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AJR 2004; 182:592
© American Roentgen Ray Society


MRI from Picture to Proton

James R. Brookeman

University of Virginia Charlottesville, VA 22908

By Donald W. McRobbie, Elizabeth A. Moore, Martin J. Graves, and Martin R. Prince. Cambridge, England: Cambridge University Press, 372 pp., 2003. $50 (soft cover), $145 (hard cover)

If you would like to review books for AJR, please send a cover letter stating your interest with a current curriculum vitae to Book Reviews, AJR, 500 22nd St. S, Ste. 504A, Birmingham, AL 35233.

Although MRI from Picture to Proton states that its intended audience is students of MRI, "whatever their background: medical, technical or scientific," the format of its contents is quite different from that of many previous MRI texts targeting this general audience. The authors have attempted a novel and quite refreshing approach to the development of the material. Essentially, the typical order in which the material is presented has been reversed, and the book begins with a description, written in an informal style, of the images, equipment, and scanning protocols before any of the underlying physics is introduced. The reader is therefore immediately brought face-to-face with the pertinent practice issues of MRI, with the theoretical background added later.

On many pages, additional technical explanations are given in secondary text boxes. Several of the later chapters deal in great detail with more specialized material such as MR artifacts and pulse sequence acronyms, MR angiography, cardiac MRI, in vivo spectroscopy, brain activation (functional MRI) using the blood oxygenation level-dependent effect, and even lung imaging with hyperpolarized helium gas. The text concludes with a useful mathematics review section appropriate for MRI and a comprehensive index.

To a large extent, the authors succeed with this new approach to learning MRI. The beginning medical student or resident can move quickly through the early chapters to obtain practical information about the scanner operation and layout and the imaging procedures before encountering the more challenging mathematics and physics associated with relaxation theory and spatial encoding. On the other hand, the more advanced physician or physicist can move directly to the specialized chapters pertinent to a particular interest. These later chapters are some of the best in the book, with excellent figures and well-written discussions on topics such as relaxation theory, spectroscopy, and pulse sequence structures. The comprehensive index also facilitates easy access to particular topics of interest.

A mild criticism of the book is the failure in some sections of the early chapters to strike the correct balance between an informal introductory approach and accurate science. In an early chapter, the authors define proton density as "the number of hydrogen atoms in the tissues" and propose that "[a]fter the RF pulse, the magnetization gets back to its equilibrium along z via two relaxation processes called spin-lattice and spin-spin relaxation." In a later chapter, we correctly learn that "the bound or restricted protons are those associated with macromolecules or hydration layers. This restricted pool.... is invisible to direct imaging" and that only spin-lattice relaxation (and not spin-spin relaxation) is associated with equilibrium along the z-axis.

I was surprised that many of the diagrams in the early chapters had obviously been hand-drawn and have somewhat wobbly exponential curves, quite unlike the excellent quality of the diagrams in the later chapters. It is also puzzling that in one figure in an early chapter, the time axis extends only to TR values of 1,600 msec. In clinical practice, many brain imaging protocols call for TR values beyond 2,000 msec. At these higher TR values, the signal level of gray matter exceeds that of white matter, which is an important consideration for understanding brain image contrast.

Overall, MRI from Picture to Proton achieves its stated goals and is an extremely readable up-to-date MRI text for both the novice and advanced practitioner, and physicians in each of these categories will find sections appropriate to their level of interest and background. The somewhat unconventional format might also appeal to a physician who wants to learn more about the fundamentals of MRI but finds the initial mathematics and physics in the current standard texts a serious stumbling block.


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This Article
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