Pulmonary MR angiography and perfusion imaging—A review of methods and applications

Johns, Chris; Swift, Andrew J.; Hughes, Paul; Ohno, Yoshiharu; Schiebler, Mark L.; Wild, Jim M.

doi:10.1016/j.ejrad.2016.10.003

Cited by 33 publications

(23 citation statements)

References 59 publications

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“…Therefore, many non-CE-MRA techniques have been developed in the past, including sequences based on turbo spin echo (TSE), spoiled gradient echo sequences, steadystate free precession (SSFP), and balanced SSFP (bSSFP) with SSFP and bSSFP being the most widely used for the assessment of the pulmonary vasculature in patients with CHD as well as other diseases affecting the pulmonary vessels, e.g. pulmonary hypertension (PH) [15][16][17][18][19]. Recently, a novel 3D Relaxation-Enhanced Angiography without Contrast and Triggering (REACT) sequence, a combination of non-volume-selective short tau inversion recovery (STIR) pulse, a T2 preparation (T2 prep) pulse, and dual gradient echo Dixon (mDIXON XD), was introduced.…”

Section: Introductionmentioning

confidence: 99%

Imaging of the pulmonary vasculature in congenital heart disease without gadolinium contrast: Intraindividual comparison of a novel Compressed SENSE accelerated 3D modified REACT with 4D contrast-enhanced magnetic resonance angiography

Pennig

Wagner

Weiss

et al. 2020

Journal of Cardiovascular Magnetic Resonance

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Background: Patients with Congenital heart disease (CHD) require repetitive imaging of the pulmonary vasculature throughout their life. In this study, we compared a novel Compressed SENSE accelerated (factor 9) electrocardiogram (ECG)and respiratory-triggered 3D modified Relaxation-Enhanced Angiography without Contrast and Triggering (modified REACTnon-contrast-enhanced magnetic resonance angiography (modified REACT-non-CE-MRA)) with standard non-ECG-triggered time-resolved 4D CE-MRA for imaging of the pulmonary arteries and veins in patients with CHD. Methods: This retrospective analysis of 25 patients (June 2018-April 2019) with known or suspected CHD was independently conducted by two radiologists executing measurements on modified REACT-non-CE-MRA and 4D CE-MRA on seven dedicated points (inner edge): Main pulmonary artery (MPA), right and left pulmonary artery, right superior and inferior pulmonary vein, left superior (LSPV) and inferior pulmonary vein. Image quality for arteries and veins was evaluated on a four-point scale in consensus. Results: Twenty-three of the 25 included patients presented a CHD. There was a high interobserver agreement for both methods of imaging at the pulmonary arteries (ICC ≥ 0.96); at the pulmonary veins, modified REACT-non-CE-MRA showed a slightly higher agreement, pronounced at LSPV (ICC 0.946 vs. 0.895). Measurements in 4D CE-MRA showed higher diameter values compared to modified REACT-non-CE-MRA, at the pulmonary arteries reaching significant difference (e.g. MPA: mean 0.408 mm, p = 0.002). Modified REACT-non-CE-MRA (average acquisition time 07:01 ± 02:44 min) showed significant better image quality than 4D CE-MRA at the pulmonary arteries (3.84 vs. 3.32, p < 0.001) and veins (3.32 vs. 2.72, p = 0.015).

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Section: Introductionmentioning

confidence: 99%

Imaging of the pulmonary vasculature in congenital heart disease without gadolinium contrast: Intraindividual comparison of a novel Compressed SENSE accelerated 3D modified REACT with 4D contrast-enhanced magnetic resonance angiography

Pennig

Wagner

Weiss

et al. 2020

Journal of Cardiovascular Magnetic Resonance

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“…Using a lower spatial, but higher resolution acquisition, the dynamic passage of contrast through the pulmonary parenchyma can also be imaged, with a frame rate of around 0.5s. This data is often presented as the peak signal for each voxel a peak perfusion image [22]. This is particularly useful in the assessment of CTEPH and has been shown to be of equivalent sensitivity to perfusion SPECT imaging [21].…”

Section: Contrast Enhanced Angiography and Perfusion Imagingmentioning

confidence: 99%

Current and emerging imaging techniques in the diagnosis and assessment of pulmonary hypertension

Johns

Wild

Rajaram

et al. 2018

Expert Review of Respiratory Medicine

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Pulmonary hypertension (PH) is a challenging condition to diagnose and treat. Over the last two decades, there have been significant advances in therapeutic approaches and imaging technologies. Current guidelines emphasize the importance of cardiac catheterization; however, the increasing availability of non-invasive imaging has the potential to improve diagnostic rates, whilst providing additional information on patient phenotypes. Areas covered: This review discusses the role of imaging in the diagnosis, prognostic assessment and follow-up of patients with PH. Imaging methods, ranging from established investigations (chest radiography, echocardiography, nuclear medicine and computerized tomography (CT)), to emerging modalities (dual energy CT, magnetic resonance imaging (MRI), optical coherence tomography and positron emission tomography (PET)) are reviewed. The value and limitations of the clinical utility of these imaging modalities and their potential clinical application are reviewed. Expert commentary: Imaging plays a key role in the diagnosis and classification of pulmonary hypertension. It also provides valuable prognostic information and emerging evidence supports a role for serial assessments. The authors anticipate an increasing role for imaging in the pulmonary hypertension clinic. This will reduce the need for invasive investigations, whilst providing valuable insights that will improve our understanding of disease facilitate a more targeted approach to treatment.

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“…Inversion recovery methods could allow similar image subtraction but the coverage of a complete 3D volume requires complicated planning of the acquisition to ensure proper inflow of inverted blood . Time of flight methods could also be potentially used but their lower spatial resolution as well as sensitivity to susceptibility artifacts and multiplanar flow directionality may limit their use for lung imaging.…”

Section: Discussionmentioning

confidence: 99%

A black‐blood ultra‐short echo time (UTE) sequence for 3D isotropic resolution imaging of the lungs

Delacoste

Feliciano

Yerly

et al. 2019

Magnetic Resonance in Med

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Purpose Ultra‐short echo time MRI is a promising alternative to chest CT for cystic fibrosis patients. Black‐blood imaging in particular could help discern small‐sized anomalies, such as mucoid plugging, which may otherwise be confused with neighboring blood vessels, particularly when contrast agent is not used. We, therefore, implemented and tested an ultra‐short echo time sequence with black‐blood preparation. Additionally, this sequence may also be used to generate bright‐blood angiograms. Methods Using this sequence, data was acquired during free breathing in 10 healthy volunteers to obtain respiratory‐motion‐resolved 3D volumes covering the entire thorax with an isotropic resolution of (1 mm)3. The magnitude of signal suppression relative to a bright‐blood reference acquisition was quantified and compared with that obtained with a turbo‐spin echo (TSE) acquisition. Bright‐blood angiograms were also generated by subtraction. Finally, an initial feasibility assessment was performed in 2 cystic fibrosis patients, and images were visually compared with contrast‐enhanced images and with CT data. Results Black‐blood preparation significantly decreased the average normalized signal intensity in the vessel lumen (−66%; P < 0.001). Similarly, blood signal was significantly lowered (−60%; P = 0.001) compared with the TSE acquisition. In patients, mucoid plugging could be emphasized in the black‐blood datasets. An intercostal artery could also be visualized in the subtraction angiograms. Conclusion Black‐blood free‐breathing ultra‐short echo time imaging was successfully implemented and motion‐resolved full volumetric coverage of the lungs with high spatial resolution was achieved, while obtaining an angiogram without contrast agent injection. Encouraging initial results in patients prompt further investigations in a larger cohort.

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Pulmonary MR angiography and perfusion imaging—A review of methods and applications

Cited by 33 publications

References 59 publications

Imaging of the pulmonary vasculature in congenital heart disease without gadolinium contrast: Intraindividual comparison of a novel Compressed SENSE accelerated 3D modified REACT with 4D contrast-enhanced magnetic resonance angiography

Imaging of the pulmonary vasculature in congenital heart disease without gadolinium contrast: Intraindividual comparison of a novel Compressed SENSE accelerated 3D modified REACT with 4D contrast-enhanced magnetic resonance angiography

Current and emerging imaging techniques in the diagnosis and assessment of pulmonary hypertension

A black‐blood ultra‐short echo time (UTE) sequence for 3D isotropic resolution imaging of the lungs

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