Motion artifact simulating aortic dissection on CT

We recently imaged two patients clinically suspected of having aortic dissection whose contrast-enhanced CT examinations, obtained on a new scanner with a 1-sec scanning time, showed findings suggesting an ascending aortic dissection. The subsequent clinical course and evaluation implied that the CT findings were predominantly artifactual. We identified identical artifacts in 18% of 50 consecutive contrast-enhanced CT examinations performed for a variety of indications on the same scanner. The double-lumen artifact, simulating an intimal flap, occurs in the proximal ascending aorta and is limited to one or two contiguous transaxial images. The artifact was not detected on two other CT units. We believe the artifact arises from motion of the aortic wall and the surrounding pericardial recesses during image acquisition.     

Effects of heart rate on motion artifacts of the aorta on non-ECG-assisted 0.5-sec thoracic MDCT

OBJECTIVE: Our aim was to evaluate the effects of heart rate on aortic motion artifacts on 0.5-sec non-ECG-assisted thoracic MDCT. MATERIALS AND METHODS: A total of 124 non-ECG-assisted thoracic MDCT scans with satisfactory simultaneous ECG data were reviewed. Scans were grouped according to patient heart rates (beats per minute [bpm]: group A, 46-55; B, 56-65; C, 66-75; D, 76-85; E, 86-95; and F > 95). The groups were compared regarding the presence, locations, and spatial distributions of pulsation artifact, number of slices affected, maximum amplitude of pulsation, continuity of artifact, and the presence of superior vena cava (SVC) pseudoflaps. RESULTS: Of the 124 scans, 114 (91.9%) had aortic motion artifacts, with prevalence ranging from 85.3% (66-75 bpm) to 100% (65 bpm or less). Of the 114 motion artifacts, all affected the ascending aorta, 105 (92.1%) involved the left anterior and right posterior aspects of the aortic circumference, and 106 (93%) were associated with SVC pseudoflaps. Group B had significantly greater numbers of images with artifacts (p < 0.001-0.006), greater artifact amplitudes (p < 0.001-0.002), and a higher continuity trend for the artifacts (p = 0.003-0.194) than did the other five groups. CONCLUSION: Aortic motion artifacts are frequently seen on thoracic MDCT, especially in patients with heart rates of 65 bpm or less. The presence of a SVC pseudoflap is helpful for distinguishing artifacts from dissection. If aortic disease is suspected, then measures to reduce motion artifact, such as ECG-gating, should be considered.     

Reduction of motion artifacts in cine MRI using variable-density spiral trajectories

Dynamic cardiac imaging in MRI is a very challenging task. To obtain high spatial resolution, temporal resolution, and signalto-noise ratio (SNR), single-shot imaging is not sufficient Use of multishot techniques resolves this problem but can cause motion artifacts because of data inconsistencies between views. Motion artifacts can be reduced by signal averaging at some cost in increased scan time. However, for the same increase in scan time, other techniques can be more effective than simple averaging in reducing the artifacts. If most of the energy of the inconsistencies is limited to a certain region of k-space, increased sampling density (oversampling) in this region can be especially effective in reducing motion artifacts. In this work, several variable-density spiral trajectories are designed and tested. Their efficiencies for artifact reduction are evaluated in computer simulations and in scans of normal volunteers. The SNR compromise of these trajectories is also investigated. The authors conclude that variable-density spiral trajectories can effectively reduce motion artifacts with a small loss in SNR as compared with a uniform density counterpart.     

Fourier tracking of myocardial motion using cine-PC data

A closed-form integration method is derived and analyzed for computing motion trajectories from velocity field data, particularly as measured by phase contrast (PC) cine MR imaging. By modeling periodic motion as composed of Fourier harmonics and integrating the material velocity of the tracked point in the frequency domain, this method gives an unbiased trajectory estimate in the presence of white measurement noise and eddy current effects. When applied to cine PC data, the method can incorporate compensation for the frequency response of the cine interpolation, offering a further improvement on the tracking accuracy. In simulation and phantom studies, the estimated trajectories were in excellent agreement with the true trajectories. Encouraging results have also been obtained on data from volunteers.     

Cine magnetic resonance microscopy of the rat heart using cardiorespiratory-synchronous projection reconstruction

PURPOSE: To tailor a cardiac magnetic resonance (MR) microscopy technique for the rat that combines improvements in pulse sequence design and physiologic control to acquire high-resolution images of cardiac structure and function. MATERIALS AND METHODS: Projection reconstruction (PR) was compared to conventional Cartesian techniques in point-spread function simulations and experimental studies to evaluate its artifact sensitivity. Female Sprague-Dawley rats were imaged at 2.0 T using PR with direct encoding of the free induction decay. Specialized physiologic support and monitoring equipment ensured consistency of biological motion and permitted synchronization of imaging with the cardiac and respiratory cycles. RESULTS: The reduced artifact sensitivity of PR offered improved delineation of cardiac and pulmonary structures. Ventilatory synchronization further increased the signal-to-noise ratio by reducing inter-view variability. High-quality short-axis and long-axis cine images of the rat heart were acquired with 10-msec temporal resolution and microscopic spatial resolution down to 175 microm x 175 microm x 1 mm. CONCLUSION: Integrating careful biological control with an optimized pulse sequence significantly limits both the source and impact of image artifacts. This work represents a novel integration of techniques designed to support measurement of cardiac morphology and function in rodent models of cardiovascular disease.     

Centric ordering is superior to gradient moment nulling for motion artifact reduction in EPI

Echo-planar imaging (EPI) is sensitive to motion despite its rapid data acquisition rate. Compared with traditional imaging techniques, it is more sensitive to motion or flow in the phase-encode direction, which can cause image artifacts such as ghosting, misregistration, and loss of spatial resolution. Consequently, EPI of dynamic structures (eg, the cardiovascular system) could benefit from methods that eliminate these artifacts. In this paper, two methods of artifact reduction for motion in the phase-encode direction are evaluated. First, the k-space trajectory is evaluated by comparing centric with top-down ordered sequences. Next, velocity gradient moment nulling (GMN) of the phase-encode direction is evaluated for each trajectory. Computer simulations and experiments in flow phantoms and rabbits in vivo show that uncompensated centric ordering produces the highest image quality. This is probably due to a shorter readout duration, which reduces T2* relaxation losses and off-resonance effects, and to the linear geometry of phantoms and vessels, which can obscure centric blurring artifacts.     

Contributions of subdiaphragmatic activity,attenuation, and diaphragmatic motion to inferior wall artifact in attenuation-corrected Tc-99m myocardial perfusion SPECT

BACKGROUND: Subdiaphragmatic activity and diaphragmatic motion both contribute to inferior wall artifacts in technetium 99m myocardial perfusion single photon emission computed tomography (SPECT). METHODS AND RESULTS: We used an anthropomorphic phantom with ventricular wall activity, liver/spleen inserts containing variable Tc-99m activity, and variable vertical (diaphragmatic) motion amplitude. SPECT and transmission scans were obtained on a GE Optima NX camera. Data were processed by use of filtered backprojection or attenuation correction (AC). Resulting myocardial activity maps were analyzed with standardized inferior-anterior and anterior-lateral wall ratios. At a subdiaphragmatic-myocardial activity ratio of 0.5:1, inferior wall attenuation predominates, producing a cold artifact. AC corrects inferior wall activity to the level of the anterior wall irrespective of diaphragmatic motion. At a subdiaphragmatic-myocardial activity ratio of 1:1, inferior wall counts vary widely depending on the proximity of subdiaphragmatic activity to the ventricle. With increasing diaphragmatic amplitude, the overlap of subdiaphragmatic activity and inferior wall worsens, leading to a complex mixture of cold and hot artifacts, not corrected by AC. CONCLUSIONS: Concentration and proximity of subdiaphragmatic Tc-99m activity relative to myocardium comprise a major factor in the nature and severity of inferior wall artifacts. If the subdiaphragmatic Tc-99m concentration is equivalent to that in the myocardium, complex, potentially uninterpretable hot and cold inferior wall artifacts are produced.     

Minimum scan speeds for suppression of motion artifacts in CT.

Cardiac and ventilatory motions cause artifacts at chest computed tomography (CT). To determine how short the scan times on third-generation units must be to avoid such artifacts, motion was measured with fast and ultrafast CT scans. Minimum detectable motion was then determined. The longest scan time that avoided a barely perceptible artifact was calculated by dividing the minimum detectable motion by the peak physiologic velocity. The posterior left ventricular wall moved at a maximum velocity of 52.5 mm/sec, necessitating a scan time of 19.1 msec or less to avoid artifact. Lung vessels near the heart moved at 40.5 mm/sec for a scan time of 24.7 msec or less. During quiet breathing, pulmonary vessels moved at 10.7 mm/sec for a scan time of 93.5 msec or less. The authors conclude that the shortest scan time on third-generation units (0.6 second) cannot prevent all artifacts arising from motion in the chest. Even ultrafast scan times (50 msec) are not short enough to eliminate artifacts on these units. Thus, reduction of motion artifacts will require techniques other than fast scanning.     

Numerical and in vivo validation of fast cine displacement‐encoded with stimulated echoes (DENSE) MRI for quantification of regional cardiac function

Quantitative assessment of regional cardiac function can improve the accuracy of detecting wall motion abnormalities due to heart disease. While recently developed fast cine displacement‐encoded with stimulated echoes (DENSE) MRI is a promising modality for the quantification of regional myocardial function, it has not been validated for clinical applications. The purpose of this study, therefore, was to validate the accuracy of fast cine DENSE MRI with numerical simulation and in vivo experiments. A numerical phantom was generated to model physiologically relevant deformation of the heart, and the accuracy of fast cine DENSE was evaluated against the numerical reference. For in vivo validation, 12 controls and 13 heart‐disease patients were imaged using both fast cine DENSE and myocardial tagged MRI. Numerical simulation demonstrated that the echo‐combination DENSE reconstruction method is relatively insensitive to clinically relevant resonance frequency offsets. The strain measurements by fast cine DENSE and the numerical reference were strongly correlated and in excellent agreement (mean difference = 0.00; 95% limits of agreement were 0.01 and ?0.02). The strain measurements by fast cine DENSE and myocardial tagged MRI were strongly correlated (correlation coefficient = 0.92) and in good agreement (mean difference = 0.01; 95% limits of agreement were 0.07 and ?0.04). Magn Reson Med, 2009. © 2009 Wiley‐Liss, Inc.     

Frequent diagnostic errors in cardiac PET/CT due to misregistration of CT attenuation and emission PET images: a definitive analysis of causes, consequences, and corrections.

Cardiac PET combined with CT is rapidly expanding despite artifactual defects and false-positive results due to misregistration of PET and CT attenuation correction data-the frequency, cause, and correction of which remain undetermined. METHODS: Two hundred fifty-nine consecutive patients underwent diagnostic rest-dipyridamole myocardial perfusion PET/CT using (82)Rb, a 16-slice PET/CT scanner, helical CT attenuation correction with breathing and also at end-expiratory breath-hold, and averaged cine CT data during breathing. Misregistration on superimposed PET/CT fusion images was objectively measured in millimeters and correlated with associated quantitative size and severity of PET defects. Misregistration artifacts were defined as PET defects with corresponding misregistration on helical CT-PET fusion images that resolved after correct coregistration using a repeat CT scan, cine CT averaged attenuation during normal breathing, or shifted cine CT data that coregistered with PET data. RESULTS: Misregistration of standard helical CT PET images caused artifactual PET defects in 103 of 259 (40%) patients that were moderate to severe in 59 (23%) (P = 0.0000) and quantitatively normalized on cine or shifted cine CT PET (P = 0.0000). Quantitative misregistration was a powerful predictor of artifact size and severity (P = 0.0000), particularly for transaxial misregistration >6 mm occurring in anterior or lateral areas in 76%, in inferior areas in 16%, and at the apex in 8% of 103 artifactual defects. CONCLUSION: Misregistration of helical CT attenuation and PET emission images causes artifactual defects with false-positive results in 40% of patients that normalize on cine CT PET using averaged CT attenuation data during normal breathing comparable to normal breathing during PET emission scanning and shifting cine CT images to coregister visually with PET.     

心肌灌注显像中位移伪影的辨析

目的 探讨心肌灌注显像时位移伪影的影像学特征、不同轴向、发生位移起始点和帧数与伪影的相关性。方法 在心肌显像过程中依次沿x,y和z轴方向,分别在不同起始点,对不同帧数作一定距离的位移。其图像与正常对照比较判断有无伪影。结果作多因素分析。结果 轻度位移伪影的特征为：x轴位移表现为下壁突出的结节状热区;y轴位移表现为间隔和侧壁呈对称分布的热区;z轴位移表现为前壁的局部热区;这些表现仅见于短轴像上。重度伪影表现为“三角形”分布的壁内热区以及典型的“双三角形”改变。位移距离相同,方向相反,伪影的“冷”“热”分布的壁内热区以及典型的“双三角形”改变。位移距离相同,方向相反,伪影的“冷”“热”区位置相反。伪影与位移帧数和轴向有关,与起始点无关。结论 不同轴向位移伪影各有特征。移动帧数和y轴位移对伪影产生的影响最大。     

Simultaneous measurement of blood and myocardial velocity in the rat heart by phase contrast MRI using sparse q-space sampling

PURPOSE: To measure cardiac blood flow patterns and ventricular wall velocities through the cardiac cycle in anesthetized Wistar Kyoto (WKY) rats. MATERIALS AND METHODS: A gradient-echo cine pulse sequence incorporating pulsed field gradients (PFGs) provided phase contrast (PC) motion encoding. We achieved a range of velocity sensitivity that was sufficient to measure simultaneously the large flow velocities within the cardiac chambers and aortic outflow tract (up to 70 cm s(-1) during systole), and the comparatively small velocities of the cardiac wall (0-3 cm s(-1)). A scheme of sparsely sampling q-space combined with a probability-based method of velocity calculation permitted such measurements along three orthogonal axes, and yielded velocity vector maps in all four chambers of the heart and the aorta, in both longitudinal and transverse sections, for up to 12 time-points in the cardiac cycle. RESULTS: Left ventricular systole was associated with a symmetrical laminar flow pattern along the cardiac axis, with no appearance of turbulence. In contrast, blood showed a swirling motion within the right ventricle (RV) in the region of the pulmonary outflow tract. During left ventricular diastole a plume of blood entered the left ventricle (LV) from the left atrium. The ventricular flow patterns could also be correlated with measurements of left ventricular wall motion. The greatest velocities of the ventricular walls occurred in the transverse cardiac plane and were maximal during diastolic refilling. The cardiac wall motion in the longitudinal axis demonstrated a caudal-apical movement that may also contribute to diastolic refilling. CONCLUSION: The successful measurements of blood and myocardial velocity during normal myocardial function may be extended to quantify pathological cardiac changes in animal models of human cardiac disease.     

0.3-second FLASH MRI of the human heart

Flow-suppressed FLASH MR images of the human heart have been recorded within a measuring time of 0.3 s using a 2.0-T whole-body research system (Siemens Magnetom) equipped with a conventional 10 mT m-1 gradient system. Subsecond imaging times have been achieved by reducing the repetition time to TR = 4.8 ms and by lowering the spatial resolution to 64 X 128 measured data points. The flip angle of the slice-selective radiofrequency (rf) pulses was adjusted to 10 degrees. Cardiac chambers, ventricular walls, and valves are well delineated in images from a single cardiac cycle using a field of 250 mm and a slice thickness of 8 mm. No motion artifacts were observed as a consequence of the short echo time of TE = 2.8 ms. Distinction between flowing blood and solid structures has been achieved by spatial presaturation of adjacent slices using two slice-selective 90 degrees rf pulses preceding the entire imaging sequence.     

Band artifacts due to bulk motion.

Band artifacts due to bulk motion were investigated in images acquired with fast gradient echo sequences. A simple analytical calculation shows that the width of the artifacts has a square-root dependence on the velocity of the imaged object, the time taken to acquire each line of k-space and the field of view in the phase-encoding direction. The theory furthermore predicts that the artifact width can be reduced using parallel imaging by a factor equal to the square root of the acceleration parameter. The analysis and results are presented for motion in the phase- and frequency-encoding directions and comparisons are made between sequential and centric ordering. The theory is validated in phantom experiments, in which bulk motion is simulated in a controlled and reproducible manner by rocking the scan table back and forth along the bore axis. Preliminary cardiac studies in healthy human volunteers show that dark bands may be observed in the endocardium in images acquired with nonsegmented fast gradient echo sequences. The fact that the position of the bands changes with the phase-encoding direction suggests that they may be artifacts due to motion of the heart walls during the image acquisition period.     

The impact of motion artifacts on the reproducibility of repeated coronary artery calcium measurements

The purpose of this study is, using a 16-section multidetector-row helical computed tomography (MDCT) scanner with retrospective reconstruction, to compare variability in repeated coronary calcium scoring and qualitative scores of the motion artifacts. One hundred forty-four patients underwent two subsequent scans using MDCT. According to Agatston and volume algorithms, the coronary calcium scores during mid-diastole (the center corresponding to 70% of the R-R cycle) were calculated and the inter-scan variability was obtained. Motion artifacts from coronary artery calcium were subjectively evaluated and classified using a 5-point scale: 1, excellent; no motion artifacts; 2, fine, minor motion artifacts; 3, moderate, mild motion artifacts; 4, bad, severe motion artifacts; 5, poor, doubling or discontinuity. Each reading was done by vessels (left main, left descending, left circumflex and right coronary arteries) and the motion artifact score (mean of the scales) was determined per patient. The variability in the low (1.2+/-0.2) and high (2.4+/-0.6) motion artifact score groups was 7+/-6 (median, 6)% and 19+/-15 (16)% on the Agatston score (P<0.01) and 7+/-7 (6)% and 16+/-13 (14)% on the volume score (P<0.01), respectively. In conclusion, motion has a significant impact on the reproducibility of coronary calcium scoring.     

Reduction in flow artifacts by using interleaved data acquisition in segmented balanced steady-state free precession cardiac MRI.

Balanced steady-state free precession (SSFP) magnetic resonance (MR) imaging is feasible for cine cardiac images because of the high contrast between myocardium and blood pool and robustness to rapid blood flow. Nonetheless, the flow artifacts are often observed because of off-resonance effects and to in-flow effects of the blood flow. Although reshimming the gradients or readjusting the center frequency reduces the artifacts, the technique can be susceptible for respiratory and cardiac motion and operator-dependent. The purpose of this study is to use another MR imaging technique for the reduction in the flow artifacts in the heart: odd-even interleaved data acquisition in segmented balanced SSFP imaging. The flow artifacts in the ventricle, ghost outside the heart, and visualization of the myocardial border were visually compared between sequential and odd-even interleaved k-space data acquisitions in cine balanced SSFP cardiac MR imaging. The odd-even interleaved k-space data acquisition significantly reduced dark flow artifacts in the left ventricle, improved the visualization of the myocardial border, and was easily installed. This imaging technique should be applied to cine segmented balanced SSFP cardiac MR imaging.     

Motion Artifacts in fMRI: Comparison of 2DFT with PR and Spiral Scan Methods

Activation signals based on BOLD contrast changes consequent to neuronal stimulation typically produce cortical intensity differences of < 10% at 1.5T. Hemodynamically driven pulsation of the brain can cause highly pulsatile phase shifts, which in turn result in motion artifacts whose intensity is larger than the activation signals in 2DFT scan methods. This paper presents a theoretical and experimental comparison of the magnitude of such artifacts for 2DFT and two other methods using non-Cartesian k-space trajectories. It is shown that artifacts increase with TR for 2DFT methods, and that projection reconstruction (PR) and spiral methods have significantly reduced artifact intensities, because these trajectories collect low spatial frequencies with every view. The spiral technique is found to be superior in terms of efficiency and motion insensitivity.     

Optimization of spiral‐based pulse sequences for first‐pass myocardial perfusion imaging

Although spiral trajectories have multiple attractive features such as their isotropic resolution, acquisition efficiency, and robustness to motion, there has been limited application of these techniques to first‐pass perfusion imaging because of potential off‐resonance and inconsistent data artifacts. Spiral trajectories may also be less sensitive to dark‐rim artifacts that are caused, at least in part, by cardiac motion. By careful consideration of the spiral trajectory readout duration, flip angle strategy, and image reconstruction strategy, spiral artifacts can be abated to create high‐quality first‐pass myocardial perfusion images with high signal‐to‐noise ratio. The goal of this article was to design interleaved spiral pulse sequences for first‐pass myocardial perfusion imaging and to evaluate them clinically for image quality and the presence of dark‐rim, blurring, and dropout artifacts. Magn Reson Med, 2011. © 2011 Wiley‐Liss, Inc.     

Prospectively gated cardiac CT. Preliminary results in normal and postinfarction animal models

Cardiac motion introduces significant artifacts into standard CT images obtained through the heart. A newly developed prospectively gated CT system produced 87 gated scan sets in ten normal and infarcted dogs. Each cycle can provide up to 24 37-70 msec composite images of one transverse slice, equally spaced in time through the cardiac cycle. Eight to 12 2-second scans, obtained during a constant infusion of contrast, were required to collect the data for each gated set. The left and right ventricular myocardium was clearly seen, regions of myocardial infarction were identified, and atrial and ventricular filling and emptying were visualized. In areas of infarction, wall thickness was unchanged from diastole to systole. In addition to improved resolution, a gated CT series evaluation of wall motion abnormalities may provide a better means of locating myocardial infarction than the ungated CT image.     

Cardiac motion in diffusion-weighted MRI of the liver: artifact and a method of correction

Purpose:

To characterize cardiac motion artifacts in the liver and assess the use of a postprocessing method to mitigate these artifacts in repeat measurements.

Materials and Methods:

Three subjects underwent breathhold diffusion‐weighted (DW) scans consisting of 25 repetitions for three b‐values (0, 500, 1000 sec/mm²). Statistical maps computed from these repetitions were used to assess the distribution and behavior of cardiac motion artifacts in the liver. An objective postprocessing method to reduce the artifacts was compared with radiologist‐defined gold standards.

Results:

Signal dropout is pronounced in areas proximal to the heart, such as the left lobe, but also present in the right lobe and in distal liver segments. The dropout worsens with b‐value and leads to overestimation of the diffusivity. By reference to a radiologist‐defined gold standard, a postprocessing correction method is shown to reduce cardiac motion artifact.

Conclusion:

Cardiac motion leads to significant artifacts in liver DW imaging; we propose a postprocessing method that may be used to mitigate the artifact and is advantageous to standard signal averaging in acquisitions with multiple repetitions. J. Magn. Reson. Imaging 2012;318‐327. © 2011 Wiley Periodicals, Inc.