Magnetic resonance imaging. Part II--Clinical applications.

Magnetic resonance (MR) imaging is the most promising new technology to appear in the clinical imaging arena since the advent of x-ray transmission computed tomography in the early 1970s. Five independent tissue characteristics (spin density, spin-lattice and spin-spin relaxation times, flow and spectral shift information) are accessible to MR imaging, and their relative influence in the magnetic resonance image can be varied by appropriate selection of pulse sequences and pulse times. All major organ systems appear to be amenable to MR imaging, and some are revealed with superior definition compared with their appearance in images obtained by alternate imaging technologies. Of particular interest is the superior contrast resolution in MR images of the brain and spinal cord, and the absence of bone- and motion-induced artifacts in images of the abdomen and pelvis. Applications of MR imaging to the heart and great vessels are just developing, as are new types of contrast agents for use in MR imaging. In vivo chemical spectroscopic measurements by magnetic resonance are heralded by some investigators as the most significant contribution that magnetic resonance will make ultimately to clinical diagnosis. At present, the number of MR imaging units is extremely low, and clinical studies are proceeding at a slow rate. Nevertheless, it is possible to provide a preliminary evaluation of the usefulness of MR imaging in a variety of clinical applications. This article is such an evaluation, tempered by the acknowledgement that much additional work remains to be done.