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.     

3D flow‐independent peripheral vessel wall imaging using T2‐prepared phase‐sensitive inversion‐recovery steady‐state free precession

Purpose:

To develop a 3D flow‐independent peripheral vessel wall imaging method using T₂‐prepared phase‐sensitive inversion‐recovery (T₂PSIR) steady‐state free precession (SSFP).

Materials and Methods:

A 3D T₂‐prepared and nonselective inversion‐recovery SSFP sequence was designed to achieve flow‐independent blood suppression for vessel wall imaging based on T₁ and T₂ properties of the vessel wall and blood. To maximize image contrast and reduce its dependence on the inversion time (TI), phase‐sensitive reconstruction was used to restore the true signal difference between vessel wall and blood. The feasibility of this technique for peripheral artery wall imaging was tested in 13 healthy subjects. Image signal‐to‐noise ratio (SNR), wall/lumen contrast‐to‐noise ratio (CNR), and scan efficiency were compared between this technique and conventional 2D double inversion recovery – turbo spin echo (DIR‐TSE) in eight subjects.

Results:

3D T₂PSIR SSFP provided more efficient data acquisition (32 slices and 64 mm in 4 minutes, 7.5 seconds per slice) than 2D DIR‐TSE (2–3 minutes per slice). SNR of the vessel wall and CNR between vessel wall and lumen were significantly increased as compared to those of DIR‐TSE (P < 0.001). Vessel wall and lumen areas of the two techniques are strongly correlated (intraclass correlation coefficients: 0.975 and 0.937, respectively; P < 0.001 for both). The lumen area of T₂PSIR SSFP is slightly larger than that of DIR‐TSE (P = 0.008). The difference in vessel wall area between the two techniques is not statistically significant.

Conclusion:

T₂PSIR SSFP is a promising technique for peripheral vessel wall imaging. It provides excellent blood signal suppression and vessel wall/lumen contrast. It can cover a 3D volume efficiently and is flow‐ and TI‐independent. J. Magn. Reson. Imaging 2010;32:399–408. © 2010 Wiley‐Liss, Inc.     

Arterial flow characteristics in the presence of vascular disease and implications for fast spin echo-based noncontrast MR angiography

Purpose:

To investigate arterial flow characteristics in the setting of vascular disease, and examine their effect on the performance of fast spin‐echo (FSE)‐based noncontrast MR angiography (NC‐MRA).

Materials and Methods:

Seventeen patients were recruited from among those scheduled for routine contrast‐enhanced MR angiography (CE‐MRA) of the lower extremities at 1.5 Tesla. The research portion of the exam was performed before the clinically‐indicated protocol and included phase‐contrast imaging at multiple levels in the legs and FSE‐based NC‐MRA in the calf and thigh, using a three‐dimensional ECG‐gated technique that exploits differences in arterial flow velocity between diastole and systole.

Results:

Vascular occlusions were associated with reduced systolic velocity, a delayed systolic peak, and, in two middle‐aged patients, an increase in diastolic velocity. Elevated systolic and diastolic velocities were observed in a subject with a nonhealing ulcer. NC‐MRA allowed visualization of arteries with systolic velocities as low as 3 cm/s, and exhibited comparable depiction to CE‐MRA for diastolic velocities as high as 6 cm/s. At the highest diastolic velocities observed (15 cm/s) arterial depiction was severely degraded.

Conclusion:

FSE‐based NC‐MRA as presently implemented performs successfully over a wide range of flow patterns, but does not accommodate extremely low systolic velocities or very high diastolic velocities. J. Magn. Reson. Imaging 2011;. © 2011 Wiley Periodicals, Inc.     

3D non-contrast-enhanced MR angiography with balanced steady-state free precession Dixon method.

Balanced steady-state free precession (bSSFP) is capable of producing ample fat-water separation. In the case of the bSSFP Dixon method, the phase between fat and water can be manipulated by setting repetition time (TR) to an odd-half-multiple of the cycle time and adjusting the center frequency to acquire fat-water in in-phase and opposed-phase images. Adding an image collected when fat and water are in-phase to an image in which fat and water are opposed-phase produces a water-only image. Of the water signals, arterial blood has the highest T(2)/T(1) contrast, making the arterial signal appear brighter than both venous blood and muscle in the final image. In this study, the bSSFP Dixon method was used to collect coronal water-only three-dimensional (3D) volumes at multiple anatomical stations in the legs of five healthy volunteers. The image quality was quantified by region-of-interest (ROI) analysis of signal intensities between arterial blood, venous blood, muscle, and fat. The images were also assessed for diagnostic quality by a trained radiologist. The bSSFP Dixon method was successful in producing non-contrast-enhanced (NCE) images of the blood vessels in the lower limbs. The work presented here is a proof-of-concept for the use of the bSSFP Dixon method for 3D peripheral angiography.     

Measuring aortic diameter with different MR techniques: Comparison of three‐dimensional (3D) navigated steady‐state free‐precession (SSFP), 3D contrast‐enhanced magnetic resonance angiography (CE‐MRA), 2D T2 black blood,and 2D cine SSFP

Purpose:

To compare nongated three‐dimensional (3D) contrast‐enhanced magnetic resonance angiography (CE‐MRA) with 3D‐navigated cardiac‐gated steady‐state free‐precession bright blood (3D‐nav SSFP) and noncontrast 2D techniques for ascending aorta dimension measurements.

Materials and Methods:

Twenty‐five clinical exams were reviewed to evaluate the ascending aorta at 1.5T using: breathhold cine bright blood (SSFP), cardiac‐triggered T2 black blood (T2 BB), axial 3D‐nav SSFP, and nongated 3D CE‐MRA. Three radiologists independently measured aortic size at three specified locations for each sequence. Means, SDs, interobserver correlation, and vessel edge sharpness were statistically evaluated.

Results:

Measurements were greatest for 3D‐nav SSFP and 3D CE‐MRA and smallest for T2 BB. There was no significant difference between 3D‐nav SSFP and 3D CE‐MRA (P = 0.43–0.86), but significance was observed comparing T2 BB to all sequences. Interobserver agreement was uniformly >0.9, with T2 BB best, followed closely by 3D‐nav SSFP and 2D cine SSFP, and 3D CE‐MRA being the worst. Edge sharpness was significantly poorer for 3D CE‐MRA compared to the other sequences (P < 0.001).

Conclusion:

If diameter measurements are the main clinical concern, 3D‐nav SSFP appears to be the best choice, as it has a sharp edge profile, is easy to acquire and postprocess, and shows very good interobserver correlation. J. Magn. Reson. Imaging 2010;31:177–184. © 2009 Wiley‐Liss, Inc.     

Noncontrast MR angiography for comprehensive assessment of abdominopelvic arteries using quadruple inversion-recovery preconditioning and 3D balanced steady-state free precession imaging

Purpose:

To develop a noncontrast magnetic resonance angiography (MRA) method for comprehensive evaluation of abdominopelvic arteries in a single 3D acquisition.

Materials and Methods:

A noncontrast MRA (NC MRA) pulse sequence was developed using four inversion‐recovery (IR) pulses and 3D balanced steady‐state free precession (b‐SSFP) readout to provide arterial imaging from renal to external iliac arteries. Respiratory triggered, high spatial resolution (1.3 × 1.3 × 1.7 mm³) noncontrast angiograms were obtained in seven volunteers and ten patients referred for gadolinium‐enhanced MRA (CE MRA). Images were assessed for diagnostic quality by two radiologists. Quantitative measurements of arterial signal contrast were also performed.

Results:

NC MRA imaging was successfully completed in all subjects in 7.0 ± 2.3 minutes. In controls, image quality of NC MRA averaged 2.79 ± 0.39 on a scale of 0–3, where 3 is maximum. Image quality of NC MRA (2.65 ± 0.41) was comparable to that of CE MRA (2.9 ± 0.32) in all patients. Contrast ratio measurements in patients demonstrated that NC MRA provides arterial contrast comparable to source CE MRA images with adequate venous and excellent background tissue suppression.

Conclusion:

The proposed noncontrast MRA pulse sequence provides high‐quality visualization of abdominopelvic arteries within clinically feasible scan times. J. Magn. Reson. Imaging 2011;33:1430–1439. © 2011 Wiley‐Liss, Inc.     

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.     

T2‐weighted 3D fMRI using S2‐SSFP at 7 tesla

In this study, the sensitivity of the S₂‐steady‐state free precession (SSFP) signal for functional MRI at 7 T was investigated. In order to achieve the necessary temporal resolution, a three‐dimensional acquisition scheme with acceleration along two spatial axes was employed. Activation maps based on S₂‐steady‐state free precession data showed similar spatial localization of activation and sensitivity as spin‐echo echo‐planar imaging (SE‐EPI), but data can be acquired with substantially lower power deposition. The functional sensitivity estimated by the average z‐values was not significantly different for SE‐EPI compared to the S₂‐signal but was slightly lower for the S₂‐signal (6.74 ± 0.32 for the TR = 15 ms protocol and 7.51 ± 0.78 for the TR = 27 ms protocol) compared to SE‐EPI (7.49 ± 1.44 and 8.05 ± 1.67) using the same activated voxels, respectively. The relative signal changes in these voxels upon activation were slightly lower for SE‐EPI (2.37% ± 0.18%) compared to the TR = 15 ms S₂‐SSFP protocol (2.75% ± 0.53%) and significantly lower than the TR = 27 ms protocol (5.38% ± 1.28%), in line with simulations results. The large relative signal change for the long TR SSFP protocol can be explained by contributions from multiple coherence pathways and the low intrinsic intensity of the S₂ signal. In conclusion, whole‐brain T₂‐weighted functional MRI with negligible image distortion at 7 T is feasible using the S₂‐SSFP sequence and partially parallel imaging. Magn Reson Med 63:1015–1020, 2010. © 2010 Wiley‐Liss, Inc.     

High‐resolution 3D radial bSSFP with IDEAL

Radial trajectories facilitate high‐resolution balanced steady state free precession (bSSFP) because the efficient gradients provide more time to extend the trajectory in k‐space. A number of radial bSSFP methods that support fat–water separation have been developed; however, most of these methods require an environment with limited B₀ inhomogeneity. In this work, high‐resolution bSSFP with fat–water separation is achieved in more challenging B₀ environments by combining a 3D radial trajectory with the IDEAL chemical species separation method. A method to maintain very high resolution within the timing constraints of bSSFP and IDEAL is described using a dual‐pass pulse sequence. The sampling of a unique set of radial lines at each echo time is investigated as a means to circumvent the longer scan time that IDEAL incurs as a multiecho acquisition. The manifestation of undersampling artifacts in this trajectory and their effect on chemical species separation are investigated in comparison to the case in which each echo samples the same set of radial lines. This new bSSFP method achieves 0.63 mm isotropic resolution in a 5‐min scan and is demonstrated in difficult in vivo imaging environments, including the breast and a knee with ACL reconstruction hardware at 1.5 T. Magn Reson Med 71:95–104, 2014. © 2013 Wiley Periodicals, Inc.     

T2-weighted balanced SSFP imaging (T2-TIDE) using variable flip angles.

A new technique for acquiring T2-weighted, balanced steady-state free precession (b-SSFP) images is presented. Based on the recently proposed transition into driven equilibrium (TIDE) method, T2-TIDE uses a special flip angle scheme to achieve T2-weighted signal decay during the transient phase. In combination with half-Fourier image acquisition, T2-weighted images can be obtained using T2-TIDE. Numerical simulations were performed to analyze the signal behavior of T2-TIDE in comparison with TSE and b-SSFP. The results indicate identical signal evolution of T2-TIDE and TSE during the transient phase. T2-TIDE was used in phantom experiments, and quantitative ROI analysis shows a linear relationship between TSE and T2-TIDE SNR values. T2-TIDE was also applied to abdominal and head imaging on healthy volunteers. The resulting images were analyzed quantitatively and compared with standard T2-weighted and standard b-SSFP methods. T2-TIDE images clearly revealed T2 contrast and less blurring compared to T2-HASTE images. In combination with a magnetization preparation technique, STIR-weighted images were obtained. T2-TIDE is a robust technique for acquiring T2-weighted images while exploiting the advantages of b-SSFP imaging, such as high signal-to-noise ratio (SNR) and short TRs.