Improved 3‐Tesla cardiac cine imaging using wideband

Cine balanced steady‐state free precession (SSFP) is the most widely used sequence for assessing cardiac ventricular function at 1.5 T because it provides high signal‐to‐noise ratio efficiency and strong contrast between myocardium and blood. At 3 T, the use of SSFP is limited by susceptibility‐induced off‐resonance, resulting in either banding artifacts or the need to use a short‐sequence pulse repetition time that limits the readout duration and hence the achievable spatial resolution. In this work, we apply wideband SSFP, a variant of SSFP that uses two alternating pulse repetition times to establish a steady state with wider band spacing in its frequency response and overcome the key limitations of SSFP. Prospectively gated cine two‐dimensional imaging with wideband SSFP is evaluated in healthy volunteers and compared to conventional balanced SSFP, using quantitative metrics and qualitative interpretation by experienced clinicians. We demonstrate that by trading off temporal resolution and signal‐to‐noise ratio efficiency, wideband SSFP mitigates banding artifacts and enables imaging with approximately 30% higher spatial resolution compared to conventional SSFP with the same effective band spacing. Magn Reson Med, 2010. © 2010 Wiley‐Liss, Inc.     

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.     

Neonatal cardiac MRI using prolonged balanced SSFP imaging at 3T with active frequency stabilization

Cardiac MRI in neonates holds promise as a tool that can provide detailed functional information in this vulnerable group. However, their small size, rapid heart rate, and inability to breath‐hold, pose particular challenges that require prolonged high‐contrast and high‐SNR methods. Balanced‐steady state free precession (SSFP) offers high SNR efficiency and excellent contrast, but is vulnerable to off‐resonance effects that cause banding artifacts. This is particularly problematic in the blood‐pool, where off‐resonance flow artifacts severely degrade image quality. Methods: In this article, we explore active frequency stabilization, combined with image‐based shimming, to achieve prolonged SSFP imaging free of banding artifacts. The method was tested using 2D multislice SSFP cine acquisitions on 18 preterm infants, and the functional measures derived were validated against phase‐contrast flow assessment. Results: Significant drifts in the resonant frequency (165 ± 23Hz) were observed during 10‐min SSFP examinations. However, full short‐axis stacks free of banding artifacts were achieved in 16 subjects with stabilization; the cardiac output obtained revealed a mean difference of 9.0 ± 8.5% compared to phase‐contrast flow measurements. Conclusion: Active frequency stabilization has enabled the use of prolonged SSFP acquisitions for neonatal cardiac imaging at 3T. The findings presented could have broader implications for other applications using prolong SSFP acquisitions. Magn Reson Med 70:776–784, 2013. © 2012 Wiley Periodicals, Inc.     

Multiple repetition time balanced steady‐state free precession imaging

Although balanced steady‐state free precession (bSSFP) imaging yields high signal‐to‐noise ratio (SNR) efficiency, the bright lipid signal is often undesirable. The bSSFP spectrum can be shaped to suppress the fat signal with scan‐efficient alternating repetition time (ATR) bSSFP. However, the level of suppression is limited, and the pass‐band is narrow due to its nonuniform shape. A multiple repetition time (TR) bSSFP scheme is proposed that creates a broad stop‐band with a scan efficiency comparable with ATR‐SSFP. Furthermore, the pass‐band signal uniformity is improved, resulting in fewer shading/banding artifacts. When data acquisition occurs in more than a single TR within the multiple‐TR period, the echoes can be combined to significantly improve the level of suppression. The signal characteristics of the proposed technique were compared with bSSFP and ATR‐SSFP. The multiple‐TR method generates identical contrast to bSSFP, and achieves up to an order of magnitude higher stop‐band suppression than ATR‐SSFP. In vivo studies at 1.5 T and 3 T demonstrate the superior fat‐suppression performance of multiple‐TR bSSFP. Magn Reson Med 62:193–204, 2009. © 2009 Wiley‐Liss, Inc.     

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.     

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.     

Frequency-modulated steady-state free precession imaging.

Exploration of the possibilities of steady-state free precession (SSFP) excitation has led to the discovery that it is tolerant of slow variations in spectral offset frequency. The effect has been used to eliminate banding artifacts from images obtained with the fully balanced SSFP imaging sequence.     

Cardiac SSFP imaging at 3 Tesla.

Balanced steady-state free precession (SSFP) techniques provide excellent contrast between myocardium and blood at a high signal-to-noise ratio (SNR). Hence, SSFP imaging has become the method of choice for assessing cardiac function at 1.5T. The expected improvement in SNR at higher field strength prompted us to implement SSFP at 3.0T. In this work, an optimized sequence protocol for cardiac SSFP imaging at 3.0T is derived, taking into account several partly adverse effects at higher field, such as increased field inhomogeneities, longer T(1), and power deposition limitations. SSFP contrast is established by optimizing the maximum amplitude of the radiofrequency (RF) field strength for shortest TR, as well as by localized linear or second-order shimming and local optimization of the resonance frequency. Given the increased SNR, sensitivity encoding (SENSE) can be employed to shorten breath-hold times. Short-axis, long-axis, and four-chamber cine views obtained in healthy adult subjects are presented, and three different types of artifacts are discussed along with potential methods for reducing them.     

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.     

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.     

Optimizing spatiotemporal sampling for k-t BLAST and k-t SENSE: application to high-resolution real-time cardiac steady-state free precession.

In k-t BLAST and k-t SENSE, data acquisition is accelerated by sparsely sampling k-space over time. This undersampling in k-t space causes the object signals to be convolved with a point spread function in x-f space (x = spatial position, f = temporal frequency). The resulting aliasing is resolved by exploiting spatiotemporal correlations within the data. In general, reconstruction accuracy can be improved by controlling the k-t sampling pattern to minimize signal overlap in x-f space. In this work, we describe an approach to obtain generally favorable patterns for typical image series without specific knowledge of the image series itself. These optimized sampling patterns were applied to free-breathing, untriggered (i.e., real-time) cardiac imaging with steady-state free precession (SSFP). Eddy-current artifacts, which are otherwise increased drastically in SSFP by the undersampling, were minimized using alternating k-space sweeps. With the synergistic combination of the k-t approach with optimized sampling and SSFP with alternating k-space sweeps, it was possible to achieve a high signal-to-noise ratio, high contrast, and high spatiotemporal resolutions, while achieving substantial immunity against eddy currents. Cardiac images are shown, demonstrating excellent image quality and an in-plane resolution of approximately 2.0 mm at >25 frames/s, using one or more receiver coils.     

Cardiac MRI of ischemic heart disease at 3 T: potential and challenges

Cardiac MRI has become a routinely used imaging modality in the diagnosis of cardiovascular disease and is considered the clinically accepted gold standard modality for the assessment of cardiac function and myocardial viability. In recent years, commercially available clinical scanners with a higher magnetic field strength (3.0 T) and dedicated multi-element coils have become available. The superior signal-to-noise ratio (SNR) of these systems has lead to their rapid acceptance in cranial and musculoskeletal MRI while the adoption of 3.0 T for cardiovascular imaging has been somewhat slower. This review article describes the benefits and pitfalls of magnetic resonance imaging of ischemic heart disease at higher field strengths. The fundamental changes in parameters such as SNR, transversal and longitudinal relaxation times, susceptibility artifacts, RF (B1) inhomogeneity, and specific absorption rate are discussed. We also review approaches to avoid compromised image quality such as banding artifacts and inconsistent or suboptimal flip angles. Imaging sequences for the assessment of cardiac function with CINE balanced SSFP imaging and MR tagging, myocardial perfusion, and delayed enhancement and their adjustments for higher field imaging are explained in detail along with several clinical examples. We also explore the use of parallel imaging at 3.0 T to improve cardiac imaging by trading the SNR gain for higher field strengths for acquisition speed with increased coverage or improved spatial and temporal resolution. This approach is particularly useful for dynamic applications that are usually limited to the duration of a single breath-hold.     

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.     

Oscillating steady states.

The signal formation and properties of steady-state free precession (SSFP) in combination with alternating RF pulse phases or alternating spin precession is analyzed. Simulations and experiments demonstrate that the amplitudes of SSFP echo paths are significantly influenced by application of alternating phases either via the exciting RF pulse or via some external mechanism producing alternating spin precession. The influence of alternating phases on echo amplitudes is different for different echo paths. The primary SSFP echo paths F(0) (-) and F(0) (+) exhibit a signal reduction whereas higher-order echoes F(-1) (-) and F(1) (+) show a signal increase upon application of oscillating phases. This behavior can be described using a simple perturbation theory applied to the frequency response profile of balanced SSFP combined with a final signal integration over one balanced SSFP band. The high sensitivity of SSFP echo amplitudes to alternating RF pulse phases or precession is exemplarily used to detect and visualize propagating transverse acoustic shear waves. Detection of flow or alternating currents are further possibilities to apply this unique feature of SSFP.     

Multishot EPI-SSFP in the heart.

Refocused steady-state free precession (SSFP), or fast imaging with steady precession (FISP or TrueFISP), has recently proven valuable for cardiac imaging because of its high signal-to-noise ratio (SNR) and excellent blood-myocardium contrast. In this study, various implementations of multiecho SSFP or EPI-SSFP for imaging in the heart are presented. EPI-SSFP has higher scan-time efficiency than single-echo SSFP, as two or more phase-encode lines are acquired per repetition time (TR) at the cost of a modest increase in TR. To minimize TR, a noninterleaved phase-encode order in conjunction with a phased-array ghost elimination (PAGE) technique was employed, removing the need for echo time shifting (ETS). The multishot implementation of EPI-SSFP was used to decrease the breath-hold duration for cine acquisitions or to increase the temporal or spatial resolution for a fixed breath-hold duration. The greatest gain in efficiency was obtained with the use of a three-echo acquisition. Image quality for cardiac cine applications using multishot EPI-SSFP was comparable to that of single-echo SSFP in terms of blood-myocardium contrast and contrast-to-noise ratio (CNR). The PAGE method considerably reduced flow artifacts due to both the inherent ghost suppression and the concomitant reduction in phase-encode blip size. The increased TR of multishot EPI-SSFP led to a reduced specific absorption rate (SAR) for a fixed RF flip angle, and allowed the use of a larger flip angle without increasing the SAR above the FDA-approved limits.     

Analysis of cardiac function--comparison between 1.5 Tesla and 3.0 Tesla cardiac cine magnetic resonance imaging: preliminary experience

PURPOSE: We sought to assess the feasibility of magnetic resonance imaging to evaluate cardiac function at 3.0 T compared with 1.5 T. MATERIAL AND METHODS: In a prospective intraindividual comparative study, 12 volunteers (range, 18-54 years), and 2 patients (range, 43-53 years) underwent cardiac cine magnetic resonance at both 3.0 T and 1.5 T. Data were acquired both with a steady-state free precession sequence (SSFP) and a spoiled gradient echo (SGE) sequence. If necessary, a frequency scout was used to correct for off-resonance artifacts. For both SSFP and SGE imaging, 6-mm thick retrospectively EKG-gated short axis views were acquired with equal matrix size (192 x 163) and comparable repetition time (TR). Cardiac function parameters were determined manually by a single investigator. Cardiac function parameters, signal to noise ratio (SNR), contrast to noise ratio (CNR), and the presence of artifacts were compared between the 2 magnetic field strengths. For statistical analysis, a Pearson's correlation coefficient was calculated, and a paired Student t test was used to test statistical significance. RESULTS: Very good correlations between cardiac function parameters at 1.5 T and 3.0 T (r > 0.84, P < 0.0011) were obtained. Compared with SGE, SSFP more frequently was prone to artifacts. With SSFP/SGE at 3.0 T, a SNR gain of 9.4/16% was achieved compared with 1.5 T. CONCLUSION: Functional cardiac cine magnetic resonance imaging can be regarded as equally accurate at 3.0 T compared with 1.5 T. Compared with SSFP imaging, the SGE sequence benefits more from higher field strengths and is less affected by artifacts.     

Fat‐water separation with alternating repetition time balanced SSFP

Balanced SSFP achieves high SNR efficiency, but suffers from bright fat signal. In this work, a multiple‐acquisition fat‐water separation technique using alternating repetition time (ATR) balanced SSFP is proposed. The SSFP profile can be modified using alternating repetition times and appropriate phase cycling to yield two spectra where fat and water are in‐phase and out‐of‐phase, respectively. The signal homogeneity and the broad width of the created in‐phase and out‐of‐phase profiles lead to signal cancellation over a broad stop‐band. The stop‐band suppression is achieved for a wide range of flip angles and tissue parameters. This property, coupled with the inherent flexibility of ATR SSFP in repetition time selection, makes the method a good candidate for fat‐suppressed SSFP imaging. The proposed method can be tailored to achieve a smaller residual stop‐band signal or a decreased sensitivity to field inhomogeneity depending on application‐specific needs. Magn Reson Med 60:479–484, 2008. © 2008 Wiley‐Liss, Inc.     

Whole‐heart coronary magnetic resonance angiography at 3.0T using short‐TR steady‐state free precession,vastly undersampled isotropic projection reconstruction

Purpose

To evaluate the feasibility of improving 3.0T steady‐state free precession (SSFP) whole‐heart coronary magnetic resonance angiography (MRA) using short‐TR (repetition time) VIPR (vastly undersampled isotropic projection reconstruction).

Materials and Methods

SSFP is highly sensitive to field inhomogeneity. VIPR imaging uses nonselective radiofrequency pulses, allowing short TR and reduced banding artifacts, while achieving isotropic 3D resolution. Coronary artery imaging was performed in nine healthy volunteers using SSFP VIPR. TR was reduced to 3.0 msec with an isotropic spatial resolution of 1.3 × 1.3 × 1.3 mm³. Image quality, vessel sharpness, and lengths of major coronary arteries were measured. Comparison between SSFP using Cartesian trajectory and SSFP using VIPR trajectory was performed in all volunteers.

Results

Short‐TR SSFP VIPR resulted in whole‐heart images without any banding artifacts, leading to excellent coronary artery visualization. The average image quality score for VIPR‐SSFP was 3.12 ± 0.42 out of four while that for Cartesian SSFP was 0.92 ± 0.61. A significant improvement (P < 0.05) in image quality was shown by Wilcoxon comparison. The visualized coronary artery lengths for VIPR‐SSFP were: 10.13 ± 0.79 cm for the left anterior descending artery (LAD), 7.90 ± 0.91 cm for the left circumflex artery (LCX), 7.50 ± 1.65 cm for the right coronary artery (RCA), and 1.84 ± 0.23 cm for the left main artery (LM). The lengths statistics for Cartesian SSFP were 1.57 ± 2.02 cm, 1.54 ± 1.93 cm, 0.94 ± 1.17 cm, 0.46 ± 0.53 cm, respectively. The image sharpness was also increased from 0.61 ± 0.13 (mm^?1) in Cartesian‐SSFP to 0.81 ± 0.11 (mm^?1) in VIPR‐SSFP.

Conclusion

With VIPR trajectory the TR is substantially decreased, reducing the sensitivity of SSFP to field inhomogeneity and resulting in whole‐heart images without banding artifacts at 3.0T. Image quality improved significantly over Cartesian sampling. J. Magn. Reson. Imaging 2010; 31:1230–1235. © 2010 Wiley‐Liss, Inc.

     

Determination of optimal angles for variable nutation proton magnetic spin-lattice, T1, and spin-spin, T2, relaxation times measurement.

T1 and T2 can be rapidly determined with a combination of multiangle spoiled gradient recalled echo (SPGR) and steady-state free precession (SSFP) imaging. Previously, we demonstrated a simple method for determining the set of SPGR and SSFP angles that provided greater T1 and T2 precision than a set of uniformly spaced angles. In this article a more rigorous approach for determining angles is described. Weighted least-squares is also introduced for T1 and T2 estimation and a novel weighting function described. This new approach, suited for imaging applications where large T1 and T2 ranges are anticipated, provides high and uniform precision over a wide range of T1 and T2 values.