Phase insensitive preparation of single-shot RARE: Application to diffusion imaging in humans

Although RARE and GRASE can produce single-shot images of excellent quality, their utility has been restricted because preparation of the magnetization with interesting contrast before imaging can cause severe artifacts. These artifacts relate to the strong sensitivity of multiple spin echo sequences to the phase of the prepared magnetization. Modifications of the RARE sequence to eliminate these artifacts are discussed, and an approach that eliminates the artifact producing signals from the very first echo is presented. The approach is applied to diffusion imaging of the human brain in normal volunteers and one patient.     

Hybrid RARE: Implementations for abdominal MR imaging

Hybrid RARE (rapid acquisition with relaxation enhancement) is a family of magnetic resonance (MR) imaging techniques whereby a set of images is phase encoded with more than one spin echo per excitation pulse. This increases the efficiency of obtaining T2-weighted images, allowing greater flexibility regarding acquisition time, resolution, signal-to-noise ratio, and tissue contrast. Hybrid RARE techniques involve several important new user-selectable parameters such as effective TE, echo train length, and echo spacing. Choices of other parameters, such as TR, sampling bandwidth, and acquisition matrix, may be different from those of comparable conventional T2-weighted spin-echo images. Different hybrid RARE implementations can be used for abdominal screening, with T2-weighted or T2-weighted and inversion-recovery contrast, or for characterizing liver lesions or imaging the biliary system with an extremely long TE. High-resolution images may be obtained by averaging multiple signals during quiet breathing, or images may be acquired more rapidly during suspended respiration. In this review, the authors discuss the basic principles of hybrid RARE techniques and how various imaging parameters can be manipulated to increase the quality and flexibility of abdominal T2-weighted MR imaging.     

T2-weighted thin-section imaging with the multislab three-dimensional RARE technique.

A novel three-dimensional (3D) RARE (rapid acquisition with relaxation enhancement) sequence was implemented on a clinical imager. In this technique, multiple slabs are excited in the same way as in the multisection spin-echo sequence, and each slab is further phase encoded into eight sections along the section-slab direction. With a 16-echo RARE sequence, 128 excitations cover the 256 X 256 X 8 3D k space. With a TR of 2,500 msec, 10 slabs can be excited sequentially at each TR, yielding 80 sections in 5 minutes. Slabs were overlapped to give contiguous sections after discarding of the aliased sections at slab edges. This relatively fast sequence makes contiguous thin-section T2-weighted imaging possible, an impractical achievement with the much longer spin-echo method. Compared with 3D Fourier transform gradient-echo imaging, the sensitivity of 3D RARE sequences to magnetic susceptibility is reduced. The clinical potential of T2-weighted 3D imaging is illustrated with high-resolution brain, spine, and temporomandibular joint images.     

Hybrid cardiac imaging with MR-CAT scan: a feasibility study

We demonstrate the feasibility of a new versatile hybrid imaging concept, the combined acquisition technique (CAT), for cardiac imaging. The cardiac CAT approach, which combines new methodology with existing technology, essentially integrates fast low-angle shot (FLASH) and echoplanar imaging (EPI) modules in a sequential fashion, whereby each acquisition module is employed with independently optimized imaging parameters. One important CAT sequence optimization feature is the ability to use different bandwidths for different acquisition modules. Twelve healthy subjects were imaged using three cardiac CAT acquisition strategies: a) CAT was used to reduce breath-hold duration times while maintaining constant spatial resolution; b) CAT was used to increase spatial resolution in a given breath-hold time; and c) single-heart beat CAT imaging was performed. The results obtained demonstrate the feasibility of cardiac imaging using the CAT approach and the potential of this technique to accelerate the imaging process with almost conserved image quality.     

Optimal fast T2‐weighted magnetic resonance microscopy imaging of the eye and its clinical application

Purpose:

To compare a half‐Fourier single‐shot rapid acquisition with relaxation enhancement (RARE) sequence with a balanced steady‐state free precession (b‐SSFP) sequence in the evaluation of the eye using magnetic resonance (MR) microscopy imaging and to clarify the usefulness of RARE microscopy imaging in evaluating nonoperative glaucoma patients and patients who have undergone surgery for glaucoma or cataract.

Materials and Methods:

One‐mm and 2‐mm slice thickness images of RARE sequence and b‐SSFP sequence using a 1.5 T MR unit and a 23‐mm microscopy coil were obtained in eight healthy volunteers. The signal‐to‐noise (S/N) ratio of aqueous humor in the anterior chamber was measured quantitatively and visualization of the anterior chamber anatomy was assessed qualitatively. Furthermore, we evaluated 21 glaucoma patients (including six postoperative patients) and four patients after cataract surgery with 2‐mm slice thickness RARE MRI.

Results:

The 2‐mm slice thickness RARE imaging had a significantly greater S/N ratio than the 1‐mm slice thickness RARE imaging (P < 0.05) and acquired the best image quality among the four types of images (P < 0.01). Additionally, 2‐mm slice thickness RARE microscopy imaging could depict anterior chamber anatomy of glaucoma eyes and eyes after cataract surgery.

Conclusion:

We believe that optimal fast T2‐weighted MR microimaging might become a useful ophthalmologic examination technique. J. Magn. Reson. Imaging 2010;31:1210–1214. ©2010 Wiley‐Liss, Inc.     

Comparison of conventional fast spin echo, single-shot two-dimensional and three-dimensional half-fourier RARE for T2-weighted female pelvic imaging

PURPOSE: To evaluate the usefulness of the three-dimensional half-Fourier RARE sequence in comparison with single-shot two-dimensional half-Fourier RARE and conventional fast spin echo (FSE) for female pelvic imaging. MATERIALS AND METHODS: Imaging with all sequences was performed in 146 patients with 166 focal lesions on a 1.5-T system. The images were compared on the basis of quality, lesion conspicuity, and lesion to the uterus contrast-to-noise ratio (CNR). RESULTS: The sharpness of intrapelvic organs on the three-dimensional half-Fourier RARE sequence was better than that on two-dimensional half-Fourier RARE and worse than that on FSE. Motion-related artifacts for three-dimensional half-Fourier RARE were more frequent than those for two-dimensional half-Fourier RARE. There was no statistical difference between the three-dimensional half-Fourier RARE sequence and FSE in regard to lesion conspicuity and overall image quality. The CNR of leiomyoma to myometrium and cervical cancer to cervical stroma was the highest with three-dimensional half-Fourier RARE (P< 0.05). CONCLUSION: The three-dimensional half-Fourier RARE sequence generates images with higher contrast and better image resolution than two-dimensional-RARE. The three-dimensional data set provided images that can be observed in any orientation without acquiring an additional scan by using the multiplanar reconstruction (MPR) method.     

Invited. Ultrafast T2-weighted imaging of the abdomen and pelvis: Use of single shot fast spin-echo imaging

Single shot (SS) rapid acquisition with relaxation enhancement (RARE) and half Fourier SS-RARE (HFSS-RARE, HASTE, or SS-FSE) sequences allow ultrafast imaging acquisition and generate high imaging quality. Images can be acquired within a very short time, without artifacts from physiologic motion. They are widely applied in the abdominal MRI. Clinical application of the ultrafast SS-RARE imaging techniques provide not only improved temporal resolution but better spatial resolution, higher SNR, and higher tissue contrast. Imaging parameters must be optimized for different MR scanners to obtain diagnostic images.     

Fast MRI by creating multiple spin echoes in a CPMG sequence

A fast multislice imaging technique has been developed. RASTER (Rapid Acquisition with Stimulated Echo Refocusing) is based on RARE (Rapid Acquisition with Relaxation Enhancement), and creates multiple spin echoes/each 180° pulse utilizing stimulated echoes, and phase encode each differently. The sequence can be much faster than RARE while keeping the same spin echo image contrast. The main limitation of the technique is reduced signal-to-noise ratio.     

RARE spiral T2-weighted imaging

Spiral imaging has a number of advantages for fast imaging, including an efficient use of gradient hardware. However, inhomogeneity-induced blurring is proportional to the data acquisition duration. In this paper, we combine spiral data acquisition with a RARE echo train. This allows a long data acquisition interval per excitation, while limiting the effects of inhomogeneity. Long spiral k-space trajectories are partitioned into smaller, annular ring trajectories. Each of these annular rings is acquired during echoes of a RARE echo train. The RARE refocusing RF pulses periodically refocus off-resonant spins while building a long data acquisition. We describe both T₂-weighted single excitation and interleaved RARE spiral sequences. A typical sequence acquires a complete data set in three excitations (32 cm FOV, 192 × 192 matrix). At a TR = 2000 ms, we can average two acquisitions in an easy breath-hold interval. A multifrequency reconstruction algorithm minimizes the effects of any off-resonant spins. Though this algorithm needs a field map, we demonstrate how signal averaging can provide the necessary phase data while increasing SNR. The field map creation causes no scan time penalty and essentially no loss in SNR efficiency. Multiple slice, 14-s breath-hold scans acquired on a conventional gradient system demonstrate the performance.     

The sensitivity of low flip angle RARE imaging

It is demonstrated that the stability of the Carr-Purcell-Mei-boom-Gill (CPMG) sequence reflects the existence of a steady state solution to the Bloch equations in the absence of T₂ and T₁ decay. The steady state theory is then used to evaluate the performance of low flip angle RARE imaging sequences with both constant and optimally varied refocusing flip angles. The theory is experimentally verified in phantoms and then optimized, single shot, low flip angle RARE is used to obtain artifact-free images from the brain of a normal volunteer.     

Perfusion-based functional magnetic resonance imaging with single-shot RARE and GRASE acquisitions.

For perfusion-based functional magnetic resonance imaging, the previously introduced flow-sensitive alternating inversion recovery (FAIR) technique is combined with single-shot RARE (rapid acquisition with relaxation enhancement) and GRASE (gradient and spin echo) imaging sequences. The advantages of these sequences compared to commonly used echo-planar imaging (EPI) are an increased signal-to-noise ratio and the absence of distortions and artifacts due to magnetic field inhomogeneities. RARE- and GRASE-FAIR are applied to functional brain mapping studies in humans during visual stimulation. Results demonstrate that the presented techniques allow for perfusion maps with higher spatial resolution compared to EPI-FAIR. Relative regional cerebral blood flow change in the occipital cortex during visual stimulation was measured to be 41+/-4% (n = 5). The comparison of FAIR data obtained with RARE and GRASE techniques shows that RARE yields images with the higher signal-to-noise ratio. However, the GRASE technique features a shorter acquisition time and less RF power deposition and is thus better suited for multi-slice acquisitions.     

Variable-averaging RARE

The RARE method and its variants have become popular, rapid-imaging alternatives to conventional spin-echo imaging, particularly for long repetition time proton density and T²-weighted imaging. One variant is to generate both early and late echo images using the same pulse sequence, which has the added benefit of reduced edge artifacts and blurring. Described in this paper is variable-averaging RARE (VARARE), a method by which independent amounts of averaging can be set for the early and late echo images generated by a single scanning sequence. Through the use of this method, the signal-to-noise ratio (SNR) of late echo images can be improved without unnecessarily increasing the number of averages for the early echo image, thus saving scanning time. Comparisons to various alternatives are made with respect to scanning time and image quality. Phantom measurements and in vivo images are given to demonstrate the effectiveness of VA-RARE as an efficient method for improving SNR of late echo time images in RARE imaging.     

Online motion correction for diffusion-weighted imaging using navigator echoes: Application to RARE imaging without sensitivity loss.

This article describes the first application of true online motion correction to diffusion-weighted RARE imaging. Two orthogonal navigator echoes were acquired and zeroth and first-order phase corrections applied in less than 8 ms between a diffusion-weighted magnetization preparation and data acquisition using the RARE sequence. The zeroth-order phase correction was realized by pulsing the system's B(0)-coil: the first-order error corrected with appropriate magnetic field gradient pulses. Online correction ensured that no irreversible signal loss could occur in the imaging experiment. Diffusion-weighted images of the brain were obtained from healthy volunteers. EGG-triggered acquisition was applied at 400 ms after the R-wave. Data were acquired on a matrix of 256 x 256 with a RARE factor of 16 and a b-value of 804 smm(-2). The images obtained with online motion correction showed a remarkably high image quality, while those acquired without motion correction were severely degraded by artifacts.     

Invited. Ultrafast MR imaging of the abdomen: Echo planar imaging and diffusion-weighted imaging

Ultrafast MRI technique has become available with the introduction of new generation MR scanners for abdominal imaging. However, there is no consensus about the optimal imaging acquisition at the present time. Because single shot echo planar imaging (EPI) technique is based on high technology and had just applied in clinical imaging, further clinical investigation will be needed. Currently, the hypersensitivity to magnetic inhomogeneity and local magnetic susceptibility and the low spatial resolution may limit the widespread application of EPI technique. In addition to providing information for morphologic diagnosis, EPI will be more widely used for functional and qualitative diagnosis. Diffusion-weighted imaging can be used for differentiation of solid tumors according to their different cellular construction, evaluation of cystic lesions based on the different viscosity of their contents, and assessment of diffused pathologic changes in the parenchyma of solid organs. In addition to the previous parameters such as proton density and T1 and T2 values, diffusion factors may provide important information for the qualitative and dynamic evaluation of abdominal pathologic changes. Even though there are many difficulties that must be solved for diffusion-weighted imaging, a more wide application of this technique is expected through technologic improvement.     

Fast proton spectroscopic imaging with high signal-to-noise ratio: spectroscopic RARE.

A new fast spectroscopic imaging (SI) method is presented which is based on spatial localization by the fast MRI method of rapid acquisition with relaxation enhancement (RARE) and encoding of the chemical shift information by shifting the position of a refocusing 180 pulse in a series of measurements. This method is termed spectroscopic RARE. In contrast to spectroscopic ultrafast low-angle RARE (U-FLARE), the formation of two echo families (odd and even) is suppressed by using a train of 180 RF pulses with an internal four-step phase cycle. By this means a high signal-to-noise ratio (SNR) per unit measurement time is obtained, because the separation of odd and even echoes, as well as dummy echoes to stabilize the echo amplitudes, is not needed anymore. The method is of particular interest for detecting signals of coupled spins, as effective homonuclear decoupling can be achieved by use of constant evolution time chemical shift encoding. The pulse sequence was implemented on a 4.7 T imaging system, tested on phantoms, and applied to the healthy rat brain in vivo. Spectroscopic RARE is particularly useful if T2* double less-than sign T2, which is typically fulfilled for in vivo proton SI measurements at high magnetic field strength.     

Traumatic injuries: imaging of abdominal and pelvic injuries

The availability of new imaging modalities has altered the diagnostic approach to patients with abdominal and pelvic trauma. Computed tomography and ultrasound have largely replaced diagnostic peritoneal lavage. Ultrasound is used in most trauma centers as the initial imaging technique for the detection of hemoperitoneum and helps to determine the need for emergency laparotomy. Computed tomography allows for an accurate diagnosis of a wide range of traumatic abdominal and pelvic conditions. The speed of single-detector helical and multi-detector row CT (MDCT) permits a rapid CT examination of the seriously ill patient in the emergency room. In particular, the technology of MDCT permits multiple, sequential CT scans to be quickly obtained in the same patient, which is a great advance in the rapid assessment of the multiple-injured patient. The evolving concepts in trauma care promoting non-operative management of liver and splenic injuries creates the need for follow-up cross-sectional imaging studies in these patients. Computed tomography and, less frequently, MR or ultrasound, are used for this purpose.     

First pass MRA of the Abdomen: Ultrafast,non-breath-hold time-of-flight imaging using Gd-DTPA bolus

The authors describe a new fast imaging sequence that can produce projection angiograms of the abdominal vessels at a rate of 2 to 3 frames per second. The result is a versatile imaging technique that can track the arrival of a bolus of contrast in major vessels. With very fast data acquisition, gross patient motion is not a problem, and routine vascular projection studies may be performed without the need for breath-holding. This method is compatible with later high-resolution three-dimensional gradient echo studies using contrast agents and may, in fact, be used as an accurate timing protocol to gauge the arrival time of contrast in various segments of the abdominal vessels. Compared with echo planar imaging, this method has the advantages of avoiding susceptibility artifacts and depicting retroperitoneum and other abdominal fat-containing landmarks and does not require extensive hardware modifications for a clinical system.     

GRASE (gradient- and spin-echo) MR imaging: a new fast clinical imaging technique

A novel technique of magnetic resonance (MR) imaging, which combines gradient-echo and spin-echo (GRASE) technique, accomplishes T2-weighted multisection imaging in drastically reduced imaging time, currently 24 times faster than spin-echo imaging. The GRASE technique maintains contrast mechanisms, high spatial resolution, and image quality of spin-echo imaging and is compatible with clinical whole-body MR systems without modification of gradient hardware. Image acquisition time is 18 seconds for 11 multisection body images (2,000/80 [repetition time msec/echo time msec]) and 36 seconds for 22 brain images (4,000/104). With a combination of multiple Hahn spin echoes and short gradient-echo trains, the GRASE technique overcomes several potential problems of echo-planar imaging, including large chemical shift, image distortions, and signal loss from field inhomogeneity. Advantages of GRASE over the RARE (rapid acquisition with relaxation enhancement) technique include faster acquisition times and lower deposition of radio-frequency power in the body. Breath holding during 18-second GRASE imaging of the upper abdomen eliminates respiratory-motion artifacts in T2-weighted images. A major improvement in T2-weighted abdominal imaging is suggested.     

Quantification of the 31P metabolite concentration in human skeletal muscle from RARE image intensity.

A method is described for quantifying the cellular phosphorus-31 (31P) concentration in human skeletal muscle based on RARE (rapid acquisition with relaxation enhancement) image intensities. The 31P concentrations were calculated using relaxation rates, RF coil spatial characteristics, and RARE signal intensities from foot muscle and an external 31P standard. 31P RARE and 1H T2-weighted images of the foot muscles in 11 normal subjects were acquired at 3.0 T using a double-tuned (31P/1H) birdcage coil. 31P PRESS (point-resolved spectroscopy) spectra were acquired to verify the measurable 31P concentrations in a multiecho acquisition. The mean measured concentration was 26.4 +/- 3.1 mM (mean +/- SD) from RARE signal intensities averaged over the entire imaged foot anatomy and 27.6 +/- 4.1 mM for a 3 x 3 pixel region-of-interest measurement. The 31P RARE image acquisition time was 4 min with a 0.55 cm3 voxel size. These results demonstrate that the 31P concentration can be accurately measured noninvasively in human muscle from RARE images acquired in short scan times with relatively high spatial resolution.