Time‐resolved lower extremity MRA with temporal interpolation and stochastic spiral trajectories: Preliminary clinical experience

Purpose:

To assess added value of a new time‐resolved technique with temporal interpolation and stochastic spiral trajectory through k‐space and parallel imaging (TR‐MRA) to conventional bolus chase MRA (BC‐MRA) for infragenual peripheral artery evaluation.

Materials and Methods:

An institutional review board‐approved retrospective review of peripheral arterial disease patients was performed. Infragenual TR‐MRA and BC‐MRA were performed in 26 patients over four months. Two readers individually assessed image quality, diagnostic confidence, and stenosis severity and length in 13 defined below knee segments, first with BC‐MRA alone, and then with a combined BC‐MRA and TR‐MRA reading (BC+TR‐MRA). Perceived contribution of TR‐MRA was rated by each reader. The reference standard was a consensus reading of both sequences. Catheter angiographic (CA) correlation was available in 6 patients.

Results:

A total of 646 infragenual segments in 51 extremities were evaluated. Image quality and diagnostic confidence were superior for BC+TR‐MRA compared with BC‐MRA alone (P < 0.001). Adding TR‐MRA improved sensitivity (85.7% versus 80.7%; P < 0.05) and diagnostic accuracy (88.1% versus 85.4%; P < 0.05) for hemodynamically significant stenosis. Venous contamination (0% versus 13.1% segments) and motion (0.9% versus 8.0%) were decreased for BC+TR‐MRA versus BC‐MRA alone, P < 0.01. For BC+TR‐MRA, TR‐MRA was rated more useful than BC‐MRA in 30/51 legs (58.8%). TR‐MRA identified retrograde flow in 5 segments. Where available, there was high concordance between CA and BC+TR‐MRA (91.6%) for stenosis.

Conclusion:

Adding TR‐MRA with temporal interpolation and stochastic spiral trajectories to bolus chase MRA improves image quality, diagnostic confidence and accuracy. It provides hemodynamic information and minimizes venous contamination and patient motion. J. Magn. Reson. Imaging 2010;31:663–672. © 2010 Wiley‐Liss, Inc.     

Improved fat suppression using multipeak reconstruction for IDEAL chemical shift fat‐water separation: Application with fast spin echo imaging

Purpose

To evaluate and quantify improvements in the quality of fat suppression for fast spin‐echo imaging of the knee using multipeak fat spectral modeling and IDEAL fat‐water separation.

Materials and Methods

T₁‐weighted and T₂‐weighted fast spin‐echo sequences with IDEAL fat‐water separation and two frequency‐selective fat‐saturation methods (fat‐selective saturation and fat‐selective partial inversion) were performed on 10 knees of five asymptomatic volunteers. The IDEAL images were reconstructed using a conventional single‐peak method and precalibrated and self‐calibrated multipeak methods that more accurately model the NMR spectrum of fat. The signal‐to‐noise ratio (SNR) was measured in various tissues for all sequences. Student t‐tests were used to compare SNR values.

Results

Precalibrated and self‐calibrated multipeak IDEAL had significantly greater suppression of signal (P < 0.05) within subcutaneous fat and bone marrow than fat‐selective saturation, fat‐selective partial inversion, and single‐peak IDEAL for both T₁‐weighted and T₂‐weighted fast spin‐echo sequences. For T₁‐weighted fast spin‐echo sequences, the improvement in the suppression of signal within subcutaneous fat and bone marrow for multipeak IDEAL ranged between 65% when compared to fat‐selective partial inversion to 86% when compared to fat‐selectivesaturation. For T2‐weighted fast spin‐echo sequences, the improvement for multipeak IDEAL ranged between 21% when compared to fat‐selective partial inversion to 81% when compared to fat‐selective saturation.

Conclusion

Multipeak IDEAL fat‐water separation provides improved fat suppression for T₁‐weighted and T₂‐weighted fast spin‐echo imaging of the knee when compared to single‐peak IDEAL and two widely used frequency‐selected fat‐saturation methods. J. Magn. Reson. Imaging 2009;29:436–442. © 2009 Wiley‐Liss, Inc.     

New look at renal vasculature: 7 tesla nonenhanced T1-weighted FLASH imaging

Purpose:

To investigate the feasibility of 7 Tesla (T) nonenhanced high field MR imaging of the renal vasculature and to evaluate the diagnostic potential of various nonenhanced T1‐weighted (T1w) sequences.

Materials and Methods:

Twelve healthy volunteers were examined on a 7T whole‐body MR system (Magnetom 7T, Siemens Healthcare Sector) using a custom‐built eight‐channel radiofrequency (RF) transmit/receive body coil. Subsequent to RF shimming, the following sequences were acquired (i) fat‐saturated two‐dimensional (2D) FLASH, (ii) fat‐saturated 3D FLASH, and a (iii) fat‐saturated 2D time‐of‐flight MR angiography (TOF MRA). SNR and CNR were measured in the aorta and both renal arteries. Qualitative analysis was performed with regard to vessel delineation (5‐point scale: 5 = excellent to 1 = nondiagnostic) and presence of artifacts (5‐point scale: 5 = no artifact present to 1 = strong impairment).

Results:

The inherently high signal intensity of the renal arterial vasculature in T1w imaging enabled moderate to excellent vessel delineation in all sequences. Qualitative (mean, 4.7) and quantitative analysis (SNR_mean: 53.9; CNR_mean: 28.0) demonstrated the superiority of TOF MRA, whereas 2D FLASH imaging provided poorest vessel delineation and was most strongly impaired by artifacts (overall impairment 3.7). The 3D FLASH MRI demonstrated its potential for fast high quality imaging of the nonenhanced arterial vasculature, providing homogeneous hyperintense vessel signal.

Conclusion:

Nonenhanced T1w imaging in general and, TOF MRA in particular, appear to be promising techniques for good quality nonenhanced renal artery assessment at 7 Tesla. J. Magn. Reson. Imaging 2012;36:714–721. © 2012 Wiley Periodicals, Inc.     

Noncontrast MR angiography for comprehensive assessment of abdominopelvic arteries using quadruple inversion-recovery preconditioning and 3D balanced steady-state free precession imaging

Purpose:

To develop a noncontrast magnetic resonance angiography (MRA) method for comprehensive evaluation of abdominopelvic arteries in a single 3D acquisition.

Materials and Methods:

A noncontrast MRA (NC MRA) pulse sequence was developed using four inversion‐recovery (IR) pulses and 3D balanced steady‐state free precession (b‐SSFP) readout to provide arterial imaging from renal to external iliac arteries. Respiratory triggered, high spatial resolution (1.3 × 1.3 × 1.7 mm³) noncontrast angiograms were obtained in seven volunteers and ten patients referred for gadolinium‐enhanced MRA (CE MRA). Images were assessed for diagnostic quality by two radiologists. Quantitative measurements of arterial signal contrast were also performed.

Results:

NC MRA imaging was successfully completed in all subjects in 7.0 ± 2.3 minutes. In controls, image quality of NC MRA averaged 2.79 ± 0.39 on a scale of 0–3, where 3 is maximum. Image quality of NC MRA (2.65 ± 0.41) was comparable to that of CE MRA (2.9 ± 0.32) in all patients. Contrast ratio measurements in patients demonstrated that NC MRA provides arterial contrast comparable to source CE MRA images with adequate venous and excellent background tissue suppression.

Conclusion:

The proposed noncontrast MRA pulse sequence provides high‐quality visualization of abdominopelvic arteries within clinically feasible scan times. J. Magn. Reson. Imaging 2011;33:1430–1439. © 2011 Wiley‐Liss, Inc.     

Multiecho time‐resolved acquisition (META): A high spatiotemporal resolution dixon imaging sequence for dynamic contrast‐enhanced MRI

Purpose

To evaluate a new dynamic contrast‐enhanced (DCE) imaging technique called multiecho time‐resolved acquisition (META) for abdominal/pelvic imaging. META combines an elliptical centric time‐resolved three‐dimensional (3D) spoiled gradient‐recalled echo (SPGR) imaging scheme with a Dixon‐based fat‐water separation algorithm to generate high spatiotemporal resolution volumes.

Materials and Methods

Twenty‐three patients referred for hepatic metastases or renal masses were imaged using the new META sequence and a conventional fat‐suppressed 3D SPGR sequence on a 3T scanner. In 12 patients, equilibrium‐phase 3D SPGR images acquired immediately after META were used for comparing the degree and homogeneity of fat suppression, artifacts, and overall image quality. In the remaining 11 of 23 patients, DCE 3D SPGR images acquired in a previous or subsequent examination were used for comparing the efficiency of arterial phase capture in addition to the qualitative analysis for the degree and homogeneity of fat suppression, artifacts, and overall image quality.

Results

META images were determined to be significantly better than conventional 3D SPGR images for degree and uniformity of fat suppression and ability to visualize the arterial phase. There were no significant differences in artifact levels or overall image quality.

Conclusion

META is a promising high spatiotemporal resolution imaging sequence for capturing the fast dynamics of hyperenhancing hepatic lesions and provides robust fat suppression even at 3T. J. Magn. Reson. Imaging 2009. © 2009 Wiley‐Liss, Inc.     

k‐space water‐fat decomposition with T2* estimation and multifrequency fat spectrum modeling for ultrashort echo time imaging

Purpose:

To demonstrate the feasibility of combining a chemical shift‐based water‐fat separation method (IDEAL) with a 2D ultrashort echo time (UTE) sequence for imaging and quantification of the short T₂ tissues with robust fat suppression.

Materials and Methods:

A 2D multislice UTE data acquisition scheme was combined with IDEAL processing, including T₂* estimation, chemical shift artifacts correction, and multifrequency modeling of the fat spectrum to image short T₂ tissues such as the Achilles tendon and meniscus both in vitro and in vivo. The integration of an advanced field map estimation technique into this combined method, such as region growing (RG), is also investigated.

Results:

The combination of IDEAL with UTE imaging is feasible and excellent water‐fat separation can be achieved for the Achilles tendon and meniscus with simultaneous T₂* estimation and chemical shift artifact correction. Multifrequency modeling of the fat spectrum yields more complete water‐fat separation with more accurate correction for chemical shift artifacts. The RG scheme helps to avoid water‐fat swapping.

Conclusion:

The combination of UTE data acquisition with IDEAL has potential applications in imaging and quantifying short T₂ tissues, eliminating the necessity for fat suppression pulses that may directly suppress the short T₂ signals. J. Magn. Reson. Imaging 2010;31:1027–1034. ©2010 Wiley‐Liss, Inc.     

Improved arterial visibility using short‐tau inversion‐recovery (STIR) fat suppression in non‐contrast‐enhanced time–spatial labeling inversion pulse (Time‐SLIP) renal MR angiography (MRA)

Purpose

To evaluate whether short‐tau inversion‐recovery (STIR) fat suppression is worthwhile in non‐contrast‐enhanced respiration‐triggered free‐breathing time–spatial labeling inversion pulse (Time‐SLIP) renal magnetic resonance angiography (MRA) compared with chemical shift selective (CHESS) fat suppression.

Materials and Methods

Simulation‐based analyses of inversion time (TI) for spatial‐selective inversion‐recovery (ssIR) pulse and breathing rate were performed, and confirmed on a phantom and in human subjects using a three‐dimensional (3D) coherent steady‐state free precession (SSFP) sequence on a 1.5T Toshiba scanner.

Results

The STIR fat suppression successfully suppressed signals from the intestines and parenchymous organs and provided better contrast between the arteries and the background, although an extension of TI was required for the ssIR pulse when a patient's respiration was extremely slow.

Conclusion

STIR fat suppression provides better renal artery contrast than CHESS fat suppression in non‐contrast free‐breathing Time‐SLIP MRA; it is also an effective screening tool for renal artery stenosis because of the lack of interference from intestinal signals. However, close attention is needed if the patient has slow respiration. As the TI for the ssIR pulse decreases, the STIR method requires faster‐paced respiration. J. Magn. Reson. Imaging 2009;29:1471–1477. © 2009 Wiley‐Liss, Inc.     

Single breathhold noncontrast thoracic MRA using highly accelerated parallel imaging with a 32-element coil array

Purpose:

To evaluate the feasibility of performing single breathhold three‐dimensional (3D) thoracic noncontrast MR angiography (NC‐MRA) using highly accelerated parallel imaging.

Materials and Methods:

We developed a single breathhold NC MRA pulse sequence using balanced steady state free precession (SSFP) readout and highly accelerated parallel imaging. In 17 subjects, highly accelerated noncontrast MRA was compared against electrocardiogram‐triggered contrast‐enhanced MRA. Anonymized images were randomized for blinded review by two independent readers for image quality, artifact severity in eight defined vessel segments and aortic dimensions in six standard sites. NC‐MRA and CE‐MRA were compared in terms of these measures using paired sample t‐ and Wilcoxon tests.

Results:

The overall image quality (3.21 ± 0.68 for NC‐MRA versus 3.12 ± 0.71 for CE‐MRA) and artifact (2.87 ± 1.01 for NC‐MRA versus 2.92 ± 0.87 for CE‐MRA) scores were not significantly different, but there were significant differences for the great vessel and coronary artery origins. NC‐MRA demonstrated significantly lower aortic diameter measurements compared with CE‐MRA; however, this difference was not considered clinically relevant (>3 mm difference) for less than 12% of segments, most commonly at the sinotubular junction. Mean total scan time was significantly lower for NC‐MRA compared with CE‐MRA (18.2 ± 6.0 s versus 28.1 ± 5.4 s, respectively; P < 0.05).

Conclusion:

Single breathhold NC‐MRA is feasible and can be a useful alternative for evaluation and follow‐up of thoracic aortic diseases. J. Magn. Reson. Imaging 2012;35:963–968. © 2011 Wiley Periodicals, Inc.     

Three‐dimensional dynamic time‐resolved contrast‐enhanced MRA using parallel imaging and a variable rate k‐space sampling strategy in intracranial arteriovenous malformations

Purpose

To evaluate the effectiveness of three‐dimensional (3D) dynamic time‐resolved contrast‐enhanced MRA (TR‐CE‐MRA) using a combination of a parallel imaging technique (ASSET: array spatial sensitivity encoding technique) and a time‐resolved method (TRICKS: time‐resolved imaging of contrast kinetics) and to compare it with 3D dynamic TR‐CE‐MRA using ASSET alone in the assessment of intracranial arteriovenous malformations (AVMs).

Materials and Methods

Twenty consecutive patients with angiographically confirmed AVMs were investigated using both 3D dynamic TR‐CE‐MRA techniques. Examinations were compared with respect to image quality, spatial resolution, number and type of feeders and drainers, nidus size, presence of early venous filling and temporal resolution. Digital subtraction angiography was used as standard of reference.

Results

The higher temporal and spatial resolution of 3D dynamic TR‐CE‐MRA TRICKS ASSET allowed a better assessment of intracranial vascular malformations, namely better depiction of feeders, drainers and better detection of early venous drainage. There was no significant difference between them in terms of nidus size.

Conclusion

3D dynamic TR‐CE‐MRA combining parallel imaging and a time‐resolved method with subsecond and submillimeter resolution could become the first‐line investigation technique in both diagnosis and follow‐up of intracranial AVMs. J. Magn. Reson. Imaging 2009;29:7–12. © 2008 Wiley‐Liss, Inc.     

MR angiography of the cerebral perforating arteries with magnetization prepared anatomical reference at 7T: Comparison with time‐of‐flight

Purpose

To develop a magnetic resonance imaging (MRI) protocol that visualizes both the perforating arteries and the related anatomy in a single acquisition at 7T.

Material and Methods

T₁‐weighted magnetization prepared imaging (MPRAGE) was empirically modified for use as angiography method at 7T. The resulting sequence depicts the vasculature simultaneously with the surrounding anatomical structures, and is referred to as “magnetization prepared anatomical reference MRA” (MPARE‐MRA). The method was compared to time‐of‐flight (TOF) MRA in seven healthy subjects. The conspicuity of the perforating arteries and the contrast between gray and white matter were evaluated both quantitatively by contrast‐to‐noise (CNR) measurements, and qualitatively by two radiologists who scored the images.

Results

The contrast‐to‐noise ratio (CNR) between blood and background was 28 ± 9 for MPARE‐MRA and 35 ± 16 for TOF‐MRA, indicating good conspicuity of the vessels. CNR values were: internal capsule (IC) vs. caudate head (CH): 4.2 ± 0.7; IC vs. putamen: 3.5 ± 0.6; white matter vs. gray matter: 9.7 ± 2.5.

Conclusion

The benefits of ultra‐high‐field MRI can transform MPRAGE into a new angiography method to image small vessels and associated parenchyma at the same time. This technique can be used to study the correlation between tissue damage and vascular pathology. J. Magn. Reson. Imaging 2008;28:1519–1526. © 2008 Wiley‐Liss, Inc.     

T2‐weighted 3D fast spin echo imaging with water–fat separation in a single acquisition

Purpose:

To develop a robust 3D fast spin echo (FSE) T₂‐weighted imaging method with uniform water and fat separation in a single acquisition, amenable to high‐quality multiplanar reformations.

Materials and Methods:

The Iterative Decomposition of water and fat with Echo Asymmetry and Least squares estimation (IDEAL) method was integrated with modulated refocusing flip angle 3D‐FSE. Echoes required for IDEAL processing were acquired by shifting the readout gradient with respect to the Carr‐Purcell‐Meiboom‐Gill echo. To reduce the scan time, an alternative data acquisition using two gradient echoes per repetition was implemented. Using the latter approach, a total of four gradient echoes were acquired in two repetitions and used in the modified IDEAL reconstruction.

Results:

3D‐FSE T₂‐weighted images with uniform water–fat separation were successfully acquired in various anatomies including breast, abdomen, knee, and ankle in clinically feasible scan times, ranging from 5:30–8:30 minutes. Using water‐only and fat‐only images, in‐phase and out‐of‐phase images were reconstructed.

Conclusion:

3D‐FSE‐IDEAL provides volumetric T₂‐weighted images with uniform water and fat separation in a single acquisition. High‐resolution images with multiple contrasts can be reformatted to any orientation from a single acquisition. This could potentially replace 2D‐FSE acquisitions with and without fat suppression and in multiple planes, thus improving overall imaging efficiency. J. Magn. Reson. Imaging 2010;32:745–751. © 2010 Wiley‐Liss, Inc.     

Iterative decomposition of water and fat with echo asymmetry and least‐squares estimation (IDEAL) of the wrist and finger at 3T: Comparison with chemical shift selective fat suppression images

Purpose:

To compare fat‐suppressed magnetic resonance imaging (MRI) quality using iterative decomposition of water and fat with echo asymmetry and least‐squares estimation (IDEAL) with that using chemical shift selective fat‐suppressed T1‐weighted spin‐echo (CHESS) images for evaluating rheumatoid arthritis (RA) lesions of the hand and finger at 3T.

Materials and Methods:

MRI was performed in eight healthy volunteers and eight RA patients with a 3.0T MR system (Signa HDxt GE healthcare) using an eight‐channel knee coil. FS‐CHESS‐T1‐SE and IDEAL imaging were acquired in the coronal planes covering the entire structure of the bilateral hands with a slice thickness of 2 mm. In the RA patients both images were obtained after intravenous gadolinium administration. Image quality was evaluated on a five‐point scale (1 = excellent to 5 = very poor). Synovitis and bone marrow contrast uptake on MR images were reviewed by two musculoskeletal radiologists using the Rheumatoid Arthritis MRI Scoring System (RAMRIS) of the Outcome Measures in Rheumatoid Arthritis Clinical Trials (OMERACT) group.

Results:

IDEAL showed uniform FS unaffected by magnetic field inhomogeneity and challenging geometry of hand and fingers, while CHESS‐T1‐SE often showed FS failure within the first metacarpal joint, tip of the finger, and ulnar aspect of the wrist joint. Overall image quality was significantly better with IDEAL than CHESS‐T1‐SE images (4.43 vs. 3.43, P < 0.01). Interobserver agreement (κ value) for synovitis and bone marrow contrast uptake was good to excellent with IDEAL (0.74–0.91, 0.62–0.89, respectively).

Conclusion:

IDEAL could compensate for the effects of field inhomogeneities, providing uniform FS of the hand and finger than did the CHESS‐T1‐SE sequence. J. Magn. Reson. Imaging 2013;37:733–738. © 2012 Wiley Periodicals, Inc.     

Image analysis in time-resolved large field of view 3D MR-angiography at 3T

Purpose

To qualitatively and quantitatively evaluate the image quality in accelerated time‐resolved 3D contrast‐enhanced MR angiography (tr‐CE‐MRA) at 3T.

Materials and Methods

In all, 113 MRA were performed in 107 patients on a 3T MR system after written informed consent and approval by the ethics committee. Twenty consecutive thoracic (n = 87) or craniocervical (n = 26) 3D data volumes were acquired. The timeframes with maximum arterial and venous contrast were determined and a total of 663 arterial and venous segments were analyzed by two blinded observers. Diagnostic image quality was graded by applying a 0 (low) to 3 (excellent) scale. Additionally, local signal‐to‐noise (SNR) and contrast‐to‐noise ratios (relative CNR) were evaluated.

Results

Tr‐CE‐MRA was successfully performed in all patients. Good to excellent image quality (2.42 ± 0.31) was observed in all individuals with preserved discrimination of arteries (2.43 ± 0.48) and veins (2.20 ± 0.56). Minor image degradation due to artifacts (2.62 ± 0.25) and constantly high vascular signal and contrast were detected. There was a significant superiority of coronal orientation during thoracic MRA (P < 0.05). In 18 cases tr‐CE‐MRA provided additional information on vascular pathologies.

Conclusion

Large field of view tr‐CE‐MRA enables constantly high‐quality thoracic and craniocervical angiographies. In addition, the dynamics of tr‐CE‐MRA can offer additional information on vascular pathologies. J. Magn. Reson. Imaging 2008;28:1116–1124. © 2008 Wiley‐Liss, Inc.     

MR Imaging of the Spine at 3.0T with T2-Weighted IDEAL Fast Recovery Fast Spin-Echo Technique

Objective

To compare the iterative decomposition of water and fat with echo asymmetry and the least-squares estimation (IDEAL) method with a fat-saturated T2-weighted (T2W) fast recovery fast spin-echo (FRFSE) imaging of the spine.

Materials and Methods

Images acquired at 3.0 Tesla (T) in 35 patients with different spine lesions using fat-saturated T2W FRFSE imaging were compared with T2W IDEAL FRFSE images. Signal-to-noise ratio (SNR)-efficiencies measurements were made in the vertebral bodies and spinal cord in the mid-sagittal plane or nearest to the mid-sagittal plane. Images were scored with the consensus of two experienced radiologists on a four-point grading scale for fat suppression and overall image quality. Statistical analysis of SNR-efficiency, fat suppression and image quality scores was performed with a paired Student''s t test and Wilcoxon''s signed rank test.

Results

Signal-to-noise ratio-efficiency for both vertebral body and spinal cord was higher with T2W IDEAL FRFSE imaging (p < 0.05) than with T2W FRFSE imaging. T2W IDEAL FRFSE demonstrated superior fat suppression (p < 0.01) and image quality (p < 0.01) compared to fat-saturated T2W FRFSE.

Conclusion

As compared with fat-saturated T2W FRFSE, IDEAL can provide a higher image quality, higher SNR-efficiency, and consistent, robust and uniform fat suppression. T2W IDEAL FRFSE is a promising technique for MR imaging of the spine at 3.0T.     

Hybrid of opposite‐contrast MRA of the brain by combining time‐of‐flight and black‐blood sequences: Initial experience in major trunk stenoocclusive diseases

Purpose:

To assess the feasibility of a new MR angiography (MRA) technique named hybrid of opposite‐contrast MRA (HOP MRA) that combined the time‐of‐flight (TOF) MRA with a flow‐sensitive black‐blood (FSBB) sequence in the diagnosis of major trunk stenoocclusive diseases.

Materials and Methods:

On a 1.5 Tesla imager using a dual‐echo three‐dimensional (3D)‐gradient‐echo sequence, we obtained the first echo for TOF MRA followed by the second echo for FSBB. We then subtracted the FSBB data set from that of TOF MRA followed by maximum intensity projection. In four normal volunteers and 19 patients with chronic stenoocclusive disease of the major trunk, we performed HOP MRA along with 3D‐TOF MRA and compared the findings.

Results:

In the volunteer group, the HOP MRA technique improved the demonstration of distal arterial branches. In 12 of the 19 patients, the HOP MRA better visualized branches distal to the lesion as well as distal branches of normal trunks than 3D‐TOF MRA, while both techniques provided equivalent depiction of branches distal to the lesion but better depiction of normal distal branches in three patients.

Conclusion:

The HOP‐MRA technique is promising in major trunk stenoocclusive diseases as it better demonstrates distal branches probably representing collaterals than 3D‐TOF MRA. J. Magn. Reson. Imaging 2010;31:56–60. © 2009 Wiley‐Liss, Inc.     

Water-fat separation with IDEAL gradient-echo imaging

Purpose

To combine gradient‐echo (GRE) imaging with a multipoint water–fat separation method known as “iterative decomposition of water and fat with echo asymmetry and least squares estimation” (IDEAL) for uniform water–fat separation. Robust fat suppression is necessary for many GRE imaging applications; unfortunately, uniform fat suppression is challenging in the presence of B₀ inhomogeneities. These challenges are addressed with the IDEAL technique.

Materials and Methods

Echo shifts for three‐point IDEAL were chosen to optimize noise performance of the water–fat estimation, which is dependent on the relative proportion of water and fat within a voxel. Phantom experiments were performed to validate theoretical SNR predictions. Theoretical echo combinations that maximize noise performance are discussed, and examples of clinical applications at 1.5T and 3.0T are shown.

Results

The measured SNR performance validated theoretical predictions and demonstrated improved image quality compared to unoptimized echo combinations. Clinical examples of the liver, breast, heart, knee, and ankle are shown, including the combination of IDEAL with parallel imaging. Excellent water–fat separation was achieved in all cases. The utility of recombining water and fat images into “in‐phase,” “out‐of‐phase,” and “fat signal fraction” images is also discussed.

Conclusion

IDEAL‐SPGR provides robust water–fat separation with optimized SNR performance at both 1.5T and 3.0T with multicoil acquisitions and parallel imaging in multiple regions of the body. J. Magn. Reson. Imaging 2007;25:644–652. © 2007 Wiley‐Liss, Inc.     

Measuring aortic diameter with different MR techniques: Comparison of three‐dimensional (3D) navigated steady‐state free‐precession (SSFP), 3D contrast‐enhanced magnetic resonance angiography (CE‐MRA), 2D T2 black blood,and 2D cine SSFP

Purpose:

To compare nongated three‐dimensional (3D) contrast‐enhanced magnetic resonance angiography (CE‐MRA) with 3D‐navigated cardiac‐gated steady‐state free‐precession bright blood (3D‐nav SSFP) and noncontrast 2D techniques for ascending aorta dimension measurements.

Materials and Methods:

Twenty‐five clinical exams were reviewed to evaluate the ascending aorta at 1.5T using: breathhold cine bright blood (SSFP), cardiac‐triggered T2 black blood (T2 BB), axial 3D‐nav SSFP, and nongated 3D CE‐MRA. Three radiologists independently measured aortic size at three specified locations for each sequence. Means, SDs, interobserver correlation, and vessel edge sharpness were statistically evaluated.

Results:

Measurements were greatest for 3D‐nav SSFP and 3D CE‐MRA and smallest for T2 BB. There was no significant difference between 3D‐nav SSFP and 3D CE‐MRA (P = 0.43–0.86), but significance was observed comparing T2 BB to all sequences. Interobserver agreement was uniformly >0.9, with T2 BB best, followed closely by 3D‐nav SSFP and 2D cine SSFP, and 3D CE‐MRA being the worst. Edge sharpness was significantly poorer for 3D CE‐MRA compared to the other sequences (P < 0.001).

Conclusion:

If diameter measurements are the main clinical concern, 3D‐nav SSFP appears to be the best choice, as it has a sharp edge profile, is easy to acquire and postprocess, and shows very good interobserver correlation. J. Magn. Reson. Imaging 2010;31:177–184. © 2009 Wiley‐Liss, Inc.     

High-resolution proton density weighted three-dimensional fast spin echo (3D-FSE) of the knee with IDEAL at 1.5 Tesla: comparison with 3D-FSE and 2D-FSE--initial experience

Purpose:

To assess the feasibility of combining three‐dimensional fast spin echo (3D‐FSE) and Iterative‐decomposition‐of water‐and‐fat‐with‐echo asymmetry‐and‐least‐squares‐estimation (IDEAL) at 1.5 Tesla (T), generating a high‐resolution 3D isotropic proton density‐weighted image set with and without “fat‐suppression” (FS) in a single acquisition, and to compare with 2D‐FSE and 3D‐FSE (without IDEAL).

Materials and Methods:

Ten asymptomatic volunteers prospectively underwent sagittal 3D‐FSE‐IDEAL, 3D‐FSE, and 2D‐FSE sequences at 1.5T (slice thickness [ST]: 0.8 mm, 0.8 mm, and 3.5 mm, respectively). 3D‐FSE and 2D‐FSE were repeated with frequency‐selective FS. Fluid, cartilage, and muscle signal‐to‐noise ratio (SNR) and fluid‐cartilage contrast‐to‐noise ratio (CNR) were compared among sequences. Three blinded reviewers independently scored quality of menisci/cartilage depiction for all sequences. “Fat‐suppression” was qualitatively scored and compared among sequences.

Results:

3D‐FSE‐IDEAL fluid‐cartilage CNR was higher than in 2D‐FSE (P < 0.05), not different from 3D‐FSE (P = 0.31). There was no significant difference in fluid SNR among sequences. 2D‐FSE cartilage SNR was higher than in 3D FSE‐IDEAL (P < 0.05), not different to 3D‐FSE (P = 0.059). 2D‐FSE muscle SNR was higher than in 3D‐FSE‐IDEAL (P < 0.05) and 3D‐FSE (P < 0.05). Good or excellent depiction of menisci/cartilage was achieved using 3D‐FSE‐IDEAL in the acquired sagittal and reformatted planes. Excellent, homogeneous “fat‐suppression” was achieved using 3D‐FSE‐IDEAL, superior to FS‐3D‐FSE and FS‐2D‐FSE (P < 0.05).

Conclusion:

3D FSE‐IDEAL is a feasible approach to acquire multiplanar images of diagnostic quality, both with and without homogeneous “fat‐suppression” from a single acquisition. J. Magn. Reson. Imaging 2012;361‐369. © 2011 Wiley Periodicals, Inc.     

Non‐contrast renal artery MRA using an inflow inversion recovery steady state free precession technique (Inhance): Comparison with 3D contrast‐enhanced MRA

Purpose:

To assess the performance of a three‐dimensional (3D) non‐contrast respiratory‐triggered steady state free precession (SSFP) pulse sequence for detection of renal artery stenosis.

Materials and Methods:

A total of 64 patients who had non‐contrast MR angiography (NC MRA) and 3D contrast‐enhanced MRA (CE MRA) performed during the same exam and three patients who had NC MRA followed by conventional catheter angiography within one month of the MRI exam were included in this retrospective study. Two blinded readers evaluated NC MRA images for the presence of significant renal artery stenosis and also rated their diagnostic confidence and evaluated the images for artifact. A similar analysis was performed for CE MRA images by two additional blinded readers, and discrepancies were resolved by consensus reading.

Results:

The 67 patients had 168 main and accessory renal arteries, with significant (>50%) stenosis in 34 arteries on CE MRA or conventional angiography. The two NC MRA readers had sensitivity and specificity for detection of significant stenosis of 94%/82% and 82%/87% respectively on a per renal artery basis.

Conclusion:

There was good agreement between CE MRA and NC MRA for detection of significant renal artery stenosis. This technique should prove useful in evaluating patients with suspected renovascular hypertension who are unable to undergo CE MRA. J. Magn. Reson. Imaging 2010;31:1411–1418. © 2010 Wiley‐Liss, Inc.     

Usefulness of IDEAL T2-weighted FSE and SPGR imaging in reducing metallic artifacts in the postoperative ankles with metallic hardware

Purpose

The aim of this work is to prospectively compare the effectiveness of iterative decomposition of water and fat with echo asymmetry and least-squares estimation (IDEAL), T2-weighted fast spin-echo (FSE), and spoiled gradient-echo (SPGR) MR imaging to frequency selective fat suppression (FSFS) protocols for minimizing metallic artifacts in postoperative ankles with metallic hardware.

Materials and methods

The T2-weighted and SPGR imaging with IDEAL and FSFS were performed on 21 ankles of 21 patients with metallic hardware. Two musculoskeletal radiologists independently analyzed techniques for visualization of ankle ligaments and articular cartilage, uniformity of fat saturation, and relative size of the metallic artifacts. A paired t test was used for statistical comparisons of MR images between IDEAL and FSFS groups.

Results

IDEAL T2-weighted FSE and SPGR images enabled significantly improved visualization of articular cartilage (p?<?0.05), the size of metallic artifact (p?<?0.05), and the uniformity of fat saturation (p?<?0.05). However, no significant improvement was found in the visibility of ligaments.

Conclusions

IDEAL T2-weighted FSE and SPGR imaging effectively reduces the degree of tissue-obscuring artifacts produced by fixation hardware in ankle joints and improves image quality compared to FSFS T2-weighted FSE and SPGR imaging. However, visibility of ligaments was not improved using IDEAL imaging.