Phase enhancement for time‐of‐flight and flow‐sensitive black‐blood MR angiography

A magnitude‐based MR angiography method of standard time‐of‐flight (TOF) employing a three‐dimensional gradient‐echo sequence with flow rephasing is widely used. A recently proposed flow‐sensitive black‐blood (FSBB) method combining three‐dimensional gradient‐echo sequence with a flow‐dephasing gradient and a hybrid technique, called hybrid of opposite‐contrast, allow depiction of smaller blood vessels than does standard TOF. To further enhance imaging of smaller vessels, a new enhancement technique combining phase with magnitude is proposed. Both TOF and FSBB pulse sequences were used with only 0th‐order gradient moment nulling, and suitable dephasing gradients were added to increase the phase shift introduced mainly by flow. Magnitude‐based vessel‐to‐background contrast‐to‐noise ratios in TOF and FSBB were further enhanced to increase the dynamic range between positive and negative signals through the use of cosine‐function‐based filters for white‐ and black‐blood imaging. The proposed phase‐enhancement processing both improved visualization of slow‐flow vessels in the brains of volunteer subjects with shorter echo time in TOF, FSBB, and hybrid of opposite‐contrast and reduced wraparound artifacts with smaller b values without sacrificing vessel‐to‐background contrast in FSBB. This method of enhancement processing has excellent potential to become clinically useful. Magn Reson Med, 2011. © 2011 Wiley‐Liss, Inc.     

Visualization of the lenticulostriate artery with flow‐sensitive black‐blood acquisition in comparison with time‐of‐flight MR angiography

Purpose

To evaluate the capability of flow‐sensitive black blood (FSBB) acquisition to visualize the lenticulostriate artery (LSA) in comparison with time‐of‐flight (TOF) angiography.

Materials and Methods

Twenty‐one healthy subjects (13 males and 8 females, 19–44 years old) were enrolled in this study after obtaining written informed consent. Magnetic resonance imaging (MRI) examinations were performed with FSBB and TOF to visualize the LSA using a 1.5T MRI unit. In FSBB acquisition a motion probing gradient of b = 4 sec/mm² was applied to dephase blood flow. Images were reconstructed into coronal sections and were evaluated in terms of number, length, and image quality at origins and distal areas of visualized LSA branches with a four‐point scale.

Results

In all, 145 LSA branches were visualized with FSBB and 66 branches with TOF. There was no LSA visualized only with TOF. In all evaluated terms, FSBB was significantly better than TOF.

Conclusion

We could better visualize the LSA with FSBB than with TOF, both quantitatively and qualitatively. FSBB is a promising method, although it remains to be evaluated in clinical cases. J. Magn. Reson. Imaging 2009;29:65–69. © 2008 Wiley‐Liss, Inc.     

Hybrid of opposite‐contrast MRA of the brain by combining time‐of‐flight and black‐blood sequences: Initial experience in major trunk stenoocclusive diseases

Purpose:

To assess the feasibility of a new MR angiography (MRA) technique named hybrid of opposite‐contrast MRA (HOP MRA) that combined the time‐of‐flight (TOF) MRA with a flow‐sensitive black‐blood (FSBB) sequence in the diagnosis of major trunk stenoocclusive diseases.

Materials and Methods:

On a 1.5 Tesla imager using a dual‐echo three‐dimensional (3D)‐gradient‐echo sequence, we obtained the first echo for TOF MRA followed by the second echo for FSBB. We then subtracted the FSBB data set from that of TOF MRA followed by maximum intensity projection. In four normal volunteers and 19 patients with chronic stenoocclusive disease of the major trunk, we performed HOP MRA along with 3D‐TOF MRA and compared the findings.

Results:

In the volunteer group, the HOP MRA technique improved the demonstration of distal arterial branches. In 12 of the 19 patients, the HOP MRA better visualized branches distal to the lesion as well as distal branches of normal trunks than 3D‐TOF MRA, while both techniques provided equivalent depiction of branches distal to the lesion but better depiction of normal distal branches in three patients.

Conclusion:

The HOP‐MRA technique is promising in major trunk stenoocclusive diseases as it better demonstrates distal branches probably representing collaterals than 3D‐TOF MRA. J. Magn. Reson. Imaging 2010;31:56–60. © 2009 Wiley‐Liss, Inc.     

Continuously moving table time‐of‐flight angiography of the peripheral veins

Time‐of‐flight (TOF) MR angiography allows for noninvasive vessel imaging. To overcome the limited volumetric coverage of standard TOF techniques, the aim of this study was to investigate the combination of TOF and continuously moving table (CMT) acquisitions for peripheral vein imaging based on image subtraction. Two acquisition strategies are presented: a simple two‐step method based on 2‐fold CMT acquisition and an advanced one‐step method requiring only one continuous scan. Image quality of both CMT TOF techniques was evaluated by semiquantitative image grading and by signal‐to‐noise ratio and contrast‐to‐noise ratio analysis for veins of the upper and lower leg in 10 healthy volunteers. Results were compared to a standard stationary two‐dimensional (2D) TOF multistation acquisition. Image grading revealed good image quality for both CMT TOF methods, thereby confirming the feasibility of axial 2D CMT TOF to assess the veins of the lower extremities during a single scan. Quantitative evaluation showed no significant difference in signal‐to‐noise ratio and contrast‐to‐noise ratio compared to the stationary experiment. Additional measurements in three patients with postthrombotic changes and varicosities demonstrated the clinical applicability of the presented methods. CMT TOF provides promising results and permits the detection of various pathologic changes of the venous system. Magn Reson Med 63:1219–1229, 2010. © 2010 Wiley‐Liss, Inc.     

Determination of the optimal first‐order gradient moment for flow‐sensitive dephasing magnetization‐prepared 3D noncontrast MR angiography

Flow‐sensitive dephasing (FSD) magnetization preparation has been developed for black‐blood vessel wall MRI and noncontrast MR angiography. The first‐order gradient moment, m₁, is a measure of the flow‐sensitization imparted by an FSD preparative module. Determination of the optimal m₁ for each individual is highly desirable for FSD‐prepared MR angiography. This work developed a 2D m₁‐scouting method that evaluates a range of m₁ values for their effectiveness in blood signal suppression in a single scan. The feasibility of using the 2D method to predict blood signal suppression in 3D FSD‐prepared imaging was validated on a flow phantom and the popliteal arteries of 5 healthy volunteers. Excellent correlation of the blood signal measurements between the 2D scouting and 3D FSD imaging was obtained. Therefore, the optimal m₁ determined from the 2D m₁‐scouting scan may be directly translated to 3D FSD‐prepared imaging. In vivo studies of additional 10 healthy volunteers and 2 patients have demonstrated the proposed method can help significantly improve the signal performance of FSD MR angiography, indicating its potential to enhance diagnostic confidence. Further systematic studies in patients are warranted to evaluate its clinical value. Magn Reson Med, 2011. © 2011 Wiley‐Liss, Inc.     

Improved time‐of‐flight magnetic resonance angiography with IDEAL water‐fat separation

Purpose

To implement IDEAL (iterative decomposition of water and fat using echo asymmetry and least squares estimation) water‐fat separation with 3D time‐of‐flight (TOF) magnetic resonance angiography (MRA) of intracranial vessels for improved background suppression by providing uniform and robust separation of fat signal that appears bright on conventional TOF‐MRA.

Materials and Methods

IDEAL TOF‐MRA and conventional TOF‐MRA were performed in volunteers and patients undergoing routine brain MRI/MRA on a 3T magnet. Images were reviewed by two radiologists and graded based on vessel visibility and image quality.

Results

IDEAL TOF‐MRA demonstrated statistically significant improvement in vessel visibility when compared to conventional TOF‐MRA in both volunteer and clinical patients using an image quality grading system. Overall image quality was 3.87 (out of 4) for IDEAL versus 3.55 for conventional TOF imaging (P = 0.02). Visualization of the ophthalmic artery was 3.53 for IDEAL versus 1.97 for conventional TOF imaging (P < 0.00005) and visualization of the superficial temporal artery was 3.92 for IDEAL imaging versus 1.97 for conventional TOF imaging (P < 0.00005).

Conclusion

By providing uniform suppression of fat, IDEAL TOF‐MRA provides improved background suppression with improved image quality when compared to conventional TOF‐MRA methods. J. Magn. Reson. Imaging 2009;29:1367–1374. © 2009 Wiley‐Liss, Inc.     

Prospective optical motion correction for 3D time‐of‐flight angiography

Magnetic resonance angiograms are often nondiagnostic due to patient motion. In clinical practice, the available time to repeat motion‐corrupted scans is very limited—especially in patients who suffer from acute cerebrovascular conditions. Here, the feasibility of an optical motion correction system to prospectively correct patient motion for 3D time‐of‐flight magnetic resonance angiography was investigated. Experiments were performed on five subjects with and without parallel imaging (SENSE R = 2) on a 1.5 T unit. Two human readers assessed the data and were in good agreement (kappa: 0.77). The results from this study indicate that the optical motion correction system greatly reduces motion artifacts when motion was present and did not impair the image quality in the absence of motion. Statistical analysis showed no significant difference between the (vendor‐provided) SENSE and the nonaccelerated acquisitions. In conclusion, the optical motion correction system tested in this study has the potential to greatly improve 3D time‐of‐flight angiograms regardless of whether it is used with or without SENSE. Magn Reson Med, 2013. © 2012 Wiley Periodicals, Inc.     

Phase‐sensitive black‐blood coronary vessel wall imaging

Black‐blood MR coronary vessel wall imaging may become a powerful tool for the quantitative and noninvasive assessment of atherosclerosis and positive arterial remodeling. Although dual‐inversion recovery is currently the gold standard, optimal lumen‐to‐vessel wall contrast is sometimes difficult to obtain, and the time window available for imaging is limited due to competing requirements between blood signal nulling time and period of minimal myocardial motion. Further, atherosclerosis is a spatially heterogeneous disease, and imaging at multiple anatomic levels of the coronary circulation is mandatory. However, this requirement of enhanced volumetric coverage comes at the expense of scanning time. Phase‐sensitive inversion recovery has shown to be very valuable for enhancing tissue‐tissue contrast and for making inversion recovery imaging less sensitive to tissue signal nulling time. This work enables multislice black‐blood coronary vessel wall imaging in a single breath hold by extending phase‐sensitive inversion recovery to phase‐sensitive dual‐inversion recovery, by combining it with spiral imaging and yet relaxing constraints related to blood signal nulling time and period of minimal myocardial motion. Magn Reson Med 63:1021–1030, 2010. © 2010 Wiley‐Liss, Inc.     

Simultaneous acquisition of MR angiography and venography (MRAV).

A dual-echo pulse sequence for simultaneous acquisition of MR angiography and venography (MRAV) is developed. Data acquisition of the second echo for susceptibility-weighted imaging-based MR venography is added to the conventional three-dimensional (3D) time-of-flight (TOF) MRA pulse sequence. Using this dual-echo acquisition approach, the venography data can be acquired without increasing the repetition time, and, therefore, the scan duration of routine TOF MRA scans is maintained. The feasibility of simultaneous acquisition of MRAV is presented in brain scans at different spatial resolutions. The effect of spatial resolution on vein-to-background contrast is also demonstrated. Venous contrast is improved in high-resolution (0.52 x 0.52 x 1.6 mm(3)) images compared to that in standard-resolution (0.78 x 0.78 x 1.6 mm(3)) images. This MRAV technique enables the acquisition of MR venography without the need of an extra scan or injection of contrast agent in routine clinical brain exams at 3T.     

Noncontrast‐enhanced peripheral MRA: Technical optimization of flow‐spoiled fresh blood imaging for screening peripheral arterial diseases

Flow‐spoiled fresh blood imaging, a noncontrast peripheral MR angiography technique, allows the depiction of the entire tree of peripheral arteries by utilizing the signal difference between systolic‐ and diastolic‐triggered data. The image quality of the technique relies on selecting the right triggering delay times and flow‐dependent read‐out spoiler gradient pulses. ECG triggering delays were verified using manual subtraction and automated software. The read‐out spoiler gradients pulses were optimized on volunteers before utilizing the flow‐spoiled fresh blood imaging technique to screen for peripheral arterial disease. Thirteen consecutive patients with suspected peripheral arterial disease underwent both flow‐spoiled fresh blood imaging and 16‐detector‐row computed tomography angiography examinations. A total of 23 segments were evaluated in the arterial vascular system. Using computed tomography angiography as the reference standard, 56 diseased segments were detected with 22 nonsignificant stenoses (<50%) and 34 significant stenoses, 15 of which were totally occluded. Flow‐spoiled fresh blood imaging had a sensitivity of 97%, a specificity of 96%, an accuracy of 96%, a positive predictive value of 88%, and a negative predictive value of 99%. With such a high negative predictive value, flow‐spoiled fresh blood imaging has the potential to become the safest noninvasive screening tool for peripheral arterial disease, especially for patients with impaired renal function. Magn Reson Med, 2011. © 2010 Wiley‐Liss, Inc.     

MR angiography of the cerebral perforating arteries with magnetization prepared anatomical reference at 7T: Comparison with time‐of‐flight

Purpose

To develop a magnetic resonance imaging (MRI) protocol that visualizes both the perforating arteries and the related anatomy in a single acquisition at 7T.

Material and Methods

T₁‐weighted magnetization prepared imaging (MPRAGE) was empirically modified for use as angiography method at 7T. The resulting sequence depicts the vasculature simultaneously with the surrounding anatomical structures, and is referred to as “magnetization prepared anatomical reference MRA” (MPARE‐MRA). The method was compared to time‐of‐flight (TOF) MRA in seven healthy subjects. The conspicuity of the perforating arteries and the contrast between gray and white matter were evaluated both quantitatively by contrast‐to‐noise (CNR) measurements, and qualitatively by two radiologists who scored the images.

Results

The contrast‐to‐noise ratio (CNR) between blood and background was 28 ± 9 for MPARE‐MRA and 35 ± 16 for TOF‐MRA, indicating good conspicuity of the vessels. CNR values were: internal capsule (IC) vs. caudate head (CH): 4.2 ± 0.7; IC vs. putamen: 3.5 ± 0.6; white matter vs. gray matter: 9.7 ± 2.5.

Conclusion

The benefits of ultra‐high‐field MRI can transform MPRAGE into a new angiography method to image small vessels and associated parenchyma at the same time. This technique can be used to study the correlation between tissue damage and vascular pathology. J. Magn. Reson. Imaging 2008;28:1519–1526. © 2008 Wiley‐Liss, Inc.