• MR angiography. As described, current traditional angiography techniques are extremely invasive. As MRI flow-study techniques are perfected, the former system may become antiquated.

  • NMR spectroscopy. A number of biomedically interesting nuclei are being investigated to delve even more deeply into specific biochemical and intracellular processes.

  • MRI guided/assisted interventional diagnosis and therapy. At present, CT and ultrasound are occasionally used in operating theaters to better control biopsy, drainage, and retrieval procedures. Significant physical obstacles would have to be overcome, but a system based on MRI could provide enhanced guidance and analysis.

  • MRI fluoroscopy. Patients move certain joint systems—the jaw, the knee, the hip, the spine—through a graded series of positions, allowing MR imaging to produce studies of movement hitherto impossible. An analogous procedure is under investigation for cardiac studies.

  • New contrast agents. A host of oral and intravenous contrast agents are being developed and tested.

  • Clinical efficacy. MRI in many diagnostic situations has dramatically improved medicine's reach, penetrating even to the interior of the body's cells. Clinical horizons are expanding dramatically, and enhanced diagnosis of many areas and processes seems inevitable. Cost and other practical considerations are clearly an important element in this future. But the gold standard is as clearly in the process of being redefined.

BIBLIOGRAPHY

Balaban, R.S., S. Chesnick, K. Hedges, F. Samaha, and F.W. Heineman. 1991. Magnetization transfer contrast in and MR imaging of the heart. Radiology 180:367–380.


Eng, J., T.L. Cecker, and R.S. Balaban. 1991. Quantitative 1-H magnetization transfer imaging in vivo. Magnetic Resonance in Medicine 17:304–314.


Fullerton, Gary D. 1988. Physiologic basis of magnetic relaxation. Pp. 36–55 in Magnetic Resonance Imaging. David D. Stark and William G. Bradley, Jr. (eds.). Mosby, St. Louis.


Stark, David D., and William G. Bradley, Jr. (eds.). 1988. Magnetic Resonance Imaging. Mosby, St. Louis.

RECOMMENDED READING

Bradley, W.G., and G.M. Bydder. 1990. MRI Atlas of the Brain. Martin Dunity Publishers, London.


Crues, J.V. (ed.). 1991. MRI of the Musculoskeletal System. The Raven MRI



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