Direct comparison of 3D spiral vs. Cartesian gradient-echo coronary magnetic resonance angiography.

While 3D thin-slab coronary magnetic resonance angiography (MRA) has traditionally been performed using a Cartesian acquisition scheme, spiral k-space data acquisition offers several potential advantages. However, these strategies have not been directly compared in the same subjects using similar methodologies. Thus, in the present study a comparison was made between 3D coronary MRA using Cartesian segmented k-space gradient-echo and spiral k-space data acquisition schemes. In both approaches the same spatial resolution was used and data were acquired during free breathing using navigator gating and prospective slice tracking. Magnetization preparation (T(2) preparation and fat suppression) was applied to increase the contrast. For spiral imaging two different examinations were performed, using one or two spiral interleaves, during each R-R interval. Spiral acquisitions were found to be superior to the Cartesian scheme with respect to the signal-to-noise ratio (SNR) and contrast-to-noise-ratio (CNR) (both P < 0.001) and image quality. The single spiral per R-R interval acquisition had the same total scan duration as the Cartesian acquisition, but the single spiral had the best image quality and a 2.6-fold increase in SNR. The double-interleaf spiral approach showed a 50% reduction in scanning time, a 1.8-fold increase in SNR, and similar image quality when compared to the standard Cartesian approach. Spiral 3D coronary MRA appears to be preferable to the Cartesian scheme. The increase in SNR may be "traded" for either shorter scanning times using multiple consecutive spiral interleaves, or for enhanced spatial resolution.     

3D magnetization-prepared true-FISP: a new technique for imaging coronary arteries.

The purpose of this work was to develop an ECG-triggered, segmented 3D true-FISP (fast imaging with steady-state precession) technique to improve the signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) of breath-hold coronary artery imaging. The major task was to optimize an appropriate magnetization preparation scheme to permit saturation of the epicardial fat signal. An alpha/2 preparation pulse was used to speed up the approach to steady-state following a frequency-selective fat-saturation pulse in each heartbeat. The application of dummy cycles was found to reduce the oscillation of the magnetization during data acquisition. The fat saturation and magnetization preparation scheme was validated with simulations and phantom studies. Volunteer studies demonstrated substantially increased SNR (55%) and CNR (178%) for coronary arteries compared to FLASH (fast low-angle shot) with the same imaging time. In conclusion, true-FISP is a promising technique for coronary artery imaging.     

Two-dimensional multishot echo-planar coronary MR angiography

This work presents a two-dimensional (2D) multishot echo-planar imaging (EPI) technique for magnetic resonance angiography (MRA) of individual coronary arteries in a 17-heart-beat breath-hold. Conventional 2D and 3D segmented gradient-echo (GRE) coronary MRA requires repetitive excitation of the same slice or slab within each cardiac cycle, which can result in reduced blood signal and in motion artifacts. Two-dimensional multishot EPI can address these limitations by eliminating multiple excitations per cardiac cycle, using large flip-angle excitations, markedly reducing the data acquisition window, and performing oblique multislice 2D imaging. The goal of this study was to assess the feasibility of breath-hold 20 multishot EPI for multislice coronary MRA and to demonstrate its reliability by consistently acquiring high-quality images of the coronary arteries in a series of 16 volunteers.     

Cervical spondylosis: contrast-enhanced magnetization transfer prepulsed 3D turbo field echo MR imaging

Magnetic resonance (MR) imaging of the cervical spine with axial, low flip angle three-dimensional (3D) gradient-echo sequences is limited by long acquisition times and also by increased sensitivity to extrinsic and intrinsic magnetic field inhomogeneity, magnetic susceptibility differences, chemical shifts, and cerebrospinal fluid pulsatility. We attempted to assess the performance of gadolinium-enhanced, magnetization transfer (MT) prepulsed 3D fast gradient-echo sequences in demonstrating spondylotic changes of the cervical spine. Twenty patients with known cervical spine spondylosis were prospectively imaged in the axial plane using two gradient-echo-based MR techniques: 3D fast field echo (FFE) and gadolinium-enhanced, MT prepulsed, segmented turbo field echo (TFE). An average of 58 neural foramina on the 3D FFE images and 47 neural foramina on the contrast-enhanced TFE images were judged to be narrowed. The degree of neural foraminal narrowing was significantly less on the contrast-enhanced TFE images compared with the FFE images (P <0.001). Contrast-enhanced, MT prepulsed, segmented 3D TFE MR imaging has potential for ameliorating some of the limitations encountered in the more widely used gradient-echo techniques.     

Continuously moving table 3D MRI with lateral frequency-encoding direction.

A method is presented for 3D MRI in an extended field of view (FOV) based on continuous motion of the patient table and an efficient acquisition scheme. A gradient-echo MR pulse sequence is applied with lateral (left-right (L/R)) frequency-encoding direction and slab selection along the direction of motion. Compensation for the table motion is achieved by a combination of slab tracking and data alignment in hybrid space. The method allows fast k-space coverage to be achieved, especially when a short sampling FOV is chosen along the direction of table motion, as is desirable for good image quality. The method can be incorporated into different acquisitions schemes, including segmented k-space scanning, which allows for contrast variation with the use of magnetization preparation. Head-to-toe images of volunteers were obtained with good quality using 3D spoiled gradient-echo sequences. As an example of magnetization-prepared imaging, fat/water separated images were acquired using chemical shift selective (CHESS) presaturation pulses.     

Feasibility and performance of breath-hold 3D true-FISP coronary MRA using self-calibrating parallel acquisition.

Spatial resolution in 3D breath-hold coronary MR angiography (MRA) is limited by imaging time. The purpose of this work was to investigate the feasibility of improving the spatial resolution of coronary MRA using generalized autocalibrating partially parallel acquisition (GRAPPA) and fast imaging with steady state precession (True-FISP) data acquisition. Coronary data were acquired in 10 healthy volunteers. In five volunteers, the data were fully acquired in k-space and decimated for GRAPPA with an outer reduction factor (ORF) of 2. The coil calibration in GRAPPA was improved by segmented least-squares fitting along the frequency-encoding direction. More than 5% of the total k-space lines were required for the calibration to achieve acceptable artifact suppression despite slightly lower signal-to-noise ratio (SNR). In another five volunteers, coronary data were obtained with both conventional and accelerated data acquisitions in the same imaging time. GRAPPA allowed a submillimeter in-plane resolution, and improved coronary artery definition with an acceptable loss of SNR. In conclusion, 3D breath-hold coronary MRA by GRAPPA and True-FISP is highly feasible.     

Optimization of parameter values for complex pulse sequences by simulated annealing: Application to 3D MP-RAGE imaging of the brain

A number of pulse sequence techniques, including magnetization-prepared gradient echo (MP-GRE), segmented GRE, and hybrid RARE, employ a relatively large number of variable pulse sequence parameters and acquire the image data during a transient signal evolution. These sequences have recently been proposed and/or used for clinical applications in the brain, spine, liver, and coronary arteries. Thus, the need for a method of deriving optimal pulse sequence parameter values for this class of sequences now exists. Due to the complexity of these sequences, conventional optimization approaches, such as applying differential calculus to signal difference equations, are inadequate. We have developed a general framework for adapting the simulated annealing algorithm to pulse sequence parameter value optimization, and applied this framework to the specific case of optimizing the white matter-gray matter signal difference for a T₁-weighted variable flip angle 3D MP-RAGE sequence. Using our algorithm, the values of 35 sequence parameters, including the magnetization-preparation RF pulse flip angle and delay time, 32 flip angles in the variable flip angle gradient-echo acquisition sequence, and the magnetization recovery time, were derived. Optimized 3D MP-RAGE achieved up to a 130% increase in white matter-gray matter signal difference compared with optimized 3D RF-spoiled FLASH with the same total acquisition time. The simulated annealing approach was effective at deriving optimal parameter values for a specific 3D MP-RAGE imaging objective, and may be useful for other imaging objectives and sequences in this general class.     

Whole-heart cine MRI using real-time respiratory self-gating.

Two-dimensional (2D) breath-hold cine MRI is used to assess cardiac anatomy and function. However, this technique requires cooperation from the patient, and in some cases the scan planning is complicated. Isotropic nonangulated three-dimensional (3D) cardiac MR can overcome some of these problems because it requires minimal planning and can be reformatted in any plane. However, current methods, even those that use undersampling techniques, involve breath-holding for periods that are too long for many patients. Free-breathing respiratory gating sequences represent a possible solution for realizing 3D cine imaging. A real-time respiratory self-gating technique for whole-heart cine MRI is presented. The technique enables assessment of cardiac anatomy and function with minimum planning or patient cooperation. Nonangulated isotropic 3D data were acquired from five healthy volunteers and then reformatted into 2D clinical views. The respiratory self-gating technique is shown to improve image quality in free-breathing scanning. In addition, ventricular volumetric data obtained using the 3D approach were comparable to those acquired with the conventional multislice 2D approach.     

Magnetic resonance imaging of the coronary vessel wall at 3 T using an obliquely oriented reinversion slab with adiabatic pulses.

Three-dimensional methods offer volumetric coverage in coronary vessel wall imaging, in addition to high signal-to-noise ratios (SNR). To increase SNR further, it is desirable to implement such 3D methods at 3 T. At this field strength, the pulse sequence must be robust to main field and RF inhomogeneities. To achieve this, the double inversion-recovery (DIR) preparation was adapted to use adiabatic pulses, with a slab-selective reinversion replacing the previously used 2D pencil-beam. The slab was oriented obliquely, in order to avoid upstream blood (e.g., left ventricle) or the navigator beam. Phantom experiments suggest that at 3 T, this approach improves both the net profile of the DIR pulse pair and the restoration of magnetization in the navigator region. Using this method, the feasibility of 3D coronary vessel wall imaging was demonstrated at 3 T. Fourteen healthy subjects were scanned using a segmented gradient-echo sequence with prospective navigator gating. Good-quality images of left and right coronary arteries were obtained, with SNR values of 29.7 +/- 7.5 (vessel wall); 10.5 +/- 4.4 (blood); 14.3 +/- 5.2 (fat); and 45.6 +/- 18.0 (myocardium). No problems occurred with ECG-gating or power deposition (SAR) limits.     

Reduction of transient signal oscillations in true-FISP using a linear flip angle series magnetization preparation.

An electrocardiogram (ECG)-triggered, magnetization-prepared, segmented, 3D true fast imaging with steady-state precession (true-FISP) sequence with fat saturation was recently proposed for coronary artery imaging. A magnetization preparation scheme consisting of an alpha/2 radiofrequency (RF) pulse followed by 20 constant flip angle dummy RF cycles was used to reduce signal oscillations in the approach to steady state. However, if large resonance offsets on the order of 70-100 Hz are present, significant magnetization oscillations will still occur during data acquisition, which will result in image ghosting and blurring. The goal of this work was to validate that a linear flip angle (LFA) series can be used during magnetization preparation to reduce these image artifacts. Computer simulations, phantom studies, and coronary artery imaging in healthy volunteers were performed to compare this magnetization preparation scheme with that of an alpha/2 pulse followed by constant flip angle dummy RF cycles. The results demonstrated substantial reduction in the apparent image artifacts when using linearly increasing flip angles during magnetization preparation.     

Lung MRI using an MR-compatible active breathing control (MR-ABC).

This work introduces an MR-compatible active breathing control device (MR-ABC) that can be applied to lung imaging. An MR-ABC consists of a pneumotachograph for respiratory monitoring and an airway-sealing unit. Using an MR-ABC, the subjects were forced to suspend breathing for short time intervals, which were used in turn for data acquisition. While the breathing flow was stopped, data acquisition was triggered by ECG to achieve simultaneous cardiac and respiratory synchronization and thus avoid artifacts from blood flow or heart movement. The flow stoppage allowed a prolonged acquisition window of up to 1.5 sec. To evaluate the potential of an MR-ABC for segmented k-space acquisition, diaphragm displacement was investigated in five volunteers and compared with images acquired using breath-holding, a respiratory belt, and free breathing. Respiratory movement was comparatively low using the breath-hold approach, a respiratory belt or an MR-ABC. During free-breathing diaphragm displacement was comparatively large. To demonstrate the potential of an MR-ABC, lung MRI was performed using whole-chest 3D gradient-echo imaging, multislice turbo spin-echo (TSE) imaging, and short tau inversion recovery TSE (STIR-TSE). Cardiorespiratory synchronization was used for each sequence. None of the volunteers reported any discomfort or inconvenience when using an MR-ABC. Flow stoppage of up to 2.5 sec per breathing cycle was well tolerated, therefore allowing for a reduction of the total imaging time as compared to usage of a respiratory belt or MR navigator.     

Coronary artery imaging at 0.5 t using segmented 3d echo planar imaging

The application of segmented 3D gradient echo EPI at 0.5 T for coronary artery imaging is described. Experiments were performed using fat suppression, ECG triggering, and a patient-controlled breath-holding scheme. This approach provides a sufficient signal-to-noise ratio for thin contiguous slices in conjunction with a phased array cardiac receive coil. Wide 3D volumes, covering the proximal branches of the coronary tree, were measured with a high spatial resolution. Such data sets can be used for subsequent vessel segmentation. Furthermore, data out of narrow 3D volumes were obtained containing fewer slices angulated in the direction of a selected coronary artery. This provides a good visualization of the selected vessel over several centimeters without the need for segmentation.     

Independent phase modulation for efficient dual-band 3D imaging.

Certain applications of MRI, such as bilateral breast imaging, require simultaneous imaging of multiple volumes. Although image data can be acquired sequentially, the SNR is often improved if both slabs are excited and imaged together, typically with phase encoding across a volume including both slabs and the space between them. The use of independent phase modulation of multiple slabs eliminates the need to encode empty space between slabs, which can result in a significant time reduction. Each slab is excited with a phase proportional to phase-encode number such that the slab positions in the acquired data are shifted to reduce empty space. With careful consideration this technique is compatible with different pulse sequences (e.g., spin-echo, gradient-echo, RF spoiling, and balanced SSFP (bSSFP)) and acceleration strategies (e.g., partial k-space and parallel imaging). This technique was demonstrated in phantoms and applied to bilateral breast imaging, where scan times were reduced by 20-30%.     

Assessment of regional differences in myocardial blood flow using T2-weighted 3D BOLD imaging.

The feasibility of detecting regional differences in myocardial blood flow based on the blood oxygen level-dependent (BOLD) effect was evaluated in vivo in dogs (N = 9) using a 3D T2-prepared segmented gradient-echo sequence at 1.5 T. Regional differences in myocardial blood flow were created by administering adenosine through a catheter placed in the left circumflex coronary artery (LCX). The difference in the R2 (1/T2) relaxation rate between the left ventricular myocardial region supplied by the LCX and regions supplied by the left anterior descending coronary artery (LAD) or septal artery during adenosine administration was correlated to the corresponding regional myocardial blood flow difference determined using fluorescent microspheres. A correlation coefficient of 0.80 was found between the MR BOLD measurements and the myocardial flow assessment. Our results show that the sequence used in this study allows fast 3D BOLD imaging of the heart, and is a promising technique for detecting regional myocardial perfusion differences.     

Centric phase-encoding order in three-dimensional MP-RAGE sequences: application to abdominal imaging.

Three-dimensional (3D) magnetization-prepared rapid gradient-echo imaging has been proposed as a method for improving signal-to-noise ratio (S/N) and contrast-to-noise ratio (C/N) in rapid abdominal imaging. Originally, a standard sequential phase-encoding order was proposed. In the present study, two approaches to a 3D centric phase-encoding order are presented: (a) application of the two-dimensional (2D) centric order to one of the 3D encoding directions, and (b) an interleaved square spiral order, which is the segmented 3D analog of the 2D centric order. With use of simulation, phantom, and volunteer results, the proposed 3D centric methods are compared in terms of S/N, C/N, and artifacts to the 3D sequential method and 2D magnetization-prepared methods. The second centric approach was found to be superior to the first; however, in general, the 3D technique was found to be inferior to the 2D technique for abdominal imaging because of motion artifact in the 3D image set caused by misregistration among the multiple breath holds required.     

Ultrafast imaging: Principles,pitfalls, solutions,and applications

Ultrafast MRI refers to efficient scan techniques that use a high percentage of the scan time for data acquisition. Often, they are used to achieve short scan duration ranging from sub‐second to several seconds. Alternatively, they may form basic components of longer scans that may be more robust or have higher image quality. Several important applications use ultrafast imaging, including real‐time dynamic imaging, myocardial perfusion imaging, high‐resolution coronary imaging, functional neuroimaging, diffusion imaging, and whole‐body scanning. Over the years, echo‐planar imaging (EPI) and spiral imaging have been the main ultrafast techniques, and they will be the focus of the review. In practice, there are important challenges with these techniques, as it is easy to push imaging speed too far, resulting in images of a nondiagnostic quality. Thus, it is important to understand and balance the trade‐off between speed and image quality. The purpose of this review is to describe how ultrafast imaging works, the potential pitfalls, current solutions to overcome the challenges, and the key applications. J. Magn. Reson. Imaging 2010;32:252–266. © 2010 Wiley‐Liss, Inc.     

Contrast-enhanced coronary artery imaging using 3D trueFISP.

An ECG-triggered, segmented, magnetization-prepared, 3D, trueFISP sequence was recently developed for coronary artery imaging. Fat saturation was achieved by a chemically selective fat saturation pulse, which is susceptible to field inhomogeneities. In addition, the blood-myocardial contrast was compromised because data were acquired during signal transience to steady state. The goals of this work were to investigate the potential benefits of T(1)-shortening agents in improving blood-myocardial contrast, and to develop a technique to make fat suppression robust to resonance offsets for coronary artery imaging using trueFISP. A magnetization-preparation scheme using saturation and inversion pulses was developed for simultaneous suppression of tissues over a wide range of T(1)'s, including myocardium and fat. An additional advantage of this method is that it is insensitive to heart rate variations. Computer simulations were used to design the magnetization preparation, and volunteer studies were performed to compare precontrast imaging to contrast-enhanced (CE) imaging. Results showed consistent fat suppression and a 78% increase in the blood-myocardial contrast-to-noise ratio (CNR) for postcontrast imaging over precontrast imaging. In conclusion, contrast agents are useful for trueFISP coronary artery imaging.     

High resolution diffusion‐weighted imaging using readout‐segmented echo‐planar imaging,parallel imaging and a two‐dimensional navigator‐based reacquisition

Single‐shot echo‐planar imaging (EPI) is well established as the method of choice for clinical, diffusion‐weighted imaging with MRI because of its low sensitivity to the motion‐induced phase errors that occur during diffusion sensitization of the MR signal. However, the method is prone to artifacts due to susceptibility changes at tissue interfaces and has a limited spatial resolution. The introduction of parallel imaging techniques, such as GRAPPA (GeneRalized Autocalibrating Partially Parallel Acquisitions), has reduced these problems, but there are still significant limitations, particularly at higher field strengths, such as 3 Tesla (T), which are increasingly being used for routine clinical imaging. This study describes how the combination of readout‐segmented EPI and parallel imaging can be used to address these issues by generating high‐resolution, diffusion‐weighted images at 1.5T and 3T with a significant reduction in susceptibility artifact compared with the single‐shot case. The technique uses data from a 2D navigator acquisition to perform a nonlinear phase correction and to control the real‐time reacquisition of unusable data that cannot be corrected. Measurements on healthy volunteers demonstrate that this approach provides a robust correction for motion‐induced phase artifact and allows scan times that are suitable for routine clinical application. Magn Reson Med, 2009. © 2009 Wiley‐Liss, Inc.     

Accelerated coronary MRA by simultaneous acquisition of multiple 3D stacks

The implementation and first in vivo results of a novel coronary magnetic resonance angiography (MRA) protocol allowing simultaneous acquisition of multiple geometrically independent 3D imaging stacks are presented. Each imaging stack is acquired in a separate cardiac phase using an individual magnetization preparation and navigator-based gating and prospective motion correction. Each stack covers one of the main coronary vessels. Thus, an improvement of scan efficiency was achieved, which was used in this study to reduce total scan time at standard image quality. Experiments performed in healthy volunteers and in patients using a two-stack approach yielded a total scan time reduction of 50% with an image quality equivalent to standard single-stack coronary MRA.