Differential flow imaging by NMR

A new method for spatially resolved NMR flow measurements, named differential flow imaging (DFI), is introduced and experimentally verified. The DFI technique is based on the fact that flow velocity in any direction may cause a pixel position shift in the phase-encoding direction of a 2DFT NMR image. In this method two flow-influenced magnitude images are obtained by properly encoding and/or compensating the flow velocity. A spatial map of the desired component of the flow velocity can consequently be calculated from these two images. Since the DFI technique uses only the magnitude information of the complex images, it is not sensitive to systematic phase errors in contrast to other methods which are based on the phase measurements. On the other hand, the DFI technique can be combined with the phase measurement methods to perform multidimensional flow measurements in a shorter data acquisition time when the phase errors are small or corrected.     

Comparison of velocity-encoded MR imaging and fluid dynamic modeling of steady and disturbed flow.

The contrast of flow-encoded magnetic resonance (MR) images obtained in vivo and the accuracy of velocity measurements are complicated by the presence of complex flow states. The effects of complex flow states on MR flow-encoded images were studied and quantitative flow information was obtained with an MR phase-subtraction technique. Regions of complex flow, including flow stagnation and separation and laminar flow, could be clearly identified on the phase images. The MR imaging velocity measurements were validated by comparison with numerical simulation results for three-dimensional velocity distributions. The velocity MR images and the profiles obtained from the simulation generally agreed well for flow rates of 660 and 1,680 mL/min. This agreement lends support to both the fluid dynamic model and the physical basis of the phase imaging technique and establishes the validity of flow-encoded phase imaging as an in vivo flow quantitation method, especially under low Reynolds number flow conditions.     

Real time blood flow imaging by spiral scan phase velocity mapping

The work describes the development of a novel sequence that uses rapid spiral k-space sampling, combined with phase velocity mapping, for real time flow velocity imaging. The performance of the technique is assessed on phantoms for both through-plane and in-plane flows. The flow measurements compared well with those measured using a bucket and stopwatch. One advantage of the technique is that flow related signal loss is minimal due to the early acquisition of the center of k-space data. Flow artifacts were observed for in-plane flow and these were understood with the aid of computer simulations. In vivo studies involved cine velocity mapping in normal volunteers; aortic blood flow waveforms acquired by spiral scanning in two cardiac cycles compared well with data from a conventional gradient-echo sequence. Potential applications of the method are demonstrated by studying the response of aortic flow to physical exercise and the real time monitoring of aortic flow during a valsalver maneuver.     

A velocity correlation method for measuring vascular compliance using MR imaging

A method for estimating vascular compliance using MR velocity imaging is presented. The technique combines an analysis of pulse propagation, based on spatially averaged equations of continuity and momentum, together with phase-contrast velocity measurements to estimate the compliance from a correlation of second-order spatial and temporal velocity derivatives. The technique can be applied in the presence of reflected flow waves and uses velocity data acquired throughout the entire cardiac cycle. The accuracy of the technique was assessed in distensible vessel phantoms spanning a physiological range of compliance through a comparison with compliance estimates obtained using high-resolution MR imaging and pressure transducers. The mean error of all measurements was found to be 0.04 ±0.02% per mm Hg, with the relative errors ranging from 1.2% to 46%. Error was found to decrease as the temporal sampling rate and/or image plane separation were increased. This suggests that an accurate hemodynamic evaluation of a vessel's elastic properties is feasible with MR velocity imaging techniques.     

4D phase contrast flow imaging for in-stent flow visualization and assessment of stent patency in peripheral vascular stents - A phantom study

Purpose

4D phase contrast flow imaging is increasingly used to study the hemodynamics in various vascular territories and pathologies. The aim of this study was to assess the feasibility and validity of MRI based 4D phase contrast flow imaging for the evaluation of in-stent blood flow in 17 commonly used peripheral stents.

Materials and methods

17 different peripheral stents were implanted into a MR compatible flow phantom. In-stent visibility, maximal velocity and flow visualization were assessed and estimates of in-stent patency obtained from 4D phase contrast flow data sets were compared to a conventional 3D contrast-enhanced magnetic resonance angiography (CE-MRA) as well as 2D PC flow measurements.

Results

In all but 3 of the tested stents time-resolved 3D particle traces could be visualized inside the stent lumen. Quality of 4D flow visualization and CE-MRA images depended on stent type and stent orientation relative to the magnetic field. Compared to the visible lumen area determined by 3D CE-MRA, estimates of lumen patency derived from 4D flow measurements were significantly higher and less dependent on stent type. A higher number of stents could be assessed for in-stent patency by 4D phase contrast flow imaging (n = 14) than by 2D phase contrast flow imaging (n = 10).

Conclusions

4D phase contrast flow imaging in peripheral vascular stents is feasible and appears advantageous over conventional 3D contrast-enhanced MR angiography and 2D phase contrast flow imaging. It allows for in-stent flow visualization and flow quantification with varying quality depending on stent type.     

Accuracy and reproducibility in phase contrast imaging using SENSE.

The purpose of this study was to evaluate the accuracy and reproducibility of phase contrast imaging using the sensitivity encoding (SENSE) method at different reduction factors. Analytical expressions were derived that state how reproducibility is influenced for velocity and flow measurements. Computer simulations, and in vitro and in vivo studies were performed in order to validate these expressions and to assess how accuracy is affected when different reduction factors are applied. It was shown that reproducibility depends on the reduction and geometry factors. Since the geometry factor varies spatially, so does the reproducibility for phase contrast imaging. In areas with high geometry factors, the standard deviation (SD) may become so large that aliasing occurs. The accuracy of phase contrast imaging is not influenced directly when SENSE is used, but may be indirectly influenced due to high SDs of the measured phase that may subsequently cause aliasing. The current results show that it is possible to achieve accurate flow measurements even at high reduction factors. By taking the geometry factor into account, it may be possible to find areas where phase contrast imaging is accurate even at high reduction factors.     

Breath-hold MR measurements of blood flow velocity in internal mammary arteries and coronary artery bypass grafts

Breath-hold velocity-encoded cine MR (VENC-MR) imaging is a feasible method for measuring phasic blood flow velocity in small vessels that move during respiration. The purposes of the current study are to compare breathhold VENC-MR measurements of flow velocities in the internal mammary arteries (IMA) with nonbreath-hold measurements and to characterize the systolic and diastolic flow velocity curves in a cardiac cycle in native IMA and IMA grafts. Flow velocity in 30 native IMA and 8 IMA grafts were evaluated with a breath-hold VENC-MR sequence with K-space segmentation and view-sharing reconstruction(TR/TE=16/9 msec, VENC=100 cm/s). In 10 native IMA, nonbreathhold VENC-MR images were acquired as well for comparison. Breath-hold VENC-MR imaging showed significantly higher systolic and diastolic peak velocities in native IMA (43.1 cm/second ± 15.0 and 10.0 cm/second ± 4.8), in comparison to those of nonbreath-hold VENC-MR imaging (27.6 cm/second ± 10.2 and 7.3 cm/second ± 3.9, P<.05). The diastolic/systolic peak velocity ratio in the IMA grafts (.88 ± .41) was significantly higher than that in native IMA (.24 ± .08, P<.01). Interobserver variability in the flow velocity measurement was less than 4%. Breath-hold VENC-MR imaging demonstrated higher peak flow velocity in the IMA than nonbreath-hold VENC-MR imaging. This technique is a rapid and effective method for the noninvasive assessment of blood flow velocity in IMA grafts.     

Temporally resolved 3D phase-contrast imaging

A conventional 3D phase contrast acquisition generates images with good spatial resolution, but often gives rise to artifacts due to pulsatile flow. 2D cine phase contrast, on the other hand, can register dynamic flow, but has a poor spatial resolution perpendicular to the imaging plane. A combination of both high spatial and temporal resolution may be advantageous in some cases, both in quantitative flow measurements and in MR angiography. The described 3D cine phase contrast pulse sequence creates a temporally resolved series of 3D data sets with velocity encoded data.     

Breathheld autocalibrated phase‐contrast imaging

Purpose:

To compare generalized autocalibrating partially parallel acquisitions (GRAPPA), modified sensitivity encoding (mSENSE), and SENSE in phase‐contrast magnetic resonance imaging (PC‐MRI) applications.

Materials and Methods:

Aliasing of the torso can occur in PC‐MRI applications. If the data are further undersampled for parallel imaging, SENSE can be problematic in correctly unaliasing signals due to coil sensitivity maps that do not match that of the aliased volume. Here, a method for estimating coil sensitivities in flow applications is described. Normal volunteers (n = 5) were scanned on a 1.5 T MRI scanner and underwent PC‐MRI scans using GRAPPA, mSENSE, SENSE, and conventional PC‐MRI acquisitions. Peak velocity and flow through the aorta and pulmonary artery were evaluated.

Results:

Bland–Altman statistics for flow in the aorta and pulmonary artery acquired with mSENSE and GRAPPA methods (R = 2 and R = 3 cases) have comparable mean differences to flow acquired with conventional PC‐MRI. GRAPPA and mSENSE PC‐MRI have more robust measurements than SENSE when there is aliasing artifact caused by insufficient coil sensitivity maps. For peak velocity, there are no considerable differences among the mSENSE, GRAPPA, and SENSE reconstructions and are comparable to conventional PC‐MRI.

Conclusion:

Flow measurements of images reconstructed with autocalibration techniques have comparable agreement with conventional PC‐MRI and provide robust measurements in the presence of wraparound. J. Magn. Reson. Imaging 2010;31:1004–1014. ©2010 Wiley‐Liss, Inc.     

Highly k‐t‐space–accelerated phase‐contrast MRI

The purpose of this study was to combine a recently introduced spatiotemporal parallel imaging technique, PEAK‐GRAPPA (parallel MRI with extended and averaged generalized autocalibrating partially parallel acquisition), with two‐dimensional (2D) cine phase‐contrast velocity mapping. Phase‐contrast MRI was applied to measure the blood flow in the thoracic aorta and the myocardial motion of the left ventricle. To evaluate the performance of different reconstruction methods, fully acquired k‐space data sets were used to compare conventional parallel imaging using GRAPPA with reduction factors of R = 2–6 and PEAK‐GRAPPA as well as sliding window reconstruction with reduction factors R = 2–12 (net acceleration factors up to 5.2). PEAK‐GRAPPA reconstruction resulted in improved image quality with considerably reduced artifacts, which was also supported by error analysis. To analyze potential blurring or low‐pass filtering effects of spatiotemporal PEAK‐GRAPPA, the velocity time courses of aortic flow and myocardial tissue motion were evaluated and compared with conventional image reconstructions. Quantitative comparisons of blood flow velocities and pixel‐wise correlation analysis of velocities highlight the potential of PEAK‐GRAPPA for highly accelerated dynamic phase‐contrast velocity mapping. Magn Reson Med 60:1169–1177, 2008. © 2008 Wiley‐Liss, Inc.     

Simulation of phase contrast MRI of turbulent flow

Phase contrast MRI is a powerful tool for the assessment of blood flow. However, especially in the highly complex and turbulent flow that accompanies many cardiovascular diseases, phase contrast MRI may suffer from artifacts. Simulation of phase contrast MRI of turbulent flow could increase our understanding of phase contrast MRI artifacts in turbulent flows and facilitate the development of phase contrast MRI methods for the assessment of turbulent blood flow. We present a method for the simulation of phase contrast MRI measurements of turbulent flow. The method uses an Eulerian‐Lagrangian approach, in which spin particle trajectories are computed from time‐resolved large eddy simulations. The Bloch equations are solved for each spin for a frame of reference moving along the spins trajectory. The method was validated by comparison with phase contrast MRI measurements of velocity and intravoxel velocity standard deviation (IVSD) on a flow phantom consisting of a straight rigid pipe with a stenosis. Turbulence related artifacts, such as signal drop and ghosting, could be recognized in the measurements as well as in the simulations. The velocity and the IVSD obtained from the magnitude of the phase contrast MRI simulations agreed well with the measurements. Magn Reson Med, 2010. © 2010 Wiley‐Liss, Inc.     

1995 SMR young investigators' award finalist: MR measurement of time-dependent blood pressure variations

An MR imaging method for measuring intravascular pressure variations is introduced. The technique is based on estimates of vascular compliance and vessel distension, which are obtained from a correlation of spatial and temporal velocity derivatives and measurements of the velocity gradient in the direction of flow, respectively. The accuracy of the technique was determined in vitro through a comparison of MR and transducer pressure measurements obtained in distensible vessel phantoms undergoing pulsatile flow. Results indicated that a root-mean-square error of 4–12% can be expected in phantoms covering a physiological range of compliance. In vivo feasibility was demonstrated by thoracic aorta pressure measurements, which produced pressure waveforms with an expected shape and magnitude.     

Estimation of average flow in ungated 3D phase contrast angiograms

Three dimensional (3D) phase contrast angiograms contain velocity data, which is discarded after the reconstruction of the projections. In extension to earlier work on velocity quantification with ungated 2D phase data, this paper shows that a useful estimate of the average velocity and flow rate can be extracted from ungated 3D phase contrast angiograms. Simulations and experiments in a phantom and in vivo were performed. For pulsatile flow and strong spin saturation, an over-estimation of the flow rate at the net in-flow end of the imaging volume and underestimation at the net out-flow end was observed. Imaging at lower RF tip angles yielded flow rates close to the correct value within the entire imaging volume. In contrast to ungated 2D experiments, the flow rates determined by repeated 3D experiments showed no variation.     

Analysis of complex cardiovascular flow with three‐component acceleration‐encoded MRI

Functional information regarding cardiac performance, pressure gradients, and local flow derangement are available from blood acceleration fields. Thus, this study examines a 2D and 3D phase contrast sequence optimized to efficiently encode three‐directional, time‐resolved acceleration in vitro and in vivo. Stenosis phantom acceleration measurements were compared to acceleration derived from standard velocity encoded phase contrast‐magnetic resonance imaging (i.e., “velocity‐derived acceleration”). For in vivo analysis, three‐directional 2D acceleration maps were compared to velocity‐derived acceleration using regions proximal and distal to the aortic valve in six healthy volunteers at 1.5 and 3.0 T (voxel size = 1.4 × 2.1 × 8 mm, temporal resolution = 16–20 ms). In addition, a 4D acceleration sequence was evaluated for feasibility in a healthy volunteer and postrepair biscuspid aortic valve patient with an ascending aortic aneurysm. The phantom magnetic resonance acceleration measurements were more accurate (nonturbulent root mean square error = 2.2 vs. 5.1 m/s² for phase contrast‐magnetic resonance imaging) and 10 times less noisy (nonturbulent σ = 0.9 vs. 13.6 m/s² for phase contrast‐magnetic resonance imaging) than velocity‐derived acceleration. Acceleration mapping of the left ventricular outflow tract and aortic arch exhibited signal voids colocated with complex flow events such as vortex formation and high order motion. 4D acceleration data, visualized in combination with the velocity data, may provide new insight into complex flow phenomena. Magn Reson Med 67:50–61, 2012. © 2011 Wiley Periodicals, Inc.     

Optimized parallel imaging for dynamic PC‐MRI with multidirectional velocity encoding

Phase contrast MRI with multidirectional velocity encoding requires multiple acquisitions of the same k‐space lines to encode the underlying velocities, which can considerably lengthen the total scan time. To reduce scan time, parallel imaging is often applied. In dynamic phase contrast MRI using standard generalized autocalibrating partially parallel acquisitions (GRAPPA), several central k‐spaces for autocalibration of the reconstruction (autocalibrating signal lines (ACS)) are typically acquired, separately for each velocity direction and each cardiac timeframe, for calculating the reconstruction weights. To further accelerate data acquisition, we developed two methods, which calculated weights with a substantially reduced number of ACSl lines. The effects on image quality and flow quantification were compared to fully sampled data, standard GRAPPA, and time‐interleaved sampling scheme in combination with generalized autocalibrating partially parallel acquisitions (TGRAPPA). The results show that the two proposed methods can clearly improve scan efficiency while maintaining image quality and accuracy of measured flow or myocardial tissue velocities. Compared to TGRAPPA, the proposed methods were more accurate in evaluating flow velocity. In conclusion, the proposed reconstruction strategies are promising for dynamic multidirectionally encoded acquisitions and can easily be implemented using the standard GRAPPA reconstruction algorithm. Magn Reson Med, 2010. © 2010 Wiley‐Liss, Inc.     

Gradient moment smoothing: A new flow compensation technique for multi-shot echo-planar imaging

This work identifies an additional source of phase error across k_y in multi-shot echo-planar imaging resulting from flow or motion along the phase-encoding direction. A velocity-independent flow compensation technique, gradient moment smoothing, is presented that corrects this error by forcing the phase to have smooth quadratic behavior. The correction is implemented, without compromising scan time, by changing the first moment of a bipolar prephaser pulse on a shot-by-shot basis. In phantom and in vivo experiments, gradient moment smoothing effectively eliminates ghosting and signal loss due to phase-encoding flow. When used in conjunction with a “flyback” echo-planar readout, which compensates for flow in the frequency-encoding direction, gradient moment smoothing renders multi-shot echo-planar imaging relatively insensitive to in-plane flow. This can make multi-shot echo-planar imaging a viable technique for accurately imaging in-plane flow and may desensitize it to the otherwise serious problem of in-plane motion.     

MR measurement of pulsatile pressure gradients

A magnetic resonance (MR) imaging method for evaluating pulsatile pressure gradients in laminar blood flow is presented. The technique is based on an evaluation of fluid shear and inertial forces from cardiac-gated phase-contrast velocity measurements. The technique was experimentally validated by comparing MR and manometer pressure gradient measurements performed in a pulsatile flow phantom. Analyses of random noise propagation and sampling error were performed to determine the precision and accuracy of the method. The results indicate that a precision of 0.01–0.03 mmHg/cm and an accuracy of better than 8% can be achieved by using standard clinical pulse sequences in tubes exceeding 6 mm in diameter. The authors conclude that MR measurement of pressure gradients is feasible and that additional hemodynamic information may be derived from conventional phase-contrast imaging studies.     

A novel MRI framework for the quantification of any moment of arbitrary velocity distributions

MRI can measure several important hemodynamic parameters but might not yet have reached its full potential. The most common MRI method for the assessment of flow is phase‐contrast MRI velocity mapping that estimates the mean velocity of a voxel. This estimation is precise only when the intravoxel velocity distribution is symmetric. The mean velocity corresponds to the first raw moment of the intravoxel velocity distribution. Here, a generalized MRI framework for the quantification of any moment of arbitrary velocity distributions is described. This framework is based on the fact that moments in the function domain (velocity space) correspond to differentials in the Fourier transform domain (k_v‐space). For proof‐of‐concept, moments of realistic velocity distributions were estimated using finite difference approximations of the derivatives of the MRI signal. In addition, the framework was applied to investigate the symmetry assumption underlying phase‐contrast MRI velocity mapping; we found that this assumption can substantially affect phase‐contrast MRI velocity estimates and that its significance can be reduced by increasing the velocity encoding range. Magn Reson Med, 2011. © 2010 Wiley‐Liss, Inc.     

Analysis and correction of background velocity offsets in phase‐contrast flow measurements using magnetic field monitoring

The value of phase‐contrast magnetic resonance imaging for quantifying tissue motion and blood flow has been long recognized. However, the sensitivity of the method to system imperfections can lead to inaccuracies limiting its clinical acceptance. A key source of error relates to eddy current‐induced phase fluctuations, which can offset the measured object velocity significantly. A higher‐order dynamic field camera was used to study the spatiotemporal evolution of background phases in cine phase‐contrast measurements. It is demonstrated that eddy current‐induced offsets in phase‐difference data are present up to the second spatial order. Oscillatory temporal behaviors of offsets in the kHz range suggest mechanical resonances of the MR system to be non‐negligible in phase‐contrast imaging. By careful selection of the echo time, their impact can be significantly reduced. When applying field monitoring data for correcting eddy current and mechanically induced velocity offsets, errors decrease to less than 0.5% of the maximum velocity for various sequence settings proving the robustness of the correction approach. In vivo feasibility is demonstrated for aortic and pulmonary flow measurements in five healthy subjects. Using field monitoring data, mean error in stroke volume was reduced from 10% to below 3%. Magn Reson Med, 2012. © 2011 Wiley Periodicals, Inc.     

Navigator gated high temporal resolution tissue phase mapping of myocardial motion.

Data acquisition for phase contrast velocity mapping of myocardial motion is typically based on multiple breath-held 2D measurements with limited acquisition duration and consequently relatively poor temporal resolution. In order to overcome the limitations of breath-hold acquisitions, an improved navigator-guided technique was implemented based on 2 navigator signals within each cardiac cycle in combination with paired acceptance and rejection criteria of successive navigator signals. Respiratory gated phase contrast measurements with 3-directional velocity encoding were performed in 12 healthy volunteers in basal, midventricular, and apical locations of the left ventricle during free breathing with a temporal resolution of 13.8 ms. Results were compared to standard breath-hold measurements with a temporal resolution of 69 ms. Data from the high temporal resolution study revealed details in left ventricular motion patterns that were previously not seen in phase contrast measurements and are only known from echocardiography. The proposed navigator gated technique for high temporal resolution velocity mapping is, therefore, highly promising for the detection of local and global motion abnormalities in patients with disturbed left ventricular performance, such as diastolic dysfunction.