1
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Ebel S, Kühn A, Köhler B, Behrendt B, Riekena B, Preim B, Denecke T, Grothoff M, Gutberlet M. Quantitative 4D flow MRI-derived thoracic aortic normal values of 2D flow MRI parameters in healthy volunteers. ROFO-FORTSCHR RONTG 2024; 196:273-282. [PMID: 37944940 DOI: 10.1055/a-2175-4165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2023]
Abstract
PURPOSE To utilize 4 D flow MRI to acquire normal values of "conventional 2 D flow MRI parameters" in healthy volunteers in order to replace multiple single 2 D flow measurements with a single 4 D flow acquisition. MATERIALS AND METHODS A kt-GRAPPA accelerated 4 D flow sequence was used. Flow volumes were assessed by forward (FFV), backward (BFV), and net flow volumes (NFV) [ml/heartbeat] and flow velocities by axial (VAX) and absolute velocity (VABS) [m/s] in 116 volunteers (58 females, 43 ± 13 years). The aortic regurgitant fraction (RF) was calculated. RESULTS The sex-neutral mean FFV, BFV, NFV, and RF in the ascending aorta were 93.5 ± 14.8, 3.6 ± 2.8, 89.9 ± 0.6 ml/heartbeat, and 3.9 ± 2.9 %, respectively. Significantly higher values were seen in males regarding FFV, BFV, NFV and RF, but there was no sex dependency regarding VAX and VABS. The mean maximum VAX was lower (1.01 ± 0.31 m/s) than VABS (1.23 ± 0.35 m/s). We were able to determine normal ranges for all intended parameters. CONCLUSION This study provides quantitative 4 D flow-derived thoracic aortic normal values of 2 D flow parameters in healthy volunteers. FFV, BFV, NFV, and VAX did not differ significantly from single 2 D flow acquisitions and could therefore replace time-consuming multiple single 2 D flow acquisitions. VABS should not be used interchangeably. KEY POINTS · 4 D flow MRI can be used to replace 2 D flow MRI measurements.. · The parameter absolute velocities can be assessed by 4 D flow MRI.. · There are sex-dependent differences regarding forward, backward, net aortic blood flow and the aortic valve regurgitant fraction..
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Affiliation(s)
- Sebastian Ebel
- Diagnostic and Interventional Radiology, Leipzig University, Leipzig, Germany
| | - Alexander Kühn
- Diagnostic and Interventional Radiology, Leipzig Heart Centre University Hospital, Leipzig, Germany
| | - Benjamin Köhler
- Simulation and Graphics, Otto von Guericke Universität Magdeburg, Germany
| | - Benjamin Behrendt
- Simulation and Graphics, Otto von Guericke Universität Magdeburg, Germany
| | - Boris Riekena
- Diagnostic and Interventional Radiology, Leipzig Heart Centre University Hospital, Leipzig, Germany
| | - Bernhard Preim
- Simulation and Graphics, Otto von Guericke Universität Magdeburg, Germany
| | - Timm Denecke
- Diagnostic and Interventional Radiology, Leipzig University, Leipzig, Germany
| | - Matthias Grothoff
- Diagnostic and Interventional Radiology, Leipzig Heart Centre University Hospital, Leipzig, Germany
| | - Matthias Gutberlet
- Diagnostic and Interventional Radiology, Leipzig Heart Centre University Hospital, Leipzig, Germany
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2
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Garreau M, Puiseux T, Toupin S, Giese D, Mendez S, Nicoud F, Moreno R. Accelerated sequences of 4D flow MRI using GRAPPA and compressed sensing: A comparison against conventional MRI and computational fluid dynamics. Magn Reson Med 2022; 88:2432-2446. [PMID: 36005271 DOI: 10.1002/mrm.29404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 06/30/2022] [Accepted: 07/14/2022] [Indexed: 01/07/2023]
Abstract
PURPOSE To evaluate hemodynamic markers obtained by accelerated GRAPPA (R = 2, 3, 4) and compressed sensing (R = 7.6) 4D flow MRI sequences under complex flow conditions. METHODS The accelerated 4D flow MRI scans were performed on a pulsatile flow phantom, along with a nonaccelerated fully sampled k-space acquisition. Computational fluid dynamics simulations based on the experimentally measured flow fields were conducted for additional comparison. Voxel-wise comparisons (Bland-Altman analysis, <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML"> <mml:semantics> <mml:mrow><mml:msub><mml:mi>L</mml:mi> <mml:mn>2</mml:mn></mml:msub> </mml:mrow> <mml:annotation>$$ {L}_2 $$</mml:annotation></mml:semantics> </mml:math> -norm metric), as well as nonderived quantities (velocity profiles, flow rates, and peak velocities), were used to compare the velocity fields obtained from the different modalities. RESULTS 4D flow acquisitions and computational fluid dynamics depicted similar hemodynamic patterns. Voxel-wise comparisons between the MRI scans highlighted larger discrepancies at the voxels located near the phantom's boundary walls. A trend for all MR scans to overestimate velocity profiles and peak velocities as compared to computational fluid dynamics was noticed in regions associated with high velocity or acceleration. However, good agreement for the flow rates was observed, and eddy-current correction appeared essential for consistency of the flow rates measurements with respect to the principle of mass conservation. CONCLUSION GRAPPA (R = 2, 3) and highly accelerated compressed sensing showed good agreement with the fully sampled acquisition. Yet, all 4D flow MRI scans were hampered by artifacts inherent to the phase-contrast acquisition procedure. Computational fluid dynamics simulations are an interesting tool to assess these differences but are sensitive to modeling parameters.
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Affiliation(s)
- Morgane Garreau
- University of Montpellier, CNRS, Montpellier, France.,Spin Up, ALARA Group, Strasbourg, France
| | - Thomas Puiseux
- Spin Up, ALARA Group, Strasbourg, France.,I2MC, INSERM/UPS UMR 1297, Toulouse, France
| | | | - Daniel Giese
- Magnetic Resonance, Siemens Healthcare GmbH, Erlangen, Germany
| | - Simon Mendez
- University of Montpellier, CNRS, Montpellier, France
| | - Franck Nicoud
- University of Montpellier, CNRS, Montpellier, France
| | - Ramiro Moreno
- I2MC, INSERM/UPS UMR 1297, Toulouse, France.,ALARA Expertise, ALARA Group, Strasbourg, France
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3
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Gorecka M, Bissell MM, Higgins DM, Garg P, Plein S, Greenwood JP. Rationale and clinical applications of 4D flow cardiovascular magnetic resonance in assessment of valvular heart disease: a comprehensive review. J Cardiovasc Magn Reson 2022; 24:49. [PMID: 35989320 PMCID: PMC9394062 DOI: 10.1186/s12968-022-00882-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 08/04/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Accurate evaluation of valvular pathology is crucial in the timing of surgical intervention. Whilst transthoracic echocardiography is widely available and routinely used in the assessment of valvular heart disease, it is bound by several limitations. Although cardiovascular magnetic resonance (CMR) imaging can overcome many of the challenges encountered by echocardiography, it also has a number of limitations. MAIN TEXT 4D Flow CMR is a novel technique, which allows time-resolved, 3-dimensional imaging. It enables visualisation and direct quantification of flow and peak velocities of all valves simultaneously in one simple acquisition, without any geometric assumptions. It also has the unique ability to measure advanced haemodynamic parameters such as turbulent kinetic energy, viscous energy loss rate and wall shear stress, which may add further diagnostic and prognostic information. Although 4D Flow CMR acquisition can take 5-10 min, emerging acceleration techniques can significantly reduce scan times, making 4D Flow CMR applicable in contemporary clinical practice. CONCLUSION 4D Flow CMR is an emerging CMR technique, which has the potential to become the new reference-standard method for the evaluation of valvular lesions. In this review, we describe the clinical applications, advantages and disadvantages of 4D Flow CMR in the assessment of valvular heart disease.
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Affiliation(s)
- Miroslawa Gorecka
- Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, LS2 9JT, UK
| | - Malenka M Bissell
- Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, LS2 9JT, UK
| | | | - Pankaj Garg
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - Sven Plein
- Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, LS2 9JT, UK
| | - John P Greenwood
- Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, LS2 9JT, UK.
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4
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Isoda H, Fukuyama A. Quality Control for 4D Flow MR Imaging. Magn Reson Med Sci 2022; 21:278-292. [PMID: 35197395 PMCID: PMC9680545 DOI: 10.2463/mrms.rev.2021-0165] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 01/08/2022] [Indexed: 01/06/2023] Open
Abstract
In recent years, 4D flow MRI has become increasingly important in clinical applications for the blood vessels in the whole body, heart, and cerebrospinal fluid. 4D flow MRI has advantages over 2D cine phase-contrast (PC) MRI in that any targeted area of interest can be analyzed post-hoc, but there are some factors to be considered, such as ensuring measurement accuracy, a long imaging time and post-processing complexity, and interobserver variability.Due to the partial volume phenomenon caused by low spatial and temporal resolutions, the accuracy of flow measurement in 4D flow MRI is reduced. For spatial resolution, it is recommended to include at least four voxels in the vessel of interest, and if possible, six voxels. In large vessels such as the aorta, large voxels can be secured and SNR can be maintained, but in small cerebral vessels, SNR is reduced, resulting in reduced accuracy. A temporal resolution of less than 40 ms is recommended. The velocity-to-noise ratio (VNR) of low-velocity blood flow is low, resulting in poor measurement accuracy. The use of dual velocity encoding (VENC) or multi-VENC is recommended to avoid velocity wrap around and to increase VNR. In order to maintain sufficient spatio-temporal resolution, a longer imaging time is required, leading to potential patient movement during examination and a corresponding decrease in measurement accuracy.For the clinical application of new technologies, including various acceleration techniques, in vitro and in vivo accuracy verification based on existing accuracy-validated 2D cine PC MRI and 4D flow MRI, as well as accuracy verification on the conservation of mass' principle, should be performed, and intraobserver repeatability, interobserver reproducibility, and test-retest reproducibility should be checked.
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Affiliation(s)
- Haruo Isoda
- Brain and Mind Research Center, Nagoya University, Nagoya, Aichi, Japan
- Biomedical Imaging Sciences, Department of Integrated Health Sciences, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Atsushi Fukuyama
- Faculty of Health Sciences, Department of Radiological Sciences, Japan Healthcare University, Sapporo, Hokkaido, Japan
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5
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Doyle CM, Orr J, Greenwood JP, Plein S, Tsoumpas C, Bissell MM. Four-Dimensional Flow Magnetic Resonance Imaging in the Assessment of Blood Flow in the Heart and Great Vessels: A Systematic Review. J Magn Reson Imaging 2021; 55:1301-1321. [PMID: 34416048 DOI: 10.1002/jmri.27874] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2021] [Revised: 07/22/2021] [Accepted: 07/23/2021] [Indexed: 12/28/2022] Open
Abstract
Four-dimensional (4D) flow magnetic resonance imaging (MRI) allows multidirectional quantification of blood flow in the heart and great vessels. Comparability of the technique to the current reference standards of flow assessment-two-dimensional (2D) flow MRI and Doppler echocardiography-varies in the literature. Image acquisition parameters likely impact upon the accuracy and reproducibility of 4D flow MRI. We therefore sought to review the current literature on 4D flow MRI in the heart and great vessels, in comparison to 2D flow MRI, Doppler echocardiography, and invasive catheterization. Using a predefined search strategy and inclusion and exclusion criteria, the databases EMBASE and Medline were searched in January 2021 for peer-reviewed research articles comparing cardiac 4D flow MRI to 2D flow MRI, Doppler echocardiography and/or invasive catheterization. The data from all relevant articles were assimilated and analyzed using Mann-Whitney U and chi χ2 test. Forty-four manuscripts met the eligibility criteria and were included in the review. The review showed agreement of 4D flow MRI to the reference standard methods of flow assessment, particular in the measurement of peak velocity and stroke volume in 55% of manuscripts. The use of valve tracking significantly improves agreement between 4D flow MRI and the reference modalities (79% matching with the use of valve tracking vs. 50% without, P = 0.04). This review highlights that the impact of acquisition parameters on 4D flow MRI accuracy is multifactorial. It is therefore important that each center conducts its own quality assurance prior to using 4D flow MRI for clinical decision-making. LEVEL OF EVIDENCE: 2 TECHNICAL EFFICACY: Stage 2.
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Affiliation(s)
- Ciara M Doyle
- Department of Biomedical Imaging Science, Leeds Institute of Cardiovascular and Metabolic Medicine, UK
| | - Jenny Orr
- Department of Biomedical Imaging Science, Leeds Institute of Cardiovascular and Metabolic Medicine, UK
| | - John P Greenwood
- Department of Biomedical Imaging Science, Leeds Institute of Cardiovascular and Metabolic Medicine, UK
| | - Sven Plein
- Department of Biomedical Imaging Science, Leeds Institute of Cardiovascular and Metabolic Medicine, UK
| | - Charalampos Tsoumpas
- Department of Biomedical Imaging Science, Leeds Institute of Cardiovascular and Metabolic Medicine, UK.,Biomedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Malenka M Bissell
- Department of Biomedical Imaging Science, Leeds Institute of Cardiovascular and Metabolic Medicine, UK
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6
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Kroeger JR, Pavesio FC, Mörsdorf R, Weiss K, Bunck AC, Baeßler B, Maintz D, Giese D. Velocity quantification in 44 healthy volunteers using accelerated multi-VENC 4D flow CMR. Eur J Radiol 2021; 137:109570. [PMID: 33596498 DOI: 10.1016/j.ejrad.2021.109570] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Accepted: 01/25/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND To evaluate the feasibility of a k-t accelerated multi-VENC 4D phase contrast flow MRI acquisition of the main heart-surrounding vessels, its benefits over a traditional single-VENC acquisition and to present reference flow and velocity values in a large cohort of volunteers. METHODS 44 healthy volunteers were examined on a 3 T MRI scanner (Ingenia, Philips, Best, The Netherlands). 4D flow measurements were obtained with a FOV including the aorta and the pulmonary arteries. VENC values were set to 40, 100 and 200 cm/s and unfolded based on an MRI signal model. Unfolded multi-VENC data was compared to the single-VENC with VENC 200 cm/s. Flow and velocity quantification was performed in several regions of interest (ROI) placed in the ascending aorta and in the main pulmonary artery. Conservation of mass analysis was performed for single- and multi-VENC datasets. Values for mean and maximal flow velocity and stroke volume were calculated and compared to the literature. RESULTS Mean scan time was 13.8 ± 4 min. Differences between stroke volumes between the ascending aorta and the main pulmonary artery were significantly lower in multi-VENC datasets compared to single-VENC datasets (9.6 ± 7.8 mL vs. 25.4 ± 26.4 mL, p < 0.001). This was also true for differences in stroke volume between up- and downstream ROIs in the ascending aorta and pulmonary artery. Values for mean and maximal velocities and stroke volume were in-line with previous studies. To highlight potential clinical applications two exemplary 4D flow measurements in patients with different pathologies are shown and compared to single-VENC datasets. CONCLUSIONS k-t accelerated multi-VENC 4D phase contrast flow MRI acquisition of the great vessels is feasible in a clinically acceptable scan duration. It offers improvements over traditional single-VENC 4D flow, expectedly being valuable when vessels with different flow velocities or complex flow phenomena are evaluated.
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Affiliation(s)
- Jan Robert Kroeger
- Department of Radiology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany; Department of Radiology, Neuroradiology and Nuclear Medicine, Johannes Wesling University Hospital, Ruhr University Bochum, Germany.
| | - Francesca Claudia Pavesio
- Department of Radiology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany.
| | - Richard Mörsdorf
- Department of Radiology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany.
| | - Kilian Weiss
- Department of Radiology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany; Philips GmbH, Hamburg, Germany.
| | - Alexander Christian Bunck
- Department of Radiology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany.
| | - Bettina Baeßler
- Department of Radiology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany; Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Zurich, Switzerland.
| | - David Maintz
- Department of Radiology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany.
| | - Daniel Giese
- Department of Radiology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany.
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7
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Neuhaus E, Weiss K, Bastkowski R, Koopmann J, Maintz D, Giese D. Accelerated aortic 4D flow cardiovascular magnetic resonance using compressed sensing: applicability, validation and clinical integration. J Cardiovasc Magn Reson 2019; 21:65. [PMID: 31638997 PMCID: PMC6802342 DOI: 10.1186/s12968-019-0573-0] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Accepted: 08/29/2019] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND Three-dimensional time-resolved phase-contrast cardiovascular magnetic resonance (4D flow CMR) enables the quantification and visualisation of blood flow, but its clinical applicability remains hampered by its long scan time. The aim of this study was to evaluate the use of compressed sensing (CS) with on-line reconstruction to accelerate the acquisition and reconstruction of 4D flow CMR of the thoracic aorta. METHODS 4D flow CMR of the thoracic aorta was acquired in 20 healthy subjects using CS with acceleration factors ranging from 4 to 10. As a reference, conventional parallel imaging (SENSE) with acceleration factor 2 was used. Flow curves, net flows, peak flows and peak velocities were extracted from six contours along the aorta. To measure internal data consistency, a quantitative particle trace analysis was performed. Additionally, scan-rescan, inter- and intraobserver reproducibility were assessed. Subsequently, 4D flow CMR with CS factor 6 was acquired in 3 patients with differing aortopathies. The flow patterns resulting from particle trace visualisation were qualitatively analysed. RESULTS All collected data were successfully acquired and reconstructed on-line. The average acquisition time including respiratory navigator efficiency with CS factor 6 was 5:02 ± 2:23 min while reconstruction took approximately 9 min. For CS factors of 8 or less, mean differences in net flow, peak flow and peak velocity as compared to SENSE were below 2.2 ± 7.8 ml/cycle, 4.6 ± 25.2 ml/s and - 7.9 ± 13.0 cm/s, respectively. For a CS factor of 10 differences reached 5.4 ± 8.0 ml/cycle, 14.4 ± 28.3 ml/s and - 4.0 ± 12.2 cm/s. Scan-rescan analysis yielded mean differences in net flow of - 0.7 ± 4.9 ml/cycle for SENSE and - 0.2 ± 8.5 ml/cycle for CS factor of 6. CONCLUSIONS A six- to eightfold acceleration of 4D flow CMR using CS is feasible. Up to a CS acceleration rate of 6, no statistically significant differences in measured flow parameters could be observed with respect to the reference technique. Acquisitions in patients with aortopathies confirm the potential to integrate the proposed method in a clinical routine setting, whereby its main benefits are scan-time savings and direct on-line reconstruction.
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Affiliation(s)
- Elisabeth Neuhaus
- Institute for Diagnostic and Interventional Radiology, University of Cologne, Faculty of Medicine and University Hospital of Cologne, Kerpener Str. 62, 50937 Cologne, Germany
| | - Kilian Weiss
- Institute for Diagnostic and Interventional Radiology, University of Cologne, Faculty of Medicine and University Hospital of Cologne, Kerpener Str. 62, 50937 Cologne, Germany
- Philips GmbH, Hamburg, Germany
| | - Rene Bastkowski
- Institute for Diagnostic and Interventional Radiology, University of Cologne, Faculty of Medicine and University Hospital of Cologne, Kerpener Str. 62, 50937 Cologne, Germany
| | - Jonas Koopmann
- Institute for Diagnostic and Interventional Radiology, University of Cologne, Faculty of Medicine and University Hospital of Cologne, Kerpener Str. 62, 50937 Cologne, Germany
| | - David Maintz
- Institute for Diagnostic and Interventional Radiology, University of Cologne, Faculty of Medicine and University Hospital of Cologne, Kerpener Str. 62, 50937 Cologne, Germany
| | - Daniel Giese
- Institute for Diagnostic and Interventional Radiology, University of Cologne, Faculty of Medicine and University Hospital of Cologne, Kerpener Str. 62, 50937 Cologne, Germany
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8
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Bock J, Töger J, Bidhult S, Markenroth Bloch K, Arvidsson P, Kanski M, Arheden H, Testud F, Greiser A, Heiberg E, Carlsson M. Validation and reproducibility of cardiovascular 4D-flow MRI from two vendors using 2 × 2 parallel imaging acceleration in pulsatile flow phantom and in vivo with and without respiratory gating. Acta Radiol 2019; 60:327-337. [PMID: 30479136 PMCID: PMC6402051 DOI: 10.1177/0284185118784981] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Background 4D-flow magnetic resonance imaging (MRI) is increasingly used. Purpose To validate 4D-flow sequences in phantom and in vivo, comparing volume flow
and kinetic energy (KE) head-to-head, with and without respiratory
gating. Material and Methods Achieva dStream (Philips Healthcare) and MAGNETOM Aera (Siemens Healthcare)
1.5-T scanners were used. Phantom validation measured pulsatile,
three-dimensional flow with 4D-flow MRI and laser particle imaging
velocimetry (PIV) as reference standard. Ten healthy participants underwent
three cardiac MRI examinations each, consisting of cine-imaging, 2D-flow
(aorta, pulmonary artery), and 2 × 2 accelerated 4D-flow with (Resp+) and
without (Resp−) respiratory gating. Examinations were acquired consecutively
on both scanners and one examination repeated within two weeks. Volume flow
in the great vessels was compared between 2D- and 4D-flow. KE were
calculated for all time phases and voxels in the left ventricle. Results Phantom results showed high accuracy and precision for both scanners.
In vivo, higher accuracy and precision (P < 0.001) was
found for volume flow for the Aera prototype with Resp+ (–3.7 ± 10.4 mL,
r = 0.89) compared to the Achieva product sequence (–17.8 ± 18.6 mL,
r = 0.56). 4D-flow Resp− on Aera had somewhat larger bias (–9.3 ± 9.6 mL,
r = 0.90) compared to Resp+ (P = 0.005). KE measurements
showed larger differences between scanners on the same day compared to the
same scanner at different days. Conclusion Sequence-specific in vivo validation of 4D-flow is needed before clinical
use. 4D-flow with the Aera prototype sequence with a clinically acceptable
acquisition time (<10 min) showed acceptable bias in healthy controls to
be considered for clinical use. Intra-individual KE comparisons should use
the same sequence.
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Affiliation(s)
- Jelena Bock
- Department of Clinical Sciences, Lund University, Clinical Physiology, Skåne University Hospital, Lund, Sweden
| | - Johannes Töger
- Department of Clinical Sciences, Lund University, Clinical Physiology, Skåne University Hospital, Lund, Sweden
- Department of Diagnostic Radiology, Lund University, Skåne University Hospital, Lund, Sweden
| | - Sebastian Bidhult
- Department of Clinical Sciences, Lund University, Clinical Physiology, Skåne University Hospital, Lund, Sweden
- Department of Biomedical Engineering, Faculty of Engineering, Lund University, Lund, Sweden
| | - Karin Markenroth Bloch
- Philips Healthcare, Lund, Sweden
- Lund University Bioimaging Center, Lund University, Lund, Sweden
| | - Per Arvidsson
- Department of Clinical Sciences, Lund University, Clinical Physiology, Skåne University Hospital, Lund, Sweden
| | - Mikael Kanski
- Department of Clinical Sciences, Lund University, Clinical Physiology, Skåne University Hospital, Lund, Sweden
| | - Håkan Arheden
- Department of Clinical Sciences, Lund University, Clinical Physiology, Skåne University Hospital, Lund, Sweden
| | | | | | - Einar Heiberg
- Department of Clinical Sciences, Lund University, Clinical Physiology, Skåne University Hospital, Lund, Sweden
- Department of Biomedical Engineering, Faculty of Engineering, Lund University, Lund, Sweden
| | - Marcus Carlsson
- Department of Clinical Sciences, Lund University, Clinical Physiology, Skåne University Hospital, Lund, Sweden
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9
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Ma LE, Markl M, Chow K, Huh H, Forman C, Vali A, Greiser A, Carr J, Schnell S, Barker AJ, Jin N. Aortic 4D flow MRI in 2 minutes using compressed sensing, respiratory controlled adaptive k-space reordering, and inline reconstruction. Magn Reson Med 2019; 81:3675-3690. [PMID: 30803006 DOI: 10.1002/mrm.27684] [Citation(s) in RCA: 66] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Revised: 01/14/2019] [Accepted: 01/15/2019] [Indexed: 01/09/2023]
Abstract
PURPOSE To evaluate the accuracy and feasibility of a free-breathing 4D flow technique using compressed sensing (CS), where 4D flow imaging of the thoracic aorta is performed in 2 min with inline image reconstruction on the MRI scanner in less than 5 min. METHODS The 10 in vitro 4D flow MRI scans were performed with different acceleration rates on a pulsatile flow phantom (9 CS acceleration factors [R = 5.4-14.1], 1 generalized autocalibrating partially parallel acquisition [GRAPPA] R = 2). Based on in vitro results, CS-accelerated 4D flow of the thoracic aorta was acquired in 20 healthy volunteers (38.3 ± 15.2 years old) and 11 patients with aortic disease (61.3 ± 15.1 years) with R = 7.7. A conventional 4D flow scan was acquired with matched spatial coverage and temporal resolution. RESULTS CS depicted similar hemodynamics to conventional 4D flow in vitro, and in vivo, with >70% reduction in scan time (volunteers: 1:52 ± 0:25 versus 7:25 ± 2:35 min). Net flow values were within 3.5% in healthy volunteers, and voxel-by-voxel comparison demonstrated good agreement. CS significantly underestimated peak velocities (vmax ) and peak flow (Qmax ) in both volunteers and patients (volunteers: vmax , -16.2% to -9.4%, Qmax : -11.6% to -2.9%, patients: vmax , -11.2% to -4.0%; Qmax , -10.2% to -5.8%). CONCLUSION Aortic 4D flow with CS is feasible in a two minute scan with less than 5 min for inline reconstruction. While net flow agreement was excellent, CS with R = 7.7 produced underestimation of Qmax and vmax ; however, these were generally within 13% of conventional 4D flow-derived values. This approach allows 4D flow to be feasible in clinical practice for comprehensive assessment of hemodynamics.
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Affiliation(s)
- Liliana E Ma
- Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.,Department of Biomedical Engineering, Northwestern University, Chicago, Illinois
| | - Michael Markl
- Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.,Department of Biomedical Engineering, Northwestern University, Chicago, Illinois
| | - Kelvin Chow
- Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.,Cardiovascular MR R&D, Siemens Medical Solutions USA, Inc, Chicago, Illinois
| | - Hyungkyu Huh
- Daegu-Gyeongbuk Medical Innovation Foundation, Medical Device Development Center, Daegu, South Korea
| | | | - Alireza Vali
- Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | | | - James Carr
- Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Susanne Schnell
- Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Alex J Barker
- Department of Radiology, Children's Hospital Colorado, University of Colorado, Anschutz Medical Campus, Denver, Colorado.,Department of Bioengineering, University of Colorado, Anschutz Medical Campus, Denver, Colorado
| | - Ning Jin
- Cardiovascular MR R&D, Siemens Medical Solutions USA, Inc, Cleveland, Ohio
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10
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Garg P, Westenberg JJM, van den Boogaard PJ, Swoboda PP, Aziz R, Foley JRJ, Fent GJ, Tyl FGJ, Coratella L, ElBaz MSM, van der Geest RJ, Higgins DM, Greenwood JP, Plein S. Comparison of fast acquisition strategies in whole-heart four-dimensional flow cardiac MR: Two-center, 1.5 Tesla, phantom and in vivo validation study. J Magn Reson Imaging 2017; 47:272-281. [PMID: 28470915 PMCID: PMC5801550 DOI: 10.1002/jmri.25746] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Accepted: 04/07/2017] [Indexed: 01/02/2023] Open
Abstract
Purpose To validate three widely‐used acceleration methods in four‐dimensional (4D) flow cardiac MR; segmented 4D‐spoiled‐gradient‐echo (4D‐SPGR), 4D‐echo‐planar‐imaging (4D‐EPI), and 4D‐k‐t Broad‐use Linear Acquisition Speed‐up Technique (4D‐k‐t BLAST). Materials and Methods Acceleration methods were investigated in static/pulsatile phantoms and 25 volunteers on 1.5 Tesla MR systems. In phantoms, flow was quantified by 2D phase‐contrast (PC), the three 4D flow methods and the time‐beaker flow measurements. The later was used as the reference method. Peak velocity and flow assessment was done by means of all sequences. For peak velocity assessment 2D PC was used as the reference method. For flow assessment, consistency between mitral inflow and aortic outflow was investigated for all pulse‐sequences. Visual grading of image quality/artifacts was performed on a four‐point‐scale (0 = no artifacts; 3 = nonevaluable). Results For the pulsatile phantom experiments, the mean error for 2D PC = 1.0 ± 1.1%, 4D‐SPGR = 4.9 ± 1.3%, 4D‐EPI = 7.6 ± 1.3% and 4D‐k‐t BLAST = 4.4 ± 1.9%. In vivo, acquisition time was shortest for 4D‐EPI (4D‐EPI = 8 ± 2 min versus 4D‐SPGR = 9 ± 3 min, P < 0.05 and 4D‐k‐t BLAST = 9 ± 3 min, P = 0.29). 4D‐EPI and 4D‐k‐t BLAST had minimal artifacts, while for 4D‐SPGR, 40% of aortic valve/mitral valve (AV/MV) assessments scored 3 (nonevaluable). Peak velocity assessment using 4D‐EPI demonstrated best correlation to 2D PC (AV:r = 0.78, P < 0.001; MV:r = 0.71, P < 0.001). Coefficient of variability (CV) for net forward flow (NFF) volume was least for 4D‐EPI (7%) (2D PC:11%, 4D‐SPGR: 29%, 4D‐k‐t BLAST: 30%, respectively). Conclusion In phantom, all 4D flow techniques demonstrated mean error of less than 8%. 4D‐EPI demonstrated the least susceptibility to artifacts, good image quality, modest agreement with the current reference standard for peak intra‐cardiac velocities and the highest consistency of intra‐cardiac flow quantifications. Level of Evidence: 1 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2018;47:272–281.
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Affiliation(s)
- Pankaj Garg
- Leeds Institute of Cardiovascular and Metabolic Medicine (LICAMM), University of Leeds, Leeds, United Kingdom
| | | | | | - Peter P Swoboda
- Leeds Institute of Cardiovascular and Metabolic Medicine (LICAMM), University of Leeds, Leeds, United Kingdom
| | - Rahoz Aziz
- Leeds Institute of Cardiovascular and Metabolic Medicine (LICAMM), University of Leeds, Leeds, United Kingdom
| | - James R J Foley
- Leeds Institute of Cardiovascular and Metabolic Medicine (LICAMM), University of Leeds, Leeds, United Kingdom
| | - Graham J Fent
- Leeds Institute of Cardiovascular and Metabolic Medicine (LICAMM), University of Leeds, Leeds, United Kingdom
| | - F G J Tyl
- Leiden University Medical Center, Leiden, The Netherlands
| | - L Coratella
- Leiden University Medical Center, Leiden, The Netherlands
| | | | | | | | - John P Greenwood
- Leeds Institute of Cardiovascular and Metabolic Medicine (LICAMM), University of Leeds, Leeds, United Kingdom
| | - Sven Plein
- Leeds Institute of Cardiovascular and Metabolic Medicine (LICAMM), University of Leeds, Leeds, United Kingdom
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11
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Bollache E, Barker AJ, Dolan RS, Carr JC, van Ooij P, Ahmadian R, Powell A, Collins JD, Geiger J, Markl M. k-t accelerated aortic 4D flow MRI in under two minutes: Feasibility and impact of resolution, k-space sampling patterns, and respiratory navigator gating on hemodynamic measurements. Magn Reson Med 2017; 79:195-207. [PMID: 28266062 DOI: 10.1002/mrm.26661] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2016] [Revised: 02/08/2017] [Accepted: 02/08/2017] [Indexed: 01/29/2023]
Abstract
PURPOSE To assess the performance of highly accelerated free-breathing aortic four-dimensional (4D) flow MRI acquired in under 2 minutes compared to conventional respiratory gated 4D flow. METHODS Eight k-t accelerated nongated 4D flow MRI (parallel MRI with extended and averaged generalized autocalibrating partially parallel acquisition kernels [PEAK GRAPPA], R = 5, TRes = 67.2 ms) using four ky -kz Cartesian sampling patterns (linear, center-out, out-center-out, random) and two spatial resolutions (SRes1 = 3.5 × 2.3 × 2.6 mm3 , SRes2 = 4.5 × 2.3 × 2.6 mm3 ) were compared in vitro (aortic coarctation flow phantom) and in 10 healthy volunteers, to conventional 4D flow (16 mm-navigator acceptance window; R = 2; TRes = 39.2 ms; SRes = 3.2 × 2.3 × 2.4 mm3 ). The best k-t accelerated approach was further assessed in 10 patients with aortic disease. RESULTS The k-t accelerated in vitro aortic peak flow (Qmax), net flow (Qnet), and peak velocity (Vmax) were lower than conventional 4D flow indices by ≤4.7%, ≤ 11%, and ≤22%, respectively. In vivo k-t accelerated acquisitions were significantly shorter but showed a trend to lower image quality compared to conventional 4D flow. Hemodynamic indices for linear and out-center-out k-space samplings were in agreement with conventional 4D flow (Qmax ≤ 13%, Qnet ≤ 13%, Vmax ≤ 17%, P > 0.05). CONCLUSION Aortic 4D flow MRI in under 2 minutes is feasible with moderate underestimation of flow indices. Differences in k-space sampling patterns suggest an opportunity to mitigate image artifacts by an optimal trade-off between scan time, acceleration, and k-space sampling. Magn Reson Med 79:195-207, 2018. © 2018 International Society for Magnetic Resonance in Medicine.
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Affiliation(s)
- Emilie Bollache
- Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Alex J Barker
- Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Ryan Scott Dolan
- Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - James C Carr
- Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Pim van Ooij
- Department of Radiology, Academic Medical Center, Amsterdam, the Netherlands
| | - Rouzbeh Ahmadian
- Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Alex Powell
- Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Jeremy D Collins
- Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Julia Geiger
- Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA.,Department of Diagnostic and Interventional Radiology, University Hospital of Würzburg, Würzburg, Germany
| | - Michael Markl
- Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA.,Department of Biomedical Engineering, McCormick School of Engineering, Northwestern University, Chicago, Illinois, USA
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12
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Bollache E, van Ooij P, Powell A, Carr J, Markl M, Barker AJ. Comparison of 4D flow and 2D velocity-encoded phase contrast MRI sequences for the evaluation of aortic hemodynamics. Int J Cardiovasc Imaging 2016; 32:1529-41. [PMID: 27435230 DOI: 10.1007/s10554-016-0938-5] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Accepted: 07/09/2016] [Indexed: 01/08/2023]
Abstract
The purpose of this study was to compare aortic flow and velocity quantification using 4D flow MRI and 2D CINE phase-contrast (PC)-MRI with either one-directional (2D-1dir) or three-directional (2D-3dir) velocity encoding. 15 healthy volunteers (51 ± 19 years) underwent MRI including (1) breath-holding 2D-1dir and (2) free breathing 2D-3dir PC-MRI in planes orthogonal to the ascending (AA) and descending (DA) aorta, as well as (3) free breathing 4D flow MRI with full thoracic aorta coverage. Flow quantification included the co-registration of the 2D PC acquisition planes with 4D flow MRI data, AA and DA segmentation, and calculation of AA and DA peak systolic velocity, peak flow and net flow volume for all sequences. Additionally, the 2D-3dir velocity taking into account the through-plane component only was used to obtain results analogous to a free breathing 2D-1dir acquisition. Good agreement was found between 4D flow and 2D-3dir peak velocity (differences = -3 to 6 %), peak flow (-7 %) and net volume (-14 to -9 %). In contrast, breath-holding 2D-1dir measurements exhibited indices significantly lower than free breathing 2D-3dir and 2D-1dir (differences = -35 to -7 %, p < 0.05). Finally, high correlations (r ≥ 0.97) were obtained for indices estimated with or without eddy current correction, with the lowest correlation observed for net volume. 4D flow and 2D-3dir aortic hemodynamic indices were in concordance. However, differences between respiration state and 2D-1dir and 2D-3dir measurements indicate that reference values should be established according to the PC-MRI sequence, especially for the widely used net flow (e.g. stroke volume in the AA).
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Affiliation(s)
- Emilie Bollache
- Department of Radiology, Feinberg School of Medicine, Northwestern University, 737 N Michigan ave-Suite 1600, Chicago, IL, 60611, USA.
| | - Pim van Ooij
- Department of Radiology, Feinberg School of Medicine, Northwestern University, 737 N Michigan ave-Suite 1600, Chicago, IL, 60611, USA
| | - Alex Powell
- Department of Radiology, Feinberg School of Medicine, Northwestern University, 737 N Michigan ave-Suite 1600, Chicago, IL, 60611, USA
| | - James Carr
- Department of Radiology, Feinberg School of Medicine, Northwestern University, 737 N Michigan ave-Suite 1600, Chicago, IL, 60611, USA
| | - Michael Markl
- Department of Radiology, Feinberg School of Medicine, Northwestern University, 737 N Michigan ave-Suite 1600, Chicago, IL, 60611, USA.,Department of Biomedical Engineering, McCormick School of Engineering, Northwestern University, Chicago, IL, USA
| | - Alex J Barker
- Department of Radiology, Feinberg School of Medicine, Northwestern University, 737 N Michigan ave-Suite 1600, Chicago, IL, 60611, USA
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13
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Advanced flow MRI: emerging techniques and applications. Clin Radiol 2016; 71:779-95. [PMID: 26944696 DOI: 10.1016/j.crad.2016.01.011] [Citation(s) in RCA: 85] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2015] [Revised: 12/10/2015] [Accepted: 01/10/2016] [Indexed: 12/12/2022]
Abstract
Magnetic resonance imaging (MRI) techniques provide non-invasive and non-ionising methods for the highly accurate anatomical depiction of the heart and vessels throughout the cardiac cycle. In addition, the intrinsic sensitivity of MRI to motion offers the unique ability to acquire spatially registered blood flow simultaneously with the morphological data, within a single measurement. In clinical routine, flow MRI is typically accomplished using methods that resolve two spatial dimensions in individual planes and encode the time-resolved velocity in one principal direction, typically oriented perpendicular to the two-dimensional (2D) section. This review describes recently developed advanced MRI flow techniques, which allow for more comprehensive evaluation of blood flow characteristics, such as real-time flow imaging, 2D multiple-venc phase contrast MRI, four-dimensional (4D) flow MRI, quantification of complex haemodynamic properties, and highly accelerated flow imaging. Emerging techniques and novel applications are explored. In addition, applications of these new techniques for the improved evaluation of cardiovascular (aorta, pulmonary arteries, congenital heart disease, atrial fibrillation, coronary arteries) as well as cerebrovascular disease (intra-cranial arteries and veins) are presented.
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14
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Zhang T, Grafendorfer T, Cheng JY, Ning P, Rainey B, Giancola M, Ortman S, Robb FJ, Calderon PD, Hargreaves BA, Lustig M, Scott GC, Pauly JM, Vasanawala SS. A semiflexible 64-channel receive-only phased array for pediatric body MRI at 3T. Magn Reson Med 2015; 76:1015-21. [PMID: 26418283 DOI: 10.1002/mrm.25999] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2015] [Revised: 08/25/2015] [Accepted: 09/01/2015] [Indexed: 12/25/2022]
Abstract
PURPOSE To design, construct, and validate a semiflexible 64-channel receive-only phased array for pediatric body MRI at 3T. METHODS A 64-channel receive-only phased array was developed and constructed. The designed flexible coil can easily conform to different patient sizes with nonoverlapping coil elements in the transverse plane. It can cover a field of view of up to 44 × 28 cm(2) and removes the need for coil repositioning for body MRI patients with multiple clinical concerns. The 64-channel coil was compared with a 32-channel standard coil for signal-to-noise ratio and parallel imaging performances on different phantoms. With IRB approval and informed consent/assent, the designed coil was validated on 21 consecutive pediatric patients. RESULTS The pediatric coil provided higher signal-to-noise ratio than the standard coil on different phantoms, with the averaged signal-to-noise ratio gain at least 23% over a depth of 7 cm along the cross-section of phantoms. It also achieved better parallel imaging performance under moderate acceleration factors. Good image quality (average score 4.6 out of 5) was achieved using the developed pediatric coil in the clinical studies. CONCLUSION A 64-channel semiflexible receive-only phased array has been developed and validated to facilitate high quality pediatric body MRI at 3T. Magn Reson Med 76:1015-1021, 2016. © 2015 Wiley Periodicals, Inc.
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Affiliation(s)
- Tao Zhang
- Department of Radiology, Stanford University, Stanford, California, USA.,Department of Electrical Engineering, Stanford University, Stanford, California, USA
| | | | - Joseph Y Cheng
- Department of Radiology, Stanford University, Stanford, California, USA.,Department of Electrical Engineering, Stanford University, Stanford, California, USA
| | - Peigang Ning
- Department of Radiology, Stanford University, Stanford, California, USA
| | | | | | | | | | - Paul D Calderon
- Department of Radiology, Stanford University, Stanford, California, USA
| | - Brian A Hargreaves
- Department of Radiology, Stanford University, Stanford, California, USA.,Department of Electrical Engineering, Stanford University, Stanford, California, USA
| | - Michael Lustig
- Department of Electrical Engineering, Stanford University, Stanford, California, USA.,Department of Electrical Engineering and Computer Sciences, University of California, Berkeley, California, USA
| | - Greig C Scott
- Department of Electrical Engineering, Stanford University, Stanford, California, USA
| | - John M Pauly
- Department of Electrical Engineering, Stanford University, Stanford, California, USA
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