Free-breathing whole-heart coronary MRA with 3D radial SSFP and self-navigated image reconstruction

Prospective self-gating for swallowing motion: a feasibility study in carotid artery wall MRI using three-dimensional variable-flip-angle turbo spin-echo

Three-dimensional black-blood MRI is a promising noninvasive imaging technique for the assessment of atherosclerotic carotid artery disease. However, this technique is inherently susceptible to motion. In particular, swallowing can result in considerable wall motion at the carotid bifurcations, which may induce drastic image degradation or substantial overestimation of wall thickness. Self-gating techniques have previously been shown to be capable of resolving and compensating for cardiac or respiratory motion during MRI. This work presents a self-gating-based prospective motion gating scheme that is combined with a three-dimensional variable-flip-angle turbo spin-echo sequence (SPACE) for detecting swallowing motion. Self-gating signal readouts along the superior-inferior direction during each repetition time period are used to derive the projection profiles of the imaging volume. Based on cross-correlation analysis between the projection profiles and the corresponding reference profiles, swallowing motion can be detected and the motion-contaminated data will subsequently be discarded and reacquired in the next repetition time. The self-gated SPACE sequence was validated on eight healthy volunteers and two patients and, when compared with the conventional SPACE sequence, proved to be more resistant to swallowing motion and significantly improved image quality as well as the sharpness of carotid artery wall boundaries.

Compressed-sensing motion compensation (CosMo): a joint prospective-retrospective respiratory navigator for coronary MRI

Prospective right hemidiaphragm navigator (NAV) is commonly used in free-breathing coronary MRI. The NAV results in an increase in acquisition time to allow for resampling of the motion-corrupted k-space data. In this study, we are presenting a joint prospective-retrospective NAV motion compensation algorithm called compressed-sensing motion compensation (CosMo). The inner k-space region is acquired using a prospective NAV; for the outer k-space, a NAV is only used to reject the motion-corrupted data without reacquiring them. Subsequently, those unfilled k-space lines are retrospectively estimated using compressed sensing reconstruction. We imaged right coronary artery in nine healthy adult subjects. An undersampling probability map and sidelobe-to-peak ratio were calculated to study the pattern of undersampling, generated by NAV. Right coronary artery images were then retrospectively reconstructed using compressed-sensing motion compensation for gating windows between 3 and 10 mm and compared with the ones fully acquired within the gating windows. Qualitative imaging score and quantitative vessel sharpness were calculated for each reconstruction. The probability map and sidelobe-to-peak ratio show that the NAV generates a random undersampling k-space pattern. There were no statistically significant differences between the vessel sharpness and subjective score of the two reconstructions. Compressed-sensing motion compensation could be an alternative motion compensation technique for free-breathing coronary MRI that can be used to reduce scan time.

3D whole-heart coronary MR angiography at 1.5T in healthy volunteers: comparison between unenhanced SSFP and Gd-enhanced FLASH sequences

Objective

To validate the optimal cardiac phase and appropriate acquisition window for three-dimensional (3D) whole-heart coronary magnetic resonance angiography (MRA) with a steady-state free precession (SSFP) sequence, and to compare image quality between SSFP and Gd-enhanced fast low-angle shot (FLASH) MR techniques at 1.5 Tesla (T).

Materials and Methods

Thirty healthy volunteers (M:F = 25:5; mean age, 35 years; range, 24-54 years) underwent a coronary MRA at 1.5T. 3D whole-heart coronary MRA with an SSFP was performed at three different times: 1) at end-systole with a narrow (120-msec) acquisition window (ESN), 2) mid-diastole with narrow acquisition (MDN); and 3) mid-diastole with wide (170-msec) acquisition (MDW). All volunteers underwent a contrast enhanced coronary MRA after undergoing an unenhanced 3D true fast imaging with steady-state precession (FISP) MRA three times. A contrast enhanced coronary MRA with FLASH was performed during MDN. Visibility of the coronary artery and image quality were evaluated for 11 segments, as suggested by the American Heart Association. Image quality was scored by a five-point scale (1 = not visible to 5 = excellent). The signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were evaluated at the proximal coronary arteries.

Results

The SSFP sequence rendered higher visibility coronary segments, higher image quality, as well as higher SNR and CNR than the Gd-enhanced FLASH technique at 1.5T (p < 0.05). The visibility of coronary segments, image quality, SNR and CNR in the ESN, MDN and MDW with SSFP sequence did not differ significantly.

Conclusion

An SSFP sequence provides an excellent method for the 3D whole-heart coronary MRA at 1.5T. Contrast enhanced coronary MRA using the FLASH sequence does not help improve the visibility of coronary segments, image quality, SNR or CNR on the 3D whole-heart coronary MRA.

Subject-specific estimation of respiratory navigator tracking factor for free-breathing cardiovascular MR

A mean respiratory navigator tracking factor of 0.6 is commonly used to estimate the respiratory motion of the heart from the displacement of the right hemi-diaphragm. A constant tracking factor can generate significant residual error in estimation of the respiratory motion of the heart for the cases where the actual tracking factor highly deviates from 0.6. In this study, we implemented and evaluated a robust method to calculate a subject-specific tracking factor for free-breathing high resolution cardiac MR. The subject-specific tracking factor was calculated from two consecutive navigator signals placed on the right hemi-diaphragm and the basal left ventricle in a training phase. To verify the accuracy of the estimated subject-specific tracking factor, nineteen subjects were recruited for comparing the estimated tracking factor in real-time with an image-based tracking factor, calculated off-line. Subsequently, in seven adult subjects, whole-heart or targeted coronary artery MR images were acquired using the estimated subject-specific tracking factor and visually compared with those acquired using a constant (0.6) tracking factor. It was shown that the proposed method can accurately estimate the subject-specific tracking factor and improve the quality of coronary images when the subject-specific tracking factor differs from 0.6.

A radial self-calibrated (RASCAL) generalized autocalibrating partially parallel acquisition (GRAPPA) method using weight interpolation

A generalized autocalibrating partially parallel acquisition (GRAPPA) method for radial k-space sampling is presented that calculates GRAPPA weights without synthesized or acquired calibration data. Instead, GRAPPA weights are fitted to the undersampled data as if they were the calibration data. Because the relative k-space shifts associated with these GRAPPA weights vary for a radial trajectory, new GRAPPA weights can be resampled for arbitrary shifts through interpolation, which are then used to generate missing projections between the acquired projections. The method is demonstrated in phantoms and in abdominal and brain imaging. Image quality is similar to radial GRAPPA using fully sampled calibration data, and improved relative to a previously described self-calibrated radial GRAPPA technique.

Whole-heart coronary MR angiography with 2D self-navigated image reconstruction

Several self-navigation techniques have been proposed to improve respiratory motion compensation in coronary MR angiography. In this work, we implemented a 2D self-navigation method by using the startup profiles of a whole-heart balanced Steady-state free precession sequence, which are primarily used to catalyze the magnetization towards the steady-state. To create 2D self-navigation images (2DSN), we added phase encoding gradients to the startup profiles. With this approach we calculated foot-head and left-right motion and performed retrospective translational motion correction. The 2DSN images were reconstructed from 10 startup profiles acquired at the beginning of each shot. Nine healthy subjects were scanned, and the proposed method was compared to a 1D self-navigation (1DSN) method with foot-head correction only. Foot-head correction was also performed with the diaphragmatic 1D pencil beam navigator (1Dnav) using a tracking factor of 0.6. 2DSN shows improved motion correction compared to 1DSN and 1Dnav for all coronary arteries and all subjects for the investigated diaphragmatic gating window of 10 mm. The visualized vessel length of the right coronary artery could be significantly improved with a multiple targeted 2D self-navigation approach, compared to 2DSN method.

New respiratory gating technique for whole heart cine imaging: integration of a navigator slice in steady state free precession sequences

PURPOSE

To evaluate the performance of a slice navigator sequence integrated into a b-SSFP sequence for obtaining real time respiratory self-gated whole heart cine imaging.

MATERIALS AND METHODS

In this work, we present a novel and robust approach for respiratory motion detection by integrating a slice navigator sequence into a balanced steady state free precession (b-SSFP) sequence, while maintaining the steady state. The slice navigator sequence is integrated into consecutive repetition times (TRs) of a b-SSFP sequence to excite and read out a navigator slice. We performed several phantom experiments to test the performance of the slice navigator sequence. Additionally, the method was evaluated in five volunteers and compared with breathing signals obtained from conventional pencil beam navigator sequence. Finally, the navigator slice was used to obtain whole heart MR cine images.

RESULTS

The breathing signals detected by the proposed method showed an excellent agreement with those obtained from pencil beam navigators. Moreover, the technique was capable of removing respiratory motion artifacts with minimal distortion of the steady state. Image quality comparison showed a statistical significant improvement from a quality score of 2.1 obtained by the nonrespiratory gated images, compared to a quality score of 3.4 obtained by the respiratory gated images.

CONCLUSION

This novel method represents a robust approach to estimate breathing motion during SSFP imaging. The technique was successfully applied to acquire whole heart artifact-free cine images.

Z intensity-weighted position self-respiratory gating method for free-breathing 3D cardiac CINE imaging

A free-breathing 3D cine steady-state free precession (SSFP) technique was developed using the z intensity-weighted position (ZIP) which is the center of mass of a projection along the slice direction as a respiratory gating signal. The ZIP signal was continuously acquired using a slice encoded k-space center sampling in every TR. The performance of this gating method was compared with a method using the k-space center signal (KC) and with conventional 2D breath-hold cine SSFP in healthy subjects by measuring image quality and left ventricular function. The preliminary data obtained here demonstrated that the ZIP gating method provided superior respiratory motion artifact suppression when compared to the KC gating and provided left ventricular ejection fractions, and end-diastolic and end-systolic volumes similar to those obtained with the breath-hold 2D cine SSFP acquisition.

Spiral phyllotaxis: the natural way to construct a 3D radial trajectory in MRI

While radial 3D acquisition has been discussed in cardiac MRI for its excellent results with radial undersampling, the self-navigating properties of the trajectory need yet to be exploited. Hence, the radial trajectory has to be interleaved such that the first readout of every interleave starts at the top of the sphere, which represents the shell covering all readouts. If this is done sub-optimally, the image quality might be degraded by eddy current effects, and advanced density compensation is needed. In this work, an innovative 3D radial trajectory based on a natural spiral phyllotaxis pattern is introduced, which features optimized interleaving properties: (1) overall uniform readout distribution is preserved, which facilitates simple density compensation, and (2) if the number of interleaves is a Fibonacci number, the interleaves self-arrange such that eddy current effects are significantly reduced. These features were theoretically assessed in comparison with two variants of an interleaved Archimedean spiral pattern. Furthermore, the novel pattern was compared with one of the Archimedean spiral patterns, with identical density compensation, in phantom experiments. Navigator-gated whole-heart coronary imaging was performed in six healthy volunteers. High reduction of eddy current artifacts and overall improvement in image quality were achieved with the novel trajectory.

Beat-to-beat respiratory motion correction with near 100% efficiency: a quantitative assessment using high-resolution coronary artery imaging

This study quantitatively assesses the effectiveness of retrospective beat-to-beat respiratory motion correction (B2B-RMC) at near 100% efficiency using high-resolution coronary artery imaging. Three-dimensional (3D) spiral images were obtained in a coronary respiratory motion phantom with B2B-RMC and navigator gating. In vivo, targeted 3D coronary imaging was performed in 10 healthy subjects using B2B-RMC spiral and navigator gated balanced steady-state free-precession (nav-bSSFP) techniques. Vessel diameter and sharpness in proximal and mid arteries were used as a measure of respiratory motion compensation effectiveness and compared between techniques. Phantom acquisitions with B2B-RMC were sharper than those acquired with navigator gating (B2B-RMC vs. navigator gating: 1.01±0.02 mm(-1) vs. 0.86±0.08 mm(-1), P<.05). In vivo B2B-RMC respiratory efficiency was significantly and substantially higher (99.7%±0.5%) than nav-bSSFP (44.0%±8.9%, P<.0001). Proximal and mid vessel sharpnesses were similar (B2B-RMC vs. nav-bSSFP, proximal: 1.00±0.14 mm(-1) vs. 1.08±0.11 mm(-1), mid: 1.01±0.11 mm(-1) vs. 1.05±0.12 mm(-1); both P=not significant [ns]). Mid vessel diameters were not significantly different (2.85±0.39 mm vs. 2.80±0.35 mm, P=ns), but proximal B2B-RMC diameters were slightly higher (2.85±0.38 mm vs. 2.70±0.34 mm, P<.05), possibly due to contrast differences. The respiratory efficiency of B2B-RMC is less variable and significantly higher than navigator gating. Phantom and in vivo vessel sharpness and diameter values suggest that respiratory motion compensation is equally effective.

3D radial sampling and 3D affine transform-based respiratory motion correction technique for free-breathing whole-heart coronary MRA with 100% imaging efficiency

The navigator gating and slice tracking approach currently used for respiratory motion compensation during free-breathing coronary magnetic resonance angiography (MRA) has low imaging efficiency (typically 30-50%), resulting in long imaging times. In this work, a novel respiratory motion correction technique with 100% scan efficiency was developed for free-breathing whole-heart coronary MRA. The navigator signal was used as a reference respiratory signal to segment the data into six bins. 3D projection reconstruction k-space sampling was used for data acquisition and enabled reconstruction of low resolution images within each respiratory bin. The motion between bins was estimated by image registration with a 3D affine transform. The data from the different respiratory bins was retrospectively combined after motion correction to produce the final image. The proposed method was compared with a traditional navigator gating approach in nine healthy subjects. The proposed technique acquired whole-heart coronary MRA with 1.0 mm(3) isotropic spatial resolution in a scan time of 6.8 ± 0.9 min, compared with 16.2 ± 2.8 min for the navigator gating approach. The image quality scores, and length, diameter and sharpness of the right coronary artery (RCA), left anterior descending coronary artery (LAD), and left circumflex coronary artery (LCX) were similar for both approaches (P > 0.05 for all), but the proposed technique reduced scan time by a factor of 2.5.

Respiratory and cardiac self-gated free-breathing cardiac CINE imaging with multiecho 3D hybrid radial SSFP acquisition

A respiratory and cardiac self-gated free-breathing three-dimensional cine steady-state free precession imaging method using multiecho hybrid radial sampling is presented. Cartesian mapping of the k-space center along the slice encoding direction provides intensity-weighted position information, from which both respiratory and cardiac motions are derived. With in plan radial sampling acquired at every pulse repetition time, no extra scan time is required for sampling the k-space center. Temporal filtering based on density compensation is used for radial reconstruction to achieve high signal-to-noise ratio and contrast-to-noise ratio. High correlation between the self-gating signals and external gating signals is demonstrated. This respiratory and cardiac self-gated, free-breathing, three-dimensional, radial cardiac cine imaging technique provides image quality comparable to that acquired with the multiple breath-hold two-dimensional Cartesian steady-state free precession technique in short-axis, four-chamber, and two-chamber orientations. Functional measurements from the three-dimensional cardiac short axis cine images are found to be comparable to those obtained using the standard two-dimensional technique.

Contrast-enhanced whole-heart coronary MRA using Gadofosveset 3.0 T versus 1.5 T

RATIONALE AND OBJECTIVES

To compare contrast-enhanced coronary magnetic resonance angiography (MRA) at 3.0 T with the same technique performed at 1.5 T using the contrast agent gadofosveset.

MATERIALS AND METHODS

In this prospective randomized study, 19 healthy male volunteers (mean age 28 years, mean weight 79.8 kg), after signing informed consents, underwent contrast-enhanced inversion recovery three-dimensional fast low angle shot (FLASH) MRA at 1.5 and at 3.0 T. Prospective electrocardiogram-triggering was combined with adaptive respiratory gating. For contrast-enhanced images, the intravascular contrast agent gadofosveset was used. Acquisition time, signal-to-noise ratio (SNR) of coronary blood, contrast-to-noise ratio (CNR) between coronaries and adjacent myocardium or epicardial fat and image quality were analyzed for statistical differences by using a two-tailed paired-sample t-test. The ratio calculations were based on measurements performed on the raw data and the image quality was blinded and independently evaluated by two experienced radiologists using a five-point scale.

RESULTS

The mean values for the acquisition time were 14.58 +/- 0.1 minutes at 1.5 T and 16.40 +/- 0.2 minutes at 3.0 T. Overall SNR of all evaluated coronary segments proved higher at 3.0 T compared to 1.5 T (74.0 +/- 42.1 at 3.0 T vs. 50.2 +/- 20.2 at 1.5 T, P = .04). Overall CNR between coronaries and myocardium was significantly increased at 3.0 T in comparison to 1.5 T (40.1 +/- 21.9 at 3.0 T vs. 24.4 +/- 17.2 at 1.5 T, P = .01). Between the two methods, no significant difference in overall CNR between coronaries and epicardial fat was observed (P = .08, NS). The 3.0 T MRA demonstrated superior overall image quality with respect to 1.5 T (2.28 +/- 0.71 at 3.0 T vs. 1.92 +/- 0.38 at 1.5T, P = .004).

CONCLUSION

The use of higher field strength, 3.0 T instead of 1.5 T, resulted in similar CNR between coronaries and epicardial fat, higher SNR values and CNR between blood and myocardium, as well as an improved overall image quality, when gadofosveset in combination with electrocardiogram and respiratory triggering for coronary MRA was used.

Coronary MR imaging: effect of timing and dose of isosorbide dinitrate administration

PURPOSE

To quantify the effect of sublingual isosorbide dinitrate (ISDN) administration on coronary magnetic resonance (MR) imaging.

MATERIALS AND METHODS

Written informed consent was obtained from all participants, and the HIPAA-compliant protocol was approved by the Institutional Review Board. Coronary MR imaging was performed at 1.5 T before and after administration of ISDN (2.5 or 5 mg) in 25 healthy adult volunteers (mean age, 23 years +/- 4; nine men, 16 women) with three-dimensional targeted (n = 20, randomized into four groups) or whole-heart (n = 5) acquisitions with gradient-recalled echo (GRE) or balanced steady-state free precession (SSFP) sequences. Image quality was assessed by two cardiologists on a four-point scale. Signal-to-noise ratio (SNR), vessel diameter, and vessel sharpness were characterized. A linear mixed-effects model was used for data analysis. A P value of less than .05 was considered to indicate a significant difference.

RESULTS

The maximum SNR enhancement with 5 mg of ISDN (GRE: 22.0% +/- 10.7%; SSFP: 20.1% +/- 6.0%) was similar (P > .05) to that with 2.5 mg (GRE: 21.9% +/- 5.4%; SSFP: 19.1% +/- 3.0%). However, the time to maximum SNR enhancement for the 5-mg dose (15.5 minutes +/- 6.0) was earlier (P < .01) than that for 2.5 mg (23.5 minutes +/- 6.7). The increase in vessel diameter with 5 mg of ISDN was greater than that with 2.5 mg (P < .05 for both GRE and SSFP sequences). The coronary images were sharper after ISDN administration (P < .03). Subjective image quality score significantly improved after ISDN administration for GRE images (P < .05 for both doses) but was similar for SSFP images (P = .24 for 2.5 mg; P = .27 for 5 mg). Whole-heart coronary SNR was improved about 10% after ISDN administration (P < .05).

CONCLUSION

Sublingual ISDN improves coronary MR imaging SNR. Practitioners need to consider the dose and temporal effects of ISDN when performing coronary MR imaging.

High spatial and temporal resolution cardiac cine MRI from retrospective reconstruction of data acquired in real time using motion correction and resorting

Cine MRI is used for assessing cardiac function and flow and is typically based on a breath-held, segmented data acquisition. Breath holding is particularly difficult for patients with congestive heart failure or in pediatric cases. Real-time imaging may be used without breath holding or ECG triggering. However, despite the use of rapid imaging sequences and accelerated parallel imaging, real-time imaging typically has compromised spatial and temporal resolution compared with gated, segmented breath-held studies. A new method is proposed that produces a cardiac cine across the full cycle, with both high spatial and temporal resolution from a retrospective reconstruction of data acquired over multiple heartbeats during free breathing. The proposed method was compared with conventional cine images in 10 subjects. The resultant image quality for the proposed method (4.2 +/- 0.4) without breath holding or gating was comparable to the conventional cine (4.4 +/- 0.5) on a five-point scale (P = n.s.). Motion-corrected averaging of real-time acquired cardiac images provides a means of attaining high-quality cine images with many of the benefits of real-time imaging, such as free-breathing acquisition and tolerance to arrhythmias.

A respiratory self-gating technique with 3D-translation compensation for free-breathing whole-heart coronary MRA

Respiratory motion remains a major challenge for robust coronary MR angiography (MRA). Diaphragmatic navigator (NAV) suffers from indirect measurement of heart position. Respiratory self-gating (RSG) approaches improve motion detection only in the head-feet direction, leaving motion in the other two dimensions unaccounted for. The purpose of this study was to extend conventional RSG (1D RSG) to RSG capable of 3D motion detection (3D RSG) by acquiring additional RSG projections with transverse-motion-encoding gradients. Simulation and volunteer studies were conducted to validate the effectiveness of this new method. Preliminary comparison was performed between coronary artery images reconstructed from the same datasets using different motion correction methods. Our simulation illustrates that a proper motion-encoding gradient and derivation method enable accurate 3D motion detection. Results from whole-heart coronary MRA show that 3D RSG can further reduce motion artifacts as compared to NAV and 1D RSG and enables use of larger gating windows for faster coronary imaging.

Motion in cardiovascular MR imaging

Modern rapid magnetic resonance (MR) imaging techniques have led to widespread use of the modality in cardiac imaging. Despite this progress, many MR studies suffer from image degradation due to involuntary motion during the acquisition. This review describes the type and extent of the motion of the heart due to the cardiac and respiratory cycles, which create image artifacts. Methods of eliminating or reducing the problems caused by the cardiac cycle are discussed, including electrocardiogram gating, subject-specific acquisition windows, and section tracking. Similarly, for respiratory motion of the heart, techniques such as breath holding, respiratory gating, section tracking, phase-encoding ordering, subject-specific translational models, and a range of new techniques are considered.

A dual-projection respiratory self-gating technique for whole-heart coronary MRA

PURPOSE

To investigate the accuracy of a dual-projection respiratory self-gating (DP-RSG) technique in dynamic heart position measurement and its feasibility for free-breathing whole-heart coronary MR angiography (MRA).

MATERIALS AND METHODS

A DP-RSG method is proposed to enable accurate direct measurement of heart position by acquiring two whole-heart projections. On 14 volunteers we quantitatively evaluated the efficacy of DP-RSG by comparison with diaphragmatic navigator (NAV) and single-projection-based respiratory self-gating (SP-RSG) methods. For DP-RSG we also compared center-of-mass and two profile-matching algorithms in deriving heart motion. Coronary imaging was conducted on eight volunteers based on retrospective gating to preliminarily validate the effectiveness of DP-RSG for whole-heart coronary MRA. Comparison of vessel delineation was performed between images reconstructed using different gating methods.

RESULTS

The quantitative evaluation shows that DP-RSG more accurately tracks heart motion than NAV with all gating window (GW) values and SP-RSG approaches with GW>or=2.5 mm and profile-matching algorithms are more reliable for motion derivation than center-of-mass calculations with GW>or=1.0 mm. Whole-heart coronary MRA studies demonstrate the feasibility of using DP-RSG to improve overall delineation of the coronary arteries.

CONCLUSION

DP-RSG is a promising approach to better resolve respiratory motion for whole-heart coronary MRA compared to conventional NAV and SP-RSG.

Respiratory self-gated four-dimensional coronary MR angiography: a feasibility study

The four-dimensional (4D) coronary MR angiography (MRA) approach has been developed to eliminate the need for accurate determination of the acquisition window and trigger delay time. Diaphragm navigator (NAV) has been the conventional respiratory gating method for free-breathing coronary MRA. However, NAV echo acquisition interrupts the continuous radiofrequency pulse application required for 4D steady-state free precession coronary MRA. The objective of this work was to investigate the feasibility of a respiratory self-gating (RSG) technique for 4D coronary MRA and its effectiveness by comparing with retrospective NAV gating. Data were acquired continuously throughout the cardiac cycle and retrospectively remapped to cardiac phases based on the electrocardiogram signal simultaneously recorded. An RSG signal extracted from a direct measurement of the heart position was used for retrospective respiratory gating and motion correction. In seven healthy volunteers, 4D MRA images were reconstructed, allowing retrospective assessment of the cardiac motion of the coronary artery and selection of the images with the best vessel delineation. Statistical analysis shows that 4D RSG provides coronary artery delineation comparable to mid-diastole images acquired using NAV. Respiratory self-gating is an effective method for eliminating respiratory motion artifacts and allows 4D coronary MRA during free breathing.

3-T navigator parallel-imaging coronary MR angiography: targeted-volume versus whole-heart acquisition

OBJECTIVE

The purpose of this study was to compare whole-heart acquisition with targeted-volume acquisition in 3-T navigator coronary MR angiography with parallel imaging.

SUBJECTS AND METHODS

The right and left coronary arteries of 20 subjects were imaged with axial whole-heart acquisition and two oblique targeted-volume acquisitions.

RESULTS

Both whole-heart and targeted-volume acquisitions were completed with similar navigator efficiencies ( approximately 50%) and depicted similar coronary artery diameters ( approximately 3 mm) (p >or= 0.06). The lengths of the coronary arteries were not significantly different (p = 0.07-0.45) for the whole-heart and targeted-volume approaches. Depiction of the sharper coronary arteries (p <or= 0.04) and overall image quality (p < 0.02) were better with the targeted-volume approach.

CONCLUSION

For current 3-T navigator parallel-imaging coronary MR angiography, targeted-volume acquisition yields sharper coronary images than does whole-heart acquisition.

Highly accelerated cardiovascular MR imaging using many channel technology: concepts and clinical applications

Cardiovascular magnetic resonance imaging (CVMRI) is of proven clinical value in the non-invasive imaging of cardiovascular diseases. CVMRI requires rapid image acquisition, but acquisition speed is fundamentally limited in conventional MRI. Parallel imaging provides a means for increasing acquisition speed and efficiency. However, signal-to-noise (SNR) limitations and the limited number of receiver channels available on most MR systems have in the past imposed practical constraints, which dictated the use of moderate accelerations in CVMRI. High levels of acceleration, which were unattainable previously, have become possible with many-receiver MR systems and many-element, cardiac-optimized RF-coil arrays. The resulting imaging speed improvements can be exploited in a number of ways, ranging from enhancement of spatial and temporal resolution to efficient whole heart coverage to streamlining of CVMRI work flow. In this review, examples of these strategies are provided, following an outline of the fundamentals of the highly accelerated imaging approaches employed in CVMRI. Topics discussed include basic principles of parallel imaging; key requirements for MR systems and RF-coil design; practical considerations of SNR management, supported by multi-dimensional accelerations, 3D noise averaging and high field imaging; highly accelerated clinical state-of-the art cardiovascular imaging applications spanning the range from SNR-rich to SNR-limited; and current trends and future directions.

Anisotropic field-of-views in radial imaging

Radial imaging techniques, such as projection-reconstruction (PR), are used in magnetic resonance imaging (MRI) for dynamic imaging, angiography, and short-T(2) imaging. They are robust to flow and motion, have diffuse aliasing patterns, and support short readouts and echo times. One drawback is that standard implementations do not support anisotropic field-of-view (FOV) shapes, which are used to match the imaging parameters to the object or region-of-interest. A set of fast, simple algorithms for 2-D and 3-D PR, and 3-D cones acquisitions are introduced that match the sampling density in frequency space to the desired FOV shape. Tailoring the acquisitions allows for reduction of aliasing artifacts in undersampled applications or scan time reductions without introducing aliasing in fully-sampled applications. It also makes possible new radial imaging applications that were previously unsuitable, such as imaging elongated regions or thin slabs. 2-D PR longitudinal leg images and thin-slab, single breath-hold 3-D PR abdomen images, both with isotropic resolution, demonstrate these new possibilities. No scan time to volume efficiency is lost by using anisotropic FOVs. The acquisition trajectories can be computed on a scan by scan basis.

Whole-heart cine MRI using real-time respiratory self-gating

Two-dimensional (2D) breath-hold cine MRI is used to assess cardiac anatomy and function. However, this technique requires cooperation from the patient, and in some cases the scan planning is complicated. Isotropic nonangulated three-dimensional (3D) cardiac MR can overcome some of these problems because it requires minimal planning and can be reformatted in any plane. However, current methods, even those that use undersampling techniques, involve breath-holding for periods that are too long for many patients. Free-breathing respiratory gating sequences represent a possible solution for realizing 3D cine imaging. A real-time respiratory self-gating technique for whole-heart cine MRI is presented. The technique enables assessment of cardiac anatomy and function with minimum planning or patient cooperation. Nonangulated isotropic 3D data were acquired from five healthy volunteers and then reformatted into 2D clinical views. The respiratory self-gating technique is shown to improve image quality in free-breathing scanning. In addition, ventricular volumetric data obtained using the 3D approach were comparable to those acquired with the conventional multislice 2D approach.

Non-model-based correction of respiratory motion using beat-to-beat 3D spiral fat-selective imaging

PURPOSE

To demonstrate the feasibility of retrospective beat-to-beat correction of respiratory motion, without the need for a respiratory motion model.

MATERIALS AND METHODS

A high-resolution three-dimensional (3D) spiral black-blood scan of the right coronary artery (RCA) of six healthy volunteers was acquired over 160 cardiac cycles without respiratory gating. One spiral interleaf was acquired per cardiac cycle, prior to each of which a complete low-resolution fat-selective 3D spiral dataset was acquired. The respiratory motion (3D translation) on each cardiac cycle was determined by cross-correlating a region of interest (ROI) in the fat around the artery in the low-resolution datasets with that on a reference end-expiratory dataset. The measured translations were used to correct the raw data of the high-resolution spiral interleaves.

RESULTS

Beat-to-beat correction provided consistently good results, with the image quality being better than that obtained with a fixed superior-inferior tracking factor of 0.6 and better than (N = 5) or equal to (N = 1) that achieved using a subject-specific retrospective 3D translation motion model.

CONCLUSION

Non-model-based correction of respiratory motion using 3D spiral fat-selective imaging is feasible, and in this small group of volunteers produced better-quality images than a subject-specific retrospective 3D translation motion model.

Dual-contrast single breath-hold 3D abdominal MR imaging

OBJECT

Multiple contrasts are often helpful for a comprehensive diagnosis. In 3D abdominal MRI, breath-hold techniques are preferred for single contrast acquisitions to avoid respiratory artifacts. In this paper, highly accelerated parallel MRI is used to acquire large 3D abdominal volumes with two different contrasts within a single breath-hold.

MATERIAL AND METHODS

In vivo studies have been performed on six healthy volunteers, combining T (1)- and T (2)-weighted, gradient- or spin-echo based scans, as well as water/fat resolved imaging in a single breath-hold. These 3D scans were acquired with an acceleration factor of six, using a prototype 32-element receive array.

RESULTS

The presented approach was tested successfully on all volunteers. The whole liver area was covered by a FOV of 350 x 250 x 200 mm(3) for all scans with reasonable spatial resolution. Arbitrary scan protocols generating different contrasts have been shown to be combinable in this single breath-hold approach. Good spatial correspondence with negligible spatial offset was achieved for all different scan combinations acquired in overall breath-hold times between 15 and 25 s.

CONCLUSION

Enabled by highly parallel imaging technology, this study demonstrates the technical feasibility and the promising image quality of single breath-hold dual contrast MRI.

Establishing a clinical cardiac MRI service

After several years of research development cardiovascular MRI has evolved into a widely accepted clinical tool. It offers important diagnostic and prognostic information for a variety of clinical indications, which include ischaemic heart disease, cardiomyopathies, valvular dysfunction and congenital heart disorders. It is a safe non-invasive technique that employs a variety of imaging sequences optimized for temporal or spatial resolution, tissue-specific contrast, flow quantification or angiography. Cardiac MRI offers specific advantages over conventional imaging techniques for a significant number of patients. The demand for cardiac MRI studies from cardiothoracic surgeons, cardiologists and other referrers is likely to continue to rise with pressure for more widespread local service provision. Setting up a cardiac MRI service requires careful consideration regarding funding issues and how it will be integrated with existing service provision. The purchase of cardiac phased array coils, monitoring equipment and software upgrades must also be considered, as well as the training needs of those involved. The choice of appropriate imaging protocols will be guided by operator experience, clinical indication and equipment capability, and is likely to evolve as the service develops. Post-processing and offline analysis form a significant part of the time taken to report studies and an efficient method of providing quantitative reports is an important requirement. Collaboration between radiologists and cardiologists is needed to develop a successful service and multi-disciplinary meetings are key component of this. This review will explore these issues from our perspective of a new clinical cardiac MRI service operating over its first year in a teaching hospital imaging department.