Comparison of three accelerated pulse sequences for semiquantitative myocardial perfusion imaging using sensitivity encoding incorporating temporal filtering (TSENSE)

PURPOSE: To investigate the parallel acquisition technique sensitivity encoding incorporating temporal filtering (TSENSE) with three saturation-recovery (SR) prepared pulse sequences (SR turbo fast low-angle shot [SR-TurboFLASH], SR true fast imaging with steady precession [SR-TrueFISP], and SR-prepared segmented echo-planar-imaging [SR-segEPI]) for semiquantitative first-pass myocardial perfusion imaging. MATERIALS AND METHODS: In blood- and tissue-equivalent phantoms the relationship between signal intensity (SI) and contrast-medium concentration was evaluated for the three pulse sequences. In volunteers, signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), and normalized upslopes (NUS) were calculated from signal-time curves (STC). Moreover, artifacts, image noise, and overall image quality were qualitatively evaluated. RESULTS: Phantom data showed a 40% increased linear range of the relation between SI and contrast-medium concentration with TSENSE. In volunteers, TSENSE introduced significantly residual artifacts and loss in SNR and CNR. No differences were found for NUS values with TSENSE. SR-TrueFISP yielded highest SNR, CNR, and quality scores. However, in SR-True-FISP images, dark-banding artifacts were most pronounced. NUS values obtained with SR-TrueFISP were significantly higher and with SR-segEPI significantly lower than with SR-TurboFLASH. CONCLUSION: Semiquantitative myocardial perfusion imaging can significantly benefit from TSENSE due to shorter acquisition times and increased linearity of the pulse sequences. Among the three pulse sequences tested, SR-TrueFISP yielded best image quality. SR-segEPI proved to be an interesting alternative due to shorter acquisition times, higher linearity and fewer dark-banding artifacts.     

Dynamic contrast-enhanced myocardial perfusion imaging using saturation-prepared TrueFISP

PURPOSE: To develop and test a saturation-recovery TrueFISP (SR-TrueFISP) pulse sequence for first-pass myocardial perfusion imaging. MATERIALS AND METHODS: First-pass magnetic resonance imaging (MRI) of Gd-DTPA (2 mL) kinetics in the heart was performed using an SR-TrueFISP pulse sequence (TR/TE/alpha = 2.6 msec/1.4 msec/55 degrees ) with saturation preparation TD = 30 msec before the TrueFISP readout. Measurements were also performed with a conventional saturation-recovery TurboFLASH (SRTF) pulse sequence for comparison. RESULTS: SR-TrueFISP images were of excellent quality and demonstrated contrast agent wash-in more clearly than SRTF images. The signal increase in myocardium was higher in SR-TrueFISP than in SRTF data. Precontrast SNR and peak CNR were not significantly different between both sequences despite 57% improved spatial resolution for SR-TrueFISP. CONCLUSION: SR-TrueFISP first-pass MRI of myocardial perfusion leads to a substantial improvement of image quality and spatial resolution. It is well suited for first-pass myocardial perfusion studies at cardiovascular MR systems with improved gradient hardware.     

Steady-state free precession sequences in myocardial first-pass perfusion MR imaging: comparison with TurboFLASH imaging

The aim of this study was to compare the image quality of a saturation-recovery gradient-recalled echo (GRE; TurboFLASH) and a saturation-recovery SSFP (SR-TrueFISP) sequence for myocardial first-pass perfusion MRI. Eight patients with chronic myocardial infarction and 8 volunteers were examined with a TurboFLASH (TR 2.1 ms, TE 1 ms, FA 8°) and a SR-TrueFISP sequence (TR 2.1 ms, TE 0.9 ms, FA, 50°) on a 1.5 T scanner. During injection of 0.05 mmol/kg BW Gd-DTPA at 4 ml/s, three short axis slices (8 mm) of the left ventricle (LV) were simultaneously scanned during breath-hold. Maximum signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR) between infarcted and normal myocardium, and percentage signal intensity change (PSIC) were measured within the LV lumen and in four regions of the LV myocardium for the three slices separately. For the LV lumen, SR-TrueFISP was superior in SNR and PSIC (factor 3.2 and 1.6, respectively). Mean maximum SNR, PSIC, and CNR during peak enhancement in the LV myocardium were higher for SR-TrueFISP compared with TurboFLASH (factor 2.4, 1.25, and 1.24, respectively). The SNR was higher in the septal portion of the ventricle than in anterior/posterior and lateral regions. The SR-TrueFISP provides higher SNR and improves image quality compared with TurboFLASH in first-pass myocardial perfusion MRI.     

Quantitative myocardial perfusion imaging using different autocalibrated parallel acquisition techniques

PURPOSE: To compare three different autocalibrated parallel acquisition techniques (PAT) for quantitative and semiquantitative myocardial perfusion imaging. MATERIALS AND METHODS: Seven healthy volunteers underwent myocardial first-pass perfusion imaging at rest using an SR-TrueFISP pulse sequence without PAT and while using GRAPPA, mSENSE, and TSENSE. signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), normalized upslopes (NUS), and myocardial blood flow (MBF) were calculated. Artifacts, image noise, and overall image quality were qualitatively assessed. Furthermore, the relation between signal intensity (SI) and contrast medium (CM) concentration was determined in phantoms. RESULTS: Using PAT the linear range of the SR-TrueFISP sequence was increased about 40%. All three PAT methods introduced significant loss in SNR and CNR. GRAPPA yielded slightly better values then mSENSE and TSENSE. Both SENSE techniques introduced significantly residual aliasing artifacts. Image noise was increased with all three PAT methods. However, overall image quality was reduced only with mSENSE. Even though GRAPPA yielded smaller NUS values than non-PAT, mSENSE, and TSENSE, no differences were found in MBF between all applied techniques. CONCLUSION: Quantitative and semiquantitative myocardial perfusion imaging can benefit from PAT due to shorter acquisition times and increased linearity of the pulse sequence. GRAPPA and TSENSE turned out to be well suited for quantitative myocardial perfusion imaging.     

Multislice first-pass myocardial perfusion imaging: Comparison of saturation recovery (SR)-TrueFISP-two-dimensional (2D) and SR-TurboFLASH-2D pulse sequences

PURPOSE: To compare signal-to-noise ratio (SNR), contrast-to-noise (CNR) ratio, and diagnostic accuracy of a newly developed saturation recovery (SR)-TrueFISP-two-dimensional (2D) sequence with an SR-TurboFLASH-2D sequence. MATERIALS AND METHODS: In seven healthy subjects and nine patients with coronary artery disease (CAD), contrast-enhanced perfusion imaging (with Gd-DTPA) was performed with SR-TrueFISP and SR-TurboFLASH sequences. Hypoperfused areas were assessed qualitatively (scale = 0-4). Furthermore, SNR and CNR were calculated and semiquantitative perfusion parameters were determined from signal intensity (SI) time curves. Standard of reference for patient studies was single-photon emission computer tomography (SPECT) and angiography. RESULTS: The perception of perfusion deficits was superior in TrueFISP images (2.6 +/- 1.0) than in TurboFLASH (1.4 +/- 0.6) (P < 0.001). Phantom measurements yielded increased SNR (143 +/- 34%) and CNR (158 +/- 64%) values for TrueFISP. In patient/volunteer studies SNR was 61% to 100% higher and signal enhancement was 110% to 115% higher with TrueFISP than with TurboFLASH. Qualitative and semiquantitative assessment of perfusion defects yielded higher sensitivities for detection of perfusion defects with TrueFISP (68% to 78%) than with TurboFLASH (44% to 59%). CONCLUSION: SR-TrueFISP-2D perfusion imaging provides superior SNR and CNR than TurboFLASH imaging. Moreover, the dynamic range of SIs was found to be higher with TrueFISP, resulting in an increased sensitivity for detection of perfusion defects.     

3-Tesla MRI for the evaluation of myocardial viability: a comparative study with 1.5-Tesla MRI

PURPOSE: We compared 3-Tesla (3-T) and 1.5-Tesla (1.5-T) cardiac magnetic resonance imaging (MRI) for the assessment of myocardial viability in nearly identical experimental conditions. MATERIALS AND METHODS: Thirty-five patients (mean age 63+/-11; 94.2% men) submitted to primary coronary angioplasty underwent both 3-T and 1.5-T cardiac MRI, which was considered the gold standard. Comparison was performed on the basis of the same viability imaging protocol, which included resting cine-MR [balanced fast-field echo (B-FFE) sequence] followed by contrast-enhanced MR to evaluate perfusion and delayed enhancement (DE). We then performed functional index measurements and visual estimation of kinesis, perfusion and DE referring to a 5-point scale. Image quality was assessed on the basis of signal to noise ratio (SNR) and contrast to noise ratio (CNR). RESULTS: We found nonsignificant differences between the two scanners (P=NS) in measuring the functional and viability parameters. Myocardial SNR was significantly higher with 3-T MRI compared with 1.5-T MRI (61.3% gain). Even though a loss of CNR was recorded in B-FFE and in first-pass perfusion sequences (12.4% and 23.7%, respectively), on DE images, we quantified the increase of SNR and CNR of infarction of 387.8% and 330%, respectively. CONCLUSIONS: We found that 3-T MRI showed high concordance with 1.5-T MRI in the evaluation of functional and viability parameters and provided better evidence of damaged myocardium.     

Myocardial first pass perfusion imaging with gadobutrol: impact of parallel imaging algorithms on image quality and signal behavior

OBJECTIVE: To implement parallel imaging algorithms in fast gradient recalled echo sequences for myocardial perfusion imaging and evaluate image quality, signal-to-noise ratio (SNR), contrast-enhancement ratio (CER), and semiquantitative perfusion parameters. MATERIALS AND METHODS: In 20 volunteers, myocardial perfusion imaging with gadobutrol was performed at rest using an accelerated TurboFLASH sequence (TR 2.3 milliseconds, TE 0.93 milliseconds, flip angle [FA] 15 degrees) with GRAPPA, R=2. A nonaccelerated TurboFLASH sequence with similar scan parameters served as standard of reference. Artifacts were assessed qualitatively. SNR, CER, and CNR were calculated and semiquantitative perfusion parameters were determined from fitted SI-time curves. RESULTS: Phantom measurements yielded significant higher SNR for nonaccelerated images (P<0.001). CER was equal; differences in CNR were statistically nonsignificant. The evaluation of semiquantitative perfusion parameters yielded significantly higher peak signal intensities in nonaccelerated images (P<0.001). Differences in maximum upslope were statistically nonsignificant. A qualitative examination of all images for artifacts by 2 board-certified radiologists yielded a significant reduction in dark rim artifacts with GRAPPA, R=2 (P<0.001). CONCLUSIONS: The application of GRAPPA with an acceleration factor of R=2 leads to a significant reduction of dark rim artifacts in fast gradient recalled echo sequences.     

Single-session magnetic resonance coronary angiography and myocardial perfusion imaging using the new blood pool compound B-22956 (gadocoletic acid): initial experience in a porcine model of coronary artery disease

OBJECTIVE: The objective of this study was to evaluate a new blood pool contrast agent, B-22956, for detecting myocardial perfusion abnormality and coronary artery stenosis by magnetic resonance imaging (MRI) in 1 setting. MATERIALS AND METHODS: Coronary artery atherosclerotic stenoses were created in 6 miniswine. Myocardial first-pass perfusion imaging was performed with a bolus injection of 0.015 mmol/kg B-22956 during pharmacologic stress followed by postcontrast coronary artery imaging after another injection of B-22956/1. The total doses for the 6 pigs were 0.1 mmol/kg (n=3) and 0.15 mmol/kg (n=3). Perfusion upslope maps were analyzed and MR coronary artery images were reviewed by 2 readers. RESULTS: For all 6 pigs, the normalized upslopes of the perfusion curves were 0.83+/-0.12, 0.74+/-0.15, and 0.52+/-0.05 (P<0.01 vs. normal) with normal or mild (<50% area stenosis), moderate (<50% and <75%), and severe stenosis (>75%), respectively. Mean signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) in right coronary artery images improved 90% and 200%, respectively, with a total dose of 0.1 mmol/kg of B-22956. Excellent agreements (kappa=0.82) were achieved for evaluating the grade of stenosis between MR postcontrast coronary artery images and histopathology by 2 reviewers. CONCLUSION: The MR blood pool contrast agent B-22956 demonstrated the ability for detecting myocardial perfusion abnormalities and coronary artery stenosis in 1 setting.     

Comprehensive cardiac magnetic resonance imaging at 3.0 Tesla: feasibility and implications for clinical applications

OBJECTIVE: The objective of this study was to examine the applicability of high magnetic field strengths for comprehensive functional and structural cardiac magnetic resonance imaging (MRI). SUBJECTS AND METHODS: Eighteen subjects underwent comprehensive cardiac MRI at 1.5 T and 3.0 T. The following imaging techniques were implemented: double and triple inversion prepared FSE for anatomic imaging, 4 different sets of echocardiographic-gated CINE strategies for functional and flow imaging, inversion prepared gradient echo for delayed enhancement imaging, T1-weighted segmented EPI for perfusion imaging and 2-dimensional (2-D) spiral, and volumetric SSFP for coronary artery imaging. RESULTS:: Use of 3 Tesla as opposed to 1.5 Tesla provided substantial baseline signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) improvements for anatomic (T1-weighted double IR: DeltaSNR = 29%, DeltaCNR = 20%, T2-weighted double IR: DeltaSNR = 39%, DeltaCNR = 33%, triple IR: DeltaSNR = 74%, DeltaCNR = 60%), functional (conventional CINE: DeltaSNR = 123%, DeltaCNR = 74%, accelerated CINE: DeltaSNR = 161%, DeltaCNR = 86%), myocardial tagging (DeltaSNRsystole = 54%, DeltaCNRsystole = 176%), phase contrast flow measurements (DeltaSNR = 79%), viability (DeltaSNR = 48%, DeltaCNR = 40%), perfusion (DeltaSNR = 109%, DeltaCNR = 87%), and breathhold coronary imaging (2-D spiral: DeltaSNRRCA = 54%, DeltaCNRRCA = 69%, 3-D SSFP: DeltaSNRRCA = 60%, DeltaCNRRCA = 126%), but also revealed image quality issues, which were successfully tackled by adiabatic radiofrequency pulses and parallel imaging. CONCLUSIONS: Cardiac MRI at 3.0 T is feasible for the comprehensive assessment of cardiac morphology and function, although SAR limitations and susceptibility effects remain a concern. The need for speed together with the SNR benefit at 3.0 T will motivate further advances in routine cardiac MRI while providing an image-quality advantage over imaging at 1.5 Tesla.     

Assessment of myocardial viability using delayed enhancement magnetic resonance imaging at 3.0 Tesla

OBJECTIVE: Cardiac magnetic resonance imaging (MRI) at 3.0 T has recently become available and potentially provides a significant improvement of tissue contrast in T1-weighted imaging techniques relying on Gd-based contrast enhancement. Imaging at high-field strength may be especially advantageous for methods relying on strong T1-weighting and imaging after contrast material administration. The aim of this study was to compare cardiac delayed enhancement (DE) MRI at 3.0 T and 1.5 T with respect to image quality, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) between infarcted and normal myocardium. MATERIALS AND METHODS: Forty consecutive patients with history of myocardial infarction were examined at 3.0 T (n = 20) or at 1.5 T (n = 20). Myocardial function was assessed using cine steady-state-free-precession (SSFP) sequences (TR 3.1 milliseconds, TE 1.6 milliseconds, flip angle 70 degrees , and a matrix of 168 x 256 at 1.5 T and TR 3.4 milliseconds, TE 1.7 milliseconds, flip angle 50 degrees and a matrix of 168 x 256 at 3.0 T), acquired in long- and short-axes views. DE images were obtained 15 minutes after the administration of 0.15 mmol of Gd-DTPA/kg body weight using a segmented inversion recovery prepared gradient echo sequence at 1.5 T (TR 9.6 milliseconds, TE 4.4 milliseconds, flip angle 25 degrees , matrix 160 x 256, bandwidth 140 Hertz/pixel) and at 3.0 T (TR 9.8 milliseconds, TE 4.3 milliseconds, flip angle 30 degrees , matrix 150 x 256, bandwidth 140 Hertz/pixel). For image analysis, standardized SNR and CNR measurements were performed in infarcted and remote myocardial regions. Two independent observers rated image quality on a 4-point scale (0 = poor image quality, 1 = sufficient image quality, 2 = good image quality, 3 = excellent image quality). RESULTS: High diagnostic image quality was obtained in all patients. Rating of mean image quality was 2.2 +/- 0.8 at 1.5 T and 2.5 +/- 0.6 at 3.0 T (P = 0.012) for observer 1 and 2.2 +/- 0.7 at 1.5 T and 2.6 +/- 0.6 at 3.0 T (P = 0.003) for observer 2, respectively. Interobserver agreement was good (kappa = 0.68 at 1.5 T and 0.78 at 3.0 T). SNR measurements yielded a mean SNR of 37.8 +/- 13.9/22.9 +/- 6.0 in infarcted myocardium (P < 0.001) and 5.6 +/- 2.2/5.9 +/- 2.4 in normal myocardium (P = 0.45) at 3.0 T/1.5 T, respectively. CNR measurements revealed mean values of 32.4 +/- 13.0/16.7 +/- 5.4 (P< 0.001) at 3.0 T/1.5 T, respectively. CONCLUSIONS: Delayed enhancement MRI at 3.0 T is feasible and provides superior image quality compared with 1.5 T. Furthermore, using identical contrast doses, increased SNR and CNR values were recorded at 3.0 T.     

Influence of high magnetic field strengths and parallel acquisition strategies on image quality in cardiac 2D CINE magnetic resonance imaging: comparison of 1.5 T vs. 3.0 T

The aim of this paper is to examine signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR) and image quality of cardiac CINE imaging at 1.5 T and 3.0 T. Twenty volunteers underwent cardiac magnetic resonance imaging (MRI) examinations using a 1.5-T and a 3.0-T scanner. Three different sets of breath-held, electrocardiogram-gated (ECG) CINE imaging techniques were employed, including: (1) unaccelerated SSFP (steady state free precession), (2) accelerated SSFP imaging and (3) gradient-echo-based myocardial tagging. Two-dimensional CINE SSFP at 3.0 T revealed an SNR improvement of 103% and a CNR increase of 19% as compared to the results obtained at 1.5 T. The SNR reduction in accelerated 2D CINE SSFP imaging was larger at 1.5 T (37%) compared to 3.0 T (26%). The mean SNR and CNR increase at 3.0 T obtained for the tagging sequence was 88% and 187%, respectively. At 3.0 T, the duration of the saturation bands persisted throughout the entire cardiac cycle. For comparison, the saturation bands were significantly diminished at 1.5 T during end-diastole. For 2D CINE SSFP imaging, no significant difference in the left ventricular volumetry and in the overall image quality was obtained. For myocardial tagging, image quality was significantly improved at 3.0 T. The SNR reduction in accelerated SSFP imaging was overcompensated by the increase in the baseline SNR at 3.0 T and did not result in any image quality degradation. For cardiac tagging techniques, 3.0 T was highly beneficial, which holds the promise to improve its diagnostic value.     

Myocardial first pass perfusion: steady-state free precession versus spoiled gradient echo and segmented echo planar imaging.

The imaging sequences used in first pass (FP) perfusion to date have important limitations in contrast-to-noise ratio (CNR), temporal and spatial resolution, and myocardial coverage. As a result, controversy exists about optimal imaging strategies for FP myocardial perfusion. Since imaging performance varies from subject to subject, it is difficult to form conclusions without direct comparison of different sequences in the same subject. The purpose of this study was to directly compare the saturation recovery SSFP technique to other more commonly used myocardial first pass perfusion techniques, namely spoiled GRE and segmented EPI. Differences in signal-to-noise ratio (SNR), CNR, relative maximal upslope (RMU) of signal amplitude, and artifacts at comparable temporal and spatial resolution among the three sequences were investigated in computer simulation, contrast agent doped phantoms, and 16 volunteers. The results demonstrate that SSFP perfusion images exhibit an improvement of approximately 77% in SNR and 23% in CNR over spoiled GRE and 85% SNR and 50% CNR over segmented EPI. Mean RMU was similar between SSFP and spoiled GRE, but there was a 58% increase in RMU with SSFP versus segmented EPI.     

Superparamagnetic iron oxide-enhanced liver magnetic resonance imaging: comparison of 1.5 T and 3.0 T imaging for detection of focal malignant liver lesions

OBJECTIVES: We sought to compare the image quality, lesion conspicuity, and the diagnostic performance of 1.5 T and 3.0 T superparamagnetic iron oxide-enhanced liver magnetic resonance imaging (MRI) for detecting focal malignant hepatic lesions. MATERIALS AND METHODS: A total of 35 patients with pathologically proven liver malignancy underwent both 1.5 and 3.0 T SPIO-enhanced MRI. The diagnostic accuracy was evaluated using the alternative-free response receiver operating characteristic method. Image artifacts, quality, and the lesion conspicuity were analyzed. The signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) of the lesion were calculated. RESULTS: No significant difference of area under ROC curve (Az value) was noted. The mean SNR and CNR of the lesions was higher in the 3.0 T sets. There was no difference between the 1.5 T and the 3.0 T image sets for lesion conspicuity, but the image quality was better on 1.5 T. Motion and susceptibility artifacts were more frequent on 3.0 T. CONCLUSION: Diagnostic accuracies of the SPIO-enhanced MRI were equivalent on the 1.5 T and 3.0 T image sets. More prominent artifacts on 3.0 T superparamagnetic iron oxide-enhanced liver MRI counteracted advantage of higher SNR and CNR of 3.0 T.     

Comparison of intracranial 3D-ToF-MRA with and without parallel acquisition techniques at 1.5T and 3.0T: preliminary results

PURPOSE: To evaluate the performance of four 3D-ToF magnetic resonance angiography (MRA) sequences with and without integrated parallel acquisition techniques (iPAT) at 1.5T and 3.0T in imaging intracranial vessels. MATERIAL AND METHODS: Seven volunteers and 5 patients (4 aneurysms, 1 AVM) underwent 3D-ToF-MRA at 1.5T (Magnetom Sonata) and 3.0T (Magnetom Trio) with and without parallel acquisition techniques (iPAT) using similarly designed 8-channel phased-array head coils. Imaging time of the pulse sequences was set to 7.15 and 7.35 min, respectively. Images were analyzed quantitatively by calculating signal-to-noise (SNR) and contrast-to-noise (CNR) ratios of proximal M2 segments and qualitatively by using a 5-point scale. RESULTS: SNR and CNR were significantly higher for both 3D-ToF sequences at 3.0T compared with both pulse sequences at 1.5T. The highest SNR and CNR were obtained at 3.0T without iPAT. However, because of a higher spatial resolution (matrix 512 x 640) visualization of small vessel details was best at 3.0T with iPAT. CONCLUSION: Intracranial 3D-ToF-MRA at 3.0T offers superior image quality compared with 1.5T, particular in the delineation of smaller vessels. In contrast to 1.5T, implementation of iPAT at 3.0T is of additional benefit since the high SNR available at 3.0T allows for higher spatial resolution without prolongation of measurement time.     

Myocardial perfusion imaging with Gadobutrol: a comparison between 3 and 1.5 Tesla with an identical sequence design

OBJECTIVES: To implement myocardial first-pass perfusion imaging at 3 Tesla and to evaluate the potential benefit with regard to signal parameters in comparison to 1.5 Tesla using identical sequence settings and an intraindividual comparison. MATERIALS AND METHODS: In 16 volunteers, myocardial first-pass perfusion imaging was performed at 1.5 Tesla (Magnetom Avanto) and 3 Tesla (Magnetom TIM Trio) after injection of 0.05 mmol/kg body weight Gadobutrol using an accelerated saturation recovery TurboFLASH technique (GRAPPA; R=2) at 1.5 and 3 Tesla. Detailed sequence parameters (TR 2.3 milliseconds, TE 0.93 milliseconds, flip angle 15 degrees , bandwidth 780 Hz/px) as well as spatial resolution were kept identical for both field strengths. Artifacts were assessed quantitatively and qualitatively, signal-to-noise ratio (SNR) and contrast enhancement ratio (CER) were calculated from raw data signal intensity-time curves. A linear fit on the upslope was performed for semiquantitative perfusion analysis. RESULTS: SNR was significantly higher at 3 Tesla than at 1.5 Tesla (35.7+/-11.9 vs. 18.0+/-5.5, P<0.001). CER was significantly greater at 3 Tesla than at 1.5 Tesla (2.2+/-0.9 vs. 1.4+/-0.5, P<0.001). Maximum upslope was significantly higher at 3 Tesla than at 1.5 Tesla (3.3+/-2.4 vs. 2.0+/-1.0, P<0.001). A qualitative examination of all images for artifacts by 2 board-certified radiologists yielded no significant differences between the field strengths. CONCLUSIONS: Three Tesla significantly improves CER and SNR compared with 1.5 Tesla with identical sequence parameters. In addition, the most important semiquantitative perfusion parameter maximum upslope is significantly increased. This may allow for an improvement of spatial resolution and potentially for a better delineation of perfusion defects. However, further studies are necessary to potentially demonstrate a benefit of 3 Tesla perfusion imaging in a clinical setting.     

A direct comparison of the sensitivity of CT and MR cardiac perfusion using a myocardial perfusion phantom

BackgroundDirect comparison of CT and magnetic resonance (MR) perfusion techniques has been limited and in vivo assessment is affected by physiological variability, timing of image acquisition, and parameter selection.ObjectiveWe precisely compared high-resolution k-t SENSE MR cardiac perfusion at 3 T with single-phase CT perfusion (CTP) under identical imaging conditions.MethodsWe used a customized MR imaging and CT compatible dynamic myocardial perfusion phantom to represent the human circulation. CT perfusion studies were performed with a Philips iCT (256 slice) CT, with isotropic resolution of 0.6 mm³. MR perfusion was performed with k-t SENSE acceleration at 3 T and spatial resolution of 1.2 × 1.2 × 10 mm. The image contrast between normal and underperfused myocardial compartments was quantified at various perfusion and photon energy settings. Noise estimates were based on published clinical data.ResultsContrast by CTP highly depends on photon energy and also timing of imaging within the myocardial perfusion upslope. For an identical myocardial perfusion deficit, the native image contrast-to-noise ratio (CNR) generated by CT and MR are similar. If slice averaging is used, the CNR of a perfusion deficit is expected to be greater for CTP than MR perfusion (MRP). Perfect timing during single time point CTP imaging is difficult to achieve, and CNR by CT decreases by 24%–31% two seconds from the optimal imaging time point. Although single-phase CT perfusion offers higher spatial resolution, MRP allows multiple time point sampling and quantitative analysis.ConclusionThe ability of CTP and current optimal MRP techniques to detect simulated myocardial perfusion deficits is similar.     

Dynamic coronary MR angiography and first-pass perfusion with intracoronary administration of contrast agent

PURPOSE: To evaluate whether dynamic imaging of the coronary arteries can be performed with intracoronary infusion of low-dose gadolinium (Gd)-based contrast agent and assess the effect of long duration and multiple infusions on the image signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR). MATERIALS AND METHODS: Dynamic coronary magnetic resonance (MR) imaging (130 msec/image) and contrast agent first pass myocardial perfusion studies were performed with intracoronary infusions of low-dose Gd-based MR contrast agent on dogs (N = 4) using a fast multislice gradient recalled echo (GRE) sequence. RESULTS: Contrast-enhanced coronary arteries were clearly imaged during infusion periods as long as 2.3 minutes. The SNR and CNR of the contrast-enhanced coronary arteries remained essentially unchanged over multiple consecutive angiographic sessions. In addition, we demonstrated that first pass studies performed with intracoronary injection of MR contrast agent can be used as a means of assessing regional myocardial perfusion. CONCLUSION: These studies demonstrated that, using intracoronary infusion of Gd, coronary magnetic resonance angiography (MRA) can be performed with high temporal resolution, and multiple low-dose slow infusions of Gd-based MR contrast agent can be performed without compromise of the vessel SNR and CNR.     

Detection of regional myocardial perfusion deficit using rest and stress perfusion MRI: a feasibility study

OBJECTIVE: Providing high temporal and spatial resolution, perfusion MRI is an attractive alternative to traditional radionuclide methods like SPECT and PET. Although first-pass perfusion MRI examinations have gained increasing attention during the past years, this technique still exhibits relatively low signal-to-noise ratio and cardiac coverage. Previous studies have suggested that refocused gradient sequence technology (e.g., true fast imaging with steady-state precession [FISP]) should improve perfusion MRI examinations. The aim of this study was to assess myocardial perfusion deficits in patients with proven coronary artery disease using a saturation recovery true FISP perfusion sequence. SUBJECTS AND METHODS: Rest and stress perfusion MRI studies were performed in 22 patients with coronary artery disease at 1.5 T using a multislice saturation recovery true FISP sequence after the bolus injection of 0.025 mmol/kg of body weight of gadopentetate dimeglumine. The myocardium of each slice was divided into 12 radial segments with subdivision into subendocardial and subepicardial subregions. Myocardial perfusion was assessed semiquantitatively and independently for each subregion. The standard of reference for myocardial perfusion was SPECT. Delayed enhancement images were acquired after the injection of 0.15 mmol/kg of body weight of gadopentetate dimeglumine. RESULTS: Sensitivity and specificity of perfusion MRI examinations for the detection of perfusion deficits were 81% and 89%, respectively, for the semiquantitative perfusion parameter upslope and 78% and 86% for the parameter peak signal intensity. More specifically, rest perfusion examinations were able to detect areas of infarction, whereas stress examinations increased the perfusion differences between normal and ischemic myocardial areas. Excellent correlation was observed between rest perfusion and late enhancement findings (r = 0.90). CONCLUSION: In patients with single-vessel coronary artery disease, perfusion deficits can reliably be detected using a saturation recovery true FISP sequence. Semiquantitative perfusion parameters upslope and peak signal intensity yielded similar results.     

肺癌疗效评估新技术-磁共振肺部高分辨率扫描

目的 探讨肺癌疗效评估新技术——磁共振肺部高分辨率扫描(HR-MRI)的临床应用.方法 60例肺癌患者行常规磁共振成像(MRI)及HR-MRI扫描.按照"5分法"评价,测量计算信噪比(SNR)病灶,SNR肺组织及对比信噪比(CNR).对比常规MRI与HR-MRI肺癌病灶扫描的图像评分,SNR病灶,SNR肺组织及CNR的...     

Cardiac MRI of ischemic heart disease at 3 T: potential and challenges

Cardiac MRI has become a routinely used imaging modality in the diagnosis of cardiovascular disease and is considered the clinically accepted gold standard modality for the assessment of cardiac function and myocardial viability. In recent years, commercially available clinical scanners with a higher magnetic field strength (3.0 T) and dedicated multi-element coils have become available. The superior signal-to-noise ratio (SNR) of these systems has lead to their rapid acceptance in cranial and musculoskeletal MRI while the adoption of 3.0 T for cardiovascular imaging has been somewhat slower. This review article describes the benefits and pitfalls of magnetic resonance imaging of ischemic heart disease at higher field strengths. The fundamental changes in parameters such as SNR, transversal and longitudinal relaxation times, susceptibility artifacts, RF (B1) inhomogeneity, and specific absorption rate are discussed. We also review approaches to avoid compromised image quality such as banding artifacts and inconsistent or suboptimal flip angles. Imaging sequences for the assessment of cardiac function with CINE balanced SSFP imaging and MR tagging, myocardial perfusion, and delayed enhancement and their adjustments for higher field imaging are explained in detail along with several clinical examples. We also explore the use of parallel imaging at 3.0 T to improve cardiac imaging by trading the SNR gain for higher field strengths for acquisition speed with increased coverage or improved spatial and temporal resolution. This approach is particularly useful for dynamic applications that are usually limited to the duration of a single breath-hold.