Split‐acquisition real‐time CINE phase‐contrast MR flow measurements

The temporal and spatial resolution of real‐time phase‐contrast magnetic resonance (PCMR) is restricted by the need to acquire two interleaved phase images. In this article, we propose a split‐acquisition real‐time CINE PCMR technique, where the acquisition of flow‐encoded and flow‐compensated data is divided into separate blocks. By comparing magnitude images, automatic matching of data in cardio‐respiratory space allows subtraction of background phase offsets. Thus, the data is acquired in real‐time but with phase correction originating from a different heart beat. This effectively doubles the frame rate, allowing either higher temporal or spatial resolution. Two split‐acquisition sequences were tested: one with high‐temporal resolution and one with high‐spatial resolution. Both sequences showed excellent agreement in stroke volumes in 20 adults when validated against cardiac‐gated PCMR and interleaved real‐time PCMR (cardiac gated: 95.2 ± 20.0 mL, interleaved real‐time: 96.2 ± 20.7 mL, high‐temporal resolution: 95.6 ± 20.1 mL, high‐spatial resolution: 95.5 ± 20.4 mL). In six children, the high‐spatial resolution sequence provided more accurate flow measurements than interleaved real‐time PCMR, when compared with cardiac‐gated PCMR (cardiac gated: 20.6 ± 7.6 mL, interleaved real‐time: 24.3 ± 9.2 mL, high‐spatial resolution: 20.8 ± 7.8 mL), due to the increased spatial resolution. The matching technique is shown to be accurate (truth: 94.6 ± 21.8, split‐acquisition: 95.0 ± 21.9 mL) and quantitative image quality (signal‐to‐noise ratio, velocity‐to‐noise ratio and edge sharpness) is acceptable. Magn Reson Med, 2010. © 2010 Wiley‐Liss, Inc.     

Fast MR parameter mapping using k‐t principal component analysis

Quantification of magnetic resonance parameters plays an increasingly important role in clinical applications, such as the detection and classification of neurodegenerative diseases. The major obstacle that remains for its widespread use in clinical routine is the long scanning times. Therefore, strategies that allow for significant decreases in scan time are highly desired. Recently, the k‐t principal component analysis method was introduced for dynamic cardiac imaging to accelerate data acquisition. This is done by undersampling k‐t space and constraining the reconstruction of the aliased data based on the k‐t Broad‐use Linear Acquisition Speed‐up Technique (BLAST) concept and predetermined temporal basis functions. The objective of this study was to investigate whether the k‐t principal component analysis concept can be adapted to parameter quantification, specifically allowing for significant acceleration of an inversion recovery fast imaging with steady state precession (TrueFISP) acquisition. We found that three basis functions and a single training data line in central k‐space were sufficient to achieve up to an 8‐fold acceleration of the quantification measurement. This allows for an estimation of relaxation times T₁ and T₂ and spin density in one slice with sub‐millimeter in‐plane resolution, in only 6 s. Our findings demonstrate that the k‐t principal component analysis method is a potential candidate to bring the acquisition time for magnetic resonance parameter mapping to a clinically acceptable level. Magn Reson Med, 2011. © 2011 Wiley‐Liss, Inc.     

Time‐resolved three‐dimensional (3D) phase‐contrast (PC) balanced steady‐state free precession (bSSFP)

In this study the feasibility of a time‐resolved, three‐dimensional (3D), three‐directional flow‐sensitive balanced steady‐state free precession (bSSFP) sequence is demonstrated. Due to its high signal‐to‐noise ratio (SNR) in blood and cerebrospinal fluid (CSF) this type of sequence is particularly effective for acquisition of blood and CSF flow velocities. Flow sensitivity was achieved with the phase‐contrast (PC) technique, implementing a custom algorithm for calculation of optimal gradient parameters. Techniques to avoid the most important sources of bSSFP‐related artifacts (including distortion due to eddy currents and signal voids due to flow‐related steady‐state disruption) are also presented. The technique was validated by means of a custom flow phantom, and in vivo experiments on blood and CSF were performed to demonstrate the suitability of this sequence for human studies. Accurate depiction of blood flow in the cerebral veins and of CSF flow in the cervical portion of the neck was obtained. Possible applications of this technique might include the study of CSF flow patterns, direct in vivo study of pathologies such as hydrocephalus and Chiari malformation, and validation for the existing CSF circulation model. Magn Reson Med, 2009. © 2009 Wiley‐Liss, Inc.     

Flow‐induced disturbances in balanced steady‐state free precession images: Means to reduce or exploit them

In this work computer simulations and phantom measurements are presented that show the effect of flow on in‐plane balanced steady‐state free precession images. The images were studied for various flow velocities, excitation regions, relaxation times, RF‐pulse angles, and off‐resonance frequencies. The work shows that flow‐induced disturbances are present in the images, but can be reduced by the application of inhomogeneous excitation regions. Also, a velocity quantification method that utilizes the disturbances was developed and proved to quantify flow velocities accurately. The work concluded that the flow‐induced disturbances can be reduced to improve image quality, but can also be exploited to quantify the flow velocity. Magn Reson Med, 2009. © 2009 Wiley‐Liss, Inc.     

FID sampling superior to spin‐echo sampling for T‐based quantification of holmium‐loaded microspheres: Theory and experiment

This work demonstrates both theoretically and experimentally that multiple gradient‐echo sampling of free induction decay (MGEFID) is superior to MGE sampling of spin echo (MGESE) for T‐based quantification of holmium‐loaded microspheres (HoMS). An interleaved sampling strategy was applied in great detail to characterize the MR signal behavior of FID and SE signals of gels and perfused rabbit livers containing HoMS in great detail. Diffusion sensitivity was demonstrated for MGESE sampling, resulting in non‐exponential signal decay on both sides of the SE peak and in an underestimation of the HoMS concentration. Other than MGESE sampling, MGEFID sampling was demonstrated to be insensitive to diffusion, to exhibit exponential signal decay, and to allow accurate T‐based quantification of HoMS. Furthermore, a fit procedure was proposed extending the upper limit of quantifiable R relaxation rates to at least 1500 sec^–1. With this post‐processing step incorporated, MGEFID was shown to correctly estimate the integral amount of inhomogeneously distributed HoMS in liver tissue, up to a clinically relevant limit. All experimental findings could be explained with the theory of nuclear magnetic resonance (NMR) signal behavior in magnetically inhomogeneous tissues. HoMS were shown to satisfy the static dephasing regime when investigated with MGEFID and to violate the static dephasing conditions for MGESE at longer echo times typically used in SE. Magn Reson Med 60:1466–1476, 2008. © 2008 Wiley‐Liss, Inc.     

Flow‐sensitive four‐dimensional cine magnetic resonance imaging for offline blood flow quantification in multiple vessels: A validation study

Purpose:

To further validate the quantitative use of flow‐sensitive four‐dimensional velocity encoded cine magnetic resonance imaging (4D VEC MRI) for simultaneously acquired venous and arterial blood flow in healthy volunteers and for abnormal flow in patients with congenital heart disease.

Materials and Methods:

Stroke volumes (SV) obtained in arterial and venous thoracic vessels were compared between standard two‐dimensional (2D), 4D VEC MRI with and without respiratory navigator gating (gated/nongated) in volunteers (n = 7). In addition, SV and regurgitation fractions (RF) measured in aorta or pulmonary trunk of patients with malformed and/or insufficient valves (n = 10) were compared between 2D and nongated 4D VEC MRI methods.

Results:

In volunteers and patients, Bland–Altman tests showed excellent agreement between 2D, gated, and nongated 4D VEC MRI obtained quantitative blood flow measurements. The bias between 2D and gated 4D VEC MRI was <0.5 mL for SV; between 2D and nongated 4D VEC MRI the bias was <0.7 mL for SV and <1% for RF.

Conclusion:

Blood flow can be quantified accurately in arterial, venous, and pathological flow conditions using 4D VEC MRI. Nongated 4D VEC MRI has the potential to be suited for clinical use in patients with congenital heart disease who require flow acquisitions in multiple vessels. J. Magn. Reson. Imaging 2010;32:677–683. © 2010 Wiley‐Liss, Inc.     

Time‐resolved absolute velocity quantification with projections

Quantitative information on time‐resolved blood velocity along the femoral/popliteal artery can provide clinical information on peripheral arterial disease and complement MR angiography as not all stenoses are hemodynamically significant. The key disadvantages of the most widely used approach to time‐resolve pulsatile blood flow by cardiac‐gated velocity‐encoded gradient‐echo imaging are gating errors and long acquisition time. Here, we demonstrate a rapid nontriggered method that quantifies absolute velocity on the basis of phase difference between successive velocity‐encoded projections after selectively removing the background static tissue signal via a reference image. The tissue signal from the reference image's center k‐space line is isolated by masking out the vessels in the image domain. The performance of the technique, in terms of reproducibility and agreement with results obtained with conventional phase contrast‐MRI was evaluated at 3 T field strength with a variable‐flow rate phantom and in vivo of the triphasic velocity waveforms at several segments along the femoral and popliteal arteries. Additionally, time‐resolved flow velocity was quantified in five healthy subjects and compared against gated phase contrast‐MRI results. To illustrate clinical feasibility, the proposed method was shown to be able to identify hemodynamic abnormalities and impaired reactivity in a diseased femoral artery. For both phantom and in vivo studies, velocity measurements were within 1.5 cm/s, and the coefficient of variation was less than 5% in an in vivo reproducibility study. In five healthy subjects, the average differences in mean peak velocities and their temporal locations were within 1 cm/s and 10 ms compared to gated phase contrast‐MRI. In conclusion, the proposed method provides temporally resolved arterial velocity with a temporal resolution of 20 ms with minimal post processing. Magn Reson Med, 2010. © 2010 Wiley‐Liss, Inc.     

Separate MRI quantification of dispersed (ferritin‐like) and aggregated (hemosiderin‐like) storage iron

A new MRI method is proposed for separately quantifying the two principal forms of tissue storage (nonheme) iron: ferritin iron, a dispersed, soluble fraction that can be rapidly mobilized, and hemosiderin iron, an aggregated, insoluble fraction that serves as a long‐term reserve. The method utilizes multiple spin echo sequences, exploiting the fact that aggregated iron can induce nonmonoexponential signal decay for multiple spin echo sequences. The method is validated in vitro for agarose phantoms, simulating dispersed iron with manganese chloride, and aggregated iron with iron oxide microspheres. To demonstrate feasibility for human studies, preliminary in vivo data from two healthy controls and six patients with transfusional iron overload are presented. For both phantoms and human subjects, conventional R₂ and R₂* relaxation rates are also measured in order to contrast the proposed method with established MRI iron quantification techniques. Quantification of dispersed (ferritin‐like) iron may provide a new means of monitoring the risk of iron‐induced toxicity in patients with iron overload and, together with quantification of aggregated (hemosiderin‐like) iron, improve the accuracy of estimates for total storage iron. Magn Reson Med 63:1201–1209, 2010. © 2010 Wiley‐Liss, Inc.     

Four‐dimensional velocity‐encoded magnetic resonance imaging improves blood flow quantification in patients with complex accelerated flow

Purpose:

To evaluate the use of four‐dimensional (4D) velocity‐encoded magnetic resonance imaging (VEC MRI) for blood flow quantification in patients with semilunar valve stenosis and complex accelerated flow.

Materials and Methods:

Peak velocities (Vmax) and stroke volumes (SV) were quantified by 2D and 4D VEC MRI in volunteers (n = 7) and patients with semilunar valve stenosis (n = 18). Measurements were performed above the aortic and pulmonary valve with both techniques and, additionally, at multiple predefined planes in the ascending aorta and in the pulmonary trunk within the 4D dataset. In patients, 4D VEC MRI streamline analysis identified flow patterns and regions of highest flow velocity (4D_{max‐targeted}) for further measurements and Vmax was also measured by Doppler‐echocardiography.

Results:

In patients, 4D VEC MRI showed higher Vmax than 2D VEC MRI (2.7 ± 0.6 m/s vs. 2.4 ± 0.5 m/s, P < 0.03) and was more comparable to Doppler‐echocardiography (2.8 ± 0.7 m/s). 4D_{max‐targeted} revealed highest Vmax values (3.1 ± 0.6 m/s). SV measurements showed significant differences between different anatomical levels in the ascending aorta in patients with complex accelerated flow, whereas differences in volunteers with laminar flow patterns were negligible (P = 0.004).

Conclusion:

4D VEC MRI improves MRI‐derived blood flow quantification in patients with semilunar valve stenosis and complex accelerated flow. J. Magn. Reson. Imaging 2013;37:208–216. © 2012 Wiley Periodicals, Inc.     

T1‐corrected fat quantification using chemical shift‐based water/fat separation: Application to skeletal muscle

Chemical shift‐based water/fat separation, like iterative decomposition of water and fat with echo asymmetry and least‐squares estimation, has been proposed for quantifying intermuscular adipose tissue. An important confounding factor in iterative decomposition of water and fat with echo asymmetry and least‐squares estimation‐based intermuscular adipose tissue quantification is the large difference in T₁ between muscle and fat, which can cause significant overestimation in the fat fraction. This T₁ bias effect is usually reduced by using small flip angles. T₁‐correction can be performed by using at least two different flip angles and fitting for T₁ of water and fat. In this work, a novel approach for the water/fat separation problem in a dual flip angle experiment is introduced and a new approach for the selection of the two flip angles, labeled as the unequal small flip angle approach, is developed, aiming to improve the noise efficiency of the T₁‐correction step relative to existing approaches. It is shown that the use of flip angles, selected such the muscle water signal is assumed to be T₁‐independent for the first flip angle and the fat signal is assumed to be T₁‐independent for the second flip angle, has superior noise performance to the use of equal small flip angles (no T₁ estimation required) and the use of large flip angles (T₁ estimation required). Magn Reson Med, 2011. © 2011 Wiley Periodicals, Inc.