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Fu Q, Lei ZQ, Li JY, Wu JW, Liu XM, Fan WL, Sun P, Wang JZ, Liu DX, Yang F, Zheng CS, Kong XC. Subtractionless compressed-sensing-accelerated whole-body MR angiography using two-point Dixon fat suppression with single-pass half-reduced contrast dose: feasibility study and initial experience. J Cardiovasc Magn Reson 2023; 25:41. [PMID: 37475047 PMCID: PMC10360239 DOI: 10.1186/s12968-023-00953-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 07/10/2023] [Indexed: 07/22/2023] Open
Abstract
PURPOSE To investigate the feasibility and clinical utility of a compressed-sensing-accelerated subtractionless whole-body MRA (CS-WBMRA) protocol with only contrast injection for suspected arterial diseases, by comparison to conventional dual-pass subtraction-based whole-body MRA (conventional-WBMRA) and available computed tomography angiography (CTA). MATERIALS AND METHODS This prospective study assessed 86 patients (mean age, 56 years ± 16.4 [standard deviation]; 25 women) with suspected arterial diseases from May 2021 to December 2022, who underwent CS-WBMRA (n = 48, mean age, 55.9 years ± 16.4 [standard deviation]; 25 women) and conventional-WBMRA (n = 38, mean age, 48 years ± 17.4 [standard deviation]; 20 women) on a 3.0 T MRI after random group assignment based on the chronological order of enrolment. Of all enrolled patients administered the CS-WBMRA protocol, 35% (17/48) underwent CTA as required by clinical demands. Two experienced radiologists independently scored the qualitative image quality and venous enhancement contamination. Quantitative image assessment was carried out by determining and comparing the apparent signal-to-noise ratios (SNRs) and contrast-to-noise ratios (CNRs) of four representative arterial segments. The total examination time and contrast-dose were also recorded. The independent samples t-test or the Wilcoxon rank sum test was used for statistical analysis. RESULTS The overall scores of CS-WBMRA outperformed those of conventional-WMBRA (3.40 ± 0.60 vs 3.22 ± 0.55, P < 0.001). In total, 1776 and 1406 arterial segments in the CS-WBMRA and conventional-WBMRA group were evaluated. Qualitative image scores for 7 (of 15) vessel segments in the CS-WMBRA group had statistically significantly increased values compared to those of the conventional-WBMRA groups (P < 0.05). Scores from the other 8 segments showed similar image quality (P > 0.05) between the two protocols. In the quantitative analysis, overall apparent SNRs were significantly higher in the conventional-WBMRA group than in the CS-WBMRA group (214.98 ± 136.05 vs 164.90 ± 118.05; P < 0.001), while overall apparent CNRs were not significantly different in these two groups (CS vs conventional: 107.13 ± 72.323 vs 161.24 ± 118.64; P > 0.05). In the CS-WBMRA group, 7 of 1776 (0.4%) vessel segments were contaminated severely by venous enhancement, while in the convention-WBMRA group, 317 of 1406 (23%) were rated as severe contamination. In the CS-WBMRA group, total examination and reconstruction times were only 7 min and 10 min, respectively, vs 20 min and < 30 s for the conventional WBMRA group, respectively. The contrast agent dose used in the CS-WBMRA protocol was reduced by half compared to conventional-WBMRA protocol (18.7 ± 3.5 ml vs 37.2 ± 5.4 ml, P = 0.008). CONCLUSION The CS-WBMRA protocol provides excellent image quality and sufficient diagnostic accuracy for whole-body arterial disease, with relatively faster workflow and half-dose reduction of contrast agent, which has greater potential in clinical practice compared with conventional-WBMRA.
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Affiliation(s)
- Qing Fu
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Jiefang Avenue #1277, Wuhan, 430022, Hubei Province, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, 430022, China
| | - Zi-Qiao Lei
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Jiefang Avenue #1277, Wuhan, 430022, Hubei Province, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, 430022, China
| | - Jing-Yang Li
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Jiefang Avenue #1277, Wuhan, 430022, Hubei Province, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, 430022, China
| | - Jia-Wei Wu
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Jiefang Avenue #1277, Wuhan, 430022, Hubei Province, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, 430022, China
| | - Xiao-Ming Liu
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Jiefang Avenue #1277, Wuhan, 430022, Hubei Province, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, 430022, China
| | - Wen-Liang Fan
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Jiefang Avenue #1277, Wuhan, 430022, Hubei Province, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, 430022, China
| | - Peng Sun
- Philips Healthcare, Beijing, 100600, China
| | | | - Ding-Xi Liu
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Jiefang Avenue #1277, Wuhan, 430022, Hubei Province, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, 430022, China
| | - Fan Yang
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Jiefang Avenue #1277, Wuhan, 430022, Hubei Province, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, 430022, China
| | - Chuan-Sheng Zheng
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Jiefang Avenue #1277, Wuhan, 430022, Hubei Province, China.
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, 430022, China.
| | - Xiang-Chuang Kong
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Jiefang Avenue #1277, Wuhan, 430022, Hubei Province, China.
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, 430022, China.
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Lee SY, Park HJ, Kim MS, Rho MH, Han CH. An initial experience with the use of whole body MRI for cancer screening and regular health checks. PLoS One 2018; 13:e0206681. [PMID: 30462666 PMCID: PMC6248944 DOI: 10.1371/journal.pone.0206681] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Accepted: 10/17/2018] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES We evaluated the utility of whole-body MRI (WB MRI) for cancer screening and other regular health evaluations. METHODS This retrospective study included 229 patients who underwent whole-body MRI as part of a routine health examination and cancer screening. The WB MRIs and radiologic reports were evaluated by a musculoskeletal radiologist, a neuroradiologist, and an abdominal radiologist. The consensus of their findings was characterized into three categories, as follows: suspicion of malignancy (category I); need for follow-up (category II); and no need for follow-up (category III). Any correlations between the abnormal findings and each study group were evaluated using the Mann-Whitney U test and chi-square test. RESULTS There were six category I lesions, among which two cases were found to involve malignancy. The most common category II findings were annular tears of the disc (14% of category II findings) and severe disc bulging or protrusion, followed by shoulder bursitis and uterine myoma. The most common category III finding was mild disc bulging or protrusion (47% of category III findings). CONCLUSIONS WB MRI can be used in cancer screening and for regular health evaluations. WB MRI not only provides information about potential malignancy, but also provides information regarding nonmalignant abnormalities that require further evaluation.
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Affiliation(s)
- So Yeon Lee
- Department of Radiology, Sungkyunkwan University School of Medicine, Kangbuk Samsung Hospital, Seoul, Korea
| | - Hee Jin Park
- Department of Radiology, Sungkyunkwan University School of Medicine, Kangbuk Samsung Hospital, Seoul, Korea
- * E-mail:
| | - Mi Sung Kim
- Department of Radiology, Sungkyunkwan University School of Medicine, Kangbuk Samsung Hospital, Seoul, Korea
| | - Myung Ho Rho
- Department of Radiology, Sungkyunkwan University School of Medicine, Kangbuk Samsung Hospital, Seoul, Korea
| | - Chul Hee Han
- Department of Radiology, Sungkyunkwan University School of Medicine, Kangbuk Samsung Hospital, Seoul, Korea
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Lambert MA, Weir-McCall JR, Salsano M, Gandy SJ, Levin D, Cavin I, Littleford R, MacFarlane JA, Matthew SZ, Nicholas RS, Struthers AD, Sullivan F, Henderson SA, White RD, Belch JJF, Houston JG. Prevalence and Distribution of Atherosclerosis in a Low- to Intermediate-Risk Population: Assessment with Whole-Body MR Angiography. Radiology 2018; 287:795-804. [PMID: 29714681 PMCID: PMC5979784 DOI: 10.1148/radiol.2018171609] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Purpose To quantify the burden and distribution of asymptomatic atherosclerosis in a population with a low to intermediate risk of cardiovascular disease. Materials and Methods Between June 2008 and February 2013, 1528 participants with 10-year risk of cardiovascular disease less than 20% were prospectively enrolled. They underwent whole-body magnetic resonance (MR) angiography at 3.0 T by using a two-injection, four-station acquisition technique. Thirty-one arterial segments were scored according to maximum stenosis. Scores were summed and normalized for the number of assessable arterial segments to provide a standardized atheroma score (SAS). Multiple linear regression was performed to assess effects of risk factors on atheroma burden. Results A total of 1513 participants (577 [37.9%] men; median age, 53.5 years; range, 40-83 years) completed the study protocol. Among 46 903 potentially analyzable segments, 46 601 (99.4%) were interpretable. Among these, 2468 segments (5%) demonstrated stenoses, of which 1649 (3.5%) showed stenosis less than 50% and 484 (1.0%) showed stenosis greater than or equal to 50%. Vascular stenoses were distributed throughout the body with no localized distribution. Seven hundred forty-seven (49.4%) participants had at least one stenotic vessel, and 408 (27.0%) participants had multiple stenotic vessels. At multivariable linear regression, SAS correlated with age (B = 3.4; 95% confidence interval: 2.61, 4.20), heart rate (B = 1.23; 95% confidence interval: 0.51, 1.95), systolic blood pressure (B = 0.02; 95% confidence interval: 0.01, 0.03), smoking status (B = 0.79; 95% confidence interval: 0.44, 1.15), and socioeconomic status (B = -0.06; 95% confidence interval: -0.10, -0.02) (P < .01 for all). Conclusion Whole-body MR angiography identifies early vascular disease at a population level. Although disease prevalence is low on a per-vessel level, vascular disease is common on a per-participant level, even in this low- to intermediate-risk cohort. © RSNA, 2018 Online supplemental material is available for this article.
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Affiliation(s)
| | | | - Marco Salsano
- From the Division of Molecular and Clinical Medicine, College of
Medicine, University of Dundee, Level 7, Ninewells Hospital, Dundee DD1 9SY,
Scotland (M.A.L., J.R.W.M., M.S., D.L., R.L., S.Z.M., A.D.S., J.J.F.B., J.G.H.);
NHS Tayside Medical Physics, Ninewells Hospital, Dundee, Scotland (S.J.G., I.C.,
J.A.M., R.S.N., S.A.H.); Department of Research and Innovation, North York
General Hospital, University of Toronto, Toronto, Canada (F.S.); and Department
of Clinical Radiology, University Hospital of Wales, Cardiff, Wales
(R.D.W.)
| | - Stephen J. Gandy
- From the Division of Molecular and Clinical Medicine, College of
Medicine, University of Dundee, Level 7, Ninewells Hospital, Dundee DD1 9SY,
Scotland (M.A.L., J.R.W.M., M.S., D.L., R.L., S.Z.M., A.D.S., J.J.F.B., J.G.H.);
NHS Tayside Medical Physics, Ninewells Hospital, Dundee, Scotland (S.J.G., I.C.,
J.A.M., R.S.N., S.A.H.); Department of Research and Innovation, North York
General Hospital, University of Toronto, Toronto, Canada (F.S.); and Department
of Clinical Radiology, University Hospital of Wales, Cardiff, Wales
(R.D.W.)
| | - Daniel Levin
- From the Division of Molecular and Clinical Medicine, College of
Medicine, University of Dundee, Level 7, Ninewells Hospital, Dundee DD1 9SY,
Scotland (M.A.L., J.R.W.M., M.S., D.L., R.L., S.Z.M., A.D.S., J.J.F.B., J.G.H.);
NHS Tayside Medical Physics, Ninewells Hospital, Dundee, Scotland (S.J.G., I.C.,
J.A.M., R.S.N., S.A.H.); Department of Research and Innovation, North York
General Hospital, University of Toronto, Toronto, Canada (F.S.); and Department
of Clinical Radiology, University Hospital of Wales, Cardiff, Wales
(R.D.W.)
| | - Ian Cavin
- From the Division of Molecular and Clinical Medicine, College of
Medicine, University of Dundee, Level 7, Ninewells Hospital, Dundee DD1 9SY,
Scotland (M.A.L., J.R.W.M., M.S., D.L., R.L., S.Z.M., A.D.S., J.J.F.B., J.G.H.);
NHS Tayside Medical Physics, Ninewells Hospital, Dundee, Scotland (S.J.G., I.C.,
J.A.M., R.S.N., S.A.H.); Department of Research and Innovation, North York
General Hospital, University of Toronto, Toronto, Canada (F.S.); and Department
of Clinical Radiology, University Hospital of Wales, Cardiff, Wales
(R.D.W.)
| | - Roberta Littleford
- From the Division of Molecular and Clinical Medicine, College of
Medicine, University of Dundee, Level 7, Ninewells Hospital, Dundee DD1 9SY,
Scotland (M.A.L., J.R.W.M., M.S., D.L., R.L., S.Z.M., A.D.S., J.J.F.B., J.G.H.);
NHS Tayside Medical Physics, Ninewells Hospital, Dundee, Scotland (S.J.G., I.C.,
J.A.M., R.S.N., S.A.H.); Department of Research and Innovation, North York
General Hospital, University of Toronto, Toronto, Canada (F.S.); and Department
of Clinical Radiology, University Hospital of Wales, Cardiff, Wales
(R.D.W.)
| | - Jennifer A. MacFarlane
- From the Division of Molecular and Clinical Medicine, College of
Medicine, University of Dundee, Level 7, Ninewells Hospital, Dundee DD1 9SY,
Scotland (M.A.L., J.R.W.M., M.S., D.L., R.L., S.Z.M., A.D.S., J.J.F.B., J.G.H.);
NHS Tayside Medical Physics, Ninewells Hospital, Dundee, Scotland (S.J.G., I.C.,
J.A.M., R.S.N., S.A.H.); Department of Research and Innovation, North York
General Hospital, University of Toronto, Toronto, Canada (F.S.); and Department
of Clinical Radiology, University Hospital of Wales, Cardiff, Wales
(R.D.W.)
| | - Shona Z. Matthew
- From the Division of Molecular and Clinical Medicine, College of
Medicine, University of Dundee, Level 7, Ninewells Hospital, Dundee DD1 9SY,
Scotland (M.A.L., J.R.W.M., M.S., D.L., R.L., S.Z.M., A.D.S., J.J.F.B., J.G.H.);
NHS Tayside Medical Physics, Ninewells Hospital, Dundee, Scotland (S.J.G., I.C.,
J.A.M., R.S.N., S.A.H.); Department of Research and Innovation, North York
General Hospital, University of Toronto, Toronto, Canada (F.S.); and Department
of Clinical Radiology, University Hospital of Wales, Cardiff, Wales
(R.D.W.)
| | - Richard S. Nicholas
- From the Division of Molecular and Clinical Medicine, College of
Medicine, University of Dundee, Level 7, Ninewells Hospital, Dundee DD1 9SY,
Scotland (M.A.L., J.R.W.M., M.S., D.L., R.L., S.Z.M., A.D.S., J.J.F.B., J.G.H.);
NHS Tayside Medical Physics, Ninewells Hospital, Dundee, Scotland (S.J.G., I.C.,
J.A.M., R.S.N., S.A.H.); Department of Research and Innovation, North York
General Hospital, University of Toronto, Toronto, Canada (F.S.); and Department
of Clinical Radiology, University Hospital of Wales, Cardiff, Wales
(R.D.W.)
| | - Allan D. Struthers
- From the Division of Molecular and Clinical Medicine, College of
Medicine, University of Dundee, Level 7, Ninewells Hospital, Dundee DD1 9SY,
Scotland (M.A.L., J.R.W.M., M.S., D.L., R.L., S.Z.M., A.D.S., J.J.F.B., J.G.H.);
NHS Tayside Medical Physics, Ninewells Hospital, Dundee, Scotland (S.J.G., I.C.,
J.A.M., R.S.N., S.A.H.); Department of Research and Innovation, North York
General Hospital, University of Toronto, Toronto, Canada (F.S.); and Department
of Clinical Radiology, University Hospital of Wales, Cardiff, Wales
(R.D.W.)
| | - Frank Sullivan
- From the Division of Molecular and Clinical Medicine, College of
Medicine, University of Dundee, Level 7, Ninewells Hospital, Dundee DD1 9SY,
Scotland (M.A.L., J.R.W.M., M.S., D.L., R.L., S.Z.M., A.D.S., J.J.F.B., J.G.H.);
NHS Tayside Medical Physics, Ninewells Hospital, Dundee, Scotland (S.J.G., I.C.,
J.A.M., R.S.N., S.A.H.); Department of Research and Innovation, North York
General Hospital, University of Toronto, Toronto, Canada (F.S.); and Department
of Clinical Radiology, University Hospital of Wales, Cardiff, Wales
(R.D.W.)
| | - Shelley A. Henderson
- From the Division of Molecular and Clinical Medicine, College of
Medicine, University of Dundee, Level 7, Ninewells Hospital, Dundee DD1 9SY,
Scotland (M.A.L., J.R.W.M., M.S., D.L., R.L., S.Z.M., A.D.S., J.J.F.B., J.G.H.);
NHS Tayside Medical Physics, Ninewells Hospital, Dundee, Scotland (S.J.G., I.C.,
J.A.M., R.S.N., S.A.H.); Department of Research and Innovation, North York
General Hospital, University of Toronto, Toronto, Canada (F.S.); and Department
of Clinical Radiology, University Hospital of Wales, Cardiff, Wales
(R.D.W.)
| | - Richard D. White
- From the Division of Molecular and Clinical Medicine, College of
Medicine, University of Dundee, Level 7, Ninewells Hospital, Dundee DD1 9SY,
Scotland (M.A.L., J.R.W.M., M.S., D.L., R.L., S.Z.M., A.D.S., J.J.F.B., J.G.H.);
NHS Tayside Medical Physics, Ninewells Hospital, Dundee, Scotland (S.J.G., I.C.,
J.A.M., R.S.N., S.A.H.); Department of Research and Innovation, North York
General Hospital, University of Toronto, Toronto, Canada (F.S.); and Department
of Clinical Radiology, University Hospital of Wales, Cardiff, Wales
(R.D.W.)
| | - Jill J. F. Belch
- From the Division of Molecular and Clinical Medicine, College of
Medicine, University of Dundee, Level 7, Ninewells Hospital, Dundee DD1 9SY,
Scotland (M.A.L., J.R.W.M., M.S., D.L., R.L., S.Z.M., A.D.S., J.J.F.B., J.G.H.);
NHS Tayside Medical Physics, Ninewells Hospital, Dundee, Scotland (S.J.G., I.C.,
J.A.M., R.S.N., S.A.H.); Department of Research and Innovation, North York
General Hospital, University of Toronto, Toronto, Canada (F.S.); and Department
of Clinical Radiology, University Hospital of Wales, Cardiff, Wales
(R.D.W.)
| | - J. Graeme Houston
- From the Division of Molecular and Clinical Medicine, College of
Medicine, University of Dundee, Level 7, Ninewells Hospital, Dundee DD1 9SY,
Scotland (M.A.L., J.R.W.M., M.S., D.L., R.L., S.Z.M., A.D.S., J.J.F.B., J.G.H.);
NHS Tayside Medical Physics, Ninewells Hospital, Dundee, Scotland (S.J.G., I.C.,
J.A.M., R.S.N., S.A.H.); Department of Research and Innovation, North York
General Hospital, University of Toronto, Toronto, Canada (F.S.); and Department
of Clinical Radiology, University Hospital of Wales, Cardiff, Wales
(R.D.W.)
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Ivanovska T, Hegenscheid K, Laqua R, Gläser S, Ewert R, Völzke H. Lung Segmentation of MR Images: A Review. VISUALIZATION IN MEDICINE AND LIFE SCIENCES III 2016. [DOI: 10.1007/978-3-319-24523-2_1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Tarnoki DL, Tarnoki AD, Richter A, Karlinger K, Berczi V, Pickuth D. Clinical value of whole-body magnetic resonance imaging in health screening of general adult population. Radiol Oncol 2015; 49:10-6. [PMID: 25810696 PMCID: PMC4362601 DOI: 10.2478/raon-2014-0031] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2013] [Accepted: 06/18/2014] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Whole-body magnetic resonance imaging (WB-MRI) and angiography (WB-MRA) has become increasingly popular in population-based research. We evaluated retrospectively the frequency of potentially relevant incidental findings throughout the body. MATERIALS AND METHODS 22 highly health-conscious managers (18 men, mean age 47±9 years) underwent WB-MRI and WB-MRA between March 2012 and September 2013 on a Discovery MR750w wide bore 3 Tesla device (GE Healthcare) using T1 weighted, short tau inversion recovery (STIR) and diffusion weighted imaging (DWI) acquisitions according to a standardized protocol. RESULTS A suspicious (pararectal) malignancy was detected in one patient which was confirmed by an endorectal sonography. Incidental findings were described in 20 subjects, including hydrocele (11 patients), benign bony lesion (7 patients) and non-specific lymph nodes (5 patients). Further investigations were recommended in 68% (ultrasound: 36%, computed tomography: 28%, mammography: 9%, additional MRI: 9%). WB-MRA were negative in 16 subjects. Vascular normal variations were reported in 23%, and a 40% left proximal common carotid artery stenosis were described in one subject. CONCLUSIONS WB-MRI and MRA lead to the detection of clinically relevant diseases and unexpected findings in a cohort of healthy adults that require further imaging or surveillance in 68%. WB-MR imaging may play a paramount role in health screening, especially in the future generation of (epi)genetic based screening of malignant and atherosclerotic disorders. Our study is the first which involved a highly selected patient group using a high field 3-T wide bore magnet system with T1, STIR, MRA and whole-body DWI acquisitions as well.
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Affiliation(s)
- David Laszlo Tarnoki
- Department of Diagnostic and Interventional Radiology, Caritasklinikum Saarbrücken St. Theresia, Academic Teaching Hospital of Saarland University, Saarbrücken, Germany
- Department of Radiology and Oncotherapy, Semmelweis University School of Medicine, Budapest, Hungary
| | - Adam Domonkos Tarnoki
- Department of Diagnostic and Interventional Radiology, Caritasklinikum Saarbrücken St. Theresia, Academic Teaching Hospital of Saarland University, Saarbrücken, Germany
- Department of Radiology and Oncotherapy, Semmelweis University School of Medicine, Budapest, Hungary
| | - Antje Richter
- Department of Diagnostic and Interventional Radiology, Caritasklinikum Saarbrücken St. Theresia, Academic Teaching Hospital of Saarland University, Saarbrücken, Germany
| | - Kinga Karlinger
- Department of Radiology and Oncotherapy, Semmelweis University School of Medicine, Budapest, Hungary
| | - Viktor Berczi
- Department of Radiology and Oncotherapy, Semmelweis University School of Medicine, Budapest, Hungary
| | - Dirk Pickuth
- Department of Diagnostic and Interventional Radiology, Caritasklinikum Saarbrücken St. Theresia, Academic Teaching Hospital of Saarland University, Saarbrücken, Germany
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Potentially relevant incidental findings on research whole-body MRI in the general adult population: frequencies and management. Eur Radiol 2012; 23:816-26. [DOI: 10.1007/s00330-012-2636-6] [Citation(s) in RCA: 84] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2012] [Revised: 07/19/2012] [Accepted: 07/26/2012] [Indexed: 12/21/2022]
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Waugh SA, Ramkumar PG, Gandy SJ, Nicholas RS, Martin P, Belch JJF, Struthers AD, Houston JG. Optimization of the contrast dose and injection rates in whole-body MR angiography at 3.0T. J Magn Reson Imaging 2010; 30:1059-67. [PMID: 19856438 DOI: 10.1002/jmri.21930] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
PURPOSE To optimize the contrast agent dose and delivery rate used in a novel whole-body magnetic resonance angiography (MRA) protocol using a 3.0T MR scanner. MATERIALS AND METHODS Six groups of 20 consenting volunteers underwent whole-body MRA, with each group receiving a different contrast dose and contrast delivery rate. The arterial tree was divided into 16 segments and the image quality at each of the anatomical locations, covering the whole body, was assessed. Qualitative analysis was carried out using a scoring assessment of image quality, and quantitative assessments were performed by measuring contrast-to-noise (CNR) and a signal-to-noise (SNR) index. RESULTS Reducing the contrast dose from 40 mL to 25 mL was found to significantly increase the CNR in several vessels of interest in the arterial tree. There was also a significant increase in the qualitative image quality score (P < 0.001). CONCLUSION This study demonstrates that reducing the contrast dose at 3.0T can result in an increase in the CNR in the vessels of interest without significantly affecting the SNR.
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Affiliation(s)
- Shelley A Waugh
- Department of Medical Physics, Ninewells Hospital, NHS Tayside, Dundee, UK.
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Whole-Body Magnetic Resonance Angiography with Additional Steady-State Acquisition of the Infragenicular Arteries in Patients with Peripheral Arterial Disease. Cardiovasc Intervent Radiol 2009; 33:484-91. [DOI: 10.1007/s00270-009-9759-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2009] [Accepted: 11/02/2009] [Indexed: 10/20/2022]
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Whole-body MR angiography with body coil acquisition at 3 T in patients with peripheral arterial disease using the contrast agent gadofosveset trisodium. Acad Radiol 2009; 16:654-61. [PMID: 19297207 DOI: 10.1016/j.acra.2008.12.018] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2008] [Revised: 11/28/2008] [Accepted: 12/12/2008] [Indexed: 11/22/2022]
Abstract
RATIONALE AND OBJECTIVES Whole-body magnetic resonance angiography (WB-MRA) at 3 T with body coil acquisition has not previously been investigated. In this study, WB-MRA was performed in this manner using the blood pool contrast agent gadofosveset trisodium. MATERIALS AND METHODS Eleven consecutive patients (five men, six women) with symptomatic peripheral arterial disease (two with critical limb ischemia, nine with claudication) were examined. Conventional digital subtraction angiography (DSA) of the aorta and the inflow and runoff arteries was used as the reference method. WB-MRA was performed using four slightly overlapping stations covering the arteries from the neck to the ankles. The arterial system was divided into 42 segments that were analyzed for the presence of significant arterial disease (> or =50% luminal narrowing or occlusion) by two blinded observers. RESULTS Sensitivities for detecting a significant arterial lesion with WB-MRA using gadofosveset as the contrast agent were 0.66 (95% confidence interval [CI], 0.49-0.79) and 0.68 (95% CI, 0.52-0.81) for the two observers. Specificities were 0.82 (95% CI, 0.74-0.88) and 0.93 (95% CI, 0.87-0.96), respectively. Intermodality agreement between WB-MRA and DSA was moderate to good, with overall kappa values of 0.44 (95% CI, 0.29-0.59) and 0.63 (95% CI, 0.5-0.77) for the two observers. Interobserver agreement for WB-MRA was good, at kappa = 0.60 (95% CI, 0.50-0.71). CONCLUSION WB-MRA at 3 T with body coil acquisition in patients with peripheral arterial disease showed good reproducibility but only moderate to good agreement with DSA. Further assessment of the method's clinical application is warranted.
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Optimisation of a high-resolution whole-body MR angiography protocol with parallel imaging and biphasic administration of a single bolus of Gd-BOPTA: preliminary experience in the systemic evaluation of atherosclerotic burden in patients referred for endovascular procedures. Radiol Med 2009; 114:538-52. [PMID: 19430733 DOI: 10.1007/s11547-009-0384-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2008] [Accepted: 07/31/2008] [Indexed: 01/15/2023]
Abstract
PURPOSE This study was performed to validate a high-resolution whole-body magnetic resonance angiography (MRA) protocol with parallel imaging and biphasic administration of a single bolus of contrast agent in the preliminary assessment of systemic atherosclerotic burden in patients referred for endovascular procedures. MATERIALS AND METHODS Forty patients referred for endovascular treatment of atherosclerotic disease of the carotid arteries (n=23), peripheral vessels (n=14) or aorta (n=3) on the basis of previous clinical and diagnostic examinations underwent high-resolution whole-body MRA at 1.5 T with 3D spoiled gradient recalled echo (GRE) sequences, featuring parallel imaging acquisition technique with x2 acceleration factor. Sixty-eight surface coil elements and a four-station imaging protocol were employed. Biphasic intravenous administration of a paramagnetic contrast agent [gadolinium benzyloxyproprionic-tetraacetic acid (Gd-BOPTA)] was performed with the following protocol: 10 ml at a speed of 1 ml/s followed by further 10 ml at a speed of 0.5 ml/s. For image analysis, the arterial system was divided into 42 segments for evaluation. The presence or absence of atherosclerotic lesions was evaluated by two observers in consensus; segments were classified as having clinically significant disease (>or=50% stenosis or an aneurysmal dilatation) or no significant disease (<50% stenosis). The presence of stenoocclusive disease, determined at all segments, was compared with findings on digital subtraction angiography (DSA), which were interpreted by a third independent reader. Sensitivity, specificity and concordance of whole-body MRA findings with DSA were calculated, and receiver operating characteristic (ROC) analysis was performed for all vascular territories. RESULTS A total of 1,680 arterial segments was evaluated; 138 (8.3%) were affected by atherosclerotic alterations. Carotid lesions were confirmed in 23 patients (34 segments), involvement of peripheral vessels in 14 (57 segments) and abdominal aneurysms in three. Sensitivity and specificity of whole-body MRA were, respectively, 95%-97% for head and neck vessels, 100%-100% for thoracoabdominal vessels, 98%-97% for thigh vessels and 84%-88% for calf vessels; concordance with the DSA findings was significant (p<0.05). Subclinical atherosclerotic lesions were evidenced in 25 patients, involving carotid arteries (12 segments), peripheral vessels (21 segments) and abdominal aorta (one segment). All these lesions were confirmed by a second modality, and ten of these patients required further care. CONCLUSIONS High-resolution whole-body MRA with Gd-BOPTA may be considered a reliable modality for imaging systemic atherosclerosis in candidates for endovascular procedures. The subclinical detection of the total atherosclerotic burden has potential implications for secondary care in this population.
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Affiliation(s)
- Hong Lei Zhang
- Department of Radiology, Weill Cornell Medical Center, New York, NY 10022, USA
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Auger F, Beregi JP, Lions C, Negaiwi Z, Gaxotte V, Akkari K, Willoteaux S. [Contrast enhanced MR angiography: evolving towards whole-body real time acquisitions]. JOURNAL DE RADIOLOGIE 2009; 90:179-189. [PMID: 19308002 DOI: 10.1016/s0221-0363(09)72468-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
MRA includes all techniques used to depict vessels with MR. Gadolinium contrast injection combined with gradient echo sequences is the technique of choice for vascular imaging. Technical advances now allow faster acquisitions. The purpose of this article is to present two main advances with MRA: whole-body MRA and dynamic 3D MRA. Technical considerations, acquisition techniques, advantages and pitfalls based on our experience with a 1.5T MR unit will be discussed in order to promote their use in routine clinical practice.
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Affiliation(s)
- F Auger
- Service d'Imagerie et de Radiologie Cardiaque et Vasculaire, Hôpital Cardiologique, CHRU de Lille, 2, avenue Oscar Lambret, 59037 Lille Cedex
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Seeger A, Kramer U, Fenchel M, Grimm F, Bretschneider C, Döring J, Klumpp B, Tepe G, Rittig K, Seidensticker PR, Claussen CD, Miller S. Comparison between a linear versus a macrocyclic contrast agent for whole body MR angiography in a clinical routine setting. J Cardiovasc Magn Reson 2008; 10:63. [PMID: 19116027 PMCID: PMC2633332 DOI: 10.1186/1532-429x-10-63] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2008] [Accepted: 12/30/2008] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Previous experiences of whole body MR angiography are predominantly available in linear 0.5 M gadolinium-containing contrast agents. The aim of this study was to compare image quality on a four-point scale (range 1-4) and diagnostic accuracy of a 1.0 M macrocyclic contrast agent (gadobutrol, n = 80 patients) with a 0.5 M linear contrast agent (gadopentetate dimeglumine, n = 85 patients) on a 1.5 T whole body MR system. Digital subtraction angiography served as standard of reference. RESULTS All examinations yielded diagnostic image quality. There was no significant difference in image quality (3.76 +/- 0.3 versus 3.78 +/- 0.3, p = n.s.) and diagnostic accuracy observed. Sensitivity and specificity of the detection of hemodynamically relevant stenoses was 93%/95% in the gadopentetate dimeglumine group and 94%/94% in the gadobutrol group, respectively. CONCLUSION The high diagnostic accuracy of gadobutrol in the clinical routine setting is of high interest as medical authorities (e.g. the European Agency for the Evaluation of Medicinal Products) recommend macrocyclic contrast agents especially to be used in patients with renal failure or dialysis.
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Affiliation(s)
- Achim Seeger
- Department of Diagnostic and Interventional Radiology, Eberhard-Karls-University Tuebingen, Hoppe-Seyler-Str. 3, 72076 Tuebingen, Germany
| | - Ulrich Kramer
- Department of Diagnostic and Interventional Radiology, Eberhard-Karls-University Tuebingen, Hoppe-Seyler-Str. 3, 72076 Tuebingen, Germany
| | - Michael Fenchel
- Department of Diagnostic and Interventional Radiology, Eberhard-Karls-University Tuebingen, Hoppe-Seyler-Str. 3, 72076 Tuebingen, Germany
| | - Florian Grimm
- Department of Diagnostic and Interventional Radiology, Eberhard-Karls-University Tuebingen, Hoppe-Seyler-Str. 3, 72076 Tuebingen, Germany
| | - Christiane Bretschneider
- Department of Diagnostic and Interventional Radiology, Eberhard-Karls-University Tuebingen, Hoppe-Seyler-Str. 3, 72076 Tuebingen, Germany
| | - Jörg Döring
- Department of Diagnostic and Interventional Radiology, Eberhard-Karls-University Tuebingen, Hoppe-Seyler-Str. 3, 72076 Tuebingen, Germany
| | - Bernhard Klumpp
- Department of Diagnostic and Interventional Radiology, Eberhard-Karls-University Tuebingen, Hoppe-Seyler-Str. 3, 72076 Tuebingen, Germany
| | - Gunnar Tepe
- Department of Diagnostic and Interventional Radiology, Eberhard-Karls-University Tuebingen, Hoppe-Seyler-Str. 3, 72076 Tuebingen, Germany
| | - Kilian Rittig
- Department of Internal Medicine IV, Eberhard-Karls-University Tuebingen, Otfried-Müller-Str. 10, 72076 Tuebingen, Germany
| | | | - Claus D Claussen
- Department of Diagnostic and Interventional Radiology, Eberhard-Karls-University Tuebingen, Hoppe-Seyler-Str. 3, 72076 Tuebingen, Germany
| | - Stephan Miller
- Department of Diagnostic and Interventional Radiology, Eberhard-Karls-University Tuebingen, Hoppe-Seyler-Str. 3, 72076 Tuebingen, Germany
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Buerke B, Allkemper T, Kugel H, Bremer C, Evers S, Kooijman H, Heindel W, Tombach B. Qualitative and quantitative analysis of routinely postprocessed (CLEAR) CE-MRA data sets: are SNR and CNR calculations reliable? Acad Radiol 2008; 15:1111-7. [PMID: 18692751 DOI: 10.1016/j.acra.2008.04.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2008] [Revised: 01/28/2008] [Accepted: 04/07/2008] [Indexed: 10/21/2022]
Abstract
RATIONALE AND OBJECTIVES To evaluate objective image quality parameters for contrast-enhanced magnetic resonance angiography (CE-MRA), contrast-to-noise (CNR), and signal-to-noise ratio (SNR) calculations based on signal intensity (SI) and standard deviation (SD) measurements of the vessel, the surrounding tissue (eg, muscle), and the background noise outside the body are commonly used. However, modern magnetic resonance scanners often use dedicated software algorithms such as Constant LEvel AppeaRance (CLEAR) to improve image quality, which may affect the established methods of SNR and CNR calculation. The purpose of this study was to intraindividually evaluate the feasibility of conventional techniques used for SNR and CNR calculation of MRA data sets that have been reconstructed with both, a standard (non-CLEAR) and a CLEAR algorithm. METHODS Supra-aortic high-resolution CE-MRA of 11 patients with headache symptoms was performed at 1.5 T using reconstruction algorithms generating both, non-CLEAR and CLEAR-corrected images from the acquired data set. A qualitative analysis with regard to image quality and contrast level was performed by two radiologists applying a score system. For quantitative analysis, distribution of SI values was measured in regions of interest in the common carotid artery (CCA) and the C1 segment of the internal carotid artery in identical positions of both data sets for intraindividual comparison of SNR and CNR calculations. For that purpose, three different equations were used for background noise assessment by determining the SD of SIs measured in the air outside the body (Eq. A), the soft tissue adjacent to the analyzed vessel segment (Eq. B), and in a contrast-medium filled tube (reference standard), which was placed around the patient's neck (Eq. C). RESULTS The qualitative analysis documented an improved image quality and a higher contrast level for CLEAR-based data sets. SNR and CNR calculations of the CCA and the C1 segment were significantly different for both reconstruction algorithms when using the background noise outside the body for image noise assessment (P<.05 [CCA]; P<.05 [C1]). SNR and CNR calculations based on the soft tissue adjacent to the analyzed segment or a reference standard were comparable. CONCLUSIONS For comparative analysis of CE-MRA data sets, SNR and CNR calculations based on SD determination of the background noise signal measured outside the body are not applicable for CE-MRA data sets reconstructed with a CLEAR-based algorithm. Therefore, noise should rather be assessed in the perivascular tissue to enable proper comparative analysis of CLEAR-enhanced CE-MRA data sets.
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Plathow C, Walz M, Lichy MP, Aschoff P, Pfannenberg C, Bock H, Eschmann SM, Claussen CD, Schlemmer HP. [Cost considerations for whole-body MRI and PET/CT as part of oncologic staging]. Radiologe 2008; 48:384-96. [PMID: 17891370 DOI: 10.1007/s00117-007-1547-z] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
PURPOSE The aim of this study was to evaluate and discuss economic aspects of whole-body MRI and PET/CT in oncologic staging. Considerations from the perspective of the health care system, the radiologist, and the patients are presented. MATERIALS AND METHODS Costs of both whole-body techniques are compared with the conventional radiologic diagnostic recommendations of the AWFM (Arbeitsgemeinschaft Wissenschaftlich Medizinischer Fachgesellschaften) in oncologic staging of the five most frequent tumor entities. Temporal and monetary aspects are calculated. Invasive, endoscopic, and endosonographic techniques are regarded as essential and cannot be replaced by other techniques. Thus only the minimal potential for cost reduction is quantified. RESULTS In the German system there is no cipher to correctly balance whole-body MRI and PET/CT. Using the frequently applied ciphers 5700-5730 and 5378, 5489 (factor 1.0) total costs were 440.45 euros, and adding the cipher for additional series 545.37 euros (60 min examination time) for whole-body MRI and 774.74 euros (879.66 euros) (60/90 min examination time) for whole-body PET/CT. Using the common factor 1.8 costs were 981.66 and 1583.38 euros. On the basis of a simple full cost analysis total costs of whole-body PET/CT were higher than of whole-body MRI by a factor of about 2.0 (about 1123 vs 575 euros). There were substantial monetary and temporal differences between tumor entities. In extended bronchial carcinoma 375.32 euros and 55 min can be saved using whole-body MRI in comparison to conventional recommended techniques and using whole-body PET/CT 88.14 euros and 45 min. In tumor entities of lower stages with thus less essential radiologic diagnostics the potential for cost reduction is substantially lower. CONCLUSION Whole-body imaging techniques make it possible to reduce the number of necessary separate radiologic examinations and thus time in oncologic staging. A substantial reduction of health care costs seems to be possible in many tumor entities but differences between different tumor entities are decisive.
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Affiliation(s)
- C Plathow
- Abteilung Diagnostische Radiologie, Eberhardt-Karls-Universität Tübingen, Tübingen.
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Whole-Body MRA. Eur Radiol 2008; 18:1925-36. [DOI: 10.1007/s00330-007-0817-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2007] [Revised: 10/17/2007] [Accepted: 10/24/2007] [Indexed: 01/10/2023]
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17
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Total-body contrast-enhanced MRA on a short, wide-bore 1.5-T system: intra-individual comparison of Gd-BOPTA and Gd-DOTA. Eur Radiol 2008; 18:2265-73. [DOI: 10.1007/s00330-008-0976-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2007] [Revised: 03/19/2008] [Accepted: 03/21/2008] [Indexed: 10/22/2022]
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Whole-body magnetic resonance angiography at 3.0 Tesla. Eur Radiol 2008; 18:1473-83. [DOI: 10.1007/s00330-008-0885-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2007] [Revised: 12/01/2007] [Accepted: 01/16/2008] [Indexed: 11/26/2022]
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A total atherosclerotic score for whole-body MRA and its relation to traditional cardiovascular risk factors. Eur Radiol 2008; 18:1174-80. [DOI: 10.1007/s00330-008-0864-6] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2007] [Revised: 11/24/2007] [Accepted: 01/08/2008] [Indexed: 10/22/2022]
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Abstract
Whole body magnetic resonance imaging (MRI) opens new opportunities in diagnostic radiology as systemic disease entities can be examined with high sensitivity. This can lead to a change of paradigm, so that not only organ-related but rather disease-specific MRI examination protocols can be applied which focus on the underlying pathophysiology of the disease. Whole body MRI has already been successfully used for several oncological and non-oncological indications. In addition, whole body MRI has broadened the discussion regarding its use for secondary prevention. Compared to computed tomography, MRI does not use radiation. Although whole body MRI is still in an early stage, the enormous medical and economical potential can be envisioned.
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Affiliation(s)
- M Goyen
- Arztliche Direktion, Universitätsklinikum Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany.
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Niendorf T, Sodickson DK. Highly accelerated cardiovascular MR imaging using many channel technology: concepts and clinical applications. Eur Radiol 2008; 18:87-102. [PMID: 17562047 PMCID: PMC2838248 DOI: 10.1007/s00330-007-0692-0] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2006] [Revised: 04/26/2007] [Accepted: 05/10/2007] [Indexed: 01/23/2023]
Abstract
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.
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Affiliation(s)
- Thoralf Niendorf
- Department of Diagnostic Radiology, RWTH Aachen, University Hospital, Pauwelsstrasse 30, 52057 Aachen, Germany, Tel.: +49-241-8080295, Fax: +49-241-803380295
| | - Daniel K. Sodickson
- Department of Radiology, Center for Biomedical Imaging, New York University, School of Medicine, 650 First Avenue, Suite 600-A, New York, NY, 10016, USA, Tel.: 212-263-4844, Fax: 212-263-4845
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Dellegrottaglie S, Sanz J, Macaluso F, Einstein AJ, Raman S, Simonetti OP, Rajagopalan S. Technology Insight: magnetic resonance angiography for the evaluation of patients with peripheral artery disease. ACTA ACUST UNITED AC 2007; 4:677-87. [PMID: 18033232 DOI: 10.1038/ncpcardio1035] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2006] [Accepted: 09/03/2007] [Indexed: 12/21/2022]
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Hansen T, Ahlström H, Johansson L. Whole-body screening of atherosclerosis with magnetic resonance angiography. Top Magn Reson Imaging 2007; 18:329-337. [PMID: 18025987 DOI: 10.1097/rmr.0b013e318159aaa2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
With whole-body magnetic resonance angiography (WBMRA), it is possible to examine the whole arterial tree except intracranial and coronary vessels in a single examination without the risks involved in ionizing radiation or arterial cannulation. Whole-body magnetic resonance angiography is well suited for repeated clinical examinations in patients with systemic diseases such as vasculitis or atherosclerosis and can also be used for scientific purposes. On the basis of the WBMRA overview, a possible further development of the WBMRA concept can be to perform further acquisitions at sites with atherosclerotic plaques with higher-resolution scans to determine the degree of stenosis more accurately or to achieve plaque characterization. A total validation of WBMRA compared with digital subtraction angiography (DSA) is not possible owing to the hazards of ionizing radiation. Studies have shown a high sensitivity and specificity for the pelvic and lower limb arteries in comparison with DSA. No systematic validation against DSA has been performed for the renal, aortic, and carotid arteries. Various methods have been used, however, for confirmation of vascular abnormalities found on WBMRA such as ultrasonography, dedicated MRA, or DSA, with reasonably high agreement. The WBMRA method has not been studied with regard to prediction of future cardiovascular (CV) events, as have intima media thickness, coronary artery calcium scoring, and the ankle-brachial index. The full usefulness of WBMRA in an epidemiological setting and as a complementary screening tool for assessing CV risk still needs to be validated against future CV events.
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Affiliation(s)
- Tomas Hansen
- Department of Radiology, Uppsala University Hospital, Uppsala, Sweden.
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Hansen T, Wikström J, Johansson LO, Lind L, Ahlström H. The Prevalence and Quantification of Atherosclerosis in an Elderly Population Assessed by Whole-Body Magnetic Resonance Angiography. Arterioscler Thromb Vasc Biol 2007; 27:649-54. [PMID: 17170372 DOI: 10.1161/01.atv.0000255310.47940.3b] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE The principal aim of the present study was to explore the feasibility of using whole-body magnetic resonance angiography to assess atherosclerosis in different vascular territories in a cohort of elderly. METHODS AND RESULTS Three hundred six 70-year-old subjects (145 women, 161 men) recruited from a population-based cohort study (Prospective Investigation of the Vasculature in Uppsala Seniors, ie, the PIVUS study) underwent 1.5-T whole-body magnetic resonance angiography with gadodiamide. The arteries were divided into 26 segments. In total, 7956 vessel segments were evaluated with 7900 segments (99.3%) possible to evaluate. Of these, 7186 segments (91%) were normal. Luminal narrowing of > or = 50% was observed in 9 (1.5%) of the renal arteries, 12 (1.8%) of the carotid arteries, in 31 segments (1.1%) of the pelvic/upper leg territories, and in 136 segments (6.2%) of territories in the lower leg. Approximately one-third of the sample had no vascular abnormalities, one-third had stenoses of < 50%, and the remainder had stenoses > or = 50% or occlusions. Six subjects (2%) had aortic aneurysms. In subjects without evident vascular disease, 26% had significant vascular abnormalities. CONCLUSIONS Whole-body magnetic resonance angiography performed with a clinical scanner can be used for quantifying atherosclerosis in different vascular territories in a single examination in an elderly population.
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Affiliation(s)
- T Hansen
- Institution of ORKI, Department of Radiology, Uppsala University Hospital, SE-751 85 Uppsala, Sweden.
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Nael K, Fenchel M, Krishnam M, Laub G, Finn JP, Ruehm SG. High-Spatial-Resolution Whole-Body MR Angiography with High-Acceleration Parallel Acquisition and 32-Channel 3.0-T Unit: Initial Experience. Radiology 2007; 242:865-72. [PMID: 17325071 DOI: 10.1148/radiol.2423060135] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The purpose of this HIPAA-compliant study was to prospectively evaluate the technical feasibility of a multistation high-spatial-resolution whole-body magnetic resonance (MR) angiography protocol in which high-acceleration parallel imaging (with acceleration factors of three and four) is performed with a 32-channel 3.0-T MR system. After institutional review board approval and written informed consent were obtained, 10 healthy volunteers (four men and six women aged 23-68 years) and four patients (two men and two women aged 56-79 years) suspected of having peripheral vascular disease underwent multistation whole-body contrast material-enhanced MR angiography. Use of multiarray surface coil technology and highly accelerated generalized autocalibrating partially parallel acquisition enabled the acquisition of isotropic high-spatial-resolution three-dimensional data sets for multiple stations. Two radiologists independently evaluated arterial image quality and presence of arterial stenoses. All examinations yielded good or excellent image quality. Interobserver agreement was excellent (kappa = 0.92; 95% confidence interval: 0.86, 0.96). Multistation whole-body MR angiography with high-acceleration parallel acquisition is feasible at 3.0 T. Further clinical studies combined with ongoing optimization of radiofrequency systems and coils seem warranted to advance the potential of this technology.
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Affiliation(s)
- Kambiz Nael
- Department of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, 10945 Le Conte Ave, Suite 3371, Los Angeles, CA 90095-7206, USA.
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Nael K, Ruehm SG, Michaely HJ, Saleh R, Lee M, Laub G, Finn JP. Multistation Whole-Body High-Spatial-Resolution MR Angiography Using a 32-Channel MR System. AJR Am J Roentgenol 2007; 188:529-39. [PMID: 17242265 DOI: 10.2214/ajr.05.2053] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
OBJECTIVE The objective of our study was to investigate a multistation whole-body MR angiography (MRA) protocol using a 32-channel MR system with multicoil technology in a population of patients with suspected peripheral vascular disease (PVD). SUBJECTS AND METHODS Fifty consecutive patients with suspected PVD (31 men, 19 women; age range, 46-91 years) underwent multistation whole-body contrast-enhanced MR angiography (CE-MRA) on a 32-channel 1.5-T MR system equipped with multicoil technology. A two-step contrast injection protocol was used: After the first injection, images of the most proximal station (station I, head and neck) were acquired, followed by the most distal station (station IV, calves). Images of the intermediate two stations (station II, chest and abdomen; station III, pelvis and thighs) were acquired during the second injection. Conventional catheter angiography was performed for symptomatic vascular regions in 30 patients. The image quality of the arterial segments and the presence and degree of the arterial stenosis were evaluated by two radiologists. The interobserver variability was calculated by kappa statistics, and comparative analysis between CE-MRA and catheter angiography was performed by means of the Spearman's rank correlation coefficient. RESULTS Most of the vascular segments (1,912/1,976 [97%]) were visualized on wholebody CE-MRA with diagnostic image quality. Significant arterial disease (> or = 50%) was detected in 167 (observer 1) and 177 (observer 2) segments with excellent interobserver agreement (kappa = 0.84). There was a significant correlation between CE-MRA and conventional angiography for the degree of stenosis (R = 0.92 and 0.89 for observers 1 and 2, respectively). The sensitivity and specificity of CE-MRA for the detection of arterial stenoses 50% or greater were 92% and 96% for observer 1 and 93% and 97% for observer 2, respectively, compared with those of conventional angiography. CONCLUSION Using a multichannel radiofrequency system with multicoil technology, the whole-body CE-MRA approach outlined in this article is able to provide high-spatial-resolution data sets with high diagnostic image quality for evaluation of arterial occlusive disease in most vascular territories.
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Affiliation(s)
- Kambiz Nael
- Department of Radiological Sciences, David Geffen School of Medicine, University of California at Los Angeles, 10945 Le Conte Ave., Ste. 3371, Los Angeles, CA 90095-7206, USA
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Magnetic Resonance Angiography and Evaluation of Vulnerable Plaque. CARDIOVASCULAR MEDICINE 2007. [DOI: 10.1007/978-1-84628-715-2_40] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Abstract
Safe, fast, accurate contrast arteriography can be obtained utilizing gadolinium (Gd) and 3D MR data acquisition for diagnosing vascular diseases. Optimizing contrast enhanced MRA (CE MRA), however, requires understanding the complex interplay between Gd injection timing, the Fourier mapping of 3D MR data acquisition and a multitude of parameters determining resolution, anatomic coverage, and sensitivity to motion artifacts. It is critical to time the bolus peak to coincide with central k-space data acquisition, which dominates image contrast. Oversampling the center of k-space allows reconstruction of multiple 3D acquisitions in rapid succession to time-resolve the passage of the contrast bolus. Parallel imaging increases resolution, shortens scan time and compresses the center of k-space into a shorter period of time, thereby minimizing motion and timing artifacts. Absence of ionizing radiation allows MRA to be repeated and combined with additional sequences to more fully characterize anatomy, flow, and physiology. Utilizing stepping table technology and thigh compression, whole body MRA is possible with a single contrast injection. As MR technology continues to advance, CE MRA becomes better and simpler to perform, increasing its efficacy in the diagnosis and management of vascular diseases.
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Affiliation(s)
- Honglei Zhang
- Department of Radiology, Weill Medical College of Cornell University, New York, New York, USA
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Lin J, Chen B, Wang JH, Zeng MS, Wang YX. Whole-body three-dimensional contrast-enhanced magnetic resonance (MR) angiography with parallel imaging techniques on a multichannel MR system for the detection of various systemic arterial diseases. Heart Vessels 2006; 21:395-8. [PMID: 17143719 DOI: 10.1007/s00380-006-0918-0] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2005] [Accepted: 03/10/2006] [Indexed: 10/23/2022]
Abstract
Using a 1.5-T magnetic resonance (MR) imager equipped with 32 receiving channels and integrated parallel acquisition techniques, 37 patients underwent whole-body three-dimensional (3D) contrast-enhanced MR angiography (WB 3D CE MRA). The patients included had clinically documented or suspected peripheral arterial occlusive disease (PAOD, n = 19), Takayasu arteritis (n = 8), polyarteritis nodosa (n = 1), type-B dissection (n = 4), thoracic and/or abdominal aneurysm (n = 5). Sixty-eight surface coils were employed to encompass the whole body. Four 3D CE MRA stations were acquired successively through automatic table moving. The spatial resolution was 1.6 x 1.0 mm and slice thickness was 1.5 mm for all stations. A total scan range of 188 cm was acquired. Overall image quality of each arterial segment and venous overlay were assessed. The depiction of various systemic arterial diseases was evaluated and compared, in 20 patients, with other imaging modalities. This WB 3D CE MRA yielded a detailed display of the arterial system with an average MR room time of 17.4 min. The image quality was considered diagnostic in 99.3% of the arterial segments. In 7 of 19 patients with PAOD, WB MRA showed additional vascular narrowing apart from peripheral arterial disease. In nine patients with vasculitis, WB MRA depicted luminal irregularity, narrowing or occlusion, aneurysm, and collateral circulation involving multiple vascular segments. WB MRA also clearly revealed the severity and extent of dissection and aortic aneurysm. In 20 cases where additional imaging investigations have been carried out, the vascular pathologies demonstrated by WB MRA agree with these additional imaging investigations.
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Affiliation(s)
- Jiang Lin
- Department of Radiology, Shanghai Zhongshan Hospital, Shanghai Medical College, Fudan University, Shanghai 200032, China.
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Diagnosis of systemic arterial diseases with whole-body 3D contrast-enhanced magnetic resonance angiography. Chin Med J (Engl) 2006. [DOI: 10.1097/00029330-200611010-00002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Frydrychowicz A, Bley TA, Winterer JT, Harloff A, Langer M, Hennig J, Markl M. Accelerated time-resolved 3D contrast-enhanced MR angiography at 3T: clinical experience in 31 patients. MAGNETIC RESONANCE MATERIALS IN PHYSICS BIOLOGY AND MEDICINE 2006; 19:187-95. [PMID: 16937136 DOI: 10.1007/s10334-006-0046-y] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2006] [Accepted: 07/24/2006] [Indexed: 10/24/2022]
Abstract
PURPOSE To evaluate whether time-resolved 3D MR-angiography at 3T with a net acceleration factor of eight is applicable in clinical routine and to evaluate whether good image quality and a low artifact level can be achieved with a temporal update rate that allows for additional information on pathologies. MATERIALS AND METHODS Thirty-one consecutive patients underwent time-resolved 3D contrast-enhanced MR-angiography on a 3T system. Imaging consisted of accelerated 3D gradient echo sequences combining parallel imaging with an acceleration factor of four, partial Fourier acquisition along phase and slice encoding direction, and twofold temporal acceleration using view sharing. Data volumes representing the arterial and venous contrast phases were independently evaluated by two experienced radiologists by grading of image quality and artifact level on a 0-3 scale. RESULTS Time-resolved MR-angiography was successfully performed in all subjects without the need for contrast agent bolus timing. Excellent arterial (average score = 2.65 +/- 0.32) and good venous (average score = 2.56 +/- 0.28) diagnostic image quality and little image degrading due to artifacts (average score = 2.20 +/- 0.16) were confirmed by both independent readers (agreement in 65.2% of all evaluations). In 14 patients vascular pathologies were identified in the arterial phases. In eight examinations temporal resolution and depiction of contrast agent dynamics provided additional information about pathology. DISCUSSION Without the necessity for additional bolus timing, time-resolved 3D contrast-enhanced MR-angiography with imaging acceleration along both the spatial encoding direction and temporal domain revealed excellent diagnostic image quality in neurovascular and thoracic imaging. Despite the limited spatial resolution as compared to high-resolution imaging of the carotid artery bifurcation, the results demonstrate the applicability of contrast-enhanced MR-angiography in thoracic and abdominal MRA as well as cervical imaging with a temporal update rate allowing for additional information on pathologies. Future studies may include an evaluation of optimal trade-offs between spatial and temporal resolution, different acceleration factors and a comparison to the gold-standard for accuracy.
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Affiliation(s)
- Alex Frydrychowicz
- Department of Diagnostic Radiology and Medical Physics, University Hospital Freiburg, Hugstetter Str. 55, 79106 Freiburg, Germany.
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Fenchel M, Nael K, Ruehm S, Finn JP, Miller S, Laub G. Isotropic High Spatial Resolution Magnetic Resonance Angiography of the Supra-Aortic Arteries Using Two-Dimensional Parallel Imaging (iPAT2) at 3 Tesla. Invest Radiol 2006; 41:545-52. [PMID: 16772847 DOI: 10.1097/01.rli.0000215435.28349.31] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVES We sought to assess the feasibility of isotropic 3-dimensional contrast-enhanced magnetic resonance angiography (MRA) covering the supra-aortic and intracranial arteries with a MR sequence using parallel-imaging in phase- and slice-encoding directions. MATERIALS AND METHODS Six volunteers and 5 patients with suspected cerebrovascular disease were examined at 3.0 T using a 16-element head-neck array. Contrast-enhanced 3-dimensional MRA (repetition time 3.2 milliseconds, echo time 1.2 milliseconds, flip angle 30 degrees , bandwidth 390 Hz/pixel) was acquired with integrated generalized autocalibrating partially parallel acquisition (GRAPPA), in both phase- and slice-encoding direction. Images were evaluated independently by 2 radiologists. Signal-to-noise ratio was calculated from phantom measurements. RESULTS Signal-to-ratio levels of 8.7 +/- 2.2/48.7 +/- 10.2 with and without parallel-imaging (GRAPPA x 6) were measured, respectively. Scoring of image quality by observer 1/observer 2 on a 4-point-scale (range 0-3) yielded 2.5 +/- 1.0/2.4 +/- 1.0 and 2.1 +/- 1.0/2.0 +/- 1.1 for extracranial and intracranial vessel segments in volunteers and 2.8 +/- 0.6/2.7 +/- 0.7 and 2.0 +/- 1.2/2.1 +/- 1.1 in patients, respectively. The interobserver agreement was excellent (k = 0.82). CONCLUSIONS This study shows that contrast-enhanced MRA, applying parallel-imaging in both phase- and slice-encoding direction (iPAT), is feasible at 3.0 T. Coverage of the carotid and vertebro-basilar circulation was achieved.
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Affiliation(s)
- Michael Fenchel
- Department of Diagnostic Radiology, Eberhard-Karls-University, Tuebingen, Germany.
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Michaely HJ, Dietrich O, Nael K, Weckbach S, Reiser MF, Schoenberg SO. MRA of abdominal vessels: technical advances. Eur Radiol 2006; 16:1637-50. [PMID: 16721552 DOI: 10.1007/s00330-006-0240-3] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2005] [Revised: 02/20/2006] [Accepted: 03/06/2006] [Indexed: 11/26/2022]
Abstract
Magnetic resonance angiography (MRA) in general and MRA of the abdominal vessels in particular have undergone substantial improvements in the past 5 years triggered by the introduction and application of parallel imaging (PI), new sequence techniques such as centric k-space trajectories and undersampling, dedicated contrast agents and clinical high-field scanners. All of these techniques have the potential to improve image quality and resolution or decrease the image acquisition time. However, each of them has its own specific advantages and drawbacks. This review describes the main technical innovations and focuses on the impact these developments may have on abdominal MRA. Special consideration is given to the interaction of these various technical advances. The clinical value of advanced MRA techniques is discussed and illustrated by characteristic cases.
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Affiliation(s)
- Henrik J Michaely
- Department of Clinical Radiology, University Hospitals - Grosshadern, Ludwig-Maximilians-University Munich, Marchioninistr.15, 81377 Munich, Germany.
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