MR angiography with a cardiac-phase--specific acquisition window.

A method for cardiac-phase-specific magnetic resonance (MR) angiography is presented. An electronics module permits incrementing of phase-encoding gradients and storage of incoming data only during a chosen portion of the cardiac cycle. Suppression of stationary material is maintained by delivering radio-frequency pulses at constant TR throughout the cycle. Imaging of a pulsatile flow phantom demonstrates that acquiring data only during systole substantially increases the signal intensity of flowing material. In addition, phase-encoding ghost artifacts are eliminated from the neighborhood of the vessel. Image acquisition time is minimized by acquiring only the low-frequency phase-encoding lines in the cardiac-phase-specific mode. In healthy volunteers, greatly improved MR angiograms of the lower extremities are obtained. Fat saturation and magnetization transfer further enhance vessel/background contrast. Acquiring data only during systole ensures rapid inflow for all phase-encoding lines, permitting a near-longitudinal section orientation without in-plane saturation. This substantially reduces total acquisition time relative to axial acquisition.     

Coupled-spin fast spin-echo MR imaging

Distinguishing between lipid and water-containing tissues is clinically important. Current techniques rely on the chemical shift difference between fat and water resonances or differences in relaxation times of the tissues, or a combination of both. A method is presented for separating the signals of lipid protons from those of water protons by using fast spin-echo magnetic resonance imaging based on the principle that lipid protons behave differently from water protons in mul-tiecho sequences. Two images are acquired with different echo train lengths and echo spacing but with identical TEs, and then subtracted to exploit differences in the behavior of lipid and water protons in mul-tiecho sequences. The method is insensitive to B₀ inhomoge-neities or susceptibility effects and provides separate lipid and water images with a high signal-to-noise ratio. The advantages of the method are demonstrated with phantom studies and clinical examples.     

Why fat is bright in RARE and fast spin-echo imaging.

Fast spin-echo (FSE) sequences are becoming popular for T2-weighted clinical imaging because they result in a severalfold reduction in imaging time and because they provide conventional spin-echo contrast for most tissues. Fat, however, has been observed to have anomalously high signal intensity on FSE images. The present study shows that the brighter fat results from the multiple 180 degrees refocusing pulses, which eliminate diffusion-mediated susceptibility dephasing and suppress J-coupling modulation of the echo train.     

Separation of fat and water in fast spin-echo MR imaging with the three-point dixon technique

A method for suppressing fat in fast spin-echo imaging with the three-point Dixon technique is described. The method differs from the three-point Dixon method used in conventional spin-echo imaging in that the readout gradient instead of a radio-frequency pulse is shifted. This method preserves the Carr-Purcell-Meiboom-Gill nature of the fast spin-echo sequence and hence is less sensitive to magnetic field inhomogeneities and resonance frequency mistiming. As in the original three-point Dixon technique used in conventional spin-echo imaging, three acquisitions are required to estimate the field inhomogeneity and completely separate fat and water. The extra time required is not excessive considering that the fast spin-echo method is frequently applied with multiple signal acquisition. Also, this technique achieves an expected signal-to-noise ratio comparable to 2.67 signal acquisitions, which is approximately 94% of the signal-to-noise ratio obtained with three signal acquisitions. The method is demonstrated with applications to phantoms and a human volunteer.     

Pulsatile flow artifacts in fast magnetization-prepared sequences

Fast magnetization-prepared magnetic resonance imaging sequences allow clinical acquisitions in about 1 second, with the preparation phase providing the desired contrast. Pulsatile flow artifacts, although reduced by rapid acquisition, can degrade image quality. The authors explore the causes of aortic pulsatile flow artifacts in inversion-recovery-prepared acquisitions of the abdomen, taking into consideration various parameters. The flow signal within an 8-mm-thick section was simulated and subsequently Fourier transformed to determine the location and extent of flow artifacts. Results of simulations were validated with abdominal images of human subjects. Recording all encodings within one cardiac cycle reduced pulsatile flow artifacts in nonsegmented acquisitions with sequential phase-encoding order, regardless of the location of magnetization preparation within the cardiac cycle. In segmented acquisitions, however, the sequential order always increased flow artifacts. To reduce the artifacts in short TI acquisitions, the magnetization should be prepared during diastole. In clinical acquisitions, flow artifacts were further reduced by modifying the phase-encoding scheme.     

Cardiac-gated MR angiography of pulsatile flow: K-space strategies

Signal strength in time-of-flight magnetic resonance (MR) anglograpny of pulsatile flow is modulated by the time-varying intraluminal magnetization strength. The specific appearance of MR angiographlc images therefore depends on the relationship of different phase-encoding steps to the pulsatile flow waveform. Cardiac-phase gating can be applied with phase-encoding reordering to acquire different regions of k-space during the desired phases of the cardiac cycle. The authors have developed a simulation program for evaluating the merits of different encoding strategies for pulsatile flow. The model was validated with phantom studies. High signal intensity relative to that in conventional MR anglographic studies can be attained with strategies that impose relatively small penalties in total acquisition time.     

Pulsation artifact in short TR MR imaging and angiography: Exacerbation with signal averaging

Averaging the signals from more than one excitation per phase-encoding view increases the signal-to-noise ratio and, in conventional spin-echo magnetic resonance imaging, reduces most motion artifacts. To determine the effects of signal averaging on two-dimensional gradient-echo images, acquisitions with different TRs and with no averaging versus multiple-signal averaging were compared in a pulsatile flow phantom and the human abdominal aorta. Intraview (each view repeated before changing the phase-encoding value) and interview (obtaining all views sequentially and then repeating the entire set) averaging methods were used. Pulsation artifacts were present on all images of the flow phantom and the aorta. Intraview signal averaging, the method most commonly used, exacerbated rather than ameliorated pulsation artifacts with short TR sequences. Pulsation artifacts on two-dimensional images obtained with a short TR can be minimized by completing the acquisition as rapidly as possible, avoiding signal averaging. If signal averaging is used for short TR images, it should be interview averaging.     

Time-resolved MR imaging by automatic data segmentation

A method for time-resolved imaging that provides a flexible trade-off between imaging time and temporal resolution is presented. It is based on a view order selection technique that automatically segments the acquired raw data into appropriate temporal frames. When used with cardiac monitoring and phase-contrast imaging, data similar to that obtained with a conventional gated phase-contrast sequence are acquired rapidly. For many applications, the temporal resolution can be reduced enough to permit imaging within a breath-hold interval, while still allowing accurate time-averaged flow quantitation. This is a general technique that can be implemented within a variety of pulse sequences and can resolve other motion cycles, including the respiratory cycle.     

Lumen definition in MR angiography.

Factors affecting blood vessel lumen definition for two-dimensional and three-dimensional inflow magnetic resonance (MR) imaging methods are considered. Vessel definition is affected (a) by the amount of dephasing of the blood in the vessels, both for uncompensated and velocity-compensated gradients; (b) by the image reconstruction technique (normal Fourier reconstruction when asymmetric echoes are collected or a maximum-intensity projection technique in post-processing); (c) by loss of signal due to T2* dephasing; (d) by misregistration; (e) by vessel wall motion; and (f) by partial-volume effects. The first two factors were found to dominate for resolution on the order of 1 mm3. To overcome these dephasing problems, the authors developed asymmetric echo, velocity-compensated sequences with TEs as short as 4.8 msec. The data were then reconstructed with an iterative partial Fourier algorithm, enabling improved lumen definition to be obtained in phantoms and in vivo.     

MR angiography with adiabatic flow excitation.

A new method of magnetic resonance (MR) angiography is presented that produces signal from flowing spins and suppresses that from stationary spins by means of a flow excitation pulse sequence consisting of adiabatic 90 degrees and 180 degrees radio-frequency (RF) pulses interleaved with flow-dephasing gradient lobes. Stationary spins are refocused along the z axis, while flowing spins are dephased by the gradient lobes and generate a transverse component that can be measured directly to produce the angiogram. Adiabatic RF pulses and unipolar gradient lobes give the pulse sequence a high degree of immunity to RF and magnetic field inhomogeneity. The pulse sequence can be successfully applied with a transmit/receive surface coil. The disadvantage of adiabatic RF pulses is that their long duration makes it difficult to suppress the signal of stationary spins with short T2.     

Tracking motion with tagged rapid gradient-echo magnetization-prepared MR imaging.

A technique for rapid assessment of tissue motion was developed by combining spatially selective radio-frequency tagging pulses with centric phase-encoding view ordering in a T1-weighted, magnetization-prepared gradient-echo acquisition sequence. This sequence allowed labeling and tracking of tissue motion with single-image acquisition times of less than 3 seconds. Multiple tagged bands 3mm thick were superimposed orthogonal to the imaging plane. Motion in the interval between tagging and the start of image acquisition could then be precisely determined. The technique was evaluated with phantom studies and then applied to human volunteers for assessment of skeletal muscle motion, phonation, and pelvic floor motion.     

Fast spin-echo studies of contrast and small-lesion definition in a liver-metastasis phantom

A liver-metastasis model was used to study the ability of fast spin-echo (FSE) imaging to show small lesions (1 pixel in diameter) relative to conventional spin-echo imaging. FSE images of the liver-metastasis phantom were acquired with various phase-encode reordering schemes to manipulate T2 contrast. The imaging time for multisection acquisitions was 27 seconds for FSE imaging and 6 minutes 48 seconds for conventional spin-echo imaging. Computer simulations were performed to determine how the point spread function varies with the different phase-encoding orders in FSE imaging. Contrast-to-noise ratios and signal profiles of the lesions were measured as a function of the effective TE and lesion size. Experimental results and theoretical simulations showed that T2-weighted FSE imaging provides high contrast and good edge definition even for small lesions. The results indicate that FSE imaging may become a powerful method for the early detection of liver metastases.     

Mechanisms of flow-induced signal loss in MR angiography.

Mechanisms of signal loss in magnetic resonance angiography were studied with a stenotic flow phantom. The results indicate that while signal loss induced by mean fluid motions is localized about the stenosis, the fluctuating component of fluid motion induces signal loss over a much larger region, primarily distal to the stenosis. For both motion components, use of gradient moment nulling (GMN) above first order was found to be an ineffective means of reducing signal loss. In contrast, shortened gradient durations were found to reduce signal loss substantially. However, though a zeroth-order gradient is generally of the shortest duration, use of a slightly longer, first-order gradient was found to be the most robust means of reducing signal loss.     

Aortoiliac disease: Two-dimensional inflow MR angiography with lipid suppression

A magnetic resonance (MR) imaging strategy, SLIP (spatially separated lipid presaturation), which can be incorporated into existing MR imaging and MR angiographic techniques, has been developed to suppress lipid signal. The authors report the clinical application of this technique, with a triple comparison of two-dimensional inflow MR angiography, with and without SLIP, and x-ray angiography in patients with aortoiliac disease. SLIP improved visualization of arterial segments, with 50 of 63 (79%) arterial segments visualized versus 41 of 63 (65%) for non-SLIP MR angiography. The SLIP strategy aids in the depiction of slow or turbulent flow, because the lipid signal is suppressed while the intravascular signal is left undisturbed. Image quality improves because of the combination of decreased background lipid signal intensity and use of the maximum-intensity-projection algorithm. Compared with x-ray arteriography, non-SLIP MR angiography had a sensitivity and specificity of 60% and 56%, respectively, for detection of lesions with 50%–100% diameter reduction, while SLIP MR angiography had a sensitivity and specificity, respectively, of 53% and 67%.     

Phase-contrast MR angiography with reduced acquisition time: New concepts in sequence design

A new acquisition scheme for three-dimensional (3D) phase-contrast MR angiography reduces by 33% the measurement time for a data set sensitive to flow in all three orthogonal directions. Background suppression is achieved by acquiring a flow-compensated data set and three data sets flow encoded in the three orthogonal directions, with subsequent complex subtraction. The data are acquired in an interleaved fashion, eliminating misregistration artifacts due to patient motion between measurements sensitive to different flow directions. A standard maximum-intensity-projection algorithm is applied to the combined 3D data set to obtain angiographic projections sensitive to all three orthogonal flow directions. The theory and implementation of the method are described and examples of its application to the intracranial and abdominal circulation are provided.     

Pulse sequence strategies for vascular contrast in time-of-flight carotid MR angiography

A systematic evaluation in healthy volunteers of the relative efficacy of various techniques for background suppression to improve two-dimensional (2D) and three-dimensional (3D) time-of-flight magnetic resonance angiography of the cervical carotid arteries was performed. Conventional 2D and 3D FISP (fast imaging with steady-state precession) sequences with flow compensation were compared with modifications of these sequences, including a tracking saturation pulse (2D), prolonged absolute TEs for fat suppression based on T2* decay (2D and 3D), frequency-selective saturation of fat (2D and 3D), in-plane spatial saturation (2D), and magnetization transfer contrast (2D and 3D). The tracking saturation pulse and slight overlap of the excitation sections provided uniform background suppression without impairing depiction of the morphology of the cervical carotid arteries. Frequency-selective fat saturation was the most effective background suppression scheme among the 2D and 3D techniques but was occasionally compromised by local field inhomo-geneities. Magnetization transfer contrast provided little suppression of stationary tissues in the neck because of the intrinsic limitations of the coil. In-plane spatial saturation yielded the highest background suppression but reduced apparent arterial diameters and could not be implemented in a 3D version. The T2* decay method not only reduced the apparent size of the vessels but also their signal intensity.     

Computer-controlled flow simulator for MR flow studies.

A novel computer-controlled flow simulator for use in magnetic resonance (MR) flow experiments was evaluated. The accuracy in constant-flow mode was better than 1%. The accuracy in pulsatile-flow mode was found to be dependent on the interconnecting tubing. The short-term and long-term reproducibilities of pulsatile waveforms were less than or equal to 0.4 mL/sec (1 standard deviation). Increased response times due to the lengths of tubing required in MR flow experiments were surmounted by using a modified tubing configuration and precompensated waveforms. Piston reversal was found not to cause major difficulties in MR flow experiments.     

Clinical comparison of three-dimensional MP-RAGE and FLASH techniques for MR imaging of the head.

Three-dimensional (3D) MP-RAGE (magnetization-prepared rapid gradient-echo) imaging was evaluated as a high-resolution 3D T1-weighted brain imaging technique for patients with suspected neurologic disease. Fourteen patients were studied. In five, 3D MP-RAGE images were compared with 3D FLASH (fast low-angle shot) images. Signal difference--to-noise ratios and T1 contrast were not statistically different for 3D MP-RAGE images as opposed to 3D FLASH images. Advantages intrinsic to the application of 3D MP-RAGE sequences include decreased imaging time and decreased motion artifact. With this technique, it is possible to perform a relatively motion-insensitive, T1-weighted screening brain study with voxel resolution of 1.0 x 1.4 x 2.0 mm or smaller, in an imaging time of 5.9 minutes or less--permitting offline (poststudy) reconstruction of high-resolution images in any desired plane.     

Frequency response of retrospectively gated phase-contrast MR imaging: Effect of interpolation

Retrospectively gated phase-contrast (PC) magnetic resonance velocity and volume flow measurements were evaluated in both in vitro and in vivo experiments. The accuracy of these measurements was found to be affected by the interpolation window width required in the reconstruction of retrospectively gated data. Interpolation modified the frequency content of the series of temporal measurements by decreasing the response at higher frequencies. With a series of sinusoidal flow waveforms, the frequency response of one specific implementation of retrospectively gated PC velocity measurements was experimentally determined. The experimental response agreed with the theoretical response predicted from an analysis of the interpolating function (2.2% root-mean-square difference). In vitro experiments with a simulated carotid flow waveform demonstrated errors in the systolic measurements that were a direct result of the modified frequency response. A volunteer study was also undertaken and confirmed the in vitro findings.     

Gadolinium-enhanced high-resolution MR angiography with adaptive vessel tracking: preliminary results in the intracranial circulation.

To overcome problems associated with poor contrast between vessels and background tissue in time-of-flight magnetic resonance angiography, the role of intravenous gadopentetate dimeglumine in conjunction with a postprocessing adaptive vessel tracking scheme was studied. Vessel tracking makes it possible to discriminate arteries from veins, to prevent problems associated with other bright tissues on maximum-intensity projections, and to increase the signal-to-noise ratio. Short, asymmetric, velocity-compensated field echoes were used in conjunction with high-resolution imaging techniques to spatially discriminate between adjacent vessels and stationary background tissue. Gadopentetate dimeglumine was shown to be useful for visualization of small vessels, aneurysms, and regions of slow flow, when used with this post-processing scheme.