Concomitant gradient field effects in balanced steady-state free precession.

Linear magnetic field gradients spatially encode the image information in MRI. Concomitant gradients are undesired magnetic fields that accompany the desired gradients and occur as an unavoidable consequence of Maxwell's equations. These concomitant gradients result in undesired phase accumulation during MRI scans. Balanced steady-state free precession (bSSFP) is a rapid imaging method that is known to suffer from signal dropout from off-resonance phase accrual. In this work it is shown that concomitant gradient phase accrual can induce signal dropout in bSSFP. The spatial variation of the concomitant phase is explored and shown to be a function of gradient strength, slice orientation, phase-encoding (PE) direction, distance from isocenter, and main field strength. The effect on the imaging signal level was simulated and then verified in phantom and in vivo experiments. The nearest signal-loss artifacts occurred in scans that were offset from isocenter along the z direction with a transverse readout. Methods for eliminating these artifacts, such as applying compensatory frequency or shim offsets, are demonstrated. Concomitant gradient artifacts can occur at 1.5T, particularly in high-resolution scans or with additional main field inhomogeneity. These artifacts will occur closer to isocenter at field strengths below 1.5T because concomitant gradients are inversely proportional to the main field strength.     

Shared velocity encoding: a method to improve the temporal resolution of phase-contrast velocity measurements

Phase-contrast magnetic resonance imaging (PC-MRI) is used routinely to measure fluid and tissue velocity with a variety of clinical applications. Phase-contrast magnetic resonance imaging methods require acquisition of additional data to enable phase difference reconstruction, making real-time imaging problematic. Shared Velocity Encoding (SVE), a method devised to improve the effective temporal resolution of phase-contrast magnetic resonance imaging, was implemented in a real-time pulse sequence with segmented echo planar readout. The effect of SVE on peak velocity measurement was investigated in computer simulation, and peak velocities and total flow were measured in a flow phantom and in volunteers and compared with a conventional ECG-triggered, segmented k-space phase-contrast sequence as a reference standard. Computer simulation showed a 36% reduction in peak velocity error from 8.8 to 5.6% with SVE. A similar reduction of 40% in peak velocity error was shown in a pulsatile flow phantom. In the phantom and volunteers, volume flow did not differ significantly when measured with or without SVE. Peak velocity measurements made in the volunteers using SVE showed a higher concordance correlation (0.96) with the reference standard than non-SVE (0.87). The improvement in effective temporal resolution with SVE reconstruction has a positive impact on the precision and accuracy of real-time phase-contrast magnetic resonance imaging peak velocity measurements.     

Morphing steady-state free precession.

A novel concept for visualization of positive contrast originating from susceptibility-related magnetic field distortions is presented. In unbalanced steady-state free precession (SSFP) the generic, gradient-induced dephasing competes with local gradient fields generated by paramagnetic materials. Thus, within the same image, SSFP may morph its own appearance from unbalanced to balanced SSFP (bSSFP) as a result of local gradient compensation. In combination with low to very low flip angles, unbalanced SSFP signals are heavily suppressed, whereas bSSFP locally produces very high steady-state amplitudes at certain frequency offsets. As a result, bSSFP signals appear hyperintense on an almost completely dark background. In this study, the conceptual issues of local gradient compensation and frequency matching, as well as the feasibility of proper detection of marker materials for interventional MRI from hyperintense pixels locations, are evaluated both in vitro and in vivo. Signal dependencies of morphing SSFP on sequence parameters such as flip angle or repetition time are investigated theoretically and experimentally. In addition to passive tracking of interventional devices, morphing SSFP might also be a promising new concept for the generation of positive contrast from super-paramagnetic iron oxide (SPIO) particles in contrast-enhanced MRI as well as for particle tracking.     

In-plane velocity encoding with coherent steady-state imaging.

Standard phase-contrast flow quantification (PC-FQ) using radiofrequency (RF) spoiled steady-state (SS) incoherent gradient-echo sequences have a relatively low signal-to-noise ratio (SNR). Unspoiled SS coherent (SSC) gradient-echo sequences have a higher intrinsic SNR and are T2/T1 weighted so that blood has a relatively large signal compared to other tissues. An SSC sequence that was modified to allow in-plane velocity encoding is presented. Velocity encoding was achieved by inverting the readout gradients. This offers the benefit that there is no resultant increase in repetition time (TR), which avoids increased sensitivity to off-resonance artifacts when conventional velocity-encoding methods using separate velocity-encoding gradients are extended to SSC sequences. The results of standard PC-FQ and the new method from in vitro experiments of constant and sinusoidal flow, and in vivo imaging of the carotid artery were compared. Vector field maps and paths obtained from particle-tracking calculations based on the velocity-encoded images were used to visualize the velocity data. The technique has the potential to increase the precision of PC-FQ measurements.     

Time-resolved three-dimensional phase-contrast MRI

PURPOSE: To demonstrate the feasibility of a four-dimensional phase contrast (PC) technique that permits spatial and temporal coverage of an entire three-dimensional volume, to quantitatively validate its accuracy against an established time resolved two-dimensional PC technique to explore advantages of the approach with regard to the four-dimensional nature of the data. MATERIALS AND METHODS: Time-resolved, three-dimensional anatomical images were generated simultaneously with registered three-directional velocity vector fields. Improvements compared to prior methods include retrospectively gated and respiratory compensated image acquisition, interleaved flow encoding with freely selectable velocity encoding (venc) along each spatial direction, and flexible trade-off between temporal resolution and total acquisition time. RESULTS: The implementation was validated against established two-dimensional PC techniques using a well-defined phantom, and successfully applied in volunteer and patient examinations. Human studies were performed after contrast administration in order to compensate for loss of in-flow enhancement in the four-dimensional approach. CONCLUSION: Advantages of the four-dimensional approach include the complete spatial and temporal coverage of the cardiovascular region of interest and the ability to obtain high spatial resolution in all three dimensions with higher signal-to-noise ratio compared to two-dimensional methods at the same resolution. In addition, the four-dimensional nature of the data offers a variety of image processing options, such as magnitude and velocity multi-planar reformation, three-directional vector field plots, and velocity profiles mapped onto selected planes of interest.     

Phase contrast using multiecho steady-state free precession.

Conventional phase-contrast (PC) MRI is limited in the temporal resolution (typically 50 ms) that can be achieved, due to the need to implement bipolar velocity encoding gradients. PC using steady-state free precession (SSFP) has recently been developed to acquire PC data at higher rates without sacrificing contrast-to-noise ratio (CNR). This work presents two multiecho SSFP PC implementations that can be used to increase the time efficiency of PCSSFP. Both approaches (extrinsic and intrinsic) enable reference image lines to be acquired within the same TR as the flow-encoded lines, thus minimizing the scan time and permitting TR-equivalent temporal resolutions. Both approaches have been implemented and tested successfully on human volunteers at 1.5T and 3T. While the intrinsic approach is useful for encoding higher velocity flows in-plane, the extrinsic implementation can be used for studying a wider range of encoding velocities for flow in the imaging plane and through the imaging plane.     

3D velocity quantification in the heart: Improvements by 3D PC‐SSFP

Purpose:

To test whether a 3D imaging sequence with phase contrast (PC) velocity encoding based on steady‐state free precession (SSFP) improves 3D velocity quantification in the heart compared to the currently available gradient echo (GE) approach.

Materials and Methods:

The 3D PC‐SSFP sequence with 1D velocity encoding was compared at the mitral valve in 12 healthy subjects with 3D PC‐GE at 1.5T. Velocity measurements, velocity‐to‐noise‐ratio efficiency (VNR_eff), intra‐ and interobserver variability of area and velocity measurements, contrast‐to‐noise‐ratio (CNR), and artifact sensitivity were evaluated in both long‐ and short‐axis orientation.

Results:

Descending aorta mean and peak velocities correlated well (r² = 0.79 and 0.93) between 3D PC‐SSFP and 3D PC‐GE. At the mitral valve, mean velocity correlation was moderate (r² = 0.70 short axis, 0.56 long axis) and peak velocity showed good correlation (r² = 0.94 short axis, 0.81 long axis). In some cases VNR_eff was higher, in others lesser, depending on slab orientation and cardiac phase. Intra‐ and interobserver variability was generally better for 3D PC‐SSFP. CNR improved significantly, especially at end systole. Artifact levels did not increase.

Conclusion:

3D SSFP velocity quantification was successfully tested in the heart. Blood‐myocardium contrast improved significantly, resulting in more reproducible velocity measurements for 3D PC‐SSFP at 1.5T. J. Magn. Reson. Imaging 2009;30:947–955. © 2009 Wiley‐Liss, Inc.     

Flow artifacts in steady-state free precession cine imaging.

Steady-state free precession (SSFP) cardiac cine images are frequently corrupted by dark flow artifacts, which can usually be eliminated by reshimming and retuning the scanner. A theoretical explanation for these artifacts is provided in terms of spins moving through an off-resonant point in the magnetic field, and the theory is validated using phantom experiments. The artifacts can be reproduced in vivo by detuning the center frequency by an amount in the range of half the inverse repetition time (TR). Since this offset is similar in magnitude to the frequency difference between the water and lipid peaks, a likely cause of the artifacts in vivo is that the center frequency is tuned incorrectly to the lipid peak rather than the water peak.     

Faster flow quantification using sensitivity encoding for velocity-encoded cine magnetic resonance imaging: in vitro and in vivo validation

PURPOSE: To test the agreement between conventional and sensitivity-encoded (SENSE) velocity encoded cine (VEC) MRI in a flow phantom and in subjects with congenital and acquired heart disease. MATERIALS AND METHODS: Flow measurements were performed in a 1.5 T scanner using a segmented k-space VEC MRI sequence and then repeated with a SENSE factor of 2. The flow phantom used a piston pump to generate physiologic arterial waveforms (0.5-4.9 L/min). In the subjects, flow measurements were performed in the ascending aorta (N = 33) and/or the main pulmonary artery (N = 24). RESULTS: Utilization of SENSE reduced the scan time by 50%. In the phantom, measurements without and with SENSE agreed closely with a mean difference of 0.01 +/- 0.08 L/min or 0.12% +/- 3.8% (P = 0.68). In the subjects, measurements without and with SENSE also agreed closely with a mean difference of 0.08 +/- 0.36 L/min or 1.3% +/- 7.2% (P = 0.08). Compared with standard imaging, the use of SENSE reduced the signal-to-noise ratio (SNR) by 28% in the phantom (N = 10) and 27% in vivo (N = 22). CONCLUSION: VEC MRI flow measurements with a SENSE factor of 2 were twice as fast and agreed closely with the conventional technique in vitro and in vivo. VEC MRI with SENSE can be used for rapid and reliable quantification of blood flow.     

Four-dimensional phase contrast MRI with accelerated dual velocity encoding

Purpose:

To validate a novel approach for accelerated four‐dimensional phase contrast MR imaging (4D PC‐MRI) with an extended range of velocity sensitivity.

Materials and Methods:

4D PC‐MRI data were acquired with a radially undersampled trajectory (PC‐VIPR). A dual V_enc (dV_enc) processing algorithm was implemented to investigate the potential for scan time savings while providing an improved velocity‐to‐noise ratio. Flow and velocity measurements were compared with a flow pump, conventional 2D PC MR, and single V_enc 4D PC‐MRI in the chest of 10 volunteers.

Results:

Phantom measurements showed excellent agreement between accelerated dV_enc 4D PC‐MRI and the pump flow rate (R² ≥ 0.97) with a three‐fold increase in measured velocity‐to‐noise ratio (VNR) and a 5% increase in scan time. In volunteers, reasonable agreement was found when combining 100% of data acquired with V_enc = 80 cm/s and 25% of the high V_enc data, providing the VNR of a 80 cm/s acquisition with a wider velocity range of 160 cm/s at the expense of a 25% longer scan.

Conclusion:

Accelerated dual V_enc 4D PC‐MRI was demonstrated in vitro and in vivo. This acquisition scheme is well suited for vascular territories with wide ranges of flow velocities such as congenital heart disease, the hepatic vasculature, and others. J. Magn. Reson. Imaging 2012;35:1462–1471. © 2012 Wiley Periodicals, Inc.     

Time‐resolved three‐dimensional (3D) phase‐contrast (PC) balanced steady‐state free precession (bSSFP)

In this study the feasibility of a time‐resolved, three‐dimensional (3D), three‐directional flow‐sensitive balanced steady‐state free precession (bSSFP) sequence is demonstrated. Due to its high signal‐to‐noise ratio (SNR) in blood and cerebrospinal fluid (CSF) this type of sequence is particularly effective for acquisition of blood and CSF flow velocities. Flow sensitivity was achieved with the phase‐contrast (PC) technique, implementing a custom algorithm for calculation of optimal gradient parameters. Techniques to avoid the most important sources of bSSFP‐related artifacts (including distortion due to eddy currents and signal voids due to flow‐related steady‐state disruption) are also presented. The technique was validated by means of a custom flow phantom, and in vivo experiments on blood and CSF were performed to demonstrate the suitability of this sequence for human studies. Accurate depiction of blood flow in the cerebral veins and of CSF flow in the cervical portion of the neck was obtained. Possible applications of this technique might include the study of CSF flow patterns, direct in vivo study of pathologies such as hydrocephalus and Chiari malformation, and validation for the existing CSF circulation model. Magn Reson Med, 2009. © 2009 Wiley‐Liss, Inc.     

Rapid T2 estimation with phase-cycled variable nutation steady-state free precession.

Variable nutation SSFP (DESPOT2) permits rapid, high-resolution determination of the transverse (T2) relaxation constant. A limitation of DESPOT2, however, is the presence of T2 voids due to off-resonance banding artifacts associated with SSFP images. These artifacts typically occur in images acquired with long repetition times (TR) in the presence of B0 inhomogeneities, or near areas of magnetic susceptibility difference, such that the transverse magnetization experiences a net phase shift during the TR interval. This places constraints on the maximum spatial resolution that can be achieved without artifact. Here, a novel implementation of DESPOT2 is presented incorporating RF phase-cycling which acts to shift the spatial location of the bands, allowing reconstruction of a single, reduced artifact-image. The method is demonstrated in vivo with the acquisition of a 0.34 mm3 isotropic resolution T2 map of the brain with high precision and accuracy and significantly reduced artifact.     

Balanced steady-state free precession vs. segmented fast low-angle shot for the evaluation of ventricular volumes, mass, and function at 3 Tesla

PURPOSE: To compare balanced steady-state free precession (SSFP) and segmented fast low angle shot (FLASH) for quantification of left and right ventricular volumes and function and for left ventricular mass at high field (3 Tesla). MATERIALS AND METHODS: A total of 33 patients (19 male, mean age 54 years) with various forms of heart disease underwent ventricular function studies using cine SSFP and FLASH sequences with identical slice orientations. RESULTS: Using SSFP, left ventricular end-diastolic (+10 mL [4.7%], P < 0.001) and end-systolic volumes (+9 mL [6.1%], P < 0.001) measured larger whereas mass was considerably smaller (-23 g [-12.9%], P < 0.001) and ejection fraction (-1% [-3.2%], P < 0.01) marginally smaller. Right ventricular end-diastolic (+4 mL [2.6%], P = 0.001) and end-systolic volumes (+4 mL [5.1%], P < 0.01) were also larger, but no significant difference for right ventricular ejection fraction (P = 0.05) was found. CONCLUSION: Similar to previous results at 1.5 Tesla, at high magnetic field the cine SSFP technique led to discrete but significantly higher ventricular volume measurements and to a significantly smaller measurement of left ventricular mass in patients. The effect on left and right ventricular ejection fraction was minor, although the difference remained significant for the left ventricle.     

Myocardial delayed enhancement imaging using inversion recovery single-shot steady-state free precession: initial experience

PURPOSE: To evaluate the feasibility of using an inversion recovery single-shot steady-state free precession (SS_SSFP) sequence for myocardial delayed enhancement (MDE) imaging, and to compare SS_SSFP with the conventional inversion recovery segmented fast gradient echo (IR_FGRE) technique. MATERIALS AND METHODS: Ten subjects (four volunteers and six patients with suspected or known coronary disease) were included in this study. All subjects were scanned with both IR_FGRE and SS_SSFP sequences 15-25 minutes after gadopentetate dimeglumine injection. Overall image quality, signal-to-noise ratios (SNRs), and contrast-to-noise ratios (CNRs) between the two techniques were compared. RESULTS: Compared to IR_FGRE, SS_SSFP exhibited adequate image quality (average scores = 3.8 for IR_FGRE and 3.9 for SS_SSFP) with much shorter acquisition time (14.4 seconds for IR_FGRE and 1.3 seconds for SS_SSFP). SS_SSFP images showed higher SNRs (P < 0.05) and less motion artifact from breathing. Enhanced myocardium was detected by both techniques in three patients, but the image sharpness is compromised in SS_SSFP images. CONCLUSION: SS_SSFP provides adequate image quality compared to IR_FGRE, while requiring a much shorter acquisition time. It is feasible to use SS_SSFP as an alternative method for MDE imaging, especially in patients who have difficulty with holding their breath.     

Fast phase-contrast velocity measurement in the steady state.

A new method of encoding flow velocity as image phase in a refocused steady-state free precession (SSFP) sequence, called steady-state phase contrast (SSPC), can be used to generate velocity images rapidly while retaining high signal. Magnitude images with refocused-SSFP contrast are simultaneously acquired. This technique is compared with the standard method of RF-spoiled phase contrast (PC), and is found to have more than double the phase-signal to phase-noise ratio (PNR) when compared with standard PC at reasonable repetition intervals (TRs). As TR decreases, this advantage increases exponentially, facilitating rapid scans with high PNR efficiency. Rapid switching between the two necessary steady states can be accomplished by the insertion of a single TR interval with no flow-encoding gradient. The technique is implemented in a 2DFT sequence and validated in a phantom study. Preliminary results indicate that further TR reduction may be necessary for high-quality cardiac images; however, images in more stationary structures, such as the descending aorta and carotid bifurcation, exhibit good signal-to-noise ratio (SNR) and PNR. Comparisons with standard-PC images verify the PNR advantage predicted by theory.     

Variable velocity encoding in a three‐dimensional,three‐directional phase contrast sequence: Evaluation in phantom and volunteers

Purpose:

To evaluate accuracy and noise properties of a novel time‐resolved, three‐dimensional, three‐directional phase contrast sequence with variable velocity encoding (denoted 4D‐vPC) on a 3 Tesla MR system, and to investigate potential benefits and limitations of variable velocity encoding with respect to depicting blood flow patterns.

Materials and Methods:

A 4D PC‐MRI sequence was modified to allow variable velocity encoding (VENC) over the cardiac cycle in all three velocity directions independently. 4D‐PC sequences with constant and variable VENC were compared in a rotating phantom with respect to measured velocities and noise levels. Additionally, comparison of flow patterns in the ascending aorta was performed in six healthy volunteers.

Results:

Phantom measurements showed a linear relationship between velocity noise and velocity encoding. 4D‐vPC MRI presented lower noise levels than 4D‐PC both in phantom and in volunteer measurements, in agreement with theory. Volunteer comparisons revealed more consistent and detailed flow patterns in early diastole for the variable VENC sequences.

Conclusion:

Variable velocity encoding offers reduced noise levels compared with sequences with constant velocity encoding by optimizing the velocity‐to‐noise ratio (VNR) to the hemodynamic properties of the imaged area. Increased VNR ratios could be beneficial for blood flow visualizations of pathology in the cardiac cycle. J. Magn. Reson. Imaging 2012; 36:1450–1459. © 2012 Wiley Periodicals, Inc.     

Single scan PC‐MRI by alternating the velocity encoding gradient polarity between phase encoding steps

The purpose of this study was to develop a faster approach to phase contrast magnetic resonance imaging. This article proposes a phase contrast imaging scheme called single scan phase contrast in which the polarity of the velocity‐encoding gradient is alternated between phase encoding steps. In single scan phase contrast, ghost images due to moving spins form. The signal intensity of the ghost images is modulated by the sine of the motion‐induce phase shift. Prior to image acquisition, the region of interest containing moving spins is identified, and the field of view is configured so to avoid overlap between the object in the image and the ghost image(s) due to motion in the region of interest. The image values of the region of interest and the ghost image are used to quantify velocity. At best, single scan phase contrast reduces the total acquisition time by a factor of two when compared to phase contrast. In this study, single scan phase contrast is validated against phase contrast in phantom and in vivo. Magn Reson Med, 2011. © 2011 Wiley‐Liss, Inc.     

Phase-sensitive inversion recovery single-shot balanced steady-state free precession for detection of myocardial infarction during a single breathhold

RATIONALE AND OBJECTIVES: We sought to show that phase-sensitive detection and a single-shot technique allow imaging of the heart for detection of myocardial infarction during a single breathhold without adaptation of the inversion time. MATERIALS AND METHODS: Thirty-five patients at 2 weeks to 3 months after Q-wave myocardial infarction were examined on a 1.5-T MR system 10 minutes after the administration of a double-dose extravascular contrast agent. In order to determine the optimal inversion recovery time (TI), a TI scout sequence was performed. An IR-turboFlash sequence with optimized TI was used as standard of reference. A phase-sensitive inversion recovery (PSIR) single-shot TrueFISP sequence, which allows imaging of nine slices during one breathhold (TR/TE/FA/BW: 2.2 ms/1.1 ms/60 degrees , 8 degrees /1220 Hz/Px) was used with a nominal TI of 200 ms. Spatial resolution was identical for both techniques: 1.3 mm x 1.8 mm x 8 mm. Infarct volumes, area of infarction on a selected slice, and scan time for imaging delayed contrast enhancement (DCE) were compared. RESULTS: The mean values for the time of imaging DCE were 10 minutes 43 seconds for the IR turboFLASH and 17 seconds (P<.001) for the PSIR single-shot TrueFISP sequence. No significant difference was found for the mean values of the infarct volumes with 18.7 ml (IR turboFLASH) and 17.3 ml (PSIR single-shot TrueFISP). The values for the correlation coefficients of the infarct volumes and infarct areas of the two different techniques were r=0.95 (P<.004) and r=0.97 (P<.002). The regression equations were y=0.76+0.92*x and y=0.07+0.93*x, respectively. CONCLUSIONS: PSIR single-shot TrueFISP allows for accurate identification of myocardial infarction during a single breathhold with reduction of scan time by a factor of 38.