Ultra-short echo-time 2D time-of-flight MR angiography using a half-pulse excitation

Use of PETRA-MRA to assess intracranial arterial stenosis: Comparison with TOF-MRA, CTA, and DSA

Background and purpose

Non-invasive and accurate assessment of intracranial arterial stenosis (ICAS) is important for the evaluation of intracranial atherosclerotic disease. This study aimed to evaluate the performance of 3D pointwise encoding time reduction magnetic resonance angiography (PETRA-MRA) and compare its performance with that of 3D time-of-flight (TOF) MRA and computed tomography angiography (CTA), using digital subtraction angiography (DSA) as the reference standard in measuring the degree of stenosis and lesion length.

Materials and methods

This single-center, prospective study included a total of 52 patients (mean age 57 ± 11 years, 27 men, 25 women) with 90 intracranial arterial stenoses who underwent PETRA-MRA, TOF-MRA, CTA, and DSA within 1 month. The degree of stenosis and lesion length were measured independently by two radiologists on these four datasets. The degree of stenosis was classified according to DSA measurement. Severe stenosis was defined as a single lesion with >70% diameter stenosis. The smaller artery stenosis referred to the stenosis, which occurred at the anterior cerebral artery, middle cerebral artery, and posterior cerebral artery, except for the first segment of them. The continuous variables were compared using paired t-test or Wilcoxon signed rank test. The intraclass correlation coefficients (ICCs) were used to assess the agreement between MRAs/CTA and DSA as well as inter-reader variabilities. The ICC value >0.80 indicated excellent agreement. The agreement of data was assessed further by Bland-Altman analysis and Spearman's correlation coefficients. When the difference between MRAs/CTA and DSA was statistically significant in the degree of stenosis, the measurement of MRAs/CTA was larger than that of DSA, which referred to the overestimation of MRAs/CTA for the degree of stenosis.

Results

The four imaging methods exhibited excellent inter-reader agreement [intraclass correlation coefficients (ICCs) > 0.80]. PETRA-MRA was more consistent with DSA than with TOF-MRA and CTA in measuring the degree of stenosis (ICC = 0.94 vs. 0.79 and 0.89) and lesion length (ICC = 0.99 vs. 0.97 and 0.73). PETRA-MRA obtained the highest specificity and positive predictive value (PPV) than TOF-MRA and CTA for detecting stenosis of >50% and stenosis of >75%. TOF-MRA and CTA overestimated considerably the degree of stenosis compared with DSA (63.0% ± 15.8% and 61.0% ± 18.6% vs. 54.0% ± 18.6%, P < 0.01, respectively), whereas PETRA-MRA did not overestimate (P = 0.13). The degree of stenosis acquired on PETRA-MRA was also more consistent with that on DSA than with that on TOF-MRA and CTA in severe stenosis (ICC = 0.78 vs. 0.30 and 0.57) and smaller artery stenosis (ICC = 0.95 vs. 0.70 and 0.80). In anterior artery circulation stenosis, PETRA-MRA also achieved a little bigger ICC than TOF-MRA and CTA in measuring the degree of stenosis (0.93 vs. 0.78 and 0.88). In posterior artery circulation stenosis, PETRA-MRA had a bigger ICC than TOF-MRA (0.94 vs. 0.71) and a comparable ICC to CTA (0.94 vs. 0.91) in measuring the degree of stenosis.

Conclusion

PETRA-MRA is more accurate than TOF-MRA and CTA for the evaluation of intracranial stenosis and lesion length when using DSA as a reference standard. PETRA-MRA is a promising non-invasive tool for ICAS assessment.

Clinical evaluation of subtracted pointwise encoding time reduction with radial acquisition-based magnetic resonance angiography compared to 3D time-of-flight magnetic resonance angiography for improved flow dephasing at 3 Tesla

OBJECTIVE

Flow dephasing artifacts within intracranial internal carotid artery (ICA) have been problematic for 3D time-of-flight magnetic resonance angiography (3D-TOF-MRA). This study aimed to evaluate pointwise encoding time reduction with radial acquisition subtraction-based MR angiography (PETRA-MRA) for decreasing flow dephasing artifacts compared to 3D-TOF-MRA in intracranial segments of ICA at 3 T.

METHODS

Sixty healthy participants and seven patients with intracranial ICA aneurysms were enrolled to undergo 3D-TOF-MRA and PETRA-MRA. Two radiologists each evaluated the image quality of healthy participants using a 4-point scale (1: the best and 4: the worst). Quantitative analysis of the extent of homogeneity in signal intensity within the ICA and intracranial aneurysms was conducted using a parameter d: the higher the d value, the greater the signal homogeneity. Wilcoxon signed rank test, Chi-square test and the weighted kappa (κ) statistic were used for statistical analyses.

RESULTS

The image quality of PETRA-MRA with an overall score of 1.35 ± 0.53 was significantly better than that obtained with 3D-TOF-MRA, with an overall score of 3.50 ± 0.62 (Z = -9.56, p < 0.001). The parameter d of PETRA-MRA was higher than that of 3D-TOF-MRA for both 60 healthy participants (0.97 ± 0.05, 0.87 ± 0.11; z = -13.21, p < 0.001) and 7 patients with intracranial aneurysms (0.81 ± 0.18, 0.74 ± 0.16; z = -2.37, p = 0.018).

CONCLUSION

Compared with conventional 3D-TOF-MRA, PETRA-MRA remarkably improved the image quality with reduced flow dephasing artifacts in segments of intracranial ICA.

Pointwise encoding time reduction with radial acquisition in subtraction-based magnetic resonance angiography to assess saccular unruptured intracranial aneurysms at 3 Tesla

PURPOSE

To investigate the clinical utility of pointwise encoding time reduction with radial acquisition in subtraction-based magnetic resonance angiography (PETRA-MRA) and time-of-flight magnetic resonance angiography (TOF-MRA) to evaluate saccular unruptured intracranial aneurysms (UIAs).

METHODS

A total of 49 patients with 54 TOF-MRA-identified saccular UIAs were enrolled. The morphologic parameters, contrast-to-noise-ratios (CNRs), and sharpness of aneurysms were measured using PETRA-MRA and TOF-MRA. Two radiologists independently evaluated subjective image scores, focusing on aneurysm signal homogeneities and sharpness depictions using a 4-point scale: 4, excellent; 3, good; 2, poor; 1, not assessable. PETRA-MRA and TOF-MRA acoustic noises were measured.

RESULTS

All aneurysms were detected with PETRA-MRA. The morphologic parameters of 15 patients evaluated with PETRA-MRA were more closely correlated with those receiving computed tomography angiography over those receiving TOF-MRA. No significant differences between PETRA-MRA and TOF-MRA parameters were seen in the 54 UIAs (p > 0.10), excluding those with inflow angles (p < 0.05). In four patients with inflow angles on PETRA-MRA, the angles were more closely related to those of digital subtraction angiography than those of TOF-MRA. CNRs between TOF-MRA and PETRA-MRA were comparable (p = 0.068), and PETRA-MRA sharpness values and subjective image scores were significantly higher than those of TOF-MRA (p < 0.001). Inter-observer agreements were excellent for both PETRA-MRA and TOF-MRA (intraclass correlation coefficients were 0.90 and 0.97, respectively). The acoustic noise levels of PETRA-MRA were much lower than those of TOF-MRA (59 vs.73 dB, p < 0.01).

CONCLUSIONS

PETRA-MRA, with better visualization of aneurysms and lower acoustic noise levels than TOF-MRA, showed a superior diagnostic performance for depicting saccular UIAs.

Ultrashort echo time magnetic resonance fingerprinting (UTE-MRF) for simultaneous quantification of long and ultrashort T2 tissues

PURPOSE

To demonstrate an ultrashort echo time magnetic resonance fingerprinting (UTE-MRF) method that allows quantifying relaxation times for muscle and bone in the musculoskeletal system and generating bone enhanced images that mimic CT scans.

METHODS

A fast imaging steady-state free precession MRF sequence with half pulse excitation and half projection readout was designed to sample fast T₂ decay signals. Varying echo time (TE) of a sinusoidal pattern was applied to enhance sensitivity for tissues with short and ultrashort T₂ values. The performance of UTE-MRF was evaluated via simulations, phantom, and in vivo experiments.

RESULTS

A minimal TE of 0.05 ms was achieved. Simulations indicated the sinusoidal TE sampling increased T₂ quantification accuracy in the cortical bone and tendon but had little impact on long T₂ muscle quantifications. For the rubber phantom, the averaged relaxometries from UTE-MRF (T₁ = 162 ms and T₂ = 1.07 ms) compared well with the gold standard (T₁ = 190 ms and T 2 ∗ = 1.03 ms). For the long T₂ agarose phantom, the linear regression slope between UTE-MRF and gold standard was 1.07 (R² = 0.991) for T₁ and 1.04 (R² = 0.994) for T₂ . In vivo experiments showed the detection of the cortical bone (averaged T₂ = 1.0 ms) and Achilles tendon (averaged T₂ = 15 ms). Scalp structures from the bone enhanced image show high similarity with CT.

CONCLUSION

The UTE-MRF with sinusoidal TEs can simultaneously quantify T₁ , T₂ , proton density, and B₀ in long, short, even ultrashort T₂ musculoskeletal structures. Bone enhanced images can be achieved in the brain with UTE-MRF.

Investigation of zero TE MR in preoperative planning in dentistry

Preoperative planning in dentistry relies on imaging to assess the separation between the teeth and mandibular canal. Cone beam CT(CBCT) shows inferior contrast of the mandible canal and features radiation. In this work, the use of zero TE (zTE) imaging as an alternative to CBCT imaging for preoperative planning in dentistry is investigated. Twenty-two patients (11 males, 11 females, age 26-65) were enrolled in this prospective study. The performance of zTE imaging was assessed using CBCT as a gold standard in preoperative planning for tooth extraction (qualitative classification) and implanting (quantitative dimensional measurement). Zero TE imaging showed clear delineation of teeth and mandible, and showed better depiction of the mandible canal as compared to CBCT. In assessing the spatial relationship between the third molar and the mandibular canal, identical results were obtained from two readers based on zTE and CBCT images; in spatial measurements related to the second premolar, high intraclass coefficient was obtained in all the performed measurements between zTE and CBCT (0.782 to 0.921) and between reviewers (0.812 to 0.958). The results of Bland Altman analysis also indicated low level of bias (max -1.8%) and disagreements (max -15.1% to 11.3%) between the results of zTE and CBCT. Zero TE imaging may be a potential imaging tool in preoperative planning in dentistry when CBCT is undesirable.

Hybrid radial-cones trajectory for accelerated MRI

PURPOSE

To design and develop a series of ultrashort echo time k-space sampling schemes, termed radial-cones, which enables high sampling efficiency while maintaining compatibility with parallel imaging and compressed sensing reconstructions.

THEORY AND METHODS

Radial-cones is a trajectory that samples three-dimensional (3D) k-space using a single base cone distributed along radial dimensions through a cost function-based optimization. Trajectories were generated for highly undersampled, short readout sampling and compared with 3D radial sampling in point spread function (PSF) analysis, digital and physical phantoms, and initial human volunteers. Parallel imaging reconstructions were evaluated with and without the use of compressed sensing-based regularization.

RESULTS

Compared with 3D radial sampling, radial-cones reduced the peak value and energy of PSF aliasing. In both digital and physical phantoms, this improved sampling behavior corresponded to a reduction in the root mean square error with a further reduction using compressed sensing. A slight increase in noise and a corresponding increase in apparent resolution was observed with radial-cones. In in vivo feasibility testing, radial-cones reconstructed images have a markedly lower number of apparent artifacts. Ultimate gains in imaging performance were limited by off-resonance blurring.

CONCLUSION

Radial-cones is an efficient non-Cartesian sampling scheme enabling short echo readout with a high level of compatibility with parallel imaging and compressed sensing. Magn Reson Med 77:1068-1081, 2017. © 2016 International Society for Magnetic Resonance in Medicine.

Ultrashort echo time (UTE) imaging using gradient pre-equalization and compressed sensing

Ultrashort echo time (UTE) imaging is a well-known technique used in medical MRI, however, the implementation of the sequence remains non-trivial. This paper introduces UTE for non-medical applications and outlines a method for the implementation of UTE to enable accurate slice selection and short acquisition times. Slice selection in UTE requires fast, accurate switching of the gradient and r.f. pulses. Here a gradient "pre-equalization" technique is used to optimize the gradient switching and achieve an effective echo time of 10μs. In order to minimize the echo time, k-space is sampled radially. A compressed sensing approach is used to minimize the total acquisition time. Using the corrections for slice selection and acquisition along with novel image reconstruction techniques, UTE is shown to be a viable method to study samples of cork and rubber with a shorter signal lifetime than can typically be measured. Further, the compressed sensing image reconstruction algorithm is shown to provide accurate images of the samples with as little as 12.5% of the full k-space data set, potentially permitting real time imaging of short T2(*) materials.

Half radiofrequency pulse excitation with a dedicated prescan to correct eddy current effect and gradient delay

PURPOSE

To improve the slice profile of the half radiofrequency (RF) pulse excitation and image quality of ultrashort echo time (UTE) imaging by compensating for an eddy current effect.

METHODS

The dedicated prescan has been developed to measure the phase accumulation due to eddy currents induced by the slice-selective gradient. The prescan measures two one-dimensional excitation k-space profiles, which can be acquired with a readout gradient in the slice-selection direction by changing the polarity of the slice-selective gradient. The time shifts due to the phase accumulation in the excitation k-space were calculated. The time shift compensated for the start time of the slice-selective gradient. The total prescan time was 6-15 s. The slice profile and the UTE image with the half RF pulse excitation were acquired to evaluate the slice selectivity and the image quality.

RESULTS

Improved slice selectivity was obtained. The simple method proposed in this paper can eliminate eddy current effect. Good UTE images were obtained.

CONCLUSIONS

The slice profile of the half RF pulse excitation and the image quality of UTE images have been improved by using a dedicated prescan. This method has a possibility that can improve the image quality of a clinical UTE imaging.

Cardiac-respiratory self-gated cine ultra-short echo time (UTE) cardiovascular magnetic resonance for assessment of functional cardiac parameters at high magnetic fields

BACKGROUND

To overcome flow and electrocardiogram-trigger artifacts in cardiovascular magnetic resonance (CMR), we have implemented a cardiac and respiratory self-gated cine ultra-short echo time (UTE) sequence. We have assessed its performance in healthy mice by comparing the results with those obtained with a self-gated cine fast low angle shot (FLASH) sequence and with echocardiography.

METHODS

2D self-gated cine UTE (TE/TR = 314 μs/6.2 ms, resolution: 129 × 129 μm, scan time per slice: 5 min 5 sec) and self-gated cine FLASH (TE/TR = 3 ms/6.2 ms, resolution: 129 × 129 μm, scan time per slice: 4 min 49 sec) images were acquired at 9.4 T. Volume of the left and right ventricular (LV, RV) myocardium as well as the end-diastolic and -systolic volume was segmented manually in MR images and myocardial mass, stroke volume (SV), ejection fraction (EF) and cardiac output (CO) were determined. Statistical differences were analyzed by using Student t test and Bland-Altman analyses.

RESULTS

Self-gated cine UTE provided high quality images with high contrast-to-noise ratio (CNR) also for the RV myocardium (CNRblood-myocardium = 25.5 ± 7.8). Compared to cine FLASH, susceptibility, motion, and flow artifacts were considerably reduced due to the short TE of 314 μs. The aortic valve was clearly discernible over the entire cardiac cycle. Myocardial mass, SV, EF and CO determined by self-gated UTE were identical to the values measured with self-gated FLASH and showed good agreement to the results obtained by echocardiography.

CONCLUSIONS

Self-gated UTE allows for robust measurement of cardiac parameters of diagnostic interest. Image quality is superior to self-gated FLASH, rendering the method a powerful alternative for the assessment of cardiac function at high magnetic fields.

Preliminary use of a double-echo pulse sequence with 3D ultrashort echo time in the MRI of bones and joints

The aim of the present study was to investigate the application of a double-echo pulse sequence with 3D ultrashort echo time (UTE) in the magnetic resonance imaging (MRI) of bones and joints. In total, 7 healthy volunteers and 1 volunteer with a suspected tear of the lateral meniscus of the left knee joint underwent MRI with a double-echo pulse sequence and 3D UTE. The imaging was performed on the tibial diaphysis, knee joint and ankle of the volunteers and on a segment of porcine fibula in vitro. The echo time of echo 1 (TE1) of the UTE images for the achilles tendon of the ankle joint were set as 0.08, 0.16, 0.24 and 0.35 msec. The maximum intensity projection (MIP) of the difference images created from the primary double-echo images with a TE1 of 0.08 msec were performed on the tendons of the ankle to display their 3D structure. The data were analyzed with a one-way ANOVA and paired-sample t-test. The 3D distribution of the tendons was displayed through MIPs of the difference images created from the primary double-echo images. The cortical bones, periosteum, tendons and menisci of the 8 volunteers appeared as high signal intensities in the UTE pulse sequence. Multiplanar reconstruction followed by subtraction of the primary double-echo images raised the image signal-to-noise (S/N) ratio from 2.80±0.75 to 3.76±0.88 (t=−4.851, P<0.01). The artifacts appeared more marked as the TE1 was prolonged. A double pulse sequence MRI with 3D UTE may display the short T₂ components which are not displayed with a conventional clinical MRI sequence, therefore creating a basis for the further quantification of these tissues.

Neuroimaging in acute stroke: choosing the right patient for neurointervention

Although the non-contrast computed tomography head continues as the sole mandatory imaging technique before intravenous thrombolysis, the increased availability of advanced infarct/penumbral imaging techniques and confidence in their use have led many to adopt them into routine practice--most particularly before intra-arterial interventions. Computed tomography versus magnetic resonance-based routes to imaging the cerebral vasculature, cell death, and parenchymal perfusion have differing advantages in terms of speed, availability, exposures to contrast and radiation, sensitivity, and resolution. Continued refinement and future developments, such as the ability to quantitate perfusion, promise to lead to tailored treatment protocols that respect the individual variations in anatomy, physiology, and pathology. This should lead both to an extension of treatment to patients currently excluded by rigid time windows and the avoidance of futile therapies and their associated morbidities.

Improved half RF slice selectivity in the presence of eddy currents with out-of-slice saturation

Ultrashort echo time imaging with half RF pulse excitation is sensitive to eddy currents induced by the slice-select gradient that distorts the half pulse slice profile. This work demonstrates improvements in the half pulse profile by using spatial saturation on both sides of the imaged slice to suppress the out-of-slice magnetization. This effectively improves the selectivity of the half pulse excitation profile. A quadratic phase RF pulse with high bandwidth and selectivity was used to achieve a wide saturation band with sharp edges. Experimental results demonstrate substantially improved slice selectivity and R(2)* quantitation accuracy obtained with the out-of-slice saturation. This approach is effective in making short T(2) imaging and quantitation with half pulses less sensitive to eddy currents.

Double half RF pulses for reduced sensitivity to eddy currents in UTE imaging

Ultrashort echo time imaging with half RF pulse excitation is challenging as eddy currents induced by the slice-select gradient distort the half pulse slice profile. This work presents two pulses with T(2)-dependent slice profiles that are less sensitive to eddy currents. The double half pulse improves the slice selectivity for long T(2) components, while the inverted double half pulse suppresses the unwanted long T(2) signal. Thus, both approaches prevent imperfect cancellation of out-of-slice signal from contaminating the desired slice. Experimental results demonstrate substantially improved slice selectivity and R(2)* quantitation accuracy with these pulses. These pulses are effective in making short T(2) imaging and quantitation less sensitive to eddy currents and provide an alternative to time-consuming gradient characterization.

Ultrashort T2* relaxometry for quantitation of highly concentrated superparamagnetic iron oxide (SPIO) nanoparticle labeled cells

A new method was developed to measure ultrashort T(2)* relaxation in tissues containing a focal area of superparamagnetic iron oxide (SPIO) nanoparticle-labeled cells in which the T(2)* decay is too short to be accurately measured using regular gradient echo T(2)* mapping. The proposed method utilizes the relatively long T(2) relaxation of SPIO-labeled cells and acquires a series of spin echo images with the readout echo shifted to sample the T(2)* decay curve. MRI experiments in phantoms and rats with SPIO-labeled tumors demonstrated that it can detect ultrashort T(2)* down to 1 ms or less. The measured T(2)* values were about 10% higher than those from the ultrashort TE (UTE) technique. The shorter the TE, the less the measurements deviated from the UTE T(2)* mapping. Combined with the regular T(2)* mapping, this technique is expected to provide quantitation of highly concentrated iron-labeled cells from direct cell transplantation.

Improved slice selection for R2* mapping during cryoablation with eddy current compensation

PURPOSE

To improve the slice profile and image quality of R2* mapping in the iceball during cryoablation with ultrashort echo time (UTE) imaging by compensating for eddy currents induced by the selective gradient when half-pulse radiofrequency (RF) excitation is employed to achieve UTEs.

MATERIALS AND METHODS

A method to measure both B0 and linear eddy currents simultaneously is first presented. This is done with a least-square fitting process on calibration data collected on a phantom. Eddy currents during excitation are compensated by redesigning the RF pulse and the selective gradient accordingly, while that resultant from the readout gradient are compensated for during image reconstruction. In vivo data were obtained continuously during the cryoablation experiments to calculate the R2* values in the iceball and to correlate them with the freezing process.

RESULTS

Image quality degradation due to eddy currents is significantly reduced with the proposed approaches. R2* maps of iceball throughout the cryoablation experiments were achieved with improved quality.

CONCLUSION

The proposed approaches are effective for compensating eddy currents during half-pulse RF excitation as well as readout. TEs as short as 100 microsec were obtained, allowing R2* maps to be obtained from frozen tissues with improved quality.

In vivo MRI of submillisecond T(2) species with two-dimensional and three-dimensional radial sequences and applications to the measurement of cortical bone water

Water in dense collagenous tissues such as tendons and ligaments, as well as water in cortical bone that occupies the spaces of the lacuno-canicular system or is tightly bound to collagen, is not ordinarily detectable by MRI. Water proton T(2) in these structures is generally less than 1 ms. Recent advances in instrumentation in conjunction with non-Cartesian imaging strategies now allow center of k-space to be scanned 100 micros or less after excitation. We examined the performance of two radial pulse sequences, a 2D sequence with half-pulse excitation and a new 3D hybrid sequence with variable-echo Cartesian encoding in the third dimension, on a whole-body 3 T scanner. Both pulse sequences used long-T(2) soft-tissue suppression pulses. The half-pulse slice profiles observed experimentally agreed well with those computed on the basis of a numerical solution of Bloch equations. The techniques yielded a signal-to-noise ratio of the order of 25 in 9 min scan time at a nominal voxel size of 0.58 x 0.58 x 8 mm(3) and 50-90 micros 'echo time' in the cortex of the tibial mid-shaft. With the use of an external reference, the water volume fraction of cortical bone in four subjects (mean +/- SD age 32.25 +/- 5.3 years) was found to be 22.5 +/- 2.7%, in good agreement with literature values.

Designing long-T2 suppression pulses for ultrashort echo time imaging

Ultrashort echo time (UTE) imaging has shown promise as a technique for imaging tissues with T2 values of a few milliseconds or less. These tissues, such as tendons, menisci, and cortical bone, are normally invisible in conventional magnetic resonance imaging techniques but have signal in UTE imaging. They are difficult to visualize because they are often obscured by tissues with longer T2 values. In this article, new long-T2 suppression RF pulses that improve the contrast of short-T2 species are introduced. These pulses are improvements over previous long-T2 suppression pulses that suffered from poor off-resonance characteristics or T1 sensitivity. Short-T2 tissue contrast can also be improved by suppressing fat in some applications. Dual-band long-T2 suppression pulses that additionally suppress fat are also introduced. Simulations, along with phantom and in vivo experiments using 2D and 3D UTE imaging, demonstrate the feasibility, improved contrast, and improved sensitivity of these new long-T2 suppression pulses. The resulting images show predominantly short-T2 species, while most long-T2 species are suppressed.

MR Angiography of Aortoiliac Occlusive Disease: A Phase III Study of the Safety and Effectiveness of the Blood-Pool Contrast Agent MS-325

PURPOSE

To evaluate prospectively the safety and effectiveness of aortoiliac magnetic resonance (MR) angiography enhanced with MS-325 (gadofosveset trisodium) at a dose of 0.03 mmol/kg; effectiveness was defined as accuracy relative to the reference standard, conventional angiography.

MATERIALS AND METHODS

Study was approved by institutional review boards of participating institutions, and required national approvals were obtained. Study protocol conformed to Good Clinical Practice guidelines, and informed patient consent was obtained. Patients with known or suspected peripheral vascular disease received 0.03 mmol/kg MS-325 for aortoiliac MR angiography. They were also examined with conventional angiography. MS-325-enhanced MR was evaluated for safety and effectiveness. Along with unenhanced two-dimensional time-of-flight MR angiography, it was compared with conventional angiography for presence of vascular stenosis. Student t tests were used to identify significant improvement in diagnostic sensitivity, specificity, and accuracy, as well as quantitative characterization of stenoses by three blinded readers. Correlations between readers of conventional angiograms were calculated and compared with MR results.

RESULTS

In 174 patients, MS-325-enhanced MR angiography showed significant improvement (P < or = .001) in sensitivity, specificity, and accuracy for diagnosis of clinically significant (> or =50%) stenosis, compared with unenhanced MR. For all readers, areas under the receiver operating characteristic curve for both quantitative and qualitative measures of significant disease increased (P < .001) for MS-325-enhanced MR compared with time-of-flight MR. All readers also expressed higher confidence in diagnosis (P < .001) and found fewer images uninterpretable with MS-325 enhancement. All measures of interpretation accuracy approached corresponding measures of correlation between readers of conventional angiograms. Incidence of severe and serious adverse events with MS-325 was low. No patients were withdrawn from study due to adverse events or abnormalities in laboratory results. There were no clinically important trends in findings at hematology, blood chemistry, urinalysis, electrocardiography, or physical examination.

CONCLUSION

MR angiography with MS-325 provides significant improvement in effectiveness over unenhanced MR (and minimal and transient side effects) at a dose of 0.03 mmol/kg and was safe and effective for MR evaluation of patients with aortoiliac occlusive disease.

Exact half pulse synthesis via the inverse scattering transform

In a paper of Nielson et al. it is shown, using the linear approximation, that it might be possible to create a pair of RF-pulses, which, after summation of the unrephased signals achieve a specified transverse magnetization. Such pulses, designed using the linear approximation, show rather poor slice selectivity. Using the inverse scattering transform formalism we give an algorithm to exactly achieve a specified "summed" transverse magnetization profile. Indeed for a constant phase transverse profile, our algorithm produces infinitely many solutions.

Magnetic Resonance: An Introduction to Ultrashort TE (UTE) Imaging

The background underpinning the clinical use of ultrashort echo-time (UTE) pulse sequences for imaging tissues or tissue components with short T2s is reviewed. Tissues properties are discussed, and tissues are divided into those with a majority of short T2 relaxation components and those with a minority. Features of the basic physics relevant to UTE imaging are described including the fact that when the radiofrequency pulse duration is of the order T2, rotation of tissue magnetization into the transverse plane is incomplete. Consequences of the broad line-width of short T2 components are also discussed including their partial saturation by off-resonance fat suppression pulses as well as multislice and multiecho imaging. The need for rapid data acquisition of the order T2 is explained. The basic UTE pulse sequence with its half excitation pulse and radial imaging from the center of k-space is described together with options that suppress fat and/or long T2 components. Image interpretation is discussed. Clinical features of the imaging of cortical bone, tendons, ligaments, menisci, and periosteum as well as brain, liver, and spine are illustrated. Short T2 components in all of these tissues may show high signals. Possible future developments are outlined as are technical limitations.

Reduction of flow-related signal loss in flow-compensated 3D TOF MR angiography, using variable echo time (3D TOF-VTE)

High-resolution MRA with phase/frequency flow compensation may require very long echo times (TEs). Variable TE (VTE) was implemented into flow-compensated 3D TOF to minimize the effective TE and reduce the flow-related signal void. The k-space of the 3D TOF was divided into segment groups ranging from two to 32 segments with different TEs. The TEs were minimized and the flow-compensation gradient lobes were calculated to null the total first moment at the peak of the echo for each segment. Possible artifacts and off-resonance effects were evaluated, with respect to the number of TE segments, using the point spread function (PSF) and corresponding experiments. The optimal number of TE segments for the least artifact was determined to be one-half of the number of slices. Two types of artifacts caused by VTE were predicted and subsequently observed. The developed pulse sequence 3D TOF-VTE was tested on clinical MRI systems, by performing scans of the cervical carotid artery and intracranial carotid artery at the carotid siphon. The signal distribution near the bifurcation and the siphon was much more uniform with VTE, and the flow-related signal loss was greatly reduced. The resultant MR angiograms provided improved vessel detail. The results show that VTE improved the quality of flow-compensated 3D TOF MRA.

Temperature mapping of frozen tissue using eddy current compensated half excitation RF pulses

Cryosurgery has been shown to be an effective therapy for prostate cancer. Temperature monitoring throughout the cryosurgical iceball could dramatically improve efficacy, since end temperatures of at least -40 degrees C are required. The results of this study indicate that MR thermometry based on tissue R(*)(2) has the potential to provide this information. Frozen tissue appears as a complete signal void on conventional MRI. Ultrashort echo times (TEs), achievable with half pulse excitation and a short spiral readout, allow frozen tissue to be imaged and MR characteristics to be measured. However, half pulse excitation is highly sensitive to eddy current distortions of the slice-select gradient. In this work, the effects of eddy currents on the half pulse technique are characterized and methods to overcome these effects are developed. The methods include: 1) eddy current compensated slice-select gradients, and 2) a correction for the phase shift between the first and second half excitations at the center of the slice. The effectiveness of these methods is demonstrated in R(*)(2) maps calculated within the frozen region during cryoablation.