spin Echo half-Fourier data acquisition and reconstruction.
See also SS-TSE.
IDEAL Iterative Decomposition of water and fat A technique for producing separate water and fat
using Echo Asymmetry and Least- images (GE Healthcare). See also Dixon.
squares estimation
IFIR Inhance inFlow Inversion Recovery Method for non-contrast MR angiography based on
fully rewound GE (GE Healthcare).
iPAT Integrated Parallel Imaging Techniques An alternative name for parallel imaging techniques
(Siemens).
IR Inversion Recovery A pulse sequence that initially inverts M0 and
measures its longitudinal relaxation after inversion
time TI.
ISCE Inclined Slab for Contrast Enhancement Linear flip angle variation used in 3D-MRA to
reduce saturation effects in slice-encoding direction
(Toshiba). See also TONE.
JET A hybrid Cartesian/radial acquisition method that
can partly correct for patient motion (Toshiba; JET is
not an acronym, it is a tradename). See also
PROPELLER.
LAVA Liver Acquisition with Volume 3D T1w GE with fat suppression used for dynamic
Acceleration liver imaging (GE Healthcare). See also THRIVE, VIBE.
M Magnetization The magnetic field vector produced in a material
when placed in an external magnetic field, with
units amperes per meter (A m–1).
M Gradient moment The time integral of a gradient waveform.
M0 Equilibrium Magnetization Equilibrium magnetization formed from the vector
sum nuclear magnetic moments when placed in an
external magnetic field B0.
MAVRIC Multi-Acquisition with Variable Method based on 3D TSE to reduce artefacts when
Resonances Image Combination imaging in the presence of metal implants (GE
xiv Healthcare). Also a generic term.

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Glossary
(cont.)

MEDIC Multi-Echo Data-Image Combination Method that combines multiple gradient echoes to
improve image quality and contrast (Siemens).
MERGE Multi-Echo Recombined Gradient Echo Method that combines multiple gradient echoes to
improve image quality and contrast (GE
Healthcare).
mFFE Multi-echo FFE Method that combines multiple gradient echoes to
improve image quality and contrast (Philips).
MIP Maximum Intensity Projection An image processing operation used in MR
angiography to produce 2D projection images
from 3D raw image data.
mIP minimum Intensity Projection An image processing operation used in
susceptibility-weighted angiography to produce 2D
projection images from 3D raw image data.
MOTSA Multiple Overlapping Thin Slab A technique for acquiring multiple 3D slabs for 3D
Acquisition non-contrast MRA, avoiding saturation effects.
MPR Multi-Planar Reformat An image processing operation used to produce
new 2D slices at arbitrary orientations from 3D raw
image data.
MP-RAGE Magnetization-Prepared Rapid IR-prepared fast 3D gradient echo for isotropic
Acquisition by Gradient Echoes brain imaging (Siemens). Also a generic term.
MRA MR Angiography Imaging of blood vessels, usually arteries.
mSENSE Modified SENSitivity Encoding An image-based parallel imaging method related
to SENSE using auto-calibration (Siemens).
MT Magnetization Transfer Excitation of the bound fraction of nuclei using an
off-resonance B1 pulse.
MultiVane MultiVane A hybrid Cartesian/radial acquisition method that
can partly correct for patient motion (Philips;
MultiVane is not an acronym, it is a tradename). See
also PROPELLER.
Mxy Transverse magnetization Component of M in the xy plane. Mxy produces the
signal.
Mz Longitudinal magnetization Component of M in the z axis, static field direction,
denoted Mz.
NATIVE Non-contrast MR of ArTerIes and VEins Methods for non-contrast MR angiography
(Siemens). NATIVE-SPACE is based on 3D TSE;
NATIVE-TrueFISP is based on fully rewound GE.
NATURAL NATural Uniformity Realization Post-processing filter to reduce signal
ALgorithm inhomogeneities caused by coil sensitivity (Hitachi).
NC-MRA Non-Contrast Magnetic Resonance Methods for acquiring MR angiograms without
Angiography using exogenous contrast agent.
NEX Number of EXcitations Number of signal averages (GE Healthcare). See
also NSA.
NMR Nuclear Magnetic Resonance The basic phenomenon underlying MRI.
xv

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Glossary
(cont.)

NSA Number of Signal Acquisitions Number of signal acquisitions averaged to improve
signal-to-noise ratio (SNR). See also NEX.
O-MAR Ortho-Metal Artefact Reduction Method based on multi-slice TSE to reduce artefacts
when imaging in the presence of metal implants
(Philips). See also SEMAC.
PACE Prospective Acquisition CorrEction Technique for updating scan geometry in real time
based on detecting motion by navigators (Siemens).
PBSG Phase Balanced SARGE A fully rewound GE imaging sequence with two
acquisitions and phase-cycling to reduce banding
artefacts (Hitachi).
PC Phase contrast A non-contrast MRA technique that relies on the
phase shift caused by spins moving through a
magnetic field gradient.
PD Proton density The MR signal intensity in the absence of relaxation,
related to number of hydrogen nuclei per unit
volume, equivalent to M0.
PE Phase Encoding A process using a phase-encode gradient to encode
the MR signal in terms of spatial frequencies.
PEAKS PEak Arterial K Space Centric k-space method for time-resolved CE-MRA
(Hitachi).
PEAR Phase-Encoded Artefact Reduction Reordered phase-encoding to reduce respiratory
motion artefacts (Philips). See also ROPE.
PERRM Phase-Encode Reordering to Reduce Reordered phase encoding to reduce respiratory
Motion motion artefacts (Hitachi). See also ROPE.
PNS Peripheral nerve stimulation Peripheral nerve stimulation is a bio-effect caused
by rapidly time-varying magnetic fields.
ppm Parts Per Million A measure of the chemical shift between
metabolites. Alternatively a measure of field
inhomogeneity.
Promo Prospective Motion correction Technique for updating scan geometry in real time
based on detecting motion by navigators (GE
Healthcare).
PROPELLER Periodically Rotated Overlapping A hybrid Cartesian/radial acquisition method that
ParallEL Lines with Enhanced can partly correct for patient motion (GE
Reconstruction Healthcare). Also a generic term.
PSIF A time-reversed GE imaging sequence with
improved T2w contrast (Siemens; PSIF is not an
acronym, it is ‘FISP’ backwards).
PURE Phased array UnifoRmity Enhancement Post-processing filter to reduce signal
inhomogeneities caused by coil sensitivity (GE
Healthcare).
r1, r2 Relaxivity The relaxivity of a contrast agent determines its
xvi shortening effect on relaxation times.

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Glossary
(cont.)

R1, R2 or R2* Relaxation rate Reciprocal of relaxation time.
RADAR RADial Acquisition Regime A hybrid Cartesian/radial acquisition method that
can partly correct for patient motion (Hitachi). See
also PROPELLER.
RAPID, RAPID-3D Rapid Acquisition through Parallel An image-based parallel imaging method related
Imaging Design to SENSE (Hitachi).
rb Rheobase The minimum threshold for a physiological
response to a stimulus.
RESTORE 90° RF pulse added to end of FSE echo train to
restore longitudinal magnetization (Siemens;
RESTORE is not an acronym, it is a tradename).
ROPE Respiratory-Ordered Phase Encoding Reordered phase encoding to reduce respiratory
motion artefacts.
RSSG RF Spoiled SARGE A spoiled GE imaging sequence using RF spoiling
(Hitachi).
SAR Specific Absorption Rate The RF power per unit mass deposited in tissue in
W kg–1.
SARGE Steady state Acquisition Rewound A rewound GE imaging sequence (Hitachi).
Gradient Echo
SE Spin echo A pulse sequence which creates a signal at time TE
by refocusing from two RF pulses, usually a 90°
followed by a 180°. Alternatively, the signal itself at
time TE.
SEMAC Slice Encoding for Metal Artefact Method based on multi-slice TSE to reduce artefacts
Correction when imaging in the presence of metal implants.
SENSE SENSitivity Encoding Technique for parallel imaging based upon image-
space unwrapping (Philips). Also a generic term.
SMASH SiMultaneous Acquisition of Spatial Technique for parallel imaging based upon k-space
Harmonics calculations.
SORS-STC Slice-selective Off-Resonance Sinc Pulse Method for magnetization transfer imaging
Saturation transfer contrast (Toshiba).
SPACE Sampling Perfection with Application of 3D TSE sequence with variable refocusing flip
optimized Contrasts using different flip angles (Siemens).
angle Evolution
SPEEDER SPEEDER An image-based parallel imaging method related
to SENSE (Toshiba; ‘SPEEDER’ is not an acronym, it is
a tradename).
SPGR SPoiled GRadient echo A spoiled GE imaging sequence using RF spoiling
(GE Healthcare). FSPGR is a fast version of SPGR.
SPL Sound Pressure Level Acoustic noise, often measured with reference to
the response of the human ear in decibels, dB(A).
SR Slew Rate The maximum gradient amplitude divided by its
minimum rise time in T m–1 s–1.
xvii

Frontmatter
More Information
Glossary
(cont.)

SS Slice Selection A process using a slice-select gradient at the same
time as a narrow-bandwidth RF pulse to excite a
slice of tissue.
SS-TSE Single Shot Turbo Spin Echo A single shot TSE imaging sequence that also uses
half-Fourier data acquisition and reconstruction.
See also HASTE.
SSP Sloped Slab Profile Linear flip angle variation used in 3D-MRA to
reduce saturation effects in slice-encoding direction
(Hitachi).
STIR Short TI Inversion Recovery An IR-based imaging sequence used to null the
signal from fat based upon its longitudinal
relaxation time T1.
SWAN T2-Star Weighted ANgiography Method for susceptibility-weighted imaging (GE
Healthcare).
SWI Susceptibility-Weighted Imaging Method for susceptibility-weighted imaging
(Siemens).
SWIp Susceptibility-Weighted Imaging with Method for susceptibility-weighted imaging
phase difference (Philips).
T1 Spin–lattice relaxation time Spin–lattice relaxation time, also known as
longitudinal relaxation time. Characterizes the
recovery of the longitudinal magnetization Mz
towards M0.
T1-FFE A spoiled GE imaging sequence using RF spoiling
(Philips).
T2 Spin–spin relaxation time Spin–spin relaxation time, also known as transverse
relaxation time. Characterizes the decay of
transverse magnetization Mxy to zero.
T2* Apparent Spin–spin relaxation time Apparent spin–spin relaxation time. Characterizes
the decay of the free induction signal to zero.
TA Acquisition or scan time.
TE Echo time Time to the peak MR signal from the initial excitation.
TFE Turbo Field Echo A fast GE imaging sequence (Philips). See also FFE.
THRIVE T1 High Resolution Isotropic Volume 3D T1w GE with fat suppression used for dynamic
Excitation liver imaging (Philips). The eTHRIVE variant
(enhanced THRIVE) uses asymmetric k-space
ordering. See also LAVA, VIBE
TI Inversion Time See IR (inversion recovery).
TIGRE T1 GRadient Echo with RF fat saturation 3D T1w GE with fat suppression used for dynamic
breast and abdomen imaging (Hitachi).
Time-SLIP Time-Spatial Labelling Inversion Pulse Method for non-contrast MR angiography based on
fully rewound GE (Toshiba).
TOF Time of Flight Non-contrast MRA technique that relies on the
xviii in-flow of unsaturated spins.

Frontmatter
More Information
Glossary
(cont.)

TONE Tilted Optimized Non-saturating Linear flip angle variation used in 3D-MRA to
Excitation reduce saturation effects in slice-encoding direction
(Philips, Siemens). Also a generic term.
TR Repetition time Repetition time of an MR pulse sequence. Time
between successive excitations.
TRANCE TRiggered Angiography Non Contrast Method for non-contrast MR angiography based on
Enhanced 3D TSE (Philips).
TRAQ Time-Resolved AcQuisition Method for time-resolved CE-MRA (Hitachi).
TRICKS Time-Resolved Imaging of Contrast Method for time-resolved CE-MRA (GE Healthcare).
KineticS
TRSG Time-Reversed SARGE A time-reversed GE imaging sequence (Hitachi).
TSE Turbo Spin Echo A multiple spin-echo sequence that uses a
segmented k-space.
TWIST Time-resolved angiography WIth Method for time-resolved CE-MRA (Siemens).
Stochastic Trajectories
UTE Ultra-short TE Ultra-short TE sequence capable of measuring the
bound fraction of nuclei.
VASC ASL VASCular Arterial Spin Labelling Method for non-contrast MR angiography based on
fully rewound GE (Hitachi).
VASC FSE VASCular Fast Spin Echo Method for non-contrast MR angiography based on
3D TSE (Hitachi).
VCG Vector CardioGram Method for ECG gating that helps reduce T-wave
mistriggering.
venc The maximum velocity that can be uniquely
encoded in phase-contrast MR angiography.
VIBE Volume Interpolated Breath-hold 3D T1w GE with fat suppression used for dynamic
Examination liver imaging (Siemens).
VIBRANT Volume Image Breast Assessment 3D T1w GE with fat suppression used for dynamic
breast imaging (GE Healthcare).
VIEW Volume Imaging with Echo Weighting 3D TSE sequence with variable refocusing flip
angles (Philips).
WFS Water–Fat Shift The spatial misregistration between water and fat in
the frequency encoding direction (Philips).
xix

MR: What’s the Attraction?
Chapter
1
1.1 It’s not Rocket Science, but I Like It makes MR very sensitive as a diagnostic technique.
MR detects subtle changes in the magnetism of the
How would you impress a stranger you meet at a nucleus, the tiny entity that lies at the heart of the
party with your intelligence? You might claim to be atom. This is probing deeper than X-rays, which
a brain surgeon or a rocket scientist. Well Magnetic interact with the clouds or shells of the electrons that
Resonance (MR) is not rocket science, it’s better. MR orbit the nucleus. MR is a truly powerful modality. At
involves an amazing combination of advanced science its most advanced, MR can be used not just to image
and engineering, including the use of superconduct- anatomy and pathology but to investigate organ func-
ivity, cryogenics, quantum physics, digital and com- tion, to probe in vivo chemistry and even to visualize
puter technology – and all within the radiology the brain thinking.
department of your local hospital. MR imaging has In the early days, the scanners were the domain of
evolved from unpromising beginnings in the 1970s to the physicists and engineers who invented and built
become nowadays the imaging method of choice for a them, and the technique was called NMR imaging
large proportion of radiological examinations and the (NMR stands for nuclear magnetic resonance). The
‘jewel in the crown’ of medical technology. A modern cynics may say that the technique really took off
MRI scanner is shown in Figure 1.1. clinically when the ‘N-word’ was dropped. This was
So what is it? It is an imaging method based sensible as the term ‘nuclear’, although scientifically
principally upon sensitivity to the presence and prop- accurate, implied a connection with nuclear energy
erties of water, which makes up 70–90% of most and, in the last of the Cold War years, resonated in the
tissues. The properties and amount of water in tissue public’s mind with the spectre of nuclear weapons.
can alter dramatically with disease and injury, which Because of the diversity of sciences and technolo-
gies that gave birth to and continues to nurture MR, it
is an extremely hard subject to learn. A lifetime is not
enough to become expert in every aspect. Clinicians,
technologists and scientists all struggle with the study
of the subject. The result is sometimes an obscurity of
understanding or a dilution of scientific truth
resulting in misconceptions. This is why we have
chosen to write this book. Our aim is to introduce
you to MR as a tool – rather like learning to drive a
car. Once you are confident on the road, we can then
start to learn how the engine works.
1.2 A Brief History of Medical Imaging

Radiology began after the accidental discovery of
‘X-rays’ by Roentgen in 1895. At about the same time
(1896) Becquerel and the Curies were discovering
Figure 1.1 Modern superconducting MR system. Courtesy of radioactivity and radium and making possible the 1
Philips Healthcare. future development of nuclear medicine. Within a
17:33:22, subject to the Cambridge Core terms of use, available at

02
Chapter 1: MR: What’s the attraction?
couple of years most of the basic techniques of radi- unique in involving no ionizing radiation and
ography were established, e.g. the use of fluorescent offering the possibility of safe, non-invasive imaging.
screens in 1896 by Pupin, contrast media reported by Its ability to image in real time and its sensitivity to
Lindenthal in the same year, even the principle of flow, through the Doppler effect, have been key
angiography. Early fluoroscopy entailed direct factors in its widespread role in obstetrics, cardiology,
viewing from a fluorescent plate, i.e. putting your abdominal investigations and vascular imaging, real-
head in the main beam, a practice frowned upon time biopsy guidance and minimally invasive surgery.
today! Unfortunately radiation protection followed As early as 1959, J. R. Singer at the University of
slightly too late for the pioneers of radiology. The California, Berkeley, proposed that NMR could be
next real technical break-through was the develop- used as a non-invasive tool to measure in vivo blood
ment of the image intensifier in the 1950s, but the flow. In 1971 Raymond Damadian discovered that
basis of conventional radiography remained the same certain mouse tumours displayed elevated relaxation
until the recent IT and digital revolutions. Computed times compared with normal tissues in vitro. This
tomography (CT) was a huge break-through, earning opened the door for a completely new way of imaging
Hounsfield and Cormack the Nobel Prize for medi- the human body, where the potential contrast
cine and physiology in 1979. X-ray CT was unique in between tissues and disease was many times greater
producing tomographic images or slices of the living than that offered by X-ray technology and ultrasound
human body for the first time and with a higher (Figure 1.2). At the same time, developments in cryo-
contrast than that achievable by conventional planar genics, or the study of very low temperatures, made
techniques. The combination of a moving X-ray the development of whole-body superconducting
gantry and the computing power necessary to recon- magnets possible. Damadian and his colleagues
struct from projections made CT possible. at the State University of New York, starved of main-
In nuclear medicine a similar evolution was occur- stream research funding, went so far as to design and
ring, from the development of the gamma camera by build their own superconducting magnet operating in
Anger in 1958 to tomographic imaging in the form of their Brooklyn laboratory, and the first human body
Single Photon Emission Computed Tomography image by NMR is attributed to them. There is some
(SPECT) and Positron Emission Tomography (PET), dispute about who actually is the founder of modern
which is ongoing today. PET’s clinical use is increas- Magnetic Resonance Imaging (MRI), but one thing is
ing, particularly in detecting metastases in oncology. certain: Damadian coined the first MR acronym,
Its ability to image minute concentrations of metabol- namely FONAR (Field fOcused Nuclear mAgnetic
ites is unique and makes it a powerful research tool in Resonance). This set a trend, and you can see the
the aetiology of disease and the effects of drugs. development of the acronym family tree in Chapter 4!
Ultrasound was developed in the 1950s following In 1973, in an article in Nature, Paul Lauterbur
the development of SONAR in World War II and was proposed using magnetic field gradients to distinguish
Figure 1.2 Raymond Damadian’s

‘Apparatus and method for detecting
cancer in tissue’. US patent 3789832 filed
17 March 1972, issued 5 February 1974.
Image from the US Patent and Trademark
Office.

02
Chapter 1: MR: What’s the Attraction?
short introduction it is impossible to do justice to them

all (see Further reading). And what of the commercial
development? EMI, the creators of X-ray CT through
Sir Godfrey Hounsfield, were involved from very early
on. Clow and Young produced the first published
human head image in 1978 (Figure 1.3). EMI sold their
research interest to Picker International, which
became Marconi and is now part of Philips. The
‘Neptune’ 0.15 T superconducting system installed at
the Hammersmith Hospital, London, was the first
commercial clinical system. Elsewhere in Europe,
Philips also dedicated substantial early investment
(Figure 1.4). General Electric introduced high-field
(1.5 T) systems around 1984. The technique developed
rapidly through the late 1980s to become the method
of choice for non-trauma neurological scanning.
By 2015 there were in excess of 35 000 scanners
worldwide.
The Spin Doctors: Nobel Laureates’ Roll-Call

Figure 1.3 First ever human head image using MRI at 0.1 T from (Figure 1.5)
EMI Central Research Laboratories. For this image CT type ‘back
projection’ was used. Courtesy of Ian Young. In 1952 Edward Purcell (Harvard) and Felix Bloch
(Stanford) jointly received the Nobel Prize for physics
‘for their development of new methods for nuclear
magnetic precision measurements and discoveries in
between NMR signals originating from different loca- connection therewith’. Of Purcell’s discovery, the
tions, combining this with a form of reconstruction Boston Herald reported that ‘it wouldn’t revolutionize
from projections (as used in CT). The use of gradients industry or help the housewife’. Purcell himself stated
still forms the basis of all modern MRI as recognized that ‘we are dealing not merely with a new tool but a
by the Nobel Committee in 2003. Unfortunately, new subject which I have simply called nuclear mag-
Lauterbur’s brilliant invention was not accompanied netism. If you will think of the history of ordinary
by a brilliant acronym; he coined the obscure term magnetism, the electronic kind, you will remember
‘zeugmatography’, meaning imaging from a joining that it has been rich in difficult and provocative
together (of the main field and the gradients). In con- problems and full of surprises.’ It seems that the
Boston Herald misjudged the importance of NMR!
temporary MR terms Lauterbur can be said to have
Bloch, a Swiss-born Jew and friend of quantum
invented frequency encoding. While the term ‘zeug-
physicist Werner Heisenberg, quit his post in Leipzig
matography’ sunk without a trace, fortunately the in 1933 in disgust at the Nazi’s expulsion of German
technique it described has gone from strength to Jews (as a Swiss citizen, Bloch himself was exempt).
strength. Bloch’s subsequent career at Stanford was crammed
Selective excitation, or the sensitization of tomo- with major contributions to physics and he has been
graphic image slices, was invented at the University of called ‘the father of solid state physics’.
Nottingham, England in 1974 by Sir Peter Mansfield’s Nicolaas Bloembergen, a Dutch citizen, was forced
group, a contribution also recognized by the to hide from the Nazis for the duration of the War,
2003 Nobel Committee, while in 1975 Richard Ernst’s reputedly living on boiled tulip bulbs, until becoming
group in Zurich invented two-dimensional Fourier Purcell’s first graduate student at Harvard two months
after the discovery of NMR. With Purcell and Robert
transform imaging (2D FT). The first practical 2D FT
Pound he developed the theory of NMR relaxation,
imaging method, dubbed ‘spin warp’, was developed
known now by their initials BPP. In 1981 he won a
by Edelstein and Hutchison at the University of Aber- Nobel Prize for his work in laser spectroscopy. In
deen, Scotland in 1980. Many other researchers con- 1991 Richard Ernst joined the MRI Nobel Laureates 3
tributed to the early development of MR, and in this

02
Figure 1.4 0.15 T resistive magnet used by Philips in the early development of MRI. Courtesy of Philips Healthcare.
‘for his contributions to the development of the meth- Paul Lauterbur is said to have been inspired
odology of high resolution nuclear magnetic reson- to use field gradients to produce an image while
ance spectroscopy’. You could say Richard Ernst eating a hamburger. His seminal paper ‘Image For-
achieved the same trick twice: by his novel applica- mation by Induced Local Interactions. Examples
tions of 2D FT in both spectroscopy and imaging. Employing Nuclear Magnetic Resonance’ (Nature
The 2003 Nobel Prize for physiology or medicine 242, 16 March 1973) was originally rejected. Thirty
was awarded to Professor Paul Lauterbur and Sir years later, Nature placed this work in a book of the
Peter Mansfield ‘for their discoveries concerning 21 most influential scientific papers of the twentieth
magnetic resonance imaging’. Peter Mansfield left century.
school at 15 with no qualifications, aiming to become Other Nobel Laureates associated with NMR
a printer. His scientific curiosity was sparked by the include Norman Ramsey (1989), a spectroscopy pion-
V1 and V2 flying bombs and rockets that fell on eer who developed the theory of the chemical shift;
London in 1944, when he was 11. After working as Isidor Rabi (1944), Ramsey’s PhD mentor, ‘for his
a scientific assistant at the Jet Propulsion Laboratory resonance method for recording the magnetic prop-
and a spell in the army, he went back to college to erties of atomic nuclei’; and Kurt Wüthrich (2002) for
complete his education, eventually becoming Profes- his development of NMR spectroscopy for determin-
sor of Physics at the University of Nottingham. He ation of the three-dimensional structure of biological
4 was knighted in 1993. macromolecules in solution.

02
(a) (b) (c)
(d) (e) (f)
Figure 1.5 Nobel prize-winners in NMR: (a) Purcell 1912–1997, (b) Bloch 1901–1999, (c) Bloembergen b. 1920, (d) Ernst b. 1933, (e) Lauterbur
1929–2007 and (f) Mansfield b. 1933–2017. Images courtesy of Ullstein Bild/Getty Images; Bettman/Getty Images; Ira Wyman/Getty Images; the
Nobel Museum; and Sven Nackstrand/Getty Images (x2) respectively.
Due to problems of low signal and high sensitivity MR development has since then exploded into
to motion, body MR did not really take off until the new innovations and clinical applications explored
1990s. The key factors were the development of fast throughout this book, some of which are illustrated
imaging techniques, particularly gradient echo, and in Figure 1.6.
phased array coil technology. The 1990s also saw the
coming of age of earlier developments, namely cardiac
MRI and Echo Planar Imaging (EPI). EPI, which is the 1.3 How to Use this Book
fastest and one of the most cutting-edge methods, was Everyone starts MRI with the same basic problem: it’s
actually one of the first imaging methods to be pro- like nothing else they’ve learned in the past. All that
posed, by Sir Peter Mansfield. EPI is now extensively knowledge you have about radioactive isotopes and
used in neurological imaging through functional MRI film-screen combinations is useless to you now. 5
(fMRI) and diffusion imaging. Where do you start? Most MRI books start at the

02
Figure 1.6 Diverse clinical applications of MRI.
beginning (a very good place to start, according to the things you can touch and look at: the equipment you
song), and introduce protons, net magnetization, pre- find in an MR unit and what the images look like, using
cession and the Larmor equation all in the first three terms like ‘T1-weighted’ simply as labels. Later on we
pages. We think there is another way: starting at the talk about how the images are produced and finally we
end with the images that are produced, which is much cover the underlying physics. By that stage you will be
more useful if you’re already working in the MR unit. able to link these rather difficult concepts back to
After all, you don’t expect to understand how the things which matter – the images.
internal combustion engine works before you learn Part II contains more advanced topics, such as
to drive. cardiac MR and spectroscopy, in no particular order.
The book is divided into two parts. In Part I you You don’t have to work right through Part I before
6 will find everything you need to know about the basics you read these chapters; we just couldn’t fit them
of MRI, but presented in reverse order. We start with neatly into the reverse order!

02
In all the chapters you will find the most basic better, re-read the chapter, this time taking in some of
information in the main text. Clinical boxes, shaded the boxes. And when you’re ready for more advanced
green, provide the clinical context as you go along. subjects like spectroscopy or fMRI, head over to Part
Yellow boxes are about trying things for yourself: II. The topics can seem to jump around a bit by
simple (and not-so-simple) imaging experiments to splitting them up this way, but we think it is a good
run on your own scanner. Advanced boxes, shaded in compromise, which allows us to include enough
blue, deal with various topics in more detail and are information for everyone, whether you are a new
placed at appropriate places throughout the text. radiographer hoping to make a good impression in
If you’re completely new to MR, we suggest you your new job, a radiologist interested in improving
read straight through Part I, skipping all the advanced diagnostic image quality or a physicist studying for a
boxes. When you need to understand something a bit postgraduate degree.
Further Reading of Medicine. Available from:

www.histmodbiomed.org/witsem/
Mansfield P (2013) The Long Road to
Stockholm: The Story of Magnetic
Christie DA and Tansey EM (eds) vol2 [accessed 8 January 2015]. Resonance Imaging – An
(1996) Making the Human Body Autobiography. Oxford: Oxford
Transparent: The Impact of Nuclear Dawson M Joan (2013) Paul Lauterbur
and the Invention of MRI. University Press.
Magnetic Resonance and Magnetic
Resonance Imaging. London: Cambridge, MA: MIT Press.
Wellcome Institute for the History

02
02
Part
I The Basic Stuff

https:/www.cambridge.org/core/terms. https://doi.org/10.1017/9781107706958
https:/www.cambridge.org/core/terms. https://doi.org/10.1017/9781107706958
Early Daze: Your First Week in MR
Chapter
2
2.1 Introduction 2.2.1 The MR Suite
In any first week of a new job or in a new environ- The MR suite will probably be arranged differently
ment, it takes a little time to become orientated and to from the remainder of the imaging department. It
find your way around. This chapter aims to ease those may have its own dedicated reception, administration,
initial experiences so that you will feel more like a waiting and patient-handling areas. Security will be
seasoned campaigner than a raw recruit. The high on the staff’s agenda and the suite usually has its
following are your essential instructions: own lockable doors. The preoccupation with security
Magnet safety, especially from ferromagnetic and the ‘separateness’ of the MR suite is principally to
projectiles, is paramount to the safe operation of prevent anyone introducing ferromagnetic items into
any MR unit; do nothing to endanger the the vicinity of the magnet, where the outcome could
wellbeing of your patients and colleagues. be disastrous.
The MRI unit should have clearly written policies MR accommodation may comprise:
and procedures for checking that patients and staff facilities for patient management: reception,
have no contraindications. waiting areas, changing facilities, toilets,
Aside from the magnet itself, the coils are the anaesthesia and recovery area, counselling room;
main items of equipment that you will have to facilities for staff: reception/office, administration
learn to handle (don’t break them!), and learn how office, reporting rooms;
to position patients comfortably and effectively MR system: the MRI scanner room (magnet/
with them. examination room), computer/technical room
Good patient cooperation is essential for safe and and operator’s console/host computer;
effective scanning; you will need good people dedicated storage areas: trolley bay, general store,
skills. resuscitation trolley bay, cleaner’s store.
The MR environment is a bit confusing at first, but
An example of a typical MRI suite layout is given in
you will soon feel at home. Enjoy the experience!
Figure 2.1.
The MRI scanner room, or magnet room or examin-
2.2 Welcome to the MR Unit ation room is a restricted access or controlled access area.
On your first day you will be asked to complete a staff See Box ‘Zonal Defence: Control and Access’ for further
safety questionnaire and should undergo a thorough details. The MR system is actually distributed between
safety induction. (Once you are MR trained you will three of the rooms in the suite: the magnet room
find yourself doing strange things such as taking off which houses the magnet and coils, an air-conditioned
your watch and emptying your pockets when you go technical (computer) room which is full of supporting
into a CT room!) As part of your induction you will electronics and electrical plant, and the control room
need to become familiar with your institution’s MR which contains the MR console.
safety policy or Local Rules. These will contain infor- You will spend most time in the control room
mation about access to the controlled area or zones, at the MR scanner console: where you enter
local policy on implants, dealing with emergencies, patient details, select and customise scan acquisition
staff roles and responsibilities, and other site-specific parameters, view and post-process images, archive
safety-related information.
11
images and send them to the Picture Archiving

03
Part I: The Basic Stuff
Workstation
Control
Magnet room RF cage room
Reporting
Quench
pipe
RF Window Console
PACS monitors Zone 1
Penetration
panel
Zone 2
Store
Electronics
Zone 3
Change
Technical room
Reception WC
Zone 4
Trolley Quench
button
Prep/recovery Self-locking
Waiting
doors
Sink
Lockers
Hospital corridor
Figure 2.1 Typical MR imaging suite, showing Zones I to IV as defined by the ACR, and the controlled access area as defined by MHRA. Access
to Zones III–IV and the controlled areas is strictly controlled.
and Communications System (PACS). As a trained

member of MR staff you will have access to the Zone III: a restricted access zone under the
control of designated MR personnel (i.e. you!),
magnet room (Zone IV) but others will not. See Box
physically demarcated from areas of greater
‘Can I Go In?’. access, with secure access only.
Zone IV: the magnet or MR examination room
itself.
Zonal Defence: Control and Access
These zones are indicated in Figure 2.1 through
The American College of Radiology (ACR) expert
shading. In the UK, the Medicines and Healthcare
panel on MR safety recommends the designation of
products Regulatory Agency (MHRA) defines the
various zones for ensuring safe practice in MR units.
‘MR Environment’ as that which encloses the entire
Zone I: areas that are accessible to the general 0.5 mT fringe field contour, to ensure no active
public, generally outside the MR environment implant malfunction. It recommends physical demar-
completely. cation, secure and restricted access to the MR
Zone II: the interface between the publicly Controlled Area (similar to ACR Zones III and IV). This
accessible area (Zone I) and the areas where strict guidance is consistent with that from the Inter-
control and supervision are required (Zones III, IV). national Commission on Non-Ionising Radiation
Patients may be screened in Zone II and will Protection (ICNIRP) and other national bodies (see
12 generally be under supervision. Further reading).

03
Another random document with
no related content on Scribd:
"Yes, already!" said Robespierre.
And he told them all about their walk through the strange crowd, so
lively and so full of enthusiasm, turning now and then to Cornélie for
corroboration. But Cornélie wore an absent air, replying only in
monosyllables, for she had just learnt that her dress had not yet arrived;
though she took some comfort on hearing that her sisters were in no better
plight.
Mother Duplay, with arms akimbo, lingered to listen with enraptured

interest to Robespierre's narrative.
"I said as much to Duplay! It will be a triumph."
Duplay here interrupted her.
"Well, are we to have supper to-night?"
"You may well ask, but when Maximilien talks I forget everything."
Then taking up her basket of salad, she called Victoire to help her. They
used to dine out of doors when the weather was fine; the table was already
there, and had only to be laid. Ah! that fête—how it turned everybody's
head! Mother Duplay was certainly late, to her great discomfiture. Yes, she
was late—she, the pink of punctuality.
"And the chicken will be burnt to a cinder!"
She ran to the kitchen, on the ground floor, next to the dining room, and
found her youngest daughter, Madame Lebas, already there.
"I thought of it, mamma!" she said.
The chicken, nicely cooked to a golden brown, swimming in gravy, was

ready to be served.
"Now then! Let us make haste!" said Madame Duplay, highly amused at
being caught by her daughter. "Strain the soup while I prepare the salad.
Oh, Victoire, we haven't laid the cloth yet!"
With the Duplays, it was a long-established custom that everything
connected with the kitchen or the table should be entrusted only to the
family; the maid washed up when the meal was over. Perhaps this was an
excess of prudence, or a fear of poison. Whatever the motive was,
Robespierre highly approved the practice.
"It is well to know what one is eating," he would often say.
The two girls and Madame Lebas took it in turns to wait at table, and so
they could all speak freely, without being restrained by the presence of the
servant.
The soup was now served up, steaming hot, and Madame Lebas was
ladling it out in equal portions, reserving the last, as the hottest, for
Robespierre.
"To table! To table!" she cried, placing chairs for every one.
But Robespierre and Duplay did not move. They were deeply interested
in something Lebas was telling them. Duplay's son-in-law had just returned
from the Tuileries, where he had gone "to feel the pulse of the Convention,"
as he expressed it. The National Assembly, although undermined by some
evil-minded members, would be excellently represented at the fête on the
morrow. The abominable rogues who had charged Robespierre with
intending to turn this popular manifestation to his own profit had been
disappointed—an appropriate reward for their drivelling calumny! No one
attached the slightest importance to their scandalous reports. The
Convention, as well as the people, were with Robespierre. Only the
Committee of Public Safety...
"But, I say, children, the soup will be cold," Madame Duplay called out
in desperation.
Simon the wooden-legged came down from his room, declaring that he
was famished.
"Here we are! Here we are!" the three men exclaimed, taking their seats.
Robespierre had made a sign to Lebas to change the conversation on
account of the women. Then significantly shrugging his shoulders, he
whispered to him—
"The Committee of Public Safety? Well, I shall be ready for them!"
At table Robespierre, who was seated between Monsieur and Madame

Duplay, hardly tasted his soup.
"The soup doesn't please you, friend?"
"Oh yes! Very good! Excellent!"
Victoire cleared away the soup plates as slowly as possible, waiting for
Robespierre. When he had finished, she said—
"That is right, bon ami. You know you have to keep up your strength for
to-morrow."
Madame Lebas now returned from the kitchen with the capon, and was
greeted by a general murmur of admiration.
"Splendid!" cried Simon Duplay, who was a bit of a gourmand.
"To-morrow, children, you shall have duck, duck and turnips!" said
Madame Duplay, much gratified, as she set to work to carve the fowl,
giving Robespierre the white meat, which he took mechanically, deep in
thought. Lebas told them that he had seen Fouquier-Tinville, the Public
Prosecutor, who was returning from the Bastille, where he had been to
inspect the new installation.
"Ah, yes! the guillotine!" interposed mother Duplay, continuing to

carve. "But it didn't work to-day, did it?"
"It will not work to-morrow either," said Robespierre, "but the day after
to-morrow ..."
"Will you allude to it in your discourse, bon ami?"

"Yes, towards the end; for it is well that the aristocrats should know that
we are not disarming."
"Decidedly," chimed in Duplay, "that would be too stupid."
Robespierre, warmed by the tone of the conversation, recovered his

appetite.
"At all events," he said, "the fête to-morrow will be a warning for every
one; for the aristocrats, as well as for many a Judas of the party."
He stopped to express his appreciation of the fowl, sending up his plate

for more.
"A leg, or a wing?" asked mother Duplay, delighted.
Robespierre suddenly turned round. He had heard a noise.
"I am sure the front door has just been opened," he said.
Simon Duplay took out a match to light a lamp, and young Maurice
rose, looking out into the dark.
"It's true," he said; "it's a woman with a large parcel."
"Our dresses, surely!" exclaimed Cornélie, who had been somewhat

morose and silent until then.
"Yes, our dresses," cried Madame Lebas and Victoire expectantly.
It was, after all, only the dresses, which the dressmaker had at last
brought. The enormous box was handled by them eagerly; they wished to
open it there and then. However, Victoire, prudently fearing to soil the
contents, carried it into the dining-room, followed by her sisters.
The conversation was resumed with lively interest by the light of the
lamp just lit, and opinions were freely expressed that as Royalty had her
fêtes, the world would now see what a Republican fête could be like. It
would be truly national, imposing, and symbolical.
The young women had not yet returned.
"Hullo! you children! what are you doing there?" called out old Duplay.
"Here we are! Here we are!" answered Victoire, appearing that moment

on the threshold of the dining-room in a pretty white dress, coquettishly
pushing back her hair, disordered by her hasty toilet.
"Doesn't it suit me?" she said. "Oh! don't look at my hair; it isn't
arranged," and she ran down the steps followed by Madame Lebas and
Cornélie, also arrayed in their new finery.
Mother Duplay scolded her daughters.
"What! You dressed yourselves in the dining-room? Why, it is positively

improper! Isn't it, Maximilien?"
Robespierre smiled.
"Let them alone, bonne mère. It's not fête every day!"
And he looked at the dresses, pronouncing them charming, and in

perfect taste.
Madame Lebas was in blue, Victoire in white, and Cornélie in red.
"The three colours!" observed the boy Maurice.
"We wanted to give you a surprise," said Cornélie, advancing towards

Robespierre.
"Nothing could have given me more pleasure," he replied. "That is what

I call true patriotism."
The noise of hurrying feet, the sound of voices and music, the hum of
Paris in the distance preparing for the coming fête centered through the
open window. Fireworks burst in mid-air, then suddenly seemed to radiate
in a blaze of glory.
"Oh, look!" exclaimed the boy Maurice, as showers of golden fire fell in
a cascade of light. Robespierre musingly watched their slow descent, which
to his overstrained imagination took the form of one huge halo of glory.
Robespierre was early up and dressed next morning, and he was

received by the Duplays in the courtyard with cries of surprise, for it was
scarcely nine o'clock. "What! dressed already! And we haven't
commenced!"
Robespierre told them he had hastened in order to be at the Tuileries in

time to superintend things a bit, and to arrange matters with his friends, that
there might be no hitch. People would talk so! The slightest thing might mar
the splendour of the manifestation, which would be a pity on such a
splendid day!
"The sky is naturally propitious for the fête of the Supreme Being," said
Victoire; "but you will have some breakfast, I suppose?"
"No, I shall breakfast over there."
They now surrounded him, retaining him to arrange the folds of his
cravat, or brush grains of powder from the revers of his coat, which they all
declared suited him to perfection. He received the compliment with visible
pleasure, as he had given himself no little trouble over his toilet for the
great occasion.
He wore a light blue coat, nankeen breeches buttoned above the knees,
where a stream of tri-colour ribbons was attached. White silk stockings and
buckled shoes completed the array of this real Republican dandy. He was
powdered of course, as usual, and had even indulged in an extra puff or so,
but his most extravagant conceit was displayed in the lace waistcoat which
spread like a filmy foam across his breast. The women went into ecstasies
over this, and declared his taste exquisite. As he was taking leave, Cornélie
appeared with an enormous bouquet of wild flowers and ears of corn in her
hand.
"And the bouquet?" she asked, giving it to him at the same time.
"Ah! yes! I had forgotten it. How kind you are! Au revoir. I shall see
you by and by, looking your best, I am sure!"
And Robespierre, spick and span in his new clothes, all curled and
perfumed, picked his way daintily across the courtyard.
At the door he found Lebas, Simon the wooden-legged, and the boy
Maurice Duplay awaiting him. They wished to escort him to the Tuileries.
Didier, the agent, now came up, accompanied by two of his men, and they
all started in the direction of the Rue Saint-Honoré, keeping to the right.
The Incorruptible conversed with Lebas.
A breeze stirred the flowers that decorated the front of the houses,
wafting abroad their perfume. People were filling the streets from all
directions, all in festive attire, with palms and ears of corn in their hands.
On recognising the Incorruptible, they bowed to him; delighted, he
discreetly returned their salutations.
Robespierre had turned into the Passage des Feuillantes, and found
himself on the terrace. Here a surprise awaited him. The garden was
already, at that early hour, three-quarters full, looking like an immense sea
with wave upon wave of tricolour ribbons, plumes, and cockades. He
continued his way along the Terrace des Feuillantes, a smile on his lips,
returning the greetings as he went, and then joined the stream of people
moving towards the Tuileries, happy to lose himself in that crowd flocking
to his own apotheosis.
Flowers festooned the front of the Palace from end to end, lending to it
the freshness of spring-tide.
When Robespierre arrived he cast a hasty glance at the vast

amphitheatre which awaited the National Convention. It was still empty.
The amphitheatre extended from the gardens to the balcony of the Horloge,
from which projected a tribune, erected above the seats of the deputies—the
tribune of the President, his tribune. It was from there that he would speak
to the people, assembled to hear and to applaud him.
Robespierre entered the Palace alone, Lebas and the two Duplays
having gone back to the Rue Saint-Honoré to fetch the family. Beaming
with expectation, the Incorruptible looked about in search of some familiar
faces, but he found none. He crossed the Convention Chamber to the offices
of the Committee of Public Safety, and questioned the men in charge, who
told him that only the members Barère, Collot d'Herbois, Prieur, and Carnot
had put in an appearance for a moment, and then had gone to breakfast at a
restaurant. As he crossed the Hall of Liberty he met Vilate, a fellow-
juryman of Duplay's on the Revolutionary Tribunal. Vilate was under an
obligation to Robespierre, who, in conjunction with Barère, had procured
for him a residence in the Palace at the Flora Pavilion. It was the surest way
of having a spy ready at hand, a reliable and silent witness of every act and
move of the Committee of Public Safety. Vilate, at once insinuating and
deferential, invited him to breakfast.
"It would be so convenient," he suggested, for he could breakfast, and

yet not lose the splendid spectacle of the crowd as seen from the first story.
Robespierre accepted the invitation, and remained for two hours there. Even
after Vilate had left him he stayed on, looking down on all the preparations,
lost in a day-dream of anticipated joy. He was nearing the supreme moment,
the popular moment, which would raise him so high above his colleagues
that henceforth any steps taken against him would be considered as directed
against the nation itself. He smiled. His dictatorship? Was it not imposed on
him by the French people? Was it not the outcome of the public will? It
would be presently called for by a hundred thousand voices in these very
gardens, in presence of all France, represented by the three hundred
deputies of the Convention. He remained in meditation, smiling still, his
forehead pressed against a pane of the window, his looks plunged in that
living sea swaying at his feet. If ever Robespierre was happy, it was at this
supreme moment.
Some one knocked.
"Come in!" he said, as if awakened from a dream.
It was Lebas, who, all out of breath, came to tell him that the
Convention was assembled, and only awaited his arrival.
"Vilate sent me here. I was wondering where to find you."
Robespierre looked up in astonishment.
"It can't be very late," he said.
"Why, it is half-past twelve!"
"Half-past twelve?"
The fête had been fixed for noon. He was then half an hour behind time!
And the ironical smiles of some of his colleagues when he appeared in the
tribune were not the least bitter consequences of his unpunctuality.
A voice was heard saying—
"He has at last decided to put in an appearance!"
And then another—
"He hasn't even the courtesy of kings, yet he has enough of their
insolence!"
Robespierre recognised the voice.
It was Barère's. Drops of gall were already falling into his cup of joy.
But as the people began to applaud at the lower end of the gardens,
Robespierre advanced to the edge of the tribune, and bowed. The expectant
crowd swayed as one man towards him, unwilling to lose a single gesture or
a single word. So stood the Incorruptible, enwrapped and penetrated by the
inebriating vapours of adulation and the perfume of all the palms and
bouquets that rose as incense at his feet.
But again a discordant note was touched, and another voice was heard
—
"See how like a throne the tribune stands!"

And in fact, set high above the steps, it did seem raised on a pedestal.
Robespierre felt this as in some embarrassment he unfolded his manuscript,
and commenced. His voice was almost inaudible, except to the members of
the Convention seated near him. Passages on which he counted most passed
unheeded, and he felt the encouragement of his friends to be indiscriminate
and misplaced, like that of some theatre claque.
When he had finished he was greeted with considerable applause, that

was more formal than genuine; it mounted from the gardens and reached
him, mingled with the strains of Gossec's hymn, just started by the Opera
choir. Robespierre left the tribune dissatisfied with himself, but convinced
that his address to the people on the Place de la Révolution, from the altar
of flowers erected at the foot of the statue of Liberty, would retrieve this
first failure. There he would be in direct contact with people, and then they
would see! For he felt the people were with him; their acclamation coming
up to him from the gardens was proof enough.
He descended the steps, followed by the Convention, and went towards

the first fountain on the lawn, from which rose an allegorical group,
representing Atheism surrounded by the Vices, led by Folly, while Wisdom,
standing apart, pointed a warning finger at the group. He was to set a match
to this ingenious specimen of artistic pyrotechny, when Atheism was
supposed to disappear, dragged down by Folly and the Vices, leaving
Wisdom alone, radiantly triumphant. But it was the very opposite that
happened. Wisdom caught fire and upset the whole arrangement, provoking
disrespectful laughter among the deputies.
Robespierre turned pale. The fête had certainly not opened auspiciously.
Then, in spite of himself, an instinctive and uncontrollable desire to lean on
some one, which always took possession of him in hours of suffering,
mastered him. As he looked round in search of a sympathising glance, his
eyes fell on a fair, rosy child, in its young mother's arms, trying to play with
bouquets of corn and wild flowers which its mother kept from him.
Robespierre recognised the bouquet which in his excitement he had left on
the tribune, and which the young woman now held out to him. This delicate
attention fell on his parched soul like refreshing dew, and he gratefully
accepted the simple homage offered with such charming frankness.
Robespierre now headed the procession, preceded by trumpets and
drums, followed by the Convention through the line of National Guards,
who kept back the curious crowd on either side of the garden, as the line
wound its way towards the swing-bridge which opened on to the Place de la
Révolution.
The deputies were all there, dressed in official garb: dark blue coat, red
collar and cuffs, tight-fitting knee breeches of doeskin, high boots, broad
tricolour sashes across the breast, fastened on the left shoulder, and tricolour
plumes in their hats. Each member carried in his hand a bouquet of flowers
and ears of corn.
Robespierre was conspicuous by the difference in his attire, which was

of a lighter blue. He walked well ahead of his colleagues, as if to accentuate
the distance between himself and them in the eyes of the crowd, who, with
keen curiosity, were climbing on stools, on ladders, on the bases of statues,
on gates, and even on the trees, to get a better view of him. Thus
Robespierre, whose serenity had now returned, advanced towards the Place
de la Révolution, where he knew that the greater mass of the people were
assembled to receive him with thunders of applause.
The sound of "Vivat! Vivat!" was heard in the distance, accompanied by

the roll of the Champ-de-Mars cannon, which fired a resounding salute at
regular intervals. Those vivas were welcoming on the Place de la
Révolution the cortège which had preceded Robespierre and the members
of the Convention; the delegates from the different sections of Paris, who
entered amidst the beat of drums and blare of brass instruments, headed by
a standard-bearer. The procession had no sooner reached the square than
they parted into two lines; on one side women and young girls, dressed in
white and crowned with roses; on the other, old men and youths, carrying
branches of oak and laurel. The crowd, kept back by a rope of tricolour
ribbons, received the procession with enthusiastic shouts, chanting with the
choirs the choruses of the Chant du Départ. To the passionate strains of
Mehul's national anthem succeeded soon after a hymn appropriate to the
occasion, Gossec's composition calling down the benediction of the
Supreme Being on France and on humanity.
The people applauded, but stopped directly to welcome another group
of the Paris section, a company of young Republican warriors dressed in
blue and rose-colour, holding aloft lances decked with tricolour ribbons.
The greatest triumph of all, however, was the group symbolising the Four
Ages—Childhood, Youth, Manhood, and Old Age—represented by a
multitude of children, youths, maidens, men and women, both middle-aged
and old, some crowned with violets, others with myrtle, oak-leaves, olive-
branches, and vine-leaves. One unanimous cry of admiration rose from the
crowd and resounded through the immense square, where the sun fell in
burning rays on the silks, velvets, and brocades, playing in the gold fringe
of flags and banners, and on the many tricolour ribbons and streamers, in a
flood of dazzling light.
The excitement of the populace was now at its height, and, as the
members of the Convention appeared in sight, a cry rose suddenly—
"He is here!"
"Who?"
"Robespierre."
A tremor of curiosity ran through the crowd who, mad with excitement,
poured forth their welcome in a storm of enthusiastic cheers and plaudits,
even before their hero came in sight. A sheriff, then a delegate, then a
master of ceremonies, were by turns loudly cheered by the eager multitude,
who in their impatience had taken them for the Incorruptible. At last he
passed, smiling affably, hat in his hand, and the cry ran from mouth to
mouth—
"It is he! It is he!"
This time it was really Robespierre; there was no mistake. Hats, caps,
handkerchiefs, waved on all sides; women raised sprays of loses in the air
and men branches of palm.
This outburst threatened to break up the cortège of the Four Ages,

which, like the preceding one, had ranged itself round the statute of Liberty,
where Robespierre was to deliver his discourse. Children begged their
mothers to lift them up, that they might see also. At the same moment the
solemn chords of a harp floated on the air.
Robespierre advanced slowly, slackening his pace, for he had become

suddenly aware of the great distance which separated him from the
deputies, who filed into the square six abreast, grave and slow, like judges.
The different groups of the procession, who had arranged themselves in
regular lines, now unveiled the statute of Liberty, where an altar of flowers
and foliage had been erected. It was at this altar that Robespierre was to
officiate, and consecrate amidst the burning of incense the worship of the
Supreme Being.
The Incorruptible was now passing the very spot where on the previous
day the scaffold still stood. A woman in the crowd called attention to this in
all simplicity. But her voice was quickly drowned by a hundred harps,
whose dulcet music filled the air. All members of the Convention had
reached the Place de la Révolution, when a new cortège came in sight, the
chariot of Agriculture, draped in blue, covered with garlands of roses, and
drawn by a yoke of oxen with gilded horns. The goddess of Agriculture was
impersonated by a beautiful girl from the Opera, who smiled on the crowd
with her light blue eyes, looking the very incarnation of luxuriant youth, her
blonde beauty framed in ripe golden corn and fruits of the rich harvest.
Robespierre, now standing before the altar, was burning incense in a

golden tripod, amidst the mute reverence of the crowd, who behaved as if
assisting at some religious ceremony. Presently, descending the steps of the
altar, he turned to address the multitude.
All music had ceased, each voice was silenced, every whisper hushed;
even the cries of pedlars and street-hawkers were unheard. A hundred
thousand eyes were fixed on Robespierre, who, set up on high and wrapped
in clouds of incense, appeared to tower in stature, to dominate that mass of
human beings with all the force of a prevailing pride.
A sudden inspiration seized him: he would repeat the more notable

phrases of his former discourse, here, to that crowd whose mighty heart he
felt beating with his own; he would have his revenge, and hear his burning
words applauded by the nation itself! Ah! had the deputies been indifferent,
cold, hesitating in their applause? Well, they should receive a lesson that
would be at once a warning and a mandate! The delegates of the nation
should be censured publicly by the very nation they represented!
Robespierre had delivered the opening sentences of his speech. Carried

away by the enthusiastic ovation of the crowd, now entirely master of
himself and of his discourse, his words flowed freely and abundantly, and
he declaimed without once referring to his notes, in a clear, penetrating
voice. Every point was greeted with a thunder of applause as he spoke on,
stimulated by a glow of satisfaction which touched the most secret fibres of
his being. He felt himself to be for ever and in very deed master of France,
acclaimed Dictator, solely by the people's will. Through the fumes of this
mad delirium he saw the Convention vanquished, paralysed with fear and
amazement.
He was thanking the French nation, who had laid aside their work to lift
their thoughts and aspirations towards the Great, the Supreme Being.
"Never," exclaimed the Incorruptible, "never has this world which He

created offered Him a sight more worthy of His regard. He has seen the
reign of tyranny, crime, and imposture on the earth——"
But a stir was noticeable in the crowd, not far from Robespierre. A man
had just made an observation in an audible whisper, attracting the attention
of the bystanders. They looked at him in surprise, trying to divine his
meaning, but Robespierre, who was too far off to have heard, continued—
"Frenchmen! if you would triumph over your enemies, be just, give to

the Divine Being the only offerings worthy of Him—virtue, compassion,
forbearance——"
"With the guillotine!" called the voice in the crowd, with a bitter laugh.
A murmur rose round the man, every one whispering out of respect for
Robespierre, who continued his harangue. They questioned the man,
threatened him. Voices grew louder. "Silence!" called the officials, but the
disturbance went on. "He ought to be arrested!" and the words drunkard,
aristocrat, chouan, were thrown at him. "What did he want? What did he
say?"
"Yes, what did you say?" asked a patriot coming close to him.
"I say only what you ought all to cry out to that charlatan—'Instead of
burning incense to your idol, Tyrant, burn the guillotine!'"
This daring critic, as the reader will guess at once, was Olivier.
His voice was drowned in a burst of applause which greeted the words
of Robespierre encouraging him to go on with his speech.
In presence of such irony Olivier lost all self-control.
"And they can applaud him, the fools! They can applaud him!"
The fury of the multitude, now unchained, knew no bounds. Cries of

"To death with him! To death!" were heard amidst the awful tumult, which
completely drowned the voice of Robespierre, whose anxiety was now also
aroused. Olivier, down-trodden, his clothes torn to tatters, fought and
struggled in the grasp of twenty or more of the infuriated populace. "He
must be killed! He is an aristocrat! A chouan! To death with him!" One of
the patriots lifted a be-ribboned spike in the air, threatening to pierce his
eyes. But a man armed to the teeth, dagger and pistols in his belt, pushed
aside the crowd and seized the offender by the throat. He then turned and
bade them make way for the officers of the peace who followed him.
"Stand back there!" he cried. "This man is to be dealt with by justice

only!"
It was Héron, chief police-agent of the Committee of Public Safety.
With the assistance of his men Héron dragged the offender to the feet of
Robespierre, who, being informed of the affair, had asked to see the
interrupter.
But a vociferating crowd obstructed the passage. Robespierre

impatiently descended the steps of the altar. The whole Convention and the
cortège had moved also, wishing to see. The police forced a way in the
crowd for Robespierre. At the name of the Incorruptible the multitude gave
way, and Olivier appeared before him, struggling in the powerful grasp of
Héron.
"Against whom does this madman, who disturbs our fête, bear a
grudge?" asked Robespierre.
"Against you! hypocrite and scoundrel!" Olivier cried; "against you,

who dare speak of justice and humanity on this spot soaked with the blood
you have spilled!"
A horrified scream rose from the crowd, but was as soon hushed at a
sign from Robespierre. Olivier tried to throw himself on him, but was held
back by the police.
"Look at the soles of your shoes, you butcher!" he cried desperately.

"They are red with blood!"
He was not allowed to continue.
The Incorruptible motioned the agents to remove him out of reach of the
furious and exasperated crowd, who continued to cry out—
"To death with him! To death!"
Olivier turned in the grasp of his gaolers and cried—
"You can kill me, murder me, ruffians! but I have cried out, as others
will cry out after me, 'Down with the scaffold!'"
His words were lost in the tumult. Robespierre reascended the steps of
the statue, and tried to calm the people.
"Citizens!" he said, "let us give ourselves up to the joys of this fête,

which the insults and outrages of a rebel shall not disturb! To-morrow the
sword of Justice will strike with renewed ardour the enemies of our
country!"
Loud plaudits followed, and cries of "Long live the Republic! Long live
Robespierre! Long live the Incorruptible!"
"Down with the scaffold!" cried a faint voice in the distance.

It was Olivier, whom the police, aided by the National Guards, were
carrying away in chains.
CHAPTER VIII
AN EVENING AT THE DUPLAYS'
Robespierre slowly descended the altar steps with a preoccupied air, for
that last desperate cry of Olivier had struck its mark. However self-
possessed he might be, he had felt the blow acutely. That voice, full of
hatred and revenge, had risen from the crowd he thought entirely at one
with him! In their very applause at that moment the people were protesting
against an insult coming from their ranks! They were driven to defend him,
when he had dreamt that the populace would receive him with instant and
unanimous enthusiasm, insuring to him for ever the esteem of France!
Pale and anxious, he followed the procession to the Champ de Mars,

where the fête was to close with one crowning patriotic demonstration. He
felt that his supremacy was tottering, and wondered how many more
discordant notes would disturb the prevailing harmony. Alas! there were
already signs of jarring discord. Certain members of the Convention talked
aloud in a free, sarcastic strain, on the road, openly exchanging opinions,
emboldened by Olivier's public insult. Words of dark and ominous import
reached the ears of Robespierre—words of hatred and scorn, of tragic
foreboding, and portentous prophecy. "I despise and hate him!" said one.
"There is but one step from the Tarpeian Rock to the Capitol!" said another.
And a third added: "A Brutus may yet arise!" To close the mouths of these
backbiters, he mentally reflected, and to save all, nothing was wanted but
the vox populi, the supreme and national mandate, uprising from the
assembled multitude and re-echoed through the whole of France:
"Robespierre Dictator! Dictator for life!" But the Incorruptible awaited any
such acclaim in vain.
The fête of the Champ de Mars which followed was wanting in the
brilliancy and magnificence of the preceding festival. Every one was hot
and unstrung. Robespierre again addressed the people, who, tired from
having stood so long under a burning sun, were listless and absent-minded.
The demonstration was drawing to its close amidst a general feeling of
depression.
Nothing but confusion reigned on the march homeward. Robespierre

was to return to the Tuileries to meet several of his colleagues, but instead,
he hurried away, fully resolved to shut himself up in his room and open his
door to no one, not even to the Duplays, who had dogged his steps the
whole way back, trying to catch him up, and only succeeding at the
threshold of their house, where Robespierre begged them to have their little
festive party without him.
"I want rest," he said.
"The fête went very well, didn't it?" asked mother Duplay.
"Yes, very well!" replied Robespierre.
"Then you are satisfied?"
"Perfectly!"
As Cornélie began to tell him of some details which she thought had
escaped him, he put her off gently, saying—
"Was it so? Indeed! Well, you will tell me that to-morrow."
"What! You will not dine with us?"
"No; I must ask to be excused."
And as she pressed him to join them, he repeated—
"No, no; I must beg you to excuse me! Au revoir till to-morrow! Au
revoir!"
With these words he went up to his room and locked himself in.
Every one was in low spirits at the Duplays' that evening. They scarcely
tasted their supper. No one was deceived by Robespierre's feigned
indisposition; they were well aware that the fête had been a great
disappointment to him, and they shared his chagrin, though they determined
that this should be in no way apparent.
"We must not disturb his meditations," observed mother Duplay.
"But are we not going to see the fireworks?" asked the boy Maurice
anxiously.
"We are not," declared mother Duplay. "How could we enjoy ourselves
without him?"
And they went early to bed.
The house, which had awakened to joy, now slumbered silently whilst
Paris was being lit up to prepare for the populace, again in holiday mood,
the promised display of fireworks.
Robespierre rejoined the Duplays next day at supper. He had spent the
morning and afternoon locked in his room, under pretext of working. And
work he did. Alone, in sullen silence, he prepared that atrocious Prairial
law, which he intended to lay before Convention forthwith—a law which
aimed at nothing less than the entire suppression of the right of defence
before the Revolutionary Tribunal. Moral evidence was to suffice; cross-
examinations, depositions, and the testimony of witnesses were to be done
away with. To be a "suspect" would itself be a proof of guilt.
Ah! he had been insulted! Well, this was his reply to the insult. He had
wished to establish his dictatorship under conditions of peace, but the great
pacific demonstration had not availed him. Were these cowards only to be
subjugated by terror? They should have it then, with renewed vigour, in a
whirlwind of tempestuous violence carrying everything before it. It should
be a fearful and memorable lesson! Every trace of those stubborn,

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Basics of ecotoxicology 1st Edition Donald W. Sparling

Marcus Aurelius 3rd Edition Donald J. Robertson

Marcus Aurelius 3rd Edition Donald J. Robertson

An Introduction to Composite Materials 3rd Edition T.

MRI from Picture to Proton

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MRI from Picture to Proton

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18.3 Perfusion Imaging 311 20.3 Gradient Effects 347

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Acronym/symbol Term Explanation

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Acronym/symbol Term Explanation

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Acronym/symbol Term Explanation

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Acronym/symbol Term Explanation

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Acronym/symbol Term Explanation

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Acronym/symbol Term Explanation

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Acronym/symbol Term Explanation

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Acronym/symbol Term Explanation

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Acronym/symbol Term Explanation

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Acronym/symbol Term Explanation

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1.2 A Brief History of Medical Imaging

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Figure 1.2 Raymond Damadian’s

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short introduction it is impossible to do justice to them

The Spin Doctors: Nobel Laureates’ Roll-Call

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(a) (b) (c)

(d) (e) (f)

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Figure 1.6 Diverse clinical applications of MRI.

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Further Reading of Medicine. Available from:

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I The Basic Stuff

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and Communications System (PACS). As a trained

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Mother Duplay, with arms akimbo, lingered to listen with enraptured

"I said as much to Duplay! It will be a triumph."