Vessel enhancement filtering in three-dimensional MR angiography

For a variety of reasons, small vessels have low signal intensity in magnetic resonance angiography. When the vessel signal Intensity is lower than the signal intensity of background tissues, these vessels tend not to be visible on maximum-intensity-projection images. The authors developed a nonlinear second-difference spatial filtering technique that enhances the details of small vessels while suppressing both noise and uniform background tissue. Two similar nonlinear second-difference filters are presented and compared with the linear Laplacian second-difference filter. To evaluate the performance of these filters, they were applied to intracranial three-dimensional time-of-night MR angiographic data and the results compared with the vessel enhancement obtained with a simple second-difference Laplacian filter and with magnetization transfer contrast (MTC) techniques. The comparisons demonstrated that nonlinear filtering and MTC techniques result in similar improvement in small-vessel visibility and apparent continuity. A quantitative comparison demonstrated that the improvement in the contrast-to-noise ratio is much greater with the nonlinear filters than the Laplacian filter.     

Vessel enhancement filtering in three-dimensional MR angiography

For a variety of reasons, small vessels have low signal Intensity in magnetic resonance angiography. When the vessel signal intensity is lower than the signal intensity of background tissues, these vessels tend not to be visible on maximum-intensity-projection images. The authors developed a nonlinear second-difference spatial filtering technique that enhances the details of small vessels while suppressing both noise and uniform background tissue. Two similar nonlinear second-difference filters are presented and compared with the linear Laplacian second-difference filter. To evaluate the performance of these filters, they were applied to intracranial three-dimensional time-of-flight MR angiographic data and the results compared with the vessel enhancement obtained with a simple second-difference Laplacian filter and with magnetization transfer contrast (MTC) techniques. The comparisons demonstrated that nonlinear filtering and MTC techniques result in similar Improvement in small-vessel visibility and apparent continuity. A quantitative comparison demonstrated that the improvement in the contrast-to-noise ratio is much greater with the nonlinear filters than the Laplacian filter.     

Retrospective registration of X-ray angiograms with MR images by using vessels as intrinsic landmarks

Conventional x-ray angiography (XRA) images are projections of the vasculature with high spatial and temporal resolution, while magnetic resonance (MR) angiography (MRA) and MR imaging data show the three-dimensional locations of vessels relative to brain parenchyma. The authors have developed a retrospective method of registering these studies, which makes it practical to produce multimodality displays of this complementary information. Registration was performed by matching vessels seen on both XRA and MRA images. First, the authors determined the coordinates of the center lines of a few “landmark” vessels on the XRA image and the three-dimensional locations of the corresponding intraluminal voxels in the MRA volume. Registration was performed by rotating and translating the MRA–MR imaging volume until the perspective projection of the MRA landmark vessels matched the corresponding vessel center lines on the XRA image. Experiments with phantoms and patients indicated that the two studies were registered with an average error of less than 2 mm. A linked-cursor display was developed to show correspondence between points on the registered XRA and MRA-MR images.     

Noise reduction in three-dimensional phase-contrast MR velocity measurementsl

The authors have developed a method to reduce noise in three-dimensional (3D) phase-contrast magnetic resonance (MR) velocity measurements by exploiting the property that blood is incompressible and, therefore, the velocity field describing its flow must be divergence-free. The divergence-free condition is incorporated by a projection operation in Hilbert space. The velocity field obtained with 3D phase-contrast MR imaging is projected onto the space of divergence-free velocity fields. The reduction of noise is achieved because the projection operation eliminates the noise component that is not divergence-free. Signal-to-noise ratio (S/N) gains on the order of 15%-25% were observed. The immediate effect of this noise reduction manifests itself in higher-quality phase-contrast MR angiograms. Alternatively, the S/N gain can be traded for a reduction in imaging time and/or improved spatial resolution.     

Aortocaval fistula complicating abdominal aortic aneurysm: diagnosis with gadolinium-enhanced three-dimensional MR angiography

With approximately 150 reported cases, fistulas between the abdominal aorta and inferior vena cava are rare. Preoperative clinical diagnosis of aortocaval fistula is difficult because the classical triad of abdominal pain, pulsatile abdominal mass, and abdominal machinery-like bruit may be absent in up to 50 % of patients. We report a case of aortocaval fistula complicating abdominal aortic aneurysm which was diagnosed preoperatively using breath-hold gadolinium-enhanced three-dimensional MR angiography. Received: 2 June 1998; Revision received: 28 September 1998; Accepted: 20 November 1998     

Effect of varying the molecular weight of the MR contrast agent Gd-DTPA-polylysine on blood pharmacokinetics and enhancement patterns

The effects of varying the molecular weight of gadolinium-DTPA (diethylenetriaminepentaacetic acid)—polylysine, a macromolecular magnetic resonance (MR) imaging contrast agent, on blood pharmacokinetics and dynamic tissue MR imaging signal enhancement characteristics were studied in normal rats. Blood elimination half-life, total blood clearance, volume of the central compartment (V_cc) and the steady-state distribution volume (V_ssd) were calculated for four Gd-DTPA-polylysine polymers with average molecular weights of 36, 43.9, 139, and 480 kd and compared with corresponding values for Gd-DTPA (0.57 kd) and Gd-DTPA-albumin (92 kd). Blood elimination half-life increased sevenfold with an increase in molecular weight from 36 to 480 kd. The V_cc values for all polylysine polymers did not differ significantly from the V_cc value for Gd-DTPA-albumin but were significantly smaller than the V_cc value for Gd-DTPA. The V_ssd value for Gd-DTPA did not differ significantly from the V_ssd value for the 36- and 43.9-kd polymers but was significantly larger than the V_ssd values for the 139-and 480-kd polymers and for Gd-DTPA-albumin. On T1-weighted coronal spin-echo MR images, dynamic signal enhancement profiles in liver and kidney for the 36-, 43.9-, and 480-kd Gd-DTPA-polylysine chelates corresponded to the blood pharma-cokinetic data. Increasing molecular weight of Gd-DTPA-polylysine formulations substantially slows blood clearance and produces a prolonged, almost constant tissue signal enhancement for the 60-minute observation period.     

MR microscopy of chick embryo vasculature.

Six-day-old chick embryos were examined with magnetic resonance microscopy after vascular perfusion fixation and perfusion with gadolinium-doped gelatin to high-light the developing vascular anatomy. Gadolinium gelatin, with its short T1, provided a source of signal contrast within the vessels. The entire embryo was embedded in gelatin to minimize susceptibility artifacts that are prevalent at the high field strength (7.0 T) used. A series of single-section spin-echo images were acquired with various TRs to determine the optimal imaging sequence for a three-dimensional (3D) acquisition. The combination of gadolinium gelatin in the vascular spaces, gelatin embedding of the specimen, and optimal acquisition parameters yielded a 3D stack of high-resolution images that was readily reconstructed and rendered to effectively demonstrate the developing thoracic vessels in the embryo.     

三维高时间分辨率动态增强MR血管成像在临床的初步应用

目的评价三维高时间分辨率动态增强MR血管成像（contrast-enhanced MR angiography using 3D time-resolved imaging of contrast kinetics，CE-MRA 3D-TRICKS）在临床中的应用价值。方法TRICKS应用超短Tn（2．8～4．0ms）、TE（0．9～1．3ms）、中心K空间3倍于外周K空间采集的方法获得高时间分辨率（2～6s）的MRA技术。TRICKS于增强前首先扫描3D模片，团注对比剂后连续扫描15～20个序列的3D图像。结果30例患者行TRICKS检查并获得满意的CE-MRA图像。12例椎动脉显示良好（7例正常，1例双侧椎动脉狭窄，4例单侧椎动脉狭窄，其中1例伴同侧颈总动脉分叉部狭窄）。4例双侧肾动脉显示正常，1例移植肾动脉正常，1例移植肾动脉狭窄。2例脑动脉显示正常，1例显示矢状窦血栓，1例显示颅内动静脉畸形。3例肺动脉显示正常，1例显示双侧肺动脉血栓，1例清晰显示左下肺肺段隔离症的供血动脉及引流静脉。1例左下肢纤维脂肪瘤可见动脉分支供血增多。1例显示左侧尺桡动脉人工造瘘口的狭窄。1例显示左前臂海绵状血管瘤。结论TRICKS能清晰显示全身各部位的血管系统，并能清晰显示各种血管异常。TRICKS具有方便、高成功率的特点，使其有望成为显示血管异常首选的影像学检查手段。     

Dynamic signal intensity changes in liver with superparamagnetic MR contrast agents.

The dynamic effects of three different superparamagnetic magnetic resonance (MR) contrast agents on liver signal were evaluated with an echo-planar imaging technique. The contrast agents were (a) USPIO (ultrasmall superparamagnetic iron oxide), which has a long blood half-life and was developed for MR imaging of lymph nodes and bone marrow; (b) AG (arabinogalactan)-USPIO, an asialoglycoprotein receptor--directed iron oxide with hepatocyte uptake; and (c) AMI-25, a conventional reticuloendothelial iron oxide agent. Dynamic liver signal intensity (SI) curves reflect different uptake mechanisms for the different agents. Receptor blocking experiments indicate that intracellular redistribution or clustering of the AG-USPIO (known to occur from electron microscopy studies) does not contribute to the decrease in liver SI. Monitoring liver SI over time with echo-planar imaging may provide a better understanding of the kinetics of the growing number of MR contrast agents and allow optimization of imaging protocols to exploit peak enhancement.     

Visualizing three-dimensional flow with simulated streamlines and three-dimensional phase-contrast MR imaging.

Three-dimensional (3D) velocity maps acquired with 3D phase-contrast magnetic resonance (MR) imaging contain information regarding complex motions that occur during imaging. A technique called simulated streamlines, which facilitates the display and comprehension of these velocity data, is presented. Single or multiple seed points may be identified within blood vessels of interest and tracked through the velocity field. The resulting trajectories are combined with a 3D MR angiogram and displayed with 3D volume visualization software. Mathematical analysis highlights potential applications and pitfalls of the technique, which was implemented both in phantoms and in vivo with excellent results. For example, single streamlines reveal helical flow patterns in aneurysms, and multiple streamlines seeded in the common carotid artery reveal branch filling-time relationships and slow filling of the carotid bulb. The technique is helpful in understanding these complex flow patterns.     

Improved vessel visualization in MR angiography by nonlinear anisotropic filtering

This paper deals with a preprocessing technique of magnetic resonance angiography (MRA) images, applied before maximum-intensity-projection (MIP). The purpose was to recover small low-intensity vessels, visible in individual slices, but lost in MIP images that usually have higher background level than the individual slices. The authors have developed a nonlinear three-dimensional spatial filtering technique (called HD filter) based on anisotropic smoothing. The filter first searches for the local orientation of the vessel. It then performs a nonlinear smoothing in the vessel's local direction so as to avoid blurring its boundaries. Noise level reduction, contrast enhancement, and improved small vessel visibility achieved by this filter are illustrated on dynamic contrast-enhanced subtraction MRA images of the lower limbs.     

Reduction of partial-volume artifacts with zero-filled interpolation in three-dimensional MR angiography

Partial-volume artifacts reduce vessel contrast and continuity (especially in small vessels) in magnetic resonance (MR angiography. The authors applied zero-filled (band-limited) interpolation to three-dimensional (3D) MR angiograms to reduce partial-volume artifacts. They demonstrated that zero-filled interpolation can also be implemented by means of voxel shifting in real space. Voxel-shifted interpolation is much less computer memory intensive than conventional zero-filled interpolation. They numerically simulated the contrast loss due to partial-volume artifacts and contrast recovery obtained with zero-filled interpolation. Zero-filled interpolation in all three orthogonal directions was applied to 3D MR angiography data sets from 29 human studies. These studies were obtained with the three commonly used 3D MR angiography techniques: 3D time of flight, multislab 3D time of flight, and 3D phase contrast. A substantial improvement in vessel contrast and vessel continuity was observed in all cases.     

Errors in quantitative dynamic three-dimensional keyhole MR imaging of the breast

Three-dimensional (3D) keyhole magnetic resonance (MR) imaging has been proposed as a means of providing dynamic monitoring of contrast agent uptake by breast lesions, with complete breast coverage and high spatial and temporal resolution. The 3D keyhole technique dynamically samples the central regions of k-space in both phase-encoding directions and provides high-frequency data from a precon-trast acquisition. Errors due to data truncation with two-dimensional and 3D region-of-lnterest measurements are estimated from a numerical simulation of various implementations of the 3D keyhole technique. Errors were found to increase with increasing temporal resolution and reduced object size. Errors of 75% are possible for objects with a diameter approaching 1 pixel when a 3D keyhole implementation that samples 50% of phase-encoding data in each direction is used. Preliminary clinical Images with this approach illustrate artifacts consistent with inadequate k-space sampling.     

Intraluminal contrast enhancement and MR visualization of the bowel wall: efficacy of PFOB.

Efforts to develop satisfactory intraluminal gastrointestinal contrast agents for magnetic resonance (MR) imaging have focused on depicting only the bowel lumen to exclude possible involvement by a pathologic process. To determine whether the bowel wall can be adequately imaged with use of the contrast agent and whether bowel wall visualization is a better index of the utility of the contrast agent for MR imaging, perfluoroocytlbromide (PFOB) was studied in human subjects. Twenty consecutive patients referred for abdominal or pelvic MR imaging were selected. All patients were given 400-1,000 mL of PFOB orally. MR imaging was performed at 0.38 and 1.5 T with T1- and T2-weighted spin-echo pulse sequences before and after administration of PFOB. The images were graded independently by three blinded readers. All readers reported significantly superior conspicuity of the bowel lumen and wall after PFOB than before PFOB administration (P less than .002). Among the post-PFOB studies, those with superior bowel wall visualization demonstrated superior overall image quality. In three patients, lesions were optimally demonstrated because the relationship of the process to the bowel wall, rather than just to the lumen, was identified. In two patients, masses arising within the bowel wall could be identified prospectively only when the bowel wall was adequately imaged. The authors conclude that while lumen identification is improved with PFOB, its greatest clinical utility may be in facilitating intestinal wall visualization.     

Cardiac-gated MR angiography of pulsatile flow: K-space strategies

Signal strength in time-of-flight magnetic resonance (MR) anglograpny of pulsatile flow is modulated by the time-varying intraluminal magnetization strength. The specific appearance of MR angiographlc images therefore depends on the relationship of different phase-encoding steps to the pulsatile flow waveform. Cardiac-phase gating can be applied with phase-encoding reordering to acquire different regions of k-space during the desired phases of the cardiac cycle. The authors have developed a simulation program for evaluating the merits of different encoding strategies for pulsatile flow. The model was validated with phantom studies. High signal intensity relative to that in conventional MR anglographic studies can be attained with strategies that impose relatively small penalties in total acquisition time.     

Gadolinium-enhanced high-resolution MR angiography with adaptive vessel tracking: preliminary results in the intracranial circulation.

To overcome problems associated with poor contrast between vessels and background tissue in time-of-flight magnetic resonance angiography, the role of intravenous gadopentetate dimeglumine in conjunction with a postprocessing adaptive vessel tracking scheme was studied. Vessel tracking makes it possible to discriminate arteries from veins, to prevent problems associated with other bright tissues on maximum-intensity projections, and to increase the signal-to-noise ratio. Short, asymmetric, velocity-compensated field echoes were used in conjunction with high-resolution imaging techniques to spatially discriminate between adjacent vessels and stationary background tissue. Gadopentetate dimeglumine was shown to be useful for visualization of small vessels, aneurysms, and regions of slow flow, when used with this post-processing scheme.     

Effect of field strength on gadolinium enhancement in MR imaging

This studv was designed to evaluate the influence of magnetic field strength on the relative enhancement effect (RE) of gadolinium (Gd)-chelates. Dilution series of two paramagnetic contrast agents (Gd-DTPA and Gd-DOTA) were examined in three commercially available MR systems. operating at different field strengths (02 T, 1. T, and 1.5 T). The RE was plotted against Gd concentration. The highest increases in signal intensity occurred with Gd concentrations of approximately L.0 mmol/L. No significant difference in RE was observed between MR systems ranging in field strength from 0.? T to 1.5 T. The RE of Gd-DTPA and Gd-DOTA was found to he equivalent.     

胸部磁共振增强血管造影时对比剂剂量和流率的依赖关系

目的 探讨正常人胸部磁共振增强血管造影(CE MRA)时对比剂剂量和流率的依赖关系。方法 无胸部疾病的正常志愿者61例，按0．08、0．17、0．25和0．33mmol／kg的不同剂量分成4组，再分别以2、3和4ml／s的流率注射对比剂，应用Siemens Vision Plus 1．5T MR系统进行三维动态增强MRA，以评价不同剂量和流率对人胸部血管MR造影的影响，结果 从血管肺组织对比度看，以0．25～0．33mmol／kg对比剂最佳，尤以0．25mmol／kg比较稳定；从2和4ml／s两种流率看，0．33mmol／kg剂量的血管肺组织对比度反而比0.25mmol／kg低，说明血管肺组织对比度并不是随剂量加大而增加的，当剂量达到一定程度时，这种对比度反而会下降。主动脉的强化与肺动脉和肺静脉相比，无论从信噪比还是对比度上均比较稳定，但也随着剂量的升高而逐渐升高，0．17mmol／kg以上基本都能获得较好的强化和对比度，尤其是0．25mmol/kg以上为佳。0．08～0．17mmol／kg剂量时，虽然4ml／s流率的血管肺组织对比度值明显高于2ml／s和3ml／s，但由于对比剂过于浓缩集中在一较短的血管节段内，所以整体图像的主观评价并不理想，达不到诊断要求。结论 胸部血管的CEMRA效果主要与对比剂的注射剂量有关，与流率关系不大。推荐胸部CE MRA对比剂剂量为0．25mmol／kg，以2～3ml／s的流率注射.     

Preprocedural MR imaging for percutaneous vertebroplasty: special interest in contrast enhancement

PURPOSE: The success of percutaneous vertebroplasty (PVP) depends greatly on preprocedural evaluation of the patients. The purpose of this study was to evaluate the efficacy of preprocedural magnetic resonance imaging (MRI) for the indications of PVP. MATERIALS AND METHODS: A retrospective review of 122 osteoporotic compression fractures in 63 patients who underwent preprocedural gadolinium-enhanced MRI and PVP was performed. Based on the extent of contrast enhancement on preprocedural MRI, each case was classified into one of two groups: group 1, which represented more than 50% of the vertebral body enhanced; and group 2, which represented less than 50% of the vertebral body enhanced. The most enhancing level was evaluated in multilevel PVP sessions. We evaluated the difference of pre- and postprocedural pain scales between groups 1 and 2 using Mann-Whitney's U-test. RESULTS: There was a trend toward higher preoperative pain score in group 1, but it was not statistically significant (P = 0.0537). In addition, the postoperative pain score in group 2 was significantly higher than that in group 1 (P = 0.0007). The difference between the pre- and postoperative pain scores was significantly higher in group 1 than in group 2 (P = 0.0001). CONCLUSION: Contrast enhancement on MRI indicates a painful lesion and extensive contrast enhancement predicts better pain relief after PVP.