Balanced phase-contrast steady-state free precession (PC-SSFP): a novel technique for velocity encoding by gradient inversion.

A technique for measuring velocity is presented that combines cine phase contrast (PC) MRI and balanced steady-state free precession (SSFP) imaging, and is thus termed PC-SSFP. Flow encoding was performed without the introduction of additional velocity encoding gradients in order to keep the repetition time (TR) as short as in typical SSFP imaging sequences. Sensitivity to through-plane velocities was instead established by inverting (i.e., negating) all gradients along the slice-select direction. Velocity sensitivity (VENC) could be adjusted by altering the first moments of the slice-select gradients. Disturbances of the SSFP steady state were avoided by acquiring different flow echoes in consecutively (i.e., sequentially) executed scans, each over several cardiac cycles, using separate steady-state preparation periods. A comparison of phantom measurements with those from established 2D-cine-PC MRI demonstrated excellent correlation between both modalities. In examinations of volunteers, PC-SSFP exhibited a higher intrinsic signal-to-noise ratio (SNR) and consequently low phase noise in measured velocities compared to conventional PC scans. An additional benefit of PC-SSFP is that it relies less on in-flow-dependent signal enhancement, and thus yields more uniform SNRs and better depictions of vessel geometry throughout the whole cardiac cycle in structures with slow and/or pulsatile flow.     

Referenceless phase velocity mapping using balanced SSFP

Phase contrast MRI (PC‐MRI) is an established technique for measuring blood flow velocities in vivo. Although spoiled gradient recalled echo (GRE) PC‐MRI is the most widely used pulse sequence today, balanced steady state free precession (SSFP) PC‐MRI has been shown to produce accurate velocity estimates with superior SNR efficiency. We propose a referenceless approach to flow imaging that exploits the intrinsic refocusing property of balanced SSFP, and achieves up to a 50% reduction in total scan time. With the echo time set to exactly one half of the sequence repetition time (TE = TR/2), we show that non‐flow‐related image phase tends to vary smoothly across the field‐of‐view, and can be estimated from static tissue regions to produce a phase reference for nearby voxels containing flowing blood. This approach produces accurate in vivo one‐dimensional velocity estimates in half the scan time compared with conventional balanced SSFP phase‐contrast methods. We also demonstrate the feasibility of referenceless time‐resolved 3D flow imaging (called “7D” flow) in the carotid bifurcation from just three acquisitions. Magn Reson Med, 2009. © 2009 Wiley‐Liss, Inc.     

3D velocity quantification in the heart: Improvements by 3D PC‐SSFP

Purpose:

To test whether a 3D imaging sequence with phase contrast (PC) velocity encoding based on steady‐state free precession (SSFP) improves 3D velocity quantification in the heart compared to the currently available gradient echo (GE) approach.

Materials and Methods:

The 3D PC‐SSFP sequence with 1D velocity encoding was compared at the mitral valve in 12 healthy subjects with 3D PC‐GE at 1.5T. Velocity measurements, velocity‐to‐noise‐ratio efficiency (VNR_eff), intra‐ and interobserver variability of area and velocity measurements, contrast‐to‐noise‐ratio (CNR), and artifact sensitivity were evaluated in both long‐ and short‐axis orientation.

Results:

Descending aorta mean and peak velocities correlated well (r² = 0.79 and 0.93) between 3D PC‐SSFP and 3D PC‐GE. At the mitral valve, mean velocity correlation was moderate (r² = 0.70 short axis, 0.56 long axis) and peak velocity showed good correlation (r² = 0.94 short axis, 0.81 long axis). In some cases VNR_eff was higher, in others lesser, depending on slab orientation and cardiac phase. Intra‐ and interobserver variability was generally better for 3D PC‐SSFP. CNR improved significantly, especially at end systole. Artifact levels did not increase.

Conclusion:

3D SSFP velocity quantification was successfully tested in the heart. Blood‐myocardium contrast improved significantly, resulting in more reproducible velocity measurements for 3D PC‐SSFP at 1.5T. J. Magn. Reson. Imaging 2009;30:947–955. © 2009 Wiley‐Liss, Inc.     

B(0)-fluctuation-induced temporal variation in EPI image series due to the disturbance of steady-state free precession.

Steady-state free precession (SSFP) can develop under a train of RF pulses, given the condition TR < T(2). SSFP in multi-shot imaging sequences has been well studied. It is shown here that serial single-shot echo-planar imaging (EPI) acquisition can also develop SSFP, and the SSFP can be disturbed by B(0) fluctuation, causing voxel-wise temporal variation. This SSFP disturbance is predominantly present in cerebrospinal fluid (CSF) regions due to the long T(2) value. By applying a sufficiently strong crusher gradient in the EPI pulse sequence, the temporal variation induced by SSFP disturbance can be suppressed due to diffusion. Evidence is provided to indicate that physiological motions such as cardiac pulsation and respiration could affect the voxel-wise time courses through the mechanism of SSFP disturbance. It is advised that if the disturbance is observed in serial EPI images, the crusher should be made stronger to eliminate the unwanted temporal variation.     

Cardiac SSFP imaging at 3 Tesla.

Balanced steady-state free precession (SSFP) techniques provide excellent contrast between myocardium and blood at a high signal-to-noise ratio (SNR). Hence, SSFP imaging has become the method of choice for assessing cardiac function at 1.5T. The expected improvement in SNR at higher field strength prompted us to implement SSFP at 3.0T. In this work, an optimized sequence protocol for cardiac SSFP imaging at 3.0T is derived, taking into account several partly adverse effects at higher field, such as increased field inhomogeneities, longer T(1), and power deposition limitations. SSFP contrast is established by optimizing the maximum amplitude of the radiofrequency (RF) field strength for shortest TR, as well as by localized linear or second-order shimming and local optimization of the resonance frequency. Given the increased SNR, sensitivity encoding (SENSE) can be employed to shorten breath-hold times. Short-axis, long-axis, and four-chamber cine views obtained in healthy adult subjects are presented, and three different types of artifacts are discussed along with potential methods for reducing them.     

Deriving blood-oxygen-level-dependent contrast in MRI with T2*-weighted, T2-prepared and phase-cycled SSFP methods: theory and experiment.

The objectives of this work were: 1) to perform a comparative evaluation of the oxygen-sensitive contrast (OC) derived from the phase-cycled steady-state free precession (SSFP PC) method against T*2-weighted gradient recalled echo (GRE) and T2-prepared (T2-prep) methods with theoretical simulations and imaging studies using an ischemic leg cuff model at 1.5T and 3.0T; and 2) to investigate the dependence of SSFP PC-based OC on imaging parameters. Results showed that the SSFP PC method (repetition time (TR) = 6.3 ms; flip angle (alpha) = 90 degrees ) provides significantly higher OC compared to T2-prep (at both field strengths) and GRE (3.0T) (P < 0.05). The OC of low TR SSFP (TR = 3.5 ms at 1.5T; TR = 4.5 ms at 3.0T; alpha = 90 degrees ) was significantly lower compared to GRE (P < 0.05) at 1.5T and 3.0T and to T2-prep methods at 1.5T (P < 0.05). In summary, the findings from this study are the following: 1) SSFP-based OC is directly dependent on TR and alpha at 1.5T and 3.0T; and 2) OC derived with SSFP PC can be increased above GRE and T2-prep methods with an appropriate choice of imaging parameters.     

Automated estimation of aortic strain from steady‐state free‐precession and phase contrast MR images

The strain values extracted from steady‐state free‐precession (SSFP) and phase contrast (PC) images acquired with a 1.5T scanner on a compliant flow phantom and within the thoracic aorta of 52 healthy subjects were compared. Aortic data were acquired perpendicular to the aorta at the level of the pulmonary artery bifurcation. Cross sectional areas were obtained by using an automatic and robust segmentation method. While a good correlation (r = 0.99) was found between the aortic areas extracted from SSFP and PC sequences, a lower correlation (r = 0.71) was found between the corresponding aortic strain values. Strain values estimated using SSFP and PC sequences were equally correlated with age. Interobserver reproducibility was better for SSFP than for PC. Strain values in the ascending and descending aorta were better correlated for SSFP (r = 0.8) than for PC (r = 0.65) and fitted with the expectation of a larger strain in the ascending aorta when using SSFP. The spatial and temporal resolutions of the acquisitions had a minor influence upon the estimated strain values. Thus, if PC acquisitions can be used to estimate both pulse wave velocity and aortic strain, an additional SSFP sequence may be useful to improve the accuracy in estimating the aortic strain. Magn Reson Med, 2010. © 2010 Wiley‐Liss, Inc.     

Double average parallel steady-state free precession imaging: optimized eddy current and transient oscillation compensation.

Balanced steady-state free precession (SSFP) imaging is sensitive to off-resonance effects, which can lead to considerable artifacts during a transient phase following magnetization preparation or steady-state interruption. In addition, nonlinear k-space encoding is required if contrast-relevant k-space regions need to be acquired at specific delays following magnetization preparation or for transient artifact reduction in cardiac-gated k-space segmented CINE imaging. Such trajectories are problematic for balanced SSFP imaging due to nonconstant eddy current effects and resulting disruption of the steady state.In this work, a novel acquisition strategy for balanced SSFP imaging is presented that utilizes scan time reduction by parallel imaging for optimized "double average" eddy current compensation and artifact reduction during the transient phase following steady-state storage and magnetization preparation. Double average parallel SSFP imaging was applied to k-space segmented CINE SSFP tagging as well as nongated centrically encoded SSFP imaging. Phantom and human studies exhibit substantial reduction in steady-state storage and eddy current artifacts while maintaining spatial resolution, signal-to-noise ratio, and similar total scan time of a standard SSFP acquisition. The proposed technique can easily be extended to other acquisition schemes that would benefit from nonlinear reordering schemes and/or rely on interruption of the balanced SSFP steady state.     

Quantitative assessment of left ventricular function: steady-state free precession MR imaging with or without sensitivity encoding

Quantitative left ventricular (LV) function was assessed with magnetic resonance imaging in 20 patients by using standard multisection multiphase steady-state free precession (SSFP) imaging and sensitivity encoding (SENSE)-accelerated cine SSFP imaging with identical spatial, contrast, and temporal resolution. The local institutional review board approved the protocol, and all patients gave signed informed consent prior to imaging. The study complied with the Health Insurance Portability and Accountability Act. Results of Bland-Altman analysis showed that both techniques produced similar estimates of LV ejection fraction, LV mass, and blood-to-muscle contrast and demonstrated minimal interobserver variability. The authors showed that it is possible, by combining SENSE with cine SSFP imaging, to reduce acquisition time by 50% without compromising spatial resolution, temporal resolution, or blood-to-muscle contrast-to-noise ratio compared with those achieved by using SSFP imaging without SENSE for quantitative LV function assessment.     

Real-time volumetric flow measurements with complex-difference MRI.

Blood flow in large vessels can be noninvasively evaluated with phase-contrast (PC) MRI by encoding the spin velocity to the image phase. Conventional phase-difference processing of the flow-encoded image data yields velocity images. Complex-difference processing is an alternative to phase-difference methods, and has the advantage of eliminating signal from stationary spins. In this study, two acquisitions with differential flow encoding are subtracted to yield a single projection that contains signal from only those spins moving in the direction of the flow-encoding gradients. The increase in acquisition efficiency allows real-time flow imaging with a temporal window as short as two acquisition lengths (60 ms). Validation of the complex-difference method by comparison with conventional gated-segmented PC-MRI in a flow phantom yielded a correlation of r > 0.99. Peak arterial flow rates in the popliteal artery and desending aorta measured in vivo with the complex-difference method were 0.92 +/- 0.06 of the values measured with conventional PC imaging. Real-time in vivo volumetric flow imaging of transient flow events is also presented.     

SSFP and GRE phase contrast imaging using a three-echo readout.

A technique for rapid in-plane phase-contrast imaging with high signal-to-noise ratio (SNR) is described. Velocity-encoding is achieved by oscillating the readout gradient, such that each 2DFT phase-encode is acquired three times following a single RF slice-selective excitation. Three images are reconstructed, from which both flow velocity and local resonance offset are calculated. This technique is compatible with both gradient-recalled echo (GRE) and balanced steady-state free precession (SSFP) imaging using a single steady-state. The proposed technique enables 1D velocity mapping with 40% higher temporal resolution and 80% higher SNR, compared to conventional PC-MRI using bipolar velocity-encoding gradient pulses.     

High-resolution diffusion-weighted 3D MRI, using diffusion-weighted driven-equilibrium (DW-DE) and multishot segmented 3D-SSFP without navigator echoes.

In this work we report on the development of a novel technique for high-resolution diffusion-weighted (DW) MRI based upon 3D steady-state free precession (3D-SSFP). First the 3D-SSFP acquisition was segmented (each segment consisting of a series of RF pulses and gradient-recalled echoes), and then DW-driven equilibrium (DE) was inserted between each segment. The in-plane imaging matrix was typically 256 x 192 or 256 x 160, which resulted in high-resolution DW images. The DW-DE segmented SSFP signal was contaminated by the non-DW magnetization, which recovered and contributed signal during the readout train (T(1) contamination). Center-out slice encoding was used to place the greatest diffusion weighting at the center of k-space. A numerical simulation and supporting experiments were performed to evaluate the relationship of the transverse magnetization to imaging parameters, such as the b-value, echo-train length (ETL), echo-train (group) repetition time (TR(g)), and RF excitation TR (Delta t). Both the numerical simulation and the experiments suggested that the effect of T(1) contamination would be reduced with a longer TR(g), smaller b-value, shorter ETL, and center-out slice phase encoding. Phase errors caused by microscopic motions during the diffusion gradients were converted into amplitude errors by the tip-up pulse at the end of the diffusion-weighting segment. As a result, small bulk motions, such as CSF pulsation, did not cause motion-related ghosting artifacts, which would be typical in images from other multishot DWI techniques. This technique can be used for high-resolution DWI of nonbrain anatomies.     

Improved 3‐Tesla cardiac cine imaging using wideband

Cine balanced steady‐state free precession (SSFP) is the most widely used sequence for assessing cardiac ventricular function at 1.5 T because it provides high signal‐to‐noise ratio efficiency and strong contrast between myocardium and blood. At 3 T, the use of SSFP is limited by susceptibility‐induced off‐resonance, resulting in either banding artifacts or the need to use a short‐sequence pulse repetition time that limits the readout duration and hence the achievable spatial resolution. In this work, we apply wideband SSFP, a variant of SSFP that uses two alternating pulse repetition times to establish a steady state with wider band spacing in its frequency response and overcome the key limitations of SSFP. Prospectively gated cine two‐dimensional imaging with wideband SSFP is evaluated in healthy volunteers and compared to conventional balanced SSFP, using quantitative metrics and qualitative interpretation by experienced clinicians. We demonstrate that by trading off temporal resolution and signal‐to‐noise ratio efficiency, wideband SSFP mitigates banding artifacts and enables imaging with approximately 30% higher spatial resolution compared to conventional SSFP with the same effective band spacing. Magn Reson Med, 2010. © 2010 Wiley‐Liss, Inc.     

MRI of respiratory dynamics with 2D steady-state free-precession and 2D gradient echo sequences at 1.5 and 3 Tesla: an observer preference study

To compare the image quality of dynamic lung MRI with variations of steady-state free-precession (SSFP) and gradient echo (GRE) cine techniques at 1.5 T and 3 T. Ventilated porcine lungs with simulated lesions inside a chest phantom and four healthy human subjects were assessed with SSFP (TR/TE = 2.9/1.22 ms; 3 ima/s) and GRE sequences (TR/TE = 2.34/0.96 ms; 8 ima/s) as baseline at 1.5 and 3 T. Modified SSFPs were performed with nine to ten images/s (parallel imaging factors 2 and 3). Image quality for representative structures and artifacts was ranked by three observers independently. At 1.5 T, standard SSFP achieved the best image quality with superior spatial resolution and signal, but equal temporal resolution to GRE. SSFP with improved temporal resolution was ranked second best. Further acceleration (PI factor 3) was of no benefit, but increased artifacts. At 3 T, GRE outranged SSFP imaging with high lesion signal intensity, while artifacts on SSFP images increased visibly. At 1.5 T, a modified SSFP with moderate parallel imaging (PI factor 2) was considered the best compromise of temporal and spatial resolution. At 3 T, GRE sequences remain the best choice for dynamic lung MRI.     

Fast phase-contrast velocity measurement in the steady state.

A new method of encoding flow velocity as image phase in a refocused steady-state free precession (SSFP) sequence, called steady-state phase contrast (SSPC), can be used to generate velocity images rapidly while retaining high signal. Magnitude images with refocused-SSFP contrast are simultaneously acquired. This technique is compared with the standard method of RF-spoiled phase contrast (PC), and is found to have more than double the phase-signal to phase-noise ratio (PNR) when compared with standard PC at reasonable repetition intervals (TRs). As TR decreases, this advantage increases exponentially, facilitating rapid scans with high PNR efficiency. Rapid switching between the two necessary steady states can be accomplished by the insertion of a single TR interval with no flow-encoding gradient. The technique is implemented in a 2DFT sequence and validated in a phantom study. Preliminary results indicate that further TR reduction may be necessary for high-quality cardiac images; however, images in more stationary structures, such as the descending aorta and carotid bifurcation, exhibit good signal-to-noise ratio (SNR) and PNR. Comparisons with standard-PC images verify the PNR advantage predicted by theory.     

Wideband SSFP: alternating repetition time balanced steady state free precession with increased band spacing.

Balanced steady-state free precession (SSFP) imaging is limited by off-resonance banding artifacts, which occur with periodicity 1/TR in the frequency spectrum. A novel balanced SSFP technique for widening the band spacing in the frequency response is described. This method, called wideband SSFP, utilizes two alternating repetition times with alternating RF phase, and maintains high SNR and T(2)/T(1) contrast. For a fixed band spacing, this method can enable improvements in spatial resolution compared to conventional SSFP. Alternatively, for a fixed readout duration this method can widen the band spacing, and potentially avoid the banding artifacts in conventional SSFP. The method is analyzed using simulations and phantom experiments, and is applied to the reduction of banding artifacts in cine cardiac imaging and high-resolution knee imaging at 3T.     

Fast 31P chemical shift imaging using SSFP methods.

Steady-state free precession (SSFP) methods have been very successful due to their high signal and short imaging times. These properties make them good candidates for applications that intrinsically suffer from low signal such as low gamma nuclei imaging. A new chemical shift imaging (CSI) technique based on the SSFP signal formation has been implemented and applied to (31)P. The signal properties of the SSFP CSI method have been evaluated and the steady-state signal of (31)P has been measured in human muscles. Due to the T(2) and T(1) signal dependence of SSFP, the steady-state signal mainly consists of phosphocreatine (PCr). The technique allows fast CSI acquisitions with high SNR of the PCr signal. The SNR gain for PCr over a FLASH-based CSI method is approx. 4-5. Fast in vivo CSI of human muscle with subcentimeter resolution and high SNR is demonstrated at 2 T.     

Improved coronary MR angiography using wideband steady state free precession at 3 tesla with sub‐millimeter resolution

Purpose:

To suppress off‐resonance artifacts in coronary artery imaging at 3 Tesla (T), and therefore improve spatial resolution.

Materials and Methods:

Wideband steady state free precession (SSFP) sequences use an oscillating steady state to reduce banding artifacts. Coronary artery images were obtained at 3T using three‐dimensional navigated gradient echo, balanced SSFP, and wideband SSFP sequences.

Results:

The highest in‐plane resolution of left coronary artery images was 0.68 mm in the frequency‐encoding direction. Wideband SSFP produced an average SNR efficiency of 70% relative to conventional balanced SSFP and suppressed off‐resonance artifacts.

Conclusion:

Wideband SSFP was found to be a promising approach for obtaining noncontrast, high‐resolution coronary artery images at 3 Tesla with reliable image quality. J. Magn. Reson. Imaging 2010;31:1224–1229. © 2010 Wiley‐Liss, Inc.     

In-plane velocity encoding with coherent steady-state imaging.

Standard phase-contrast flow quantification (PC-FQ) using radiofrequency (RF) spoiled steady-state (SS) incoherent gradient-echo sequences have a relatively low signal-to-noise ratio (SNR). Unspoiled SS coherent (SSC) gradient-echo sequences have a higher intrinsic SNR and are T2/T1 weighted so that blood has a relatively large signal compared to other tissues. An SSC sequence that was modified to allow in-plane velocity encoding is presented. Velocity encoding was achieved by inverting the readout gradients. This offers the benefit that there is no resultant increase in repetition time (TR), which avoids increased sensitivity to off-resonance artifacts when conventional velocity-encoding methods using separate velocity-encoding gradients are extended to SSC sequences. The results of standard PC-FQ and the new method from in vitro experiments of constant and sinusoidal flow, and in vivo imaging of the carotid artery were compared. Vector field maps and paths obtained from particle-tracking calculations based on the velocity-encoded images were used to visualize the velocity data. The technique has the potential to increase the precision of PC-FQ measurements.