Fast 3D 1H spectroscopic imaging at 3 Tesla using spectroscopic missing-pulse SSFP with 3D spatial preselection.

Three-dimensional (3D) (1)H MR spectroscopic imaging (SI) allows metabolic changes in human tissue to be identified. In clinical practice, fast acquisition techniques are required to achieve an adequate spatial resolution within acceptable total measurement times. In this study a novel fast pulse sequence for 3D (1)H SI based on the condition of steady-state free precession (SSFP), termed "spectroscopic missing-pulse SSFP" (spMP-SSFP), is proposed. It combines 3D spatial preselection with the acquisition of full spin echoes (SEs), and thus makes subsequent phase correction of spectra redundant. The sequence was applied to a phantom and healthy human brains in vivo at 3 Tesla. Metabolic images are acquired with a spatial resolution of 1.8 cm(3) within a total measurement time of about 6 min. With a lower signal-to-noise ratio (SNR) per unit measurement time compared to previous spectroscopic SSFP implementations, 3D spatial preselection can now be realized with spMP-SSFP. Since the method does not require separate techniques for water and lipid suppression, and employs a simple data-processing approach, spMP-SSFP is a robust, fast SI method that requires only minimal user interaction.     

MR angiography using steady-state free precession.

Contrast-enhanced MR angiography (CE-MRA) using steady-state free precession (SSFP) pulse sequences is described. Using SSFP, vascular structures can be visualized with high signal-to-noise ratio (SNR) at a substantial (delay) time after the initial arterial pass of contrast media. The peak blood SSFP signal was diminished by <20% 30 min after the initial administration of 0.2 mmol/kg of Gd-chelate. The proposed method allows a second opportunity to study arterial or venous structures with high image SNR and high spatial resolution. A mask subtraction scheme using spin echo SSFP-S(-) acquisition is also described to reduce stationary background signal from the delayed SSFP angiography images.     

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.     

Three-dimensional breathhold SSFP coronary MRA: a comparison between 1.5T and 3.0T

PURPOSE: To assess the feasibility of three-dimensional breathhold coronary magnetic resonance angiography (MRA) at 3.0T using the steady-state free precession (SSFP) sequence, and quantify the signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) gains of coronary MRA from 1.5T to 3.0T using whole-body and phased-array cardiac coils as the signal receiver. MATERIALS AND METHODS: Eight healthy volunteers were scanned on 1.5T and 3.0T whole-body systems using the SSFP sequence. Numerical simulations were performed for the SSFP sequence to optimize the flip angle and predict signal enhancement from 1.5T to 3.0T. Coronary artery images were acquired with the whole-body coil in transmit-receive mode or transmit-only with phased-array cardiac coil receivers. RESULTS: In vivo studies of the same volunteer group at both field strengths showed increases of 87% in SNR and 83% in CNR from 1.5T to 3.0T using a whole-body coil as the signal receiver. The corresponding increases using phased-array receivers were 53% in SNR and 92% in CNR. However, image quality at 3.0T was more variable than 1.5T, with increased susceptibility artifacts and local brightening as the result of increased B(0) and B(1) inhomogeneities. CONCLUSION: Coronary MRA at 3.0T using a three-dimensional breathhold SSFP sequence is feasible. Improved SNR at 3.0T warrants the use of coronary MRA with faster acquisition and/or improved spatial resolution. Further investigations are required to improve the consistency of image quality and signal uniformity at 3.0T.     

Application of refocused steady-state free-precession methods at 1.5 and 3 T to in vivo high-resolution MRI of trabecular bone: simulations and experiments

PURPOSE: To evaluate the potential of fully-balanced steady-state free-precession (SSFP) sequences in in vivo high-resolution (HR) MRI of trabecular bone at field strengths of 1.5 and 3 T by simulation and experimental methods. MATERIALS AND METHODS: Using simulation studies, refocused SSFP acquisition was optimized for our imaging purposes with a focus on signal-to-noise ratio (SNR) and SNR efficiency. The signal behavior in trabecular bone was estimated using a magnetostatic model of the trabecular bone and marrow. Eight normal volunteers were imaged at the proximal femur, calcaneus, and the distal tibia on a GE Signa scanner at 1.5 and at 3 T with an optimized single-acquisition SSFP sequence (three-dimensional FIESTA) and an optimized multiple-acquisition SSFP sequence (three-dimensional FIESTA-c). Images were also acquired with a fast gradient echo (FGRE) sequence for evaluation of the SNR performance of SSFP methods. RESULTS: Refocused SSFP images outperformed FGRE acquisitions in both SNR and SNR efficiency at both field strengths. At 3 T, susceptibility effects were visible in FIESTA and FGRE images and much reduced in FIESTA-c images. The magnitude of SNR boost at 3 T was closely predicted by simulations. CONCLUSION: Single-acquisition SSFP (at 1.5 T) and multiple-acquisition SSFP (at 3 T) hold great potential for HR-MRI of trabecular bone.     

Myocardial first pass perfusion: steady-state free precession versus spoiled gradient echo and segmented echo planar imaging.

The imaging sequences used in first pass (FP) perfusion to date have important limitations in contrast-to-noise ratio (CNR), temporal and spatial resolution, and myocardial coverage. As a result, controversy exists about optimal imaging strategies for FP myocardial perfusion. Since imaging performance varies from subject to subject, it is difficult to form conclusions without direct comparison of different sequences in the same subject. The purpose of this study was to directly compare the saturation recovery SSFP technique to other more commonly used myocardial first pass perfusion techniques, namely spoiled GRE and segmented EPI. Differences in signal-to-noise ratio (SNR), CNR, relative maximal upslope (RMU) of signal amplitude, and artifacts at comparable temporal and spatial resolution among the three sequences were investigated in computer simulation, contrast agent doped phantoms, and 16 volunteers. The results demonstrate that SSFP perfusion images exhibit an improvement of approximately 77% in SNR and 23% in CNR over spoiled GRE and 85% SNR and 50% CNR over segmented EPI. Mean RMU was similar between SSFP and spoiled GRE, but there was a 58% increase in RMU with SSFP versus segmented EPI.     

Signal-to-noise ratio behavior of steady-state free precession.

Steady-state free precession (SSFP) is a rapid gradient-echo imaging technique that has recently gained popularity and is used in a variety of applications, including cardiac and real-time imaging, because of its high signal and favorable contrast between blood and myocardium. The purpose of this work was to examine the signal-to-noise ratio (SNR) behavior of images acquired with SSFP, and the dependence of SNR on imaging parameters such as TR, bandwidth, and image resolution, and the use of multi-echo sequences. In this work it is shown that the SNR of SSFP sequences is dependent only on pulse sequence efficiency, voxel dimensions, and relaxation parameters (T1 and T2). Notably, SNR is insensitive to bandwidth unless increases in bandwidth significantly decrease efficiency. Finally, we examined the relationship between pulse sequence performance (TR and efficiency) and gradient performance (maximum gradient strength and slew rate) for several imaging scenarios, including multi-echo sequences, to determine the optimum matching of maximum gradient strength and slew rate for gradient hardware designs. For standard modern gradient hardware (40 mT/m and 150 mT/m/ms), we found that the maximum gradient strength is more than adequate for the imaging resolution that is commonly encountered with rapid scouting (3 mm x 4 mm x 10 mm voxel). It is well matched for typical CINE and real-time cardiac imaging applications (1.5 mm x 2 mm x 6 mm voxel), and is inadequate for optimal matching with slew rate for high-resolution applications such as musculoskeletal imaging (0.5 x 0.8 x 3 mm voxel). For the lower-resolution methods, efficiency could be improved with higher slew rates; this provokes interest in designing methods for limiting dB/dt peripherally while achieving high switching rates in the imaging field of view. The use of multi-echo SSFP acquisitions leads to substantial improvements in sequence performance (i.e., increased efficiency and shorter TR).     

Navigator-gated coronary magnetic resonance angiography using steady-state-free-precession: comparison to standard T2-prepared gradient-echo and spiral imaging

RATIONALE AND OBJECTIVES: Recent developments of magnetic resonance imaging enabled free-breathing coronary MRA (cMRA) using steady-state-free-precession (SSFP) for endogenous contrast. The purpose of this study was a systematic comparison of SSFP cMRA with standard T2-prepared gradient-echo and spiral cMRA. METHODS: Navigator-gated free-breathing T2-prepared SSFP-, T2-prepared gradient-echo- and T2-prepared spiral cMRA was performed in 18 healthy swine (45-68 kg body-weight). Image quality was investigated subjectively and signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR) and vessel sharpness were compared. RESULTS: SSFP cMRA allowed for high quality cMRA during free breathing with substantial improvements in SNR, CNR and vessel sharpness when compared with standard T2-prepared gradient-echo imaging. Spiral imaging demonstrated the highest SNR while image quality score and vessel definition was best for SSFP imaging. CONCLUSION: Navigator-gated free-breathing T2-prepared SSFP cMRA is a promising new imaging approach for high signal and high contrast imaging of the coronary arteries with improved vessel border definition.     

Implications of pulse sequence in structural imaging of trabecular bone

PURPOSE: To investigate the SNR and image properties of 3D steady-state free precession (SSFP), fast large-angle spin echo (FLASE), gradient-recalled acquisition in steady state (GRASS), and spoiled GRASS (SPGR) for structural imaging of trabecular bone (TB). MATERIALS AND METHODS: SNR was examined theoretically and experimentally on phantoms, bone specimens, and in vivo. The bone volume fraction, TB thickness, and echo time (TE) dependence of the thickness were compared. The trabecula was modeled as a cylinder in simulations to examine the intra-voxel spin-dephasing in SSFP and GRASS. Images were acquired on a 1.5 T Siemens Sonata system (40 mT/m maximum gradient, 200 T/m/s peak slew rate). RESULTS: Within the hardware and safety limit constraints, SNR of FLASE was superior, followed by SSFP, GRASS, and SPGR. The trabecular thickness derived from gradient-echo images was 10-45% greater than that obtained with FLASE. Conversely, SSFP images delineated partial volume trabeculae better than FLASE. Simulations indicated that the artifactual thickening was more severe in SSFP than in GRASS, which was attributed to off-resonance effects from the induced gradients at the bone/marrow interface. CONCLUSION: FLASE had the highest SNR and was insensitive to susceptibility dephasing. Although SSFP has superior SNR compared to GRASS, off-resonance effects and duty cycle limitations may compromise its practicality in this application. Inc.     

MRI of respiratory dynamics with 2D steady-state free-precession and 2D gradient echo sequences at 1.5 and 3 Tesla: an observer preference study

To compare the image quality of dynamic lung MRI with variations of steady-state free-precession (SSFP) and gradient echo (GRE) cine techniques at 1.5 T and 3 T. Ventilated porcine lungs with simulated lesions inside a chest phantom and four healthy human subjects were assessed with SSFP (TR/TE = 2.9/1.22 ms; 3 ima/s) and GRE sequences (TR/TE = 2.34/0.96 ms; 8 ima/s) as baseline at 1.5 and 3 T. Modified SSFPs were performed with nine to ten images/s (parallel imaging factors 2 and 3). Image quality for representative structures and artifacts was ranked by three observers independently. At 1.5 T, standard SSFP achieved the best image quality with superior spatial resolution and signal, but equal temporal resolution to GRE. SSFP with improved temporal resolution was ranked second best. Further acceleration (PI factor 3) was of no benefit, but increased artifacts. At 3 T, GRE outranged SSFP imaging with high lesion signal intensity, while artifacts on SSFP images increased visibly. At 1.5 T, a modified SSFP with moderate parallel imaging (PI factor 2) was considered the best compromise of temporal and spatial resolution. At 3 T, GRE sequences remain the best choice for dynamic lung MRI.     

Effects of intravoxel incoherent motions (IVIM) in steady-state free precession (SSFP) imaging: application to molecular diffusion imaging

A theoretical analysis of the effects of diffusion and perfusion in steady-state free precession (SSFP) imaging sequences sensitized to intravoxel incoherent motions by magnetic field gradients is presented and supported by phantom studies. The capability of such sequences to image diffusion and perfusion quickly was recently demonstrated. The possible residual effects of T1 and T2 in diffusion measurements are evaluated, as are the effects of the sequence design and the acquisition parameters (repetition time, flip angle, gradient pulses). It is shown theoretically and confirmed by experiments on phantoms that diffusion coefficients can be directly measured from SSFP images when large enough diffusion gradient pulses are used.     

B(0)-fluctuation-induced temporal variation in EPI image series due to the disturbance of steady-state free precession.

Steady-state free precession (SSFP) can develop under a train of RF pulses, given the condition TR < T(2). SSFP in multi-shot imaging sequences has been well studied. It is shown here that serial single-shot echo-planar imaging (EPI) acquisition can also develop SSFP, and the SSFP can be disturbed by B(0) fluctuation, causing voxel-wise temporal variation. This SSFP disturbance is predominantly present in cerebrospinal fluid (CSF) regions due to the long T(2) value. By applying a sufficiently strong crusher gradient in the EPI pulse sequence, the temporal variation induced by SSFP disturbance can be suppressed due to diffusion. Evidence is provided to indicate that physiological motions such as cardiac pulsation and respiration could affect the voxel-wise time courses through the mechanism of SSFP disturbance. It is advised that if the disturbance is observed in serial EPI images, the crusher should be made stronger to eliminate the unwanted temporal variation.     

Direct comparison of myocardial perfusion cardiovascular magnetic resonance sequences with parallel acquisition

PURPOSE: To directly compare the three main myocardial perfusion cardiovascular magnetic resonance (CMR) sequences incorporating parallel acquisition methods. MATERIALS AND METHODS: In 15 subjects (12 men, 57 +/- 15.7 years) referred for diagnostic coronary angiography, we acquired first-pass perfusion images (0.1 mmol/kg gadolinium-DTPA) at rest and during adenosine (140 microg/kg/min) on three separate occasions using three sequences incorporating parallel acquisition methods and approximately equivalent spatiotemporal resolution: hybrid echo planar imaging (hEPI), steady-state free precession (SSFP), and gradient echo imaging (GRE). We calculated the contrast-to-noise ratio (CNR) of each scan and blinded observers scored the presence and severity of artifacts (1, worst to 4, best), diagnostic confidence (0, low to 2, high), transmurality, area, and epicardial vessel territory of perfusion defects. RESULTS: CNR was greatest with SSFP and least with hEPI (13.15 vs 7.85 P < 0.001). The most artifacts were recorded with SSFP and least with hEPI (2.00 vs 3.03 P < 0.001). Observers were significantly more confident in reporting hEPI images (1.6 hEPI vs 0.9 SSFP, P < 0.001). Results for GRE were intermediate for all assessments. CONCLUSION: The hEPI sequence scored best for diagnostic performance despite the SSFP sequence having greater CNR. This trial favors hEPI for clinical myocardial perfusion CMR and suggests CNR should not be the sole criterion used to gauge the best candidate sequence.     

Clinical utility of optimized three-dimensional T1-, T2-, and T2*-weighted sequences in spinal magnetic resonance imaging

This article reviews the clinical utility of 3D magnetic resonance imaging (MRI) sequences optimized for the evaluation of various intraspinal lesions. First, intraspinal tumors with hypervascular components and arteriovenous malformations (AVM) are clearly shown on contrast-enhanced (CE)-3D T1-weighted gradient-echo (GE) sequences with high spatial resolution. Second, dynamic CE-3D time-resolved magnetic resonance angiography (MRA) shows delineated feeding arteries of intraspinal AVM or arteriovenous fistula (AVF), greatly aiding subsequent digital subtraction angiography (DSA). Third, 3D multiecho T2*-weighted GE sequences are used to visualize intraspinal structures and spinal cord lesions and are sensitive to the magnetic susceptibility of intraspinal hemorrhages. Three-dimensional balanced steady-state free precession (SSFP) and multishot 3D balanced non-SSFP sequences produce contiguous thin images with high signal-to-noise ratio (SNR) in short scanning times. Intraspinal cystic lesions and small nerve-root tumors in subarachnoid space can be viewed using 3D balanced SSFP. Spinal cord myelomalacia and cord compression can be evaluated on fat-suppressed multishot 3D balanced non-SSFP. Finally, a 3D T2-weighted fast spin-echo (FSE) sequence with variable flip angle (FA) refocusing pulse improves through-plane spatial resolution over conventional 2D T2-weighted FSE sequences while matching image contrast.     

Influence of high magnetic field strengths and parallel acquisition strategies on image quality in cardiac 2D CINE magnetic resonance imaging: comparison of 1.5 T vs. 3.0 T

The aim of this paper is to examine signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR) and image quality of cardiac CINE imaging at 1.5 T and 3.0 T. Twenty volunteers underwent cardiac magnetic resonance imaging (MRI) examinations using a 1.5-T and a 3.0-T scanner. Three different sets of breath-held, electrocardiogram-gated (ECG) CINE imaging techniques were employed, including: (1) unaccelerated SSFP (steady state free precession), (2) accelerated SSFP imaging and (3) gradient-echo-based myocardial tagging. Two-dimensional CINE SSFP at 3.0 T revealed an SNR improvement of 103% and a CNR increase of 19% as compared to the results obtained at 1.5 T. The SNR reduction in accelerated 2D CINE SSFP imaging was larger at 1.5 T (37%) compared to 3.0 T (26%). The mean SNR and CNR increase at 3.0 T obtained for the tagging sequence was 88% and 187%, respectively. At 3.0 T, the duration of the saturation bands persisted throughout the entire cardiac cycle. For comparison, the saturation bands were significantly diminished at 1.5 T during end-diastole. For 2D CINE SSFP imaging, no significant difference in the left ventricular volumetry and in the overall image quality was obtained. For myocardial tagging, image quality was significantly improved at 3.0 T. The SNR reduction in accelerated SSFP imaging was overcompensated by the increase in the baseline SNR at 3.0 T and did not result in any image quality degradation. For cardiac tagging techniques, 3.0 T was highly beneficial, which holds the promise to improve its diagnostic value.     

Rapid dark-blood carotid vessel-wall imaging with random bipolar gradients in a radial SSFP acquisition

PURPOSE: To investigate and evaluate a new rapid dark-blood vessel-wall imaging method using random bipolar gradients with a radial steady-state free precession (SSFP) acquisition in carotid applications. MATERIALS AND METHODS: The carotid artery bifurcations of four asymptomatic volunteers (28-37 years old, mean age = 31 years) were included in this study. Dark-blood contrast was achieved through the use of random bipolar gradients applied prior to the signal acquisition of each radial projection in a balanced SSFP acquisition. The resulting phase variation for moving spins established significant destructive interference in the low-frequency region of k-space. This phase variation resulted in a net nulling of the signal from flowing spins, while the bipolar gradients had a minimal effect on the static spins. The net effect was that the regular SSFP signal amplitude (SA) in stationary tissues was preserved while dark-blood contrast was achieved for moving spins. In this implementation, application of the random bipolar gradient pulses along all three spatial directions nulled the signal from both in-plane and through-plane flow in phantom and in vivo studies. RESULTS: In vivo imaging trials confirmed that dark-blood contrast can be achieved with the radial random bipolar SSFP method, thereby substantially reversing the vessel-to-lumen contrast-to-noise ratio (CNR) of a conventional rectilinear SSFP "bright-blood" acquisition from bright blood to dark blood with only a modest increase in TR (approximately 4 msec) to accommodate the additional bipolar gradients. CONCLUSION: Overall, this sequence offers a simple and effective dark-blood contrast mechanism for high-SNR SSFP acquisitions in vessel wall imaging within a short acquisition time.     

4D radial coronary artery imaging within a single breath-hold: cine angiography with phase-sensitive fat suppression (CAPS).

Coronary artery data acquisition with steady-state free precession (SSFP) is typically performed in a single frame in mid-diastole with a spectrally selective pulse to suppress epicardial fat signal. Data are acquired while the signal approaches steady state, which may lead to artifacts from the SSFP transient response. To avoid sensitivity to cardiac motion, an accurate trigger delay and data acquisition window must be determined. Cine data acquisition is an alternative approach for resolving these limitations. However, it is challenging to use conventional fat saturation with cine imaging because it interrupts the steady-state condition. The purpose of this study was to develop a 4D coronary artery imaging technique, termed "cine angiography with phase-sensitive fat suppression" (CAPS), that would result in high temporal and spatial resolution simultaneously. A 3D radial stacked k-space was acquired over the entire cardiac cycle and then interleaved with a sliding window. Sensitivity-encoded (SENSE) reconstruction with rescaling was developed to reduce streak artifact and noise. Phase-sensitive SSFP was employed for fat suppression using phase detection. Experimental studies were performed on volunteers. The proposed technique provides high-resolution coronary artery imaging for all cardiac phases, and allows multiple images at mid-diastole to be averaged, thus enhancing the signal-to-noise ratio (SNR) and vessel delineation.     

Improved coronary MR angiography using wideband steady state free precession at 3 tesla with sub‐millimeter resolution

Purpose:

To suppress off‐resonance artifacts in coronary artery imaging at 3 Tesla (T), and therefore improve spatial resolution.

Materials and Methods:

Wideband steady state free precession (SSFP) sequences use an oscillating steady state to reduce banding artifacts. Coronary artery images were obtained at 3T using three‐dimensional navigated gradient echo, balanced SSFP, and wideband SSFP sequences.

Results:

The highest in‐plane resolution of left coronary artery images was 0.68 mm in the frequency‐encoding direction. Wideband SSFP produced an average SNR efficiency of 70% relative to conventional balanced SSFP and suppressed off‐resonance artifacts.

Conclusion:

Wideband SSFP was found to be a promising approach for obtaining noncontrast, high‐resolution coronary artery images at 3 Tesla with reliable image quality. J. Magn. Reson. Imaging 2010;31:1224–1229. © 2010 Wiley‐Liss, Inc.     

Implementation of three‐dimensional wavelet encoding spectroscopic imaging: In vivo application and method comparison

We have recently proposed a two‐dimensional Wavelet Encoding‐Spectroscopic Imaging (WE‐SI) technique as an alternative to Chemical Shift Imaging (CSI), to reduce acquisition time and crossvoxel contamination in magnetic resonance spectroscopic imaging (MRSI). In this article we describe the extension of the WE‐SI technique to three dimensions and its implementation on a clinical 1.5 T General Electric (GE) scanner. Phantom and in vivo studies are carried out to demonstrate the usefulness of this technique for further acquisition time reduction with low voxel contamination. In wavelet encoding, a set of dilated and translated prototype functions called wavelets are used to span a localized space by dividing it into a set of subspaces with predetermined sizes and locations. In spectroscopic imaging, this process is achieved using radiofrequency (RF) pulses with profiles resembling the wavelet shapes. Slice selective excitation and refocusing RF pulses, with single‐band and dual‐band profiles similar to Haar wavelets, are used in a modified PRESS sequence to acquire 3D WE‐SI data. Wavelet dilation and translation are achieved by changing the strength of the localization gradients and frequency shift of the RF pulses, respectively. The desired spatial resolution in each direction sets the corresponding number of dilations (increases in the localization gradients), and consequently, the number of translations (frequency shift) of the Haar wavelets (RF pulses), which are used to collect magnetic resonance (MR) signals from the corresponding subspaces. Data acquisition time is reduced by using the minimum recovery time (TR_min), also called effective time, when successive MR signals from adjacent subspaces are collected. Inverse wavelet transform is performed on the acquired data to produce metabolite maps. The proposed WE‐SI method is compared in terms of acquisition time, pixel bleed, and signal‐to‐noise ratio to the CSI technique. The study outcome shows that 3D WE‐SI provides accurate results while reducing both acquisition time and voxel contamination. Magn Reson Med 61:6–15, 2009. © 2008 Wiley‐Liss, Inc.     

Balanced phase-contrast steady-state free precession (PC-SSFP): a novel technique for velocity encoding by gradient inversion.

A technique for measuring velocity is presented that combines cine phase contrast (PC) MRI and balanced steady-state free precession (SSFP) imaging, and is thus termed PC-SSFP. Flow encoding was performed without the introduction of additional velocity encoding gradients in order to keep the repetition time (TR) as short as in typical SSFP imaging sequences. Sensitivity to through-plane velocities was instead established by inverting (i.e., negating) all gradients along the slice-select direction. Velocity sensitivity (VENC) could be adjusted by altering the first moments of the slice-select gradients. Disturbances of the SSFP steady state were avoided by acquiring different flow echoes in consecutively (i.e., sequentially) executed scans, each over several cardiac cycles, using separate steady-state preparation periods. A comparison of phantom measurements with those from established 2D-cine-PC MRI demonstrated excellent correlation between both modalities. In examinations of volunteers, PC-SSFP exhibited a higher intrinsic signal-to-noise ratio (SNR) and consequently low phase noise in measured velocities compared to conventional PC scans. An additional benefit of PC-SSFP is that it relies less on in-flow-dependent signal enhancement, and thus yields more uniform SNRs and better depictions of vessel geometry throughout the whole cardiac cycle in structures with slow and/or pulsatile flow.