PurposeDynamic contrast enhanced MRI of the heart typically acquires 2–4 short-axis (SA) slices to detect and characterize coronary artery disease. This acquisition scheme is limited by incomplete coverage of the left ventricle. We studied the feasibility of using radial simultaneous multi-slice (SMS) technique to achieve SA, 2-chamber and/or 4-chamber long-axis (2CH LA and/or 4CH LA) coverage with and without electrocardiography (ECG) gating using a motion-robust reconstruction framework.Methods12 subjects were scanned at rest and/or stress, free breathing, with or without ECG gating. Multiple sets of radial SMS k-space were acquired within each cardiac cycle, and each SMS set sampled 3 parallel slices that were either SA, 2CH LA, or 4CH LA slices. The radial data was interpolated onto Cartesian space using an SMS GRAPPA operator gridding method. Self-gating and respiratory states binning of the data were done. The binning information as well as a pixel tracking spatiotemporal constrained reconstruction method were applied to obtain motion-robust image reconstructions. Reconstructions with and without the pixel tracking method were compared for signal-to-noise ratio and contrast-to-noise ratio.ResultsFull coverage of the heart (at least 3 SA and 3 LA slices) during the first pass of contrast at every heartbeat was achieved by using the radial SMS acquisition. The proposed pixel tracking reconstruction improves the average SNR and CNR by 21% and 30% respectively, and reduces temporal blurring for both gated and ungated acquisitions.ConclusionAcquiring simultaneous multi-slice SA, 2CH LA and/or 4CH LA myocardial perfusion images in every heartbeat is feasible in both gated and ungated acquisitions. This can add confidence when detecting and characterizing coronary artery disease by revealing ischemia in different views, and by providing apical coverage that is improved relative to SA slices alone. The proposed pixel tracking framework improves the reconstruction while adding little computational cost.
Purpose To develop a whole‐heart, free‐breathing, non‐electrocardiograph (ECG)‐gated, cardiac‐phase‐resolved myocardial perfusion MRI framework (CRIMP; Continuous Radial Interleaved simultaneous Multi‐slice acquisitions at sPoiled steady‐state) and test its quantification feasibility. Methods CRIMP used interleaved radial simultaneous multi‐slice (SMS) slice groups to cover the whole heart in 9 or 12 short‐axis slices. The sequence continuously acquired data without magnetization preparation, ECG gating or breath‐holding, and captured multiple cardiac phases. Images were reconstructed by a motion‐compensated patch‐based locally low‐rank reconstruction. Bloch simulations were performed to study the signal‐to‐noise ratio/contrast‐to‐noise ratio (SNR/CNR) for CRIMP and to study the steady‐state signal under motion. Seven patients were scanned with CRIMP at stress and rest to develop the sequence. One human and two dogs were scanned at rest with a dual‐bolus method to test the quantification feasibility of CRIMP. The dual‐bolus scans were performed using both CRIMP and an ungated radial SMS saturation recovery (SMS‐SR) sequence with injection dose = 0.075 mmol/kg to compare the sequences in terms of SNR, cardiac phase resolution and quantitative myocardial blood flow (MBF). Results Perfusion images with multiple cardiac phases in all image slices with a temporal resolution of 72 ms/frame were obtained. Simulations and in‐vivo acquisitions showed CRIMP kept the inner slices in steady‐state regardless of motion. CRIMP outperformed SMS‐SR in slice coverage (9 over 6), SNR (mean 20% improvement), and provided cardiac phase resolution. CRIMP and SMS‐SR sequences provided comparable MBF values (rest systolic CRIMP = 0.58 ± 0.07, SMS‐SR = 0.61 ± 0.16). Conclusion CRIMP allows for whole‐heart, cardiac‐phase‐resolved myocardial perfusion images without ECG‐gating or breath‐holding. The sequence can provide MBF if an accurate arterial input function is obtained separately.
The use of phase correlation to detect rigid-body translational motion is reviewed and applied to individual echotrains in turbo-spin-echo data acquisition. It is shown that when the same echotrain is acquired twice, the subsampled correlation provides an array of delta-functions, from which the motion that occurred between the acquisitions of the two echotrains can be measured. It is shown further that a similar correlation can be found between two sets of equally spaced measurements that are adjacent in k-space. By measuring the motion between all adjacent pairs of k-space subgroups, the complete motion history of a subject can be determined and the motion artifacts in the image can be corrected. Some of the limiting factors in using this technique are investigated with turbo-spin-echo head and hand images.
Purpose The purpose of this study was to further develop and combine several innovative sequence designs to achieve quantitative 3D myocardial perfusion. These developments include an optimized 3D stack‐of‐stars readout (150 ms per beat), efficient acquisition of a 2D arterial input function, tailored saturation pulse design, and potential whole heart coverage during quantitative stress perfusion. Theory and Methods All studies were performed free‐breathing on a Prisma 3T MRI scanner. Phantom validation was used to verify sequence accuracy. A total of 21 subjects (3 patients with known disease) were scanned, 12 with a rest only protocol and 9 with both stress (regadenoson) and rest protocols. First pass quantitative perfusion was performed with gadoteridol (0.075 mmol/kg). Results Implementation and quantitative perfusion results are shown for healthy subjects and subjects with known coronary disease. Average rest perfusion for the 15 included healthy subjects was 0.79 ± 0.19 mL/g/min, the average stress perfusion for 6 healthy subject studies was 2.44 ± 0.61 mL/g/min, and the average global myocardial perfusion reserve ratio for 6 healthy subjects was 3.10 ± 0.24. Perfusion deficits for 3 patients with ischemia are shown. Average resting heart rate was 59 ± 7 bpm and the average stress heart rate was 81 ± 10 bpm. Conclusion This work demonstrates that a quantitative 3D myocardial perfusion sequence with the acquisition of a 2D arterial input function is feasible at high stress heart rates such as during stress. T1 values and gadolinium concentrations of the sequence match the reference standard well in a phantom, and myocardial rest and stress perfusion and myocardial perfusion reserve values are consistent with those published in literature.
Carotid artery atherosclerosis is a major cause of ischemic stroke. For more than 30 years, future stroke risk and carotid stroke etiology have been determined using percent diameter stenosis based on clinical trials in the 1990s. In the past 10 years, magnetic resonance imaging (MRI) sequences have been developed to detect carotid intraplaque hemorrhage. By detecting carotid intraplaque hemorrhage, MRI identifies potential stroke sources that are often overlooked by lumen imaging. In addition, MRI can dramatically improve assessment of future stroke risk beyond lumen stenosis alone. In this review, we discuss the use of heavily T1-weighted MRI sequences used to detect carotid intraplaque hemorrhage. In addition, advances in ciné imaging, motion robust techniques, and specialized neck coils will be reviewed. Finally, the clinical use and future impact of MRI plaque hemorrhage imaging will be discussed.
High-resolution turbo spin echo (TSE) images have demonstrated important details of carotid artery morphology; however, it is evident that pulsatile blood and wall motion related to the cardiac cycle are still significant sources of image degradation. Although ECG gating can reduce artifacts due to cardiac-induced pulsations, gating is rarely used because it lengthens the acquisition time and can cause image degradation due to nonconstant repetition time. This work introduces a relatively simple method of converting a conventional TSE acquisition into a retrospectively ECG-correlated cineTSE sequence. The cineTSE sequence generates a full sequence of ECG-correlated images at each slice location throughout the cardiac cycle in the same scan time that is conventionally used by standard TSE sequences to produce a single image at each slice location. The cineTSE images exhibit reduced pulsatile artifacts associated with a gated sequence but without the increased scan time or associated nonconstant repetition time effects. Magn Reson Med 66:1286-1292,
Magnetization Prepared Rapid Acquisition Gradient Echo (3D MPRAGE) has been shown to be a sensitive method to image carotid intraplaque hemorrhage (IPH). Since the MPRAGE sequence used to identify potential IPH does not utilize cardiac gating, it is difficult to optimize the inversion times due to the dynamic nature of flowing blood. As a result, a best fit inversion time is often determined experimentally and then used for in vivo clinical examination. This results in compromised blood suppression and occasional hemorrhage mimicking flow artifacts. We demonstrate that a retrospective cardiac correlated reconstruction can be applied to the conventional MPRAGE sequence (CineMPRAGE) to more accurately identify blood signal. This CineMPRAGE reconstruction uses the data from a standard non-gated MPRAGE sequence to generate a full sequence of cardiac correlated images throughout the cardiac cycle and therefore provides a dynamic view of the carotid artery and a better ability to discern blood signal from potential intraplaque hemorrhage. In our preliminary study of 35 patients, signal from potential hemorrhage was constant over the cardiac cycle while any signal from blood flow artifact was observed as an oscillating signal over the cardiac cycle.
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