CNG NGH CHN ON HNH NH

TO NH CNG HNG T

(MAGNETIC RESONANCE IMAGING MRI)

Gv: BM:

Nguyn Thu Vn Cng ngh in t & KT in t Y sinh Khoa T-VT

Gii thiu chung

Gii thiu chung:

To nh cng hng t l phng php to nh cc c quan ni tng trong c th con ngi mt cch chnh xc v khng gy nguy him cho bnh nhn. MRI da trn c s hp th v pht ra nng lng trong di tn s radio ca ph in t. MRI to nh da trn nhng thay i khng gian v pha v tn s ca nng lng c hp th v pht ra t vt th to nh.

Lch s pht trin:

Nm 1946, hai nh vt l ngi M tm ra hin tng CHT ht nhn, mi lin quan gia cng t trng v tn s radio. T nhng nm 1980, my chp cng hng t u tin trn th gii xut hin. n nay trn th gii c khong 22000 my v thu c 60 triu hnh nh c chp t ngi bnh. Nm 2003, CHT cho php to nh cc cu trc khc nhau ca c th sng trong khng gian ba chiu.

Gii thiu chung

ng dng:

To nh 3D hu ht cc c quan trong c th To nh rt r nt khi chp no b v tu sng. H tr vi phu thut no H tr chn on v iu tr ung th, (cho bit kch thc, v tr khi u v cc vng b xm ln, cc hch di cn,...), t la chn phng thc iu tr thch hp.

Gii thiu chung

u im:
1. 2. 3. 4. 5. 1. 2. 3. 4. To c nh c phn gii rt cao i vi m mm m cho ti nay cc phng php khc cha t c. C th to nh lp ct vi gc bt k. Khng dng cc b phn chuyn ng nh GANTRY v cc b pht hin phc tp nh trong CT SCANNER Khng x dng bc x c hi. Khi chp mch, khng cn cht cn quang.

Nhc im:
Thi gian ti to nh di. Chi ph u t ln. Bung my phi c b chn cao tn. Chi ph vn hnh cao, c bit loi my s dng nam chm siu dn phi nh k np cht lm lnh 5. i hi nghim ngt v iu kin lp t (din tch mt bng, ngun cp in) v mi trng (n, m)
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Gii thiu chung

C th tm tt qu trnh to nh cng hng t nh sau:

1. t bnh nhn vo trong t trng - Cc proton trong c th tng tc vi t trng. 2. Kch thch cc ht nhn nguyn t - Pht xung sng v tuyn RF. 3. B xung thng tin v khng gian - p dng cc cun dy chnh t. 4. Theo di phn ng ca cc ht nhn - pht hin v thu tn hiu nh cun thu. 5. Bin i tn hiu thnh hnh nh - Ti to nh thng qua php bin i Fourier.

Cng Hng T ht nhn

Khi vt liu c t trong t trng, chng nhn c mt c tnh cng hng, ngha l vt liu c th hp th bc x in t v pht ra bc x in t mt tn s c th. i tng tham gia vo qu trnh trn l cc ht nhn ca cc nguyn t. M c th thng thng c tn s cng hng nm trong di tn s radio (RF), do vy bc x pht ra nm di dng cc tn hiu radio. Tn hiu RF c c tnh xc nh bi cc c tnh l v ho ca m.

CHT ht nhn

CHT ht nhn
Mi im trong t trng c cng nht nh. n v cng t trng: tesla (T) hoc Gauss (G). 1T = 10000G. To nh s dng t trng ng nht, c cng t 0.15 n 1.5 T. Gradient:

Gradient trong t trng cho php ta xc nh chnh xc v tr khng gian ca spin. N biu th s thay i ca t trng theo v tr. Gradient theo hng x, y, z c k hiu l Gx, Gy, Gz.

CHT ht nhn
Nng lng RF:

Trong qu trnh to nh, nng lng RF c trao i gia h thng to nh v c th ngi bnh qua cun RF. Cun RF va ng vai tr l ngun pht v thu nng lng. Trong cc tn hiu thu c c tn ti nhiu.

Vai tr pht v thu ca cun RF trong h thng to nh

CHT ht nhn
Khi a vo mt nng lng RF c tn s bng vi tn s tin ng ca moment t ht nhn, hin tng cng hng xy ra. Khi tn hiu thu c t c th l mnh nht. Tn s cng hng ca mt ht nhn c xc nh bi c tnh ca ht nhn v cng t trng. Tn s cng hng c gi l tn s Lamor. Mi quan h gia tn s cng hng v cng t trng ph thuc vo t s t hi chuyn.

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 t ho m
Khi m c t trong t trng, mt s ht nhn sp xp theo hng ca trng, to ra t ho m theo hng ca trng. S nhim t cc i ph thuc: (1) mt ca ht nhn t trong voxel, (2) nhy t ca ht nhn, (3) cng t trng. Lng t ho m quyt nh cng tn hiu RF pht ra t m trong qu trnh to nh.
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C s vt l ca cng hng t ht nhn

Proton v s t ho:

Nguyn t bao gm ht nhn, in t. Ht nhn bao gm proton v neutron. Trong t nhin, ht nhn ca nguyn t hydrogen c cu to n gin nht, n ch cha mt proton v khng cha neutron. Trong cng hng t nguyn t hydrogen c nhng u im sau:
L nguyn t ph bin nht trong c th ngi C nhy cao nht i vi cng hng t

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C s vt l ca to nh CHT
Trong c th ngi, bn nguyn t hydro, carbon, nit v oxy chim ti 99% m. Cc nguyn t khc (natri, phosphor, kali, magi) c mt tp rt thp. Canxi tp trung trong xng hoc trong cc cht lng cn ring bit. ng v nhiu nht ca 4 nguyn t chim 99% m l hydro-1, carbon-12, nit-14, oxy-16, trong hydro c ht nhn vi t tnh mnh nht. Ht nhn ca nguyn t hydro c 1 proton n. Hn na, hydro c tp trung tng i cao trong hu ht cc m trong c th. Nu coi nhy cng hng t ca ht nhn hydro bng 1, th cc nguyn t t tnh khc u c nhy thp hn (Flo-19 l 0.83, Natri-23 l 0.093, Phosphor-31 l 0.066).
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To nh cng hng t - Nguyn l hot ng

Proton v cc ht khc (neutron, in t ...) c c tnh t quay quanh mnh, gi l SPIN. S quay ca ht khng bao gi dng, n ch thay i hng trc quay di mt tc ng no t bn ngoi. Proton mang in tch dng, khi chuyn ng s to ra dng in v dng in to ra t trng. V vy c th xem proton nh mt nam chm cc nh.

Hng ca spin ht nhn

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To nh cng hng t - Nguyn l hot ng

Nam chm c biu th bng cng t trng v hng vect t trng,.

Cng t trng: Chiu di vect. Hng nam chm l hng vect. Thnh phn t ho dc: song song ng sc t ngoi. Thnh phn t ho ngang: Vung gc ng sc t ngoi.

Chiu vect ln mt phng:

Trong iu kin bnh thng, cc proton-nam chm trong c th sp xp ngu nhin do vy t trng tng ca chng bng khng.

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Nguyn l hot ng Proton di tc ng ca t trng ngoi

Khi t proton vo mt t trng ngoi, vector spin ca proton s chuyn hng theo t trng ngoi. Cc proton c thnh phn t ho dc hng song song vi ng sc t trng ngoi l nhng proton c mc nng lng thp. Thng thng s lng proton mc nng lng thp nhiu hn s proton mc nng lng cao. Proton c th chuyn t mc thp ln mc cao bng cch hp th mt nng lng bng lng chnh lch gia hai mc. E= h.v (v: tn s Lamor hoc tn s cng hng).

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Nguyn l hot ng Proton di tc ng ca t trng ngoi

t bnh nhn vo mt t trng mnh

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Nguyn l hot ng Proton di tc ng ca t trng ngoi

T trng tng khc 0

S hnh thnh thnh phn t ho dc

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Nguyn l hot ng Proton di tc ng ca t trng ngoi

Cc proton quay o khng ng nhp-lch pha, m cc thnh phn t ho ngang sp xp ngu nhin nn cc thnh phn t ho ny trit tiu ln nhau, dn ti tng ca chng bng 0.
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Proton di tc ng ca t trng ngoi v sng v tuyn

Nu dng mt ngun sng in t / sng v tuyn (RF), c tn s bng tn s o ca proton pht ra t mt my pht, tc ng vo mt vng no cn xt nghim ca c th th nhng proton (nam chm) nm trong vng ny s thay i trng thi.
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Proton di tc ng ca t trng ngoi v sng v tuyn

Mt s chuyn t mc nng lng thp sang mc nng lng cao - thnh phn t ho dc ca chng s chuyn sang hng i song song vi t trng ngoi khin cho cng thnh phn t ho dc tng s gim. Cc proton s chuyn t trng thi quay o sai nhp sang trng thi quay o cng nhp - ng pha nn thnh phn t ho ngang ca chng s khng cn trit tiu nhau na m s cng li thnh mt thnh phn t ho ngang tng. Cng ca cc thnh phn t ho lc ny ph thuc vo:

Tn s v cng ngun sng RF Cng t trng ngoi Thuc tnh ca proton Mt ca proton

Ta c th la chn sng RF sao cho thnh phn t ho dc tng b trit tiu v ch cn thnh phn t ho ngang. Sng RF ny c gi l sng RF 90o tng t c sng RF 180o.
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Cc qu trnh hi phc ca proton khi tt sng v tuyn - thu tn hiu to nh

Tt xung RF: Cc proton s quay tr v trng thi ban u khi cha c xung RF qu trnh hi phc. T1 l thi gian th gin thnh phn t ho dc tr li trng thi ban u s hi phc dc. T2 l thi gian cc proton chuyn t ng pha sang di pha, t ho ngang tng bng 0 s hi phc ngang. Qu trnh hi phc dc v ngang din ra trong mt khong thi gian di, ngn ph thuc vo bn cht t bo. Hai qu trnh ny xy ra ng thi v c lp vi nhau. T1 thng di hn T2, T1 thng trong khong 300-2000 ms, T2 trong khong 30-150 ms.
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T1
trng thi cn bng, vector t ho thc nm theo hng ca t trng ngoi B0, v c gi l vector t ho cn bng M0. Khi M0 = Mz. C th thay i vector t ho thc bng cch a vo h thng cc spin ny mt nng lng bng lng chnh lch gia hai trng thi ca spin. Khi nng lng ny ln, Mz = 0. Mz = M0(1-e-t/T1). Nh vy T1 l thi gian cn thit gim s chnh lch gia vector t ho dc Mz v gi tr cn bng ca n theo h s bng e.

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T2
Nu thnh phn t ho thc nm trn mt phng XY th n s quay quanh trc Z tn s bng tn s Lamor. Thnh phn t ho thc bt u di pha do cc nhm spin chu tc ng ca mt t trng hi khc nhau v quay tn s Lamor ca ring n. Thi gian quay cng di th s di pha cng ln. Hng s thi gian miu t s tr v trng thi cn bng ca thnh phn t ho ngang, MXY, c gi l thi gian hi phc ngang T2. MXY = MXYo e-t/T2.
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T1 v T2
T2 lun nh hn hoc bng T1, ngha l thnh phn t ho ngang tr v 0 v thnh phn t ho dc hi phc li n gi tr M0 trn trc Z. Hai yu t gp phn vo s suy gim thnh phn t ho ngang:

Tng tc phn t (hiu ng phn t T2 thun tu). Thay i trong B0 (hiu ng T2 khng ng nht).

Thi gian tng t hai yu t trn gi l T2*.

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Cc qu trnh hi phc ca proton khi tt sng v tuyn - thu tn hiu to nh

Trong khi hi phc trng thi, cc proton-t trng quay ny s pht ra sng in t vi cng v tn s khc nhau ph thuc vo bn cht t bo. Nu ta t mt ng-ten/my thu trong vng tc ng ca sng in t ny th s thu c tn hiu in cm ng. Tn hiu in cm ng ny s c x l bng cch s dng php bin i Fourier thnh tn hiu ti to nh cng hng t

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Cc qu trnh hi phc ca proton khi tt sng v tuyn - thu tn hiu to nh

Minh ho qu trnh t ho v pht thu sng v tuyn

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T trng xung
T trng c to ra bi cun dy vi dng xoay chiu i qua tn s Lamor c gi l t trng B1. Khi dng xoay chiu c bt v tt, n s to ra mt t trng xung B1. Cc spin p ng li xung ny theo cch lm cho vector t ho thc quay quanh hng ca B1. Gc quay ph thuc vo thi gian c t trng v cng t trng = 2..T.B1. T trng xung xc nh sng RF 900, 1800 hay bt c mt gi tr gc no khc.

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iu ch khng gian - Xc nh b dy lp ct v v tr khng gian cc nh im

T thng tin v t bo bit cn xc nh v tr, m nht, cng tn hiu trong khng gian ca chng. m ho v tr khng gian ca cc nguyn t th tch cng nh xc nh b dy ca lp ct, thay v ng dng mt t trng ngoi ng nht ta s dng mt t trng bin thin theo mt quy lut bit v d quy lut tng gim tuyn tnh. T trng bin thin ny c to ra bng cch s dng cc cun dy chnh t, t trng do chng sinh ra s cng vi t trng chnh v t trng tng tc ng vo c th s l mt t trng bin thin tuyn tnh theo khng gian.
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iu ch khng gian - Xc nh b dy lp ct v v tr khng gian cc nh im

a. b.

T trng bin thin t 1,4 n 1,6 T Tn s LAMOR thay i 60 - 68 MHz

T trng bin thin theo 3 trc GZ, GY, GX

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iu ch khng gian - Xc nh b dy lp ct v v tr khng gian cc nh im

Tn hiu thu c t cc t bo s c tn s khc nhau, ph thuc vo cng t trng c iu khin, do c th xc nh c v tr khng gian tng ng vi cc t bo ny. Tng ng vi 3 trc khng gian X,Y,Z s c 3 cun dy chnh t. Trong cc cun dy chnh t theo trc X v Y nh v cc t bo trong mt phng lp ct, cun dy chnh t theo trc Z xc nh b dy lp ct.

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Cc nguyn l to nh
Trong c th ngi, nc v m l i tng c quan tm trong to nh CHT, v l ngun cung cp hydro chnh ca c th. Phng trnh c bn: tn s cng hng (tn s Lamor) ca mt spin t l vi t trng ngoi B0 tc ng ln n v = . B0. M ho tn s:
Khi a vo mt gradient, 3 vng cha spin s chu cc t trng khc nhau, ph CHT c nhiu hn mt tn hiu. Bin tn hiu t l vi s lng spin trong mt phng vung gc vi gradient qu trnh m ho tn s
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Cc nguyn l to nh
Php chiu li:

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Cu trc h thng to nh cng hng t

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Cu trc h thng to nh cng hng t

Nam chm (magnet): to t trng B0 cho quy trnh to nh. Cun gradient (gradient coil): to gradient trong B0 theo cc hng X, Y, Z. Cun RF (RF coil): to t trng B1 cn thit quay cc spin theo cc gc 900, 1800 hoc mt gi tr bt k do chui xung la chn. Cun RF cng pht hin cc tn hiu t spin trong c th. Bnh nhn c t nm trn bn bnh nhn. Chuyn ng ca bn bnh nhn do my tnh iu khin, chnh xc ln n 1 mm.

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Cu trc h thng to nh cng hng t

My tnh lm nhim v iu khin tt c c thnh phn trong h thng to nh. Thnh phn RF, di s iu khin ca my tnh, l ngun pht tn s radio v lp trnh xung. Ngun pht RF sinh ra sng hnh sin c tn s mong mun. B lp trnh xung nh hnh xung RF thnh cc xung mong mun. B khuch i RF khuch i cng sut cc xung t mmW ln kW. My tnh cng iu khin b lp trnh xung gradient. B ny thit lp hnh dng v bin ca tng trng gradient. B khuch i gradient khuch i cng sut ca xung gradient ln mc li cun gradient.
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Cu trc h thng to nh cng hng t

Mt s h thng to nh c b x l mng, l mt thit b c kh nng thc hin bin i Fourier hai chiu trong thi gian rt ngn. My tnh chuyn php x l ny sang thit b ny. Ngi iu khin h thng to nh a u vo vo my tnh qua mt bng iu khin. Ngi iu khin c th nhn thy cc nh trn mn hnh video cnh bng iu khin hoc c th lu nh ln phim.

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Nam chm
L thnh phn t nht trong h thng. Nam chm siu dn: Phn ln cc h thng s dng nam chm siu dn.

To ra t trng mnh (1 n 4 T), ng u cao. L mt nam chm in s dng vt liu siu dn (khi nhit h thp n 1 gi tr nht nh th khng cn tr khng i vi dng in). Dy dn hp kim t trong mi trng nhit thp (khong 100K). To ra v duy tr bng cht heli ho lng. Cu to phc tp. Chi ph vn hnh cao.

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Nam chm
Nam chm in: gm dy dn in qun anh li bng vt liu t tnh (st/ thp). Ngoi tr khng ca dy, khi dng in truyn qua cht dn to t trng, nhit cng c sinh ra. iu ny gii hn cng t trng (t ti 0.5T). Cu trc n gin, chim t din tch v khng dng cht lm lnh. Nam chm vnh cu: Khng yu cu cung cp in hoc h thng lm lnh. Tuy nhin ch sinh ra cng t trng tng i thp, v thay i theo nhit , trng lng ln.

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Nam chm

Cc loi nam chm dng trong CHT

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Cun gradient
To gradient trong t trng B0 . Vn hnh nhit phng.

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Cun gradient

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Cun RF
To trng B1 lm quay vector t ho trong mt chui xung, ng thi pht hin vector t ho ngang khi n chuyn ng tin ng trong mt phng XY. c chia lm 3 loi:

Cun pht v thu Cun ch thu Cun ch pht.

Cun RF phi cng hng, hoc tr nng lng tn s Lamor. Tt c cc cun to nh u gm cc thnh phn cun dy v cc thnh phn t in.

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Thu nhn v ti to nh

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Gii thiu chung

Trong qu trnh to nh, c th bnh nhn c chia thnh cc lt ct. Mi lt ct c chia thnh cc hng v ct, to thnh mt ma trn cc voxel. Tn hiu t mi voxel cn c tch bit khi cc voxel khc v cng ca n c hin th tng ng vi cc pixel trn nh. Qu trnh xy ra theo 2 pha: pha th nht l thu nhn tn hiu, pha th hai l ti to tn hiu.

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Thu nhn tn hiu

Cc tn hiu RF c pht ra t m v c cun RF thu nhn. Cc d liu thu nhn c c lu trong b nh my tnh. Cc d liu ny c c trng bi tn s v pha. D liu c nh v trong khng gian k, sau ny c chuyn thnh khng gian nh.

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Ti to nh
L mt qu trnh ton hc c thc hin bng my tnh. Thng nhanh hn qu trnh thu nhn nh.

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Gradient
Gradient t trng biu th thay i ca t trng theo v tr. Khi cun gradient khng c bt ln, t trng i qua c th ngi l t trng ng nht. Khi cun gradient c bt ln, cng t trng thay i. Cun gradient cha 3 cp cun gradient ring l. Chng c nh hng sao cho cc gradient ny c to ra theo ba hng trc giao X, Y, Z.

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Gradient

Ba gradient trc giao trong h thng MRI

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Gradient
Mt gradient trong mt hng c dng to ra cc lt ct, v cc gradient trong cc hng khc s chia lt ct thnh cc hng v ct. C hai phng thc to lt ct:

Kch thch la chn to lt ct trong pha thu nhn nh. Thu nhn tn hiu t mt khi m ln v to ra cc lt ct trong qu trnh ti to nh. Khi mt gradient hng dc theo trc bnh nhn, mi lt ct m nm trong mt cng t trng khc nhau v c tn s cng hng khc nhau. Gradient la chn lt ct xut hin bt c khi no xung RF c a vo c th.

Kch thch la chn:

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Gradient

Do cc xung RF c cc tn s trong mt phm vi gii hn nn chng ch c th kch thch m ch trong mt lt ct c th. B dy lt ct c xc nh bi: (1) cng , hoc dc ca gradient, (2) di thng trong xung RF

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Gradient

To nh a lt ct:
u im: tp cc lt ct c thu nhn trong cng mt lc nh

mt lt ct n. Nhc im: s lt ct b hn ch v khng th to ra cc lt ct lin k mng

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Gradient
Thu nhn khi:

Khng xut hin gradient khi xung RF c a vo m, m t mt gradient m ho pha trong hng la chn lt ct. Ti mi ln t gradient, ton b chu k to nh cn c thc hin. V vy lm tng tng thi gian thu nhn nh. u im: to ra cc lt ct mng hn v gn nhau hn so vi qu trnh kch thch la chn.

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Gradient

So snh (A) qu trnh thu nhn khi v (B) kch thch la chn
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M ho tn s
c trng c bn ca tn hiu RF l tn s. 1 Hz = 1 dao ng trong 1 giy. M ho tn s: Trm pht pht ra cc tn s khc nhau. Trm thu chn v phn tch ra ng tn s m mnh cn. Qu trnh m ho tn s c dng lm cho cc voxel to ra cc tn hiu khc nhau. Cc tn hiu RF c to ra ch khi c s t ho ngang. Vector t ho ngang quay xung quanh trc ca t trng. Khi vector t ho quay vi tc hng triu vng/ giy th s to ra 1 tn hiu RF.

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M ho tn s

To ra tn hiu RF

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M ho tn s
Tn s cng hng:

Tn s tn hiu RF c xc nh bng tc quay ca vector t ho ngang. Khi s dng gradient m ho tn s, mi voxel c nh v trong mt cng t trng khc nhau v cng hng ti mt tn s khc nhau. Cc tn hiu t tt c cc voxel c to ra ng thi v c pht ra t c th, trn ln vi nhau v hnh thnh nn tn hiu hn hp. Cc tn hiu ring l s c phn tch sau ny bng qu trnh ti to.

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M ho tn s

S dng gradient m ho tn s tn hiu

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M ho pha
Pha l mi lin h gia tn hiu ny vi tn hiu khc.

(A) Lch pha (B) Lch tn s

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M ho pha
S khc pha gia tn hiu t voxel ny so vi tn hiu t voxel khc c dng phn bit cc tn hiu. S lch pha sinh ra do s thay i tm thi tc quay ca vector t ho ca voxel ny so vi voxel khc. iu ny xy ra khi hai voxel nm trong t trng c cng khc nhau, thc hin bng cch dng gradient.

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Ti to nh
L qu trnh x l ton hc c thc hin bng my tnh chuyn i cc tn hiu thu c thnh mt nh thc t. Phng thc c dng ph bin nht l bin i Fourier. Bin i Fourier cho php sp xp mt tn hiu tng hp thnh cc thnh phn tn s v pha ring l. Mi voxel trong mt hng pht ra mt tn s khc nhau, bin i Fourier c th xc nh v tr mi thnh phn tn hiu v hng n vo pixel tng ng.

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Nhiu nh
Nhiu nh l bt c c tnh no xut hin trn nh m khng thc s c trn i tng. Nhiu do b pht hin RF:

Do s khng tng xng gia hai knh thc v o ca b pht hin RF. Khi xy ra li ny, bin i Fourier c th c mt thnh phn tn s m nh ca bt c tn s no xut hin trong tn hiu.

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Nhiu nh
Nhiu RF:

V bc RF ngn cc nhiu t bn ngoi i vo b pht hin b hng. Dng nhiu ph thuc vo ngun nhiu.

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Nhiu nh
B0 khng ng nht:

Gy mo nh. C th mo v khng gian hoc cng , hoc c hai.

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Nhiu nh
Gradient: Gradient thay i theo hng s lm mo nh. Thng xy ra khi cun gradient b hng, hoc dng qua cun gradient thay i bt thng.

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Nhiu nh
Tnh nhy: Nhiu nhy sinh ra bi s hin din ca mt vt th trong trng quan st. Khi t trong t trng, vt liu nghch t c trng nh hn mt cht so vi chn khng, trong khi vt liu thun t c trng ln hn mt cht. St t c trng rt ln.

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RF khng ng nht: s hin din mt thay i khng mong mun trong cng tn hiu ch trong cun nhn.

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68