Blood attenuation with SSFP-compatible saturation (BASS)

PURPOSE: To investigate a rapid flow-suppression method for improving the contrast-to-noise ratio (CNR) between the vessel wall and the lumen for cardiovascular imaging applications. MATERIALS AND METHODS: In this study a new dark-blood steady-state free precession (SSFP) sequence utilizing two excitation pulses per TR was developed. The first pulse is applied immediately adjacent to the slice of interest, while the second is a conventional slice-selective pulse designed to excite an SSFP signal for the static spins in the slice of interest. The slice-selective pulse is followed by fully refocused gradients along all three imaging axes over each TR. The signal amplitude (SA) from the moving spins excited by the "saturation" pulse is attenuated since they are not fully refocused at the TE. RESULTS: This work provides confirmation, by both simulation and experiments, that modest adaptations of the basic True-FISP structure can limit unwanted "bright blood" signal within the vessels while simultaneously preserving the contrast and speed advantages of this well-established rapid imaging method. CONCLUSION: Animal imaging trials confirm that dark-blood contrast is achieved with the BASS sequence, which substantially reverses the lumen-to-muscle CNR of a conventional True-FISP "bright blood" acquisition from 14.77 (bright blood) to -13.96 (dark blood) with a modest increase (24.2% of regular TR of SSFP for this implementation) in acquisition time to accommodate the additional slab-selective excitation pulse and gradient pulses.     

Fast proton spectroscopic imaging using steady-state free precession methods.

Various pulse sequences for fast proton spectroscopic imaging (SI) using the steady-state free precession (SSFP) condition are proposed. The sequences use either only the FID-like signal S(1), only the echo-like signal S(2), or both signals in separate but adjacent acquisition windows. As in SSFP imaging, S(1) and S(2) are separated by spoiler gradients. RF excitation is performed by slice-selective or chemical shift-selective pulses. The signals are detected in absence of a B(0) gradient. Spatial localization is achieved by phase-encoding gradients which are applied prior to and rewound after each signal acquisition. Measurements with 2D or 3D spatial resolution were performed at 4.7 T on phantoms and healthy rat brain in vivo allowing the detection of uncoupled and J-coupled spins. The main advantages of SSFP based SI are the short minimum total measurement time (T(min)) and the high signal-to-noise ratio per unit measurement time (SNR(t)). The methods are of particular interest at higher magnetic field strength B(0), as TR can be reduced with increasing B(0) leading to a reduced T(min) and an increased SNR(t). Drawbacks consist of the limited spectral resolution, particularly at lower B(0), and the dependence of the signal intensities on T(1) and T(2). Further improvements are discussed including optimized data processing and signal detection under oscillating B(0) gradients leading to a further reduction in T(min).     

Improved spectral selectivity and reduced susceptibility in SSFP using a near zero TE undersampled three-dimensional PR sequence

PURPOSE: To improve the performance of fat/water separation and reduce the sensitivity to susceptibility variation in balanced SSFP sequences. MATERIALS AND METHODS: Decreasing the repetition time (TR) reduces susceptibility artifacts in SSFP imaging. A shorter TR may also improve the spectral selectivity obtained when linearly combining data acquired using different radiofrequency phase cycling schedules. The desired short TR is achieved by using an angularly undersampled three-dimensional radial acquisition sequence that achieves a near zero echo time (TE) and also a short TR. RESULTS: Images from human volunteers demonstrate broad coverage of the cervical spine and knee with isotropic resolution. Excellent fat/water separation is achieved in these studies. CONCLUSION: The short TR capability of the proposed sequence greatly improves the fat suppression in SSFP imaging. High-resolution volumetric T2-like contrast imaged with reduced susceptibility artifacts can be obtained from a single acquisition using this technique.     

T2-prepared SSFP improves diagnostic confidence in edema imaging in acute myocardial infarction compared to turbo spin echo.

T2-weighted MRI of edema in acute myocardial infarction (MI) provides a means of differentiating acute and chronic MI, and assessing the area at risk of infarction. Conventional T2-weighted imaging of edema uses a turbo spin-echo (TSE) readout with dark-blood preparation. Clinical applications of dark-blood TSE methods can be limited by artifacts such as posterior wall signal loss due to through-plane motion, and bright subendocardial artifacts due to stagnant blood. Single-shot imaging with a T2-prepared SSFP readout provides an alternative to dark-blood TSE and may be conducted during free breathing. We hypothesized that T2-prepared SSFP would be a more reliable method than dark-blood TSE for imaging of edema in patients with MI. In patients with MI (22 acute and nine chronic MI cases), T2-weighted imaging with both methods was performed prior to contrast administration and delayed-enhancement imaging. The T2-weighted images using TSE were nondiagnostic in three of 31 cases, while six additional cases rated as being of diagnostic quality yielded incorrect diagnoses. In all 31 cases the T2-prepared SSFP images were rated as diagnostic quality, correctly differentiated acute or chronic MI, and correctly determined the coronary territory. Free-breathing T2 prepared SSFP provides T2-weighted images of acute MI with fewer artifacts and better diagnostic accuracy than conventional dark-blood TSE.     

Real-time volumetric flow measurements with complex-difference MRI.

Blood flow in large vessels can be noninvasively evaluated with phase-contrast (PC) MRI by encoding the spin velocity to the image phase. Conventional phase-difference processing of the flow-encoded image data yields velocity images. Complex-difference processing is an alternative to phase-difference methods, and has the advantage of eliminating signal from stationary spins. In this study, two acquisitions with differential flow encoding are subtracted to yield a single projection that contains signal from only those spins moving in the direction of the flow-encoding gradients. The increase in acquisition efficiency allows real-time flow imaging with a temporal window as short as two acquisition lengths (60 ms). Validation of the complex-difference method by comparison with conventional gated-segmented PC-MRI in a flow phantom yielded a correlation of r > 0.99. Peak arterial flow rates in the popliteal artery and desending aorta measured in vivo with the complex-difference method were 0.92 +/- 0.06 of the values measured with conventional PC imaging. Real-time in vivo volumetric flow imaging of transient flow events is also presented.     

Inflow quantification in three-dimensional cardiovascular MR imaging

Purpose

To investigate blood inflow enhancement (or lack thereof) in three‐dimensional (3D) cardiovascular MR for both single phase whole‐heart and cine biventricular functions.

Materials and Methods

A 3D imaging sequence is proposed in which radiofrequency excitation gradient is changed without modifying image acquisition or phase/slice encoding. This imaging sequence enables direct inflow measurement while retaining static voxel signal‐to‐noise ratio. Inflow measurements were performed for both spoiled gradient‐echo (GRE) imaging and balanced steady‐state free precession (SSFP) in 18 healthy subjects.

Results

For single phase imaging, increasing slab thickness from 3 to 10 cm lead to 73% and 59% reductions in contrast‐to‐noise ratio (CNR) with GRE and SSFP, respectively. For cine acquisitions, systolic CNR was reduced by 85% and 50% for the GRE and SSFP acquisitions, respectively, while diastolic CNR was reduced by 64% and 42%.

Conclusion

There is significant loss of CNR between blood and myocardium when using larger 3D slabs due to saturation of inflowing spins. The loss of contrast is less pronounced for SSFP than for GRE, though both acquisition techniques suffer. J. Magn. Reson. Imaging 2008;28:1273–1279. © 2008 Wiley‐Liss, Inc.     

Halting the effects of flow enhancement with effective intermittent zeugmatographic encoding (HEFEWEIZEN) in SSFP

Purpose

To describe a new method for performing dark blood (DB) magnetization preparation in TrueFISP (bSSFP) and apply the technique to high‐resolution carotid artery imaging.

Materials and Methods

The developed method (HEFEWEIZEN) provides directional flow suppression, while preserving bSSFP contrast, by periodically applying spatial saturation in short repetition time (TR) TrueFISP. Steady‐state free precession (SSFP) conditions are maintained throughout the acquisition for the imaging slice magnetization. HEFEWEIZEN was implemented on a 1.5 T scanner with standard receiver coils. Studies were performed in phantoms, eight asymptomatic volunteers, and two patients with low‐ and high‐grade carotid artery stenosis.

Results

Average flow suppression was 88% ± 4% (arterial) and 85% ± 3% (venous) in a multislice study. Stationary signal, contrast, and fine details were maintained with only slight signal suppression (11% ± 11%). Comparison to diffusion‐prepared SSFP in the common carotid artery demonstrated significant improvement in wall‐lumen contrast‐to‐noise ratio efficiency (P = 0.024). DB contrast was achieved with only 13% increased acquisition time (14.3 sec). Further acceleration was possible by confining the DB preparation to the central 60% of k‐space.

Conclusion

A fast, short TR, DB TrueFISP pulse sequence was developed and tested in the carotid arteries of asymptomatic volunteers and patients. J. Magn. Reson. Imaging 2009;29:1163–1174. © 2009 Wiley‐Liss, Inc.     

Effect of vascular crushing on FAIR perfusion kinetics, using a BIR-4 pulse in a magnetization prepared FLASH sequence.

Flow-sensitive alternating inversion recovery (FAIR) perfusion imaging suffers from high vascular signal, resulting in artifacts and overestimation of perfusion. With TurboFLASH acquisition, crushing of vascular signal by bipolar gradients after each excitation is difficult due to the requirement of an ultrashort repetition time. Therefore, insertion of a preparation phase in the FAIR sequence, after labeling and prior to TurboFLASH acquisition, is proposed. A segmented adiabatic BIR-4 pulse, interleaved with crusher gradients, was used for flow crushing. The effect of the crusher preparation is shown as a function of crusher strength for a flow phantom and in rat brain. Influence of crusher strength on the time-dependent FAIR signal from rat brain was also measured. Signal from flowing spins in a flow phantom and from arterial spins in rat brain was significantly suppressed. Image quality was improved and the overestimation of perfusion at short inflow times was eliminated.     

Spiral balanced steady-state free precession cardiac imaging.

Balanced steady-state free precession (SSFP) sequences are useful in cardiac imaging because they achieve high signal efficiency and excellent blood-myocardium contrast. Spiral imaging enables the efficient acquisition of cardiac images with reduced flow and motion artifacts. Balanced SSFP has been combined with spiral imaging for real-time interactive cardiac MRI. New features of this method to enable scanning in a clinical setting include short, first-moment nulled spiral trajectories and interactive control over the spatial location of banding artifacts (SSFP-specific signal variations). The feasibility of spiral balanced SSFP cardiac imaging at 1.5 T is demonstrated. In observations from over 40 volunteer and patient studies, spiral balanced SSFP imaging shows significantly improved contrast compared to spiral gradient-spoiled imaging, producing better visualization of cardiac function, improved localization, and reduced flow artifacts from blood.     

Helical MR: continuously moving table axial imaging with radial acquisitions.

A technique for extended field of view MRI is presented. Similar to helical computed tomography, the method utilizes a continuously moving patient table, a 2D axial slice that remains fixed relative to the MRI magnet, and a radial k-space trajectory. A fully refocused SSFP acquisition enables spatial resolution comparable to current clinical protocols in scan times that are sufficiently short to allow a reasonable breathhold duration. RF transmission and signal reception are performed using the RF body coil and the images are reconstructed in real time. Experimental results are presented that illustrate the technique's ability to resolve small structures in the table-motion direction. Simulation experiments to study the steady-state response of the fully refocused SSFP acquisition during continuous table motion are also presented. Finally, whole body images of healthy volunteers demonstrate the high image quality achieved using the helical MRI approach.     

Fast 31P chemical shift imaging using SSFP methods.

Steady-state free precession (SSFP) methods have been very successful due to their high signal and short imaging times. These properties make them good candidates for applications that intrinsically suffer from low signal such as low gamma nuclei imaging. A new chemical shift imaging (CSI) technique based on the SSFP signal formation has been implemented and applied to (31)P. The signal properties of the SSFP CSI method have been evaluated and the steady-state signal of (31)P has been measured in human muscles. Due to the T(2) and T(1) signal dependence of SSFP, the steady-state signal mainly consists of phosphocreatine (PCr). The technique allows fast CSI acquisitions with high SNR of the PCr signal. The SNR gain for PCr over a FLASH-based CSI method is approx. 4-5. Fast in vivo CSI of human muscle with subcentimeter resolution and high SNR is demonstrated at 2 T.     

Correction for vascular artifacts in cerebral blood flow values measured by using arterial spin tagging techniques

?Vascular”? artifacts can have substantial effects on human cerebral blood flow values calculated by using arterial spin tagging approaches. One vascular artifact arises from the contribution of ?tagged”? arterial water spins to the observed change in brain water MR signal. This artifact can be reduced if large bipolar gradients are used to ?crush”? the MR signal from moving arterial water spins. A second vascular artifact arises from relaxation of ?tagged”? arterial blood during transit from the tagging plane to the capillary exchange site in the imaging slice. This artifact can be corrected if the arterial transit times are measured by using ?dynamic”? spin tagging approaches. The mean transit time from the tagging plane to capillary exchange sites in a gray matter region of interest was calculated to be ～0.94 s. Cerebral blood flow values calculated for seven normal volunteers agree reasonably well with values calculated by using radioactive tracer approaches.     

Reduction of flow artifacts by using partial saturation in RF‐spoiled gradient‐echo imaging

Radiofrequency (RF)‐spoiled gradient‐echo imaging provides a signal intensity close to pure T₁ contrast by using spoiler gradients and RF phase cycling to eliminate net transverse magnetization. Generally, spins require many RF excitations to reach a steady‐state magnetization level; therefore, when unsaturated flowing spins enter the imaging slab, they can cause undesirable signal enhancement and generate image artifacts. These artifacts can be reduced by partially saturating an outer slab upstream to drive the longitudinal magnetization close to the steady state, while the partially saturated spins generate no signal until they enter the imaging slab. In this work, magnetization evolution of flowing spins in RF‐spoiled gradient‐echo sequences with and without partial saturation was simulated using the Bloch equations. Next, the simulations were validated by phantom and in vivo experiments. For phantom experiments, a pulsatile flow phantom was used to test partial saturation for a range of flip angles and relaxation times. For in vivo experiments, the technique was used to image the carotid arteries, abdominal aorta, and femoral arteries of normal volunteers. All experiments demonstrated that partial saturation can provide consistent T₁ contrast across the slab while reducing inflow artifacts. Magn Reson Med, 2011. © 2011 Wiley‐Liss, Inc.     

Three-dimensional steady-state MR angiography of the lower extremities

Volume steady-state black-blood magnetic resonance imaging was evaluated as a method for depicting lower extremity vasculature. In steady-state imaging, flow has low signal intensity because motion destroys the coherence of transverse magnetization. To optimize image contrast, computations and measurements were obtained for the three-dimensional (3D) GRASS (gradient-recalled acquisition in the steady state) and 3D SSFP (steady-state free precession) sequences and a range of TRs and flip angles to determine optimal vessel-muscle contrast. The best results were achieved with a 3D GRASS sequence with a TR msec/TE msec of 25/5 and a flip angle of 30°. Coronal images of the femoral and popliteal vessels were obtained in healthy volunteers with various fields of view and voxel sizes. Inflow of unsaturated spins from outside the image region, yielding high signal intensity, could be a potential drawback in steady-state black-blood imaging; however, problems can be avoided by using coronal acquisitions and large fields of view. Steady-state black-blood imaging depicts vessels with high accuracy and is faster and free of flow artifacts.     

MR vascular imaging with a fast gradient refocusing pulse sequence and reformatted images from transaxial sections

The authors present a method for obtaining magnetic resonance (MR) images of intra- and extracranial vessels from thin contiguous transaxial sections. A section-selective gradient refocusing pulse sequence with a short repetition time caused flow-related enhancement from spins that flowed perpendicular to the transaxial sections. The signal was further enhanced by means of flow compensation gradients to rephase any phase shifts resulting from moving spins in the presence of the imaging gradients. Coronal and sagittal sections, reformatted from multiple transaxial sections, are shown to have excellent vessel contrast without the use of contrast material. These images were obtained in 12 minutes of acquisition time from as many as 60 sections of 3-mm thickness. Such a technique shows significant promise for MR angiography.     

Black-blood imaging of the human heart using rapid stimulated echo acquisition mode (STEAM) MRI

PURPOSE: To develop a rapid stimulated echo acquisition mode (STEAM) MRI technique for "black-blood" imaging of the human heart that overcomes the single-slice limitation and partially compromised blood suppression associated with double inversion-recovery techniques. MATERIALS AND METHODS: Black-blood multislice images of the heart along anatomic orientations and triggered to end diastole were obtained from healthy human subjects at 3T using rapid STEAM MRI sequences with five-eighths partial Fourier encoding and variable flip angles. Single-shot STEAM images at 2.5 x 2.5 mm2 in-plane resolution and 6-mm section thickness were recorded in 230 msec from individual heartbeats. Improved signal-to-noise ratio (SNR) and higher spatial resolution of 2.0 x 2.0 mm2 and 1.5 x 1.5 mm2 were achieved by segmented multishot STEAM MRI with interleaved k-space acquisitions (160 msec each) from several heartbeats. In a single breathhold covering 18 heartbeats selected applications employed either three segments with six sections or six segments with three sections. RESULTS: Because stimulated echoes (STEs) dephase signals from moving spins, rapid STEAM images are free from blood signal contamination. The method offers a flexible tradeoff between spatial resolution, imaging speed (i.e., number of segments), and volume coverage (i.e., number of sections). CONCLUSION: Rapid STEAM MRI of the heart emerges as a simple technique for multislice imaging of the myocardial wall with efficient flow suppression.     

Comparison of gated and non-gated fast multislice black-blood carotid imaging using rapid extended coverage and inflow/outflow saturation techniques

PURPOSE: To comparatively analyze two fast in vivo multislice black-blood carotid artery vessel wall imaging techniques with and without cardiac gating. MATERIALS AND METHODS: Eight subjects with carotid artery atherosclerosis, and four healthy subjects were studied using two black-blood multislice techniques: rapid extended coverage double inversion recovery (REX-DIR), and inflow/outflow saturation band (IOSB) rapid acquisition with relaxation enhancement (RARE) multislice acquisitions. Quantitative, qualitative, and morphometric analyses were performed on images. RESULTS: Gating produced significantly lower values for the REX-DIR sequence with respect to signal intensity in muscle and the carotid artery wall, whereas it had no effect on flow suppression compared to non-gated images. For the IOSB sequences, gating had no significant effect on signal intensity of muscle and the carotid artery wall, but worsened flow suppression. REX-DIR and IOSB sequences were statistically different with respect to signal intensity of muscle (with REX-DIR sequences having lower values), while no statistical significance was observed for flow suppression and wall delineation. A morphologic analysis of the vessel wall and lumen comparing REX-DIR gated, IOSB gated, REX-DIR non-gated, and IOSB non-gated sequences revealed no significant differences between the acquisition techniques tested. CONCLUSION: Non-gated sequences may be used instead of gated sequences in atherosclerotic vessel wall imaging without compromising image quality. This may shorten examination time and improve patient comfort.