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.     

Steady state free precession magnetization transfer imaging

The formerly proposed concept for magnetization transfer imaging (MTI) using balanced steady‐state free precession (SSFP) image acquisitions is in this work extended to nonbalanced protocols. This allows SSFP‐based MTI of targets with high susceptibility variation (such as the musculoskeletal system), or at ultra‐high magnetic fields (where balanced SSFP suffers from considerable off‐resonance related image degradations). In the first part, SSFP‐based MTI in human brain is analyzed based on magnetization transfer ratio (MTR) histograms. High correlations are observed among all different SSFP MTI protocols and thereby ensure proper conceptual extension to nonbalanced SSFP. The second part demonstrates SSFP‐based MTI allowing fast acquisition of high resolution volumetric MTR data from human brain and cartilage at low (1.5T) to ultra‐high (7.0T) magnetic fields. Magn Reson Med 60:1261–1266, 2008. © 2008 Wiley‐Liss, Inc.     

Quantitative in vivo diffusion imaging of cartilage using double echo steady-state free precession

Single-shot echo-planar imaging techniques are commonly used for diffusion-weighted imaging (DWI) but offer rather poor spatial resolution and field-of-view coverage for species with short T(2) . In contrast, steady-state free precession (SSFP) has shown promising results for DWI of the musculoskeletal system, but quantification is generally hampered by its prominent sensitivity on relaxation times. In this work, a new and truly diffusion-weighted (that is relaxation time independent) SSFP DWI technique is introduced using a double-echo steady-state approach. Within this framework (and this is in contrast to common SSFP DWI techniques using SSFP-Echo) both primary echo paths of nonbalanced SSFP are acquired, namely the FID and the Echo. Simulations and in vitro measurements reveal that the ratio of the Echo/FID signal ratios of two double-echo steady-state scans acquired with and without diffusion sensitizing dephasing moments provides a highly relaxation independent quantity for diffusion quantification. As a result, relaxation-independent high-resolution (0.4 × 0.4 - 0.6 × 0.6 mm(2) in-plane resolution) quantitative in vivo SSFP DWI is demonstrated for human articular cartilage using diffusion-weighted double-echo steady-state scans in the knee and ankle joint at 3.0 T. The derived diffusion coefficients for cartilage (D ～ 1.0-1.5 μm(2) /ms) and synovial fluid (D ～ 2.6 μm(2) /ms) are in agreement with previous work.     

Comparison of wideband steady‐state free precession and T2‐weighted fast spin echo in spine disorder assessment at 1.5 and 3 T

Wideband steady‐state free precession (WB‐SSFP) is a modification of balanced steady‐state free precession utilizing alternating repetition times to reduce susceptibility‐induced balanced steady‐state free precession limitations, allowing its use for high‐resolution myelographic‐contrast spinal imaging. Intertissue contrast and spatial resolution of complete‐spine‐coverage 3D WB‐SSFP were compared with those of 2D T₂‐weighted fast spin echo, currently the standard for spine T₂‐imaging. Six normal subjects were imaged at 1.5 and 3 T. The signal‐to‐noise ratio efficiency (SNR per unit‐time and unit‐volume) of several tissues was measured, along with four intertissue contrast‐to‐noise ratios; nerve‐ganglia:fat, intradural‐nerves:cerebrospinal fluid, nerve‐ganglia:muscle, and muscle:fat. Patients with degenerative and traumatic spine disorders were imaged at both MRI fields to demonstrate WB‐SSFP clinical advantages and disadvantages. At 3 T, WB‐SSFP provided spinal contrast‐to‐noise ratios 3.7–5.2 times that of fast spin echo. At 1.5 T, WB‐SSFP contrast‐to‐noise ratio was 3–3.5 times that of fast spin echo, excluding a 1.7 ratio for intradural‐nerves:cerebrospinal fluid. WB‐SSFP signal‐to‐noise ratio efficiency was also higher. Three‐dimensional WB‐SSFP disadvantages relative to 2D fast spin echo are reduced edema hyperintensity, reduced muscle signal, and higher motion sensitivity. WB‐SSFP's high resolution and contrast‐to‐noise ratio improved visualization of intradural nerve bundles, foraminal nerve roots, and extradural nerve bundles, improving detection of nerve compression in radiculopathy and spinal‐stenosis. WB‐SSFP's high resolution permitted reformatting into orthogonal planes, providing distinct advantages in gauging fine spine pathology. Magn Reson Med, 2012. © 2012 Wiley Periodicals, Inc.     

Fast SSFP gradient echo sequence for simultaneous acquisitions of FID and echo signals

Recently, the gradient echo imaging sequence in conjunction with small flip angle excitations and short repetition times has been widely used for fast NMR imaging. As the repetition time decreases to an extent comparable to the spin-spin relaxation time T2, the residual phase coherency of the transverse spin magnetization tends to form another nuclear signal which is heavily weighted by T2 and similar to a long TR/long TE spin-echo signal. This effect, although expected, has not been utilized in the conventional fast gradient echo imaging. When this residual phase coherency is utilized in conjunction with the fast SSFP (steady-state free precession) technique, both the FID and the echo signals can be obtained. In this paper, we have proposed a new technique by which simultaneous acquisitions of both the FID and the echo signals are possible. Experiments on this fast SSFP mode imaging have shown that the FID signal is T1-weighted while the echo signal is strongly T2-weighted. The flip angle optimal for maximizing signal and related contrast are also studied in conjunction with the proposed sequence and the experimental results are presented.     

Quantitative magnetization transfer in in vivo healthy human skeletal muscle at 3 T

The value of quantitative MR methods as potential biomarkers in neuromuscular disease is being increasingly recognized. Previous studies of the magnetization transfer ratio have demonstrated sensitivity to muscle disease. The aim of this work was to investigate quantitative magnetization transfer imaging of skeletal muscle in healthy subjects at 3 T to evaluate its potential use in pathological muscle. The lower limb of 10 subjects was imaged using a 3D fast low‐angle shot acquisition with variable magnetization transfer saturation pulse frequencies and amplitudes. The data were analyzed with an established quantitative two‐pool model of magnetization transfer. T₁ and B₁ amplitude of excitation radiofrequency field maps were acquired and used as inputs to the quantitative magnetization transfer model, allowing properties of the free and restricted proton pools in muscle to be evaluated in seven different muscles in a region of interest analysis. The average restricted pool T₂ relaxation time was found to be 5.9 ± 0.2μs in the soleus muscle and the restricted proton pool fraction was 8 ± 1%. Quantitative magnetization transfer imaging of muscle offers potential new biomarkers in muscle disease within a clinically feasible scan time. Magn Reson Med, 2010. © 2010 Wiley‐Liss, Inc.     

Superbalanced steady state free precession

Steady state free precession (SSFP) signal theory is commonly derived in the limit of quasi-instantaneous radiofrequency (RF) excitation. SSFP imaging protocols, however, are frequently set up with minimal pulse repetition times and RF pulses can thus constitute a considerable amount to the actual pulse repetition time. As a result, finite RF pulse effects can lead to 10-20% signal deviation from common SSFP theory in the transient and in the steady state which may impair the accuracy of SSFP-based quantitative imaging techniques. In this article, a new and generic approach for intrinsic compensation of finite RF pulse effects is introduced. Compensation is based on balancing relaxation effects during finite RF excitation, similar to flow or motion compensation of gradient moments. RF pulse balancing, in addition to the refocusing of gradient moments with balanced SSFP, results in a superbalanced SSFP sequence free of finite RF pulse effects in the transient and in the steady state; irrespective of the RF pulse duration, flip angles, relaxation times, or off-resonances. Superbalancing of SSFP sequences can be used with all quantitative SSFP techniques where finite RF pulse effects are expected or where elongated RF pulses are used.     

Double average parallel steady-state free precession imaging: optimized eddy current and transient oscillation compensation.

Balanced steady-state free precession (SSFP) imaging is sensitive to off-resonance effects, which can lead to considerable artifacts during a transient phase following magnetization preparation or steady-state interruption. In addition, nonlinear k-space encoding is required if contrast-relevant k-space regions need to be acquired at specific delays following magnetization preparation or for transient artifact reduction in cardiac-gated k-space segmented CINE imaging. Such trajectories are problematic for balanced SSFP imaging due to nonconstant eddy current effects and resulting disruption of the steady state.In this work, a novel acquisition strategy for balanced SSFP imaging is presented that utilizes scan time reduction by parallel imaging for optimized "double average" eddy current compensation and artifact reduction during the transient phase following steady-state storage and magnetization preparation. Double average parallel SSFP imaging was applied to k-space segmented CINE SSFP tagging as well as nongated centrically encoded SSFP imaging. Phantom and human studies exhibit substantial reduction in steady-state storage and eddy current artifacts while maintaining spatial resolution, signal-to-noise ratio, and similar total scan time of a standard SSFP acquisition. The proposed technique can easily be extended to other acquisition schemes that would benefit from nonlinear reordering schemes and/or rely on interruption of the balanced SSFP steady state.     

Non‐contrast‐enhanced flow‐independent peripheral MR angiography with balanced SSFP

Flow‐independent angiography is a non‐contrast‐enhanced technique that can generate vessel contrast even with reduced blood flow in the lower extremities. A method is presented for producing these angiograms with magnetization‐prepared balanced steady‐state free precession (bSSFP). Because bSSFP yields bright fat signal, robust fat suppression is essential for detailed depiction of the vasculature. Therefore, several strategies have been investigated to improve the reliability of fat suppression within short scan times. Phase‐sensitive SSFP can efficiently suppress fat; however, partial volume effects due to fat and water occupying the same voxel can lead to the loss of blood signal. In contrast, alternating repetition time (ATR) SSFP minimizes this loss; however, the level of suppression is compromised by field inhomogeneity. Finally, a new double‐acquisition ATR‐SSFP technique reduces this sensitivity to off‐resonance. In vivo results indicate that the two ATR‐based techniques provide more reliable contrast when partial volume effects are significant. Magn Reson Med, 2009. © 2009 Wiley‐Liss, Inc.     

Reproducibility of quantitative magnetization‐transfer imaging parameters from repeated measurements

Quantitative magnetization‐transfer imaging methods provide in vivo estimates of parameters of the two‐pool model for magnetization‐transfer in tissue. The goal of this study was to evaluate the reproducibility of quantitative magnetization‐transfer imaging parameter estimates in healthy subjects. Magnetization‐transfer–weighted and T₁ relaxometry data were acquired in five healthy subjects at multiple time points, and the variability of the resulting fitted magnetization‐transfer parameters was evaluated. The impact of subsampling the magnetization‐transfer data and correcting field inhomogeneities was also evaluated. The key parameters measured in this study had an average variability, across time points, of 4.7% for the relative size of the restricted pool (F), 7.3% for the forward exchange constant (k_f), 1.9% for the free pool spin‐lattice relaxation constant (R_1f), 4.5% for the T₂ of the free pool (T_2f), and 2.3% for the T₂ of the restricted pool (T_2r). Our findings show that serial quantitative magnetization‐transfer imaging experiments can be performed reliably, with good reproducibility of the model parameter estimates, and demonstrate the reproducibility of acquisition schemes with fewer magnetization‐transfer contrasts. This establishes the feasibility of this technique for monitoring patients affected by degenerative white matter diseases while providing critical data to estimate the statistical power of such studies. Magn Reson Med, 2010. © 2010 Wiley‐Liss, Inc.     

Whole heart magnetization‐prepared steady‐state free precession coronary vein MRI

Purpose

To compare two coronary vein imaging techniques using whole‐heart balanced steady‐state free precession (SSFP) and a targeted double‐oblique spoiled gradient‐echo (GRE) sequences in combination with magnetization transfer (MT) preparation sequence for tissue contrast improvement.

Materials and Methods

Nine healthy subjects were imaged with the proposed technique. The results are compared with optimized targeted MT prepared GRE acquisitions. Both quantitative and qualitative analyses were performed to evaluate each imaging method.

Results

Whole‐heart images were successfully acquired with no visible image artifact in the vicinity of the coronary veins. The anatomical features and visual grading of both techniques were comparable. However, the targeted small slab acquisition of the left ventricular lateral wall was superior to whole‐heart acquisition for visualization of relevant information for cardiac resynchronization therapy (CRT) lead implantation.

Conclusion

We demonstrated the feasibility of whole‐heart coronary vein MRI using a 3D MT‐SSFP imaging sequence. A targeted acquisition along the lateral left ventricular wall is preferred for visualization of branches commonly used in CRT lead implantation. J. Magn. Reson. Imaging 2009;29:1293–1299. © 2009 Wiley‐Liss, Inc.     

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.     

Quantification of fat infiltration in oculopharyngeal muscular dystrophy: comparison of three MR imaging methods

Purpose

To analyze and compare three quantitative MRI methods to determine the degree of muscle involvement in oculopharyngeal muscular dystrophy (OPMD).

Materials and Methods

Muscle fat content (MFC) was determined based on water–fat quantification using a 2‐point Dixon (2PD) method and on a histogram analysis of the free induction decay (FID) signal of a gradient‐spoiled steady‐state free precession (SSFP) sequence. In addition, transverse relaxation times (T₂) of muscle tissue were calculated using a monoexponential decay model.

Results

We observed an increased mean MFC in OPMD patients as compared to healthy controls with the adductor magnus and soleus muscles being the most involved muscles in the thigh and calf, respectively. Furthermore, strong correlations (0.78 < R² < 0.94) between different quantitative MR methods were observed. Fewer outliers, however, were obtained by the 2PD method and T₂ measurements, suggesting these methods being superior to the SSFP‐FID method.

Conclusion

Quantitative MR techniques, such as fast multiecho Dixon methods and T₂ imaging, can reliably differentiate between healthy and dystrophic muscles in OPMD, even if muscles are only marginally affected. Quantitative methods thus represent a promising tool that may be able to monitor more objectively the individual disease progression and treatment response in future clinical trials in muscular dystrophies. J. Magn. Reson. Imaging 2011;33:203–210. © 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.     

Quantitative imaging of magnetization transfer exchange and relaxation properties in vivo using MRI.

We describe a novel imaging technique that yields all of the observable properties of the binary spin-bath model for magnetization transfer (MT) and demonstrate this method for in vivo studies of the human head. Based on a new model of the steady-state behavior of the magnetization during a pulsed MT-weighted imaging sequence, this approach yields parametric images of the fractional size of the restricted pool, the magnetization exchange rate, the T(2) of the restricted pool, as well as the relaxation times in the free pool. Validated experimentally on agar gels and samples of uncooked beef, we demonstrate the method's application on two normal subjects and a patient with multiple sclerosis.     

Fundamentals of balanced steady state free precession MRI

Balanced steady state free precession (balanced SSFP) has become increasingly popular for research and clinical applications, offering a very high signal‐to‐noise ratio and a T₂/T₁‐weighted image contrast. This review article gives an overview on the basic principles of this fast imaging technique as well as possibilities for contrast modification. The first part focuses on the fundamental principles of balanced SSFP signal formation in the transient phase and in the steady state. In the second part, balanced SSFP imaging, contrast, and basic mechanisms for contrast modification are revisited and contemporary clinical applications are discussed. J. Magn. Reson. Imaging 2013;38:2–11. © 2013 Wiley Periodicals, Inc.     

Design and implementation of magnetization transfer pulse sequences for clinical use.

The transfer of magnetization between a free and a bound pool of spins is described in terms of the respective longitudinal relaxation times and the life times of spins in each pool. The effect of an off resonance radiofrequency (RF) pulse in producing saturation in the bound pool and a consequent decrease in both the available longitudinal magnetization and the T1 of spins in the free pool is described. The effects of increasing duration of the saturating RF pulse on image pixel signal intensity were used to determine values for the decrease in both T1 and the available magnetization in gray and white matter of the brain as well as in muscle, fat, and CSF. At 0.15 T the available magnetization of muscle was reduced by approximately 60% and its T1 was decreased from 350 to 150 ms. The available magnetization of white and gray matter was reduced by 40% and their values of T1 were reduced by 80-110 ms. The reduction in available magnetization was used to increase contrast on proton density weighted or T2-weighted SE pulse sequences. These changes were also used to design inversion recovery (IR) pulse sequences with particular contrast properties. A short inversion time (TI) magnetization transfer (MT) IR (MT-STIR) pulse sequence was used to reduce the signal from normal muscle to zero to produce an angiographic effect in the leg. Increased tissue contrast was observed with a T2-weighted (MT-SE) sequence in a patient with bilateral cerebral infarction and with an MT-IR pulse sequence in a patient who had an intracranial hematoma. Three patients with cerebral tumors showed high lesion contrast with MT-STIR sequences. Components within two tumors were changed to different degrees by MT and in one case change in the brain attributable to recent radiotherapy treatment was only identified with an MT-STIR sequence. Magnetization transfer can be used to manipulate both the available longitudinal magnetization and the T1 of normal and abnormal tissues. The changes in tissue contrast produced by this can be very substantial and are likely to be of importance in clinical imaging.     

Fast 31P chemical shift imaging using SSFP methods.

Steady-state free precession (SSFP) methods have been very successful due to their high signal and short imaging times. These properties make them good candidates for applications that intrinsically suffer from low signal such as low gamma nuclei imaging. A new chemical shift imaging (CSI) technique based on the SSFP signal formation has been implemented and applied to (31)P. The signal properties of the SSFP CSI method have been evaluated and the steady-state signal of (31)P has been measured in human muscles. Due to the T(2) and T(1) signal dependence of SSFP, the steady-state signal mainly consists of phosphocreatine (PCr). The technique allows fast CSI acquisitions with high SNR of the PCr signal. The SNR gain for PCr over a FLASH-based CSI method is approx. 4-5. Fast in vivo CSI of human muscle with subcentimeter resolution and high SNR is demonstrated at 2 T.