Real-time MR fluoroscopic data acquisition and image reconstruction

MRI-guided endovascular intervention: current methods and future potential

INTRODUCTION

Image-guided endovascular interventions, performed using the insertion and navigation of catheters through the vasculature, have been increasing in number over the years, as minimally invasive procedures continue to replace invasive surgical procedures. Such endovascular interventions are almost exclusively performed under x-ray fluoroscopy, which has the best spatial and temporal resolution of all clinical imaging modalities. Magnetic resonance imaging (MRI) offers unique advantages and could be an attractive alternative to conventional x-ray guidance, but also brings with it distinctive challenges.

AREAS COVERED

In this review, the benefits and limitations of MRI-guided endovascular interventions are addressed, systems and devices for guiding such interventions are summarized, and clinical applications are discussed.

EXPERT OPINION

MRI-guided endovascular interventions are still relatively new to the interventional radiology field, since significant technical hurdles remain to justify significant costs and demonstrate safety, design, and robustness. Clinical applications of MRI-guided interventions are promising but their full potential may not be realized until proper tools designed to function in the MRI environment are available. Translational research and further preclinical studies are needed before MRI-guided interventions will be practical in a clinical interventional setting.

Parallel imaging with nonlinear reconstruction using variational penalties

A new approach based on nonlinear inversion for autocalibrated parallel imaging with arbitrary sampling patterns is presented. By extending the iteratively regularized Gauss-Newton method with variational penalties, the improved reconstruction quality obtained from joint estimation of image and coil sensitivities is combined with the superior noise suppression of total variation and total generalized variation regularization. In addition, the proposed approach can lead to enhanced removal of sampling artifacts arising from pseudorandom and radial sampling patterns. This is demonstrated for phantom and in vivo measurements.

Large field-of-view real-time MRI with a 32-channel system

The emergence of parallel MRI techniques and new applications for real-time interactive MRI underscores the need to evaluate performance gained by increasing the capability of MRI phased-array systems beyond the standard four to eight high-bandwidth channels. Therefore, to explore the advantages of highly parallel MRI a 32-channel 1.5 T MRI system and 32-element torso phased arrays were designed and constructed for real-time interactive MRI. The system was assembled from multiple synchronized scanner-receiver subsystems. Software was developed to coordinate across subsystems the real-time acquisition, reconstruction, and display of 32-channel images. Real-time, large field-of-view (FOV) body-survey imaging was performed using interleaved echo-planar and single-shot fast-spin-echo pulse sequences. A new method is demonstrated for augmenting parallel image acquisition by independently offsetting the frequency of different array elements (FASSET) to variably shift their FOV. When combined with conventional parallel imaging techniques, image acceleration factors of up to 4 were investigated. The use of a large number of coils allowed the FOV to be doubled in two dimensions during rapid imaging, with no degradation of imaging time or spatial resolution. The system provides a platform for evaluating the applications of many-channel real-time MRI, and for understanding the factors that optimize the choice of array size.

Reduced field-of-view MRI with two-dimensional spatially-selective RF excitation and UNFOLD

When the region of interest (ROI) is smaller than the object, one can increase MRI speed by reducing the imaging field of view (FOV). However, when such an approach is used, features outside the reduced FOV will alias into the reduced-FOV image along the phase-encoding direction. Reduced-FOV methods are designed to correct this aliasing problem. In the present study, we propose a combination of two different approaches to reduce the acquired FOV: 1) two-dimensional (2D) spatially-selective RF excitation, and 2) the unaliasing by Fourier-encoding the overlaps using the temporal dimension (UNFOLD) technique. While 2D spatially-selective RF excitation can restrict the spins excited within a reduced FOV, the UNFOLD technique can help to eliminate any residual aliased signals and thus relaxes the requirement for a long RF excitation pulse. This hybrid method was implemented for MR-based temperature mapping, and resulted in artifact-free images with a fourfold improvement in temporal resolution.

Imaging freely moving subjects using continuous interleaved orthogonal magnetic resonance imaging

Magnetic resonance imaging has shown increasing clinical utility for the diagnosis of abnormalities in fetal development. MRI is not yet as effective for fetal imaging as ultrasound because of the difficulty of imaging freely moving subjects. We describe a design approach to overcome this difficulty. By interleaving orthogonal images of a subject, it is possible to rapidly and interactively localize the scan plane in a moving subject and confirm image plane orientation relative to the subject. We derive the equations necessary to optimize the tip angles for the acquisition of the orthogonal images so as to minimize artifact in the main image despite the long T1 of a fluid environment (e.g., amniotic fluid). To fully utilize the orthogonal images for rapid localization, it is critical to minimize the delay between acquisition and display, and to avoid segmented reconstruction techniques that are commonly used in high frame rate imaging. We demonstrate that this approach can be used to perform interactive scan plane localization on a moving subject and can obtain high temporal resolution images while confirming the image plane orientation relative to the subject.

Real-time accelerated interactive MRI with adaptive TSENSE and UNFOLD

Reduced field-of-view (FOV) acceleration using time-adaptive sensitivity encoding (TSENSE) or unaliasing by Fourier encoding the overlaps using the temporal dimension (UNFOLD) can improve the depiction of motion in real-time MRI. However, increased computational resources are required to maintain a high frame rate and low latency in image reconstruction and display. A high-performance software system has been implemented to perform TSENSE and UNFOLD reconstructions for real-time MRI with interactive, on-line display. Images were displayed in the scanner room to investigate image-guided procedures. Examples are shown for normal volunteers and cardiac interventional experiments in animals using a steady-state free precession (SSFP) sequence. In order to maintain adequate image quality for interventional procedures, the imaging rate was limited to seven frames per second after an acceleration factor of 2 with a voxel size of 1.8 x 3.5 x 8 mm. Initial experiences suggest that TSENSE and UNFOLD can each improve the compromise between spatial and temporal resolution in real-time imaging, and can function well in interactive imaging. UNFOLD places no additional constraints on receiver coils, and is therefore more flexible than SENSE methods; however, the temporal image filtering can blur motion and reduce the effective acceleration. Methods are proposed to overcome the challenges presented by the use of TSENSE in interactive imaging. TSENSE may be temporarily disabled after changing the imaging plane to avoid transient artifacts as the sensitivity coefficients adapt. For imaging with a combination of surface and interventional coils, a hybrid reconstruction approach is proposed whereby UNFOLD is used for the interventional coils, and TSENSE with or without UNFOLD is used for the surface coils.

Real-time imaging of two-dimensional cardiac strain using a harmonic phase magnetic resonance imaging (HARP-MRI) pulse sequence

The harmonic phase (HARP) method provides automatic and rapid analysis of tagged magnetic resonance (MR) images for quantification and visualization of myocardial strain. In this article, the development and implementation of a pulse sequence that acquires HARP images in real time are described. In this pulse sequence, a CINE sequence of images with 1-1 spatial modulation of magnetization (SPAMM) tags are acquired during each cardiac cycle, alternating between vertical and horizontal tags in successive heartbeats. An incrementing train of imaging RF flip angles is used to compensate for the decay of the harmonic peaks due to both T(1) relaxation and the applied imaging pulses. The magnitude images displaying coarse anatomy are automatically reconstructed and displayed in real time after each heartbeat. HARP strain images are generated offline at a rate of four images per second; real-time processing should be possible with faster algorithms or computers. A comparison of myocardial contractility in non-breath-hold and breath-hold experiments in normal humans is presented.

Optical on-line running reconstruction of MR-images in the phase-scrambling Fourier-imaging technique

Recently, the use of magnetic-resonance-guided navigation to improve the safety and effectiveness of surgical procedures has shown great promise. The purpose of the present study was to develop and demonstrate an imaging strategy that allows surgeons to continue operating without delays caused by imaging. The phase-scrambling Fourier-imaging technique has two prominent characteristics: localized image reconstruction and holographic image reconstruction. The combination of these characteristics allows images to be observed even during the data-acquisition period, because the acquired signal is converted into a hologram and the image is reconstructed instantly in the coherent optical image-processing system. Experimental studies have shown that the phase-scrambling Fourier-imaging technique enables the motion of objects to be imaged more quickly than the standard fast imaging. The proposed running reconstruction strategy can be easily implemented in the well-established magnetic-resonance imaging equipment that is currently in use.

Interactive body magnetic resonance fluoroscopy using modified single-shot half-Fourier rapid acquisition with relaxation enhancement (RARE) with multiparameter control

PURPOSE

To develop a technique for interactive fluoroscopic abdominal magnetic resonance imaging (MRI) based on a single-shot half-Fourier rapid acquisition and relaxation-enhanced sequence.

MATERIALS AND METHODS

The sequence was modified by incorporating inner-volume excitation, driven-equilibrium signal enhancement, and reduced flip angle refocusing pulses. Contrast control was provided by integrating "on-the-fly" selection of phase encoding view order, fat suppression, and section thickness. The resulting sequence was evaluated with phantom experiments to quantify the signal-to-noise ratio (SNR) effects of the modifications and in healthy volunteers for imaging the bile ducts, stomach, and duodenum using water and gaseous contrast media.

RESULTS

Observed SNR relating to driven-equilibrium and flip angle scaling matched theoretical predictions. Volunteer examinations demonstrated the ability of the modified sequence to provide interactive, artifact-free imaging of the abdomen, including switching between conventional proton density-weighted, T2-weighted imaging and "hydrographic" projection imaging.

CONCLUSION

Refinement of this technique may provide an abdomino-pelvic imaging capability similar in concept to real-time ultrasound, but with the advantages of MRI.

A truly hybrid interventional MR/X-ray system: feasibility demonstration

A system enabling both x-ray fluoroscopy and MRI in a single exam, without requiring patient repositioning, would be a powerful tool for image-guided interventions. We studied the technical issues related to acquisition of x-ray images inside an open MRI system (GE Signa SP). The system includes a flat-panel x-ray detector (GE Medical Systems) placed under the patient bed, a fixed-anode x-ray tube overhead with the anode-cathode axis aligned with the main magnetic field and a high-frequency x-ray generator (Lunar Corp.). New challenges investigated related to: 1) deflection and defocusing of the electron beam of the x-ray tube; 2) proper functioning of the flat panel; 3) effects on B0 field homogeneity; and 4) additional RF noise in the MR images. We have acquired high-quality x-ray and MR images without repositioning the object using our hybrid system, which demonstrates the feasibility of this new configuration. Further work is required to ensure that the highest possible image quality is achieved with both MR and x-ray modalities.

Pulse sequences for interventional magnetic resonance imaging

Interventional magnetic resonance imaging (iMRI) is different from diagnostic magnetic resonance imaging (MRI) in its spatial, temporal, and contrast resolution requirements due to its specific clinical applications. As a result, the pulse sequences used in iMRI often are significantly different than those used in the more conventional diagnostic arena. The focus of this article is to summarize how iMRI is different from diagnostic MRI, to describe a variety of MRI pulse sequences and sequence strategies that have evolved because of these differences, and to describe some MRI sequence strategies that are in development and may be seen in future iMRI applications.

Three-dimensional contrast-enhanced MR angiography with real-time fluoroscopic triggering: design specifications and technical reliability in 330 patient studies

Technical reliability was determined for triggering three-dimensional (3D) contrast material-enhanced magnetic resonance (MR) angiography with MR fluoroscopy. Technical requirements for high reliability were also identified. Reliability was evaluated in 330 consecutive patient studies of the neck, thorax, abdomen, and pelvis. Contrast material arrival was detected fluoroscopically in 325 of the 330 studies (98.5%), and the 3D sequence was successfully triggered in 321 of 330 studies (97.3%). Fluoroscopic triggering of centrically encoded 3D MR angiographic acquisitions is a highly reliable means of obtaining 3D MR angiograms with high spatial resolution.

Prospective multiaxial motion correction for fMRI

Corruption of the image time series due to interimage head motion limits the clinical utility of functional MRI. This paper presents a method for real-time prospective correction of rotation and translation in all six degrees of rigid body motion. By incorporating an orbital navigator (ONAV) echo for each of the sagittal, axial, and coronal planes into the fMRI pulse sequence, rotation and translation can be measured and the spatial orientation of the image acquisition sequence that follows can be corrected prospectively in as little as 160 msec. Testing of the method using a computerized motion phantom capable of performing complex multiaxial motion showed subdegree rotational and submillimeter translational accuracy over a range of +/-8 degrees and +/-8 mm of motion. In vivo images demonstrate correction of simultaneous through-plane and in-plane motion and improved detection of fMRI activation in the presence of head motion.

Retrospective adaptive motion correction for navigator-gated 3D coronary MR angiography

Retrospective adaptive motion correction (AMC) was developed for reducing effects of residual respiration in real-time navigator-gated three-dimensional (3D) coronary magnetic resonance (MR) angiography. In both motion phantom and in vivo experiments, AMC improved image sharpness of coronary arteries. This navigator-based technique combining adaptive correction and real-time gating is potentially an efficient and effective motion reduction method for 3D coronary MR angiography.

A flexible view ordering technique for high-quality real-time 2DFT MR fluoroscopy

A method to tailor the view order to the reconstruction cycle is introduced for real-time MRI. It is well known that view sharing and oversampling central k-space views can improve the temporal resolution of gradient-echo pulse sequences. By ordering phase-encodes to synchronize k-space acquisition with the reconstruction cycle, apparent temporal resolution can match the frame rate with as few as one-fourth of the phase-encodes sampled per reconstruction. Spatial resolution is maintained by periodically updating high spatial frequencies. In addition to apparent temporal resolution, three other criteria for real-time imaging are identified and evaluated: display latency, dispersion, and frame-to-frame consistency. Latency is minimized by ordering views in a reverse-centric manner within each reconstruction interval, sampling high-energy views immediately prior to beginning reconstruction. Dispersion is kept low and consistent by synchronizing acquisition and reconstruction, thus avoiding poorly timed reconstruction instances. Real-time implementation demonstrates pulsatile time-of-flight blood signal enhancement in humans.

Real-time cardiac MRI using DSP's

A real-time cardiac magnetic resonance imaging (MRI) system has been implemented using digital signal processing (DSP) technology. The system enables real-time acquisition, processing, and display of ungated cardiac movies at moderate video rates of 20 images/s. A custom graphical user interface (GUI) provides interactive control of data acquisition parameters and image display functions. Images can be compressed into moving-picture experts group (MPEG) movies, but are displayed on the console without compression during the scan. Compared to existing real-time MRI systems, implementation with DSP's allows rapid parallel computations, fast data transfers, and greater system flexibility, including the ability to scale to multiple channels, at the expense of somewhat higher component cost.

Interactive three-point localization of double-oblique sections using MR fluoroscopy

Magnetic resonance imaging allows significant freedom in selecting the orientation and position of a tomographic section. However, it can nonetheless be challenging to determine quickly and efficiently the correct parameters required to image a targeted anatomic structure that may lie at an oblique angle in the imaging volume. We describe a three-point tool in which a) the user interactively selects three points from an anatomic structure of interest during live MR fluoroscopy; b) adjustments to pulse sequence are calculated to image the tomographic section defined by the three points; and c) the section is then immediately imaged fluoroscopically. The tool allows quick localization of, for example, longitudinal images of specific arterial structures.

Image guidance of endovascular interventions on a clinical MR scanner

Magnetic resonance imaging (MRI) offers potential advantages over conventional X-ray techniques for guiding and evaluating vascular interventions. Image guidance of such interventions via passive catheter tracking requires real-time image processing. Commercially available MR scanners currently do not provide this functionality. This paper describes an image processing environment that allows near-real-time MR-guided vascular interventions. It demonstrates 1) that flexibility can be achieved by separating the scanner and the image processing/display system, thereby preserving the stability of the scanner and 2) that sufficiently rapid visualization can be achieved by low-cost workstations equipped with graphics hardware. The setup of the hardware and the software is described in detail. Furthermore, image processing techniques are presented for guiding the interventionalist through simple vascular anatomy. Finally, results of a phantom balloon angioplasty experiment are presented.

Real-time image reconstruction and display system for MRI using a high-speed personal computer

A real-time NMR image reconstruction and display system was developed using a high-speed personal computer and optimized for the 32-bit multitasking Microsoft Windows 95 operating system. The system was operated at various CPU clock frequencies by changing the motherboard clock frequency and the processor/bus frequency ratio. When the Pentium CPU was used at the 200 MHz clock frequency, the reconstruction time for one 128 x 128 pixel image was 48 ms and that for the image display on the enlarged 256 x 256 pixel window was about 8 ms. NMR imaging experiments were performed with three fast imaging sequences (FLASH, multishot EPI, and one-shot EPI) to demonstrate the ability of the real-time system. It was concluded that in most cases, high-speed PC would be the best choice for the image reconstruction and display system for real-time MRI.

Interactive coronary MRI

The acquisition of complete three-dimensional (3D), segmented gradient-echo data sets to visualize the coronary arteries can be both time consuming and sensitive to motion, even with use of multiple breath-holding or respiratory gating. An alternate hybrid approach is demonstrated here, in which real-time interactive imaging is first used to locate an optimal oblique coronary scan plane. Then, a limited number of contiguous slices are acquired around that plane within a breath-hold with use of two-dimensional (2D) segmented gradient-echo imaging. Dual inversion nulling is used to suppress fat and myocardium. Finally, if needed, a limited reformat of the data is performed to produce images from relatively long sections of the coronaries. This approach yields relatively rapid visualization of portions of the coronary tree. Several different methods are compared for interactively moving the scan plane.

A prospective approach to correct for inter-image head rotation in fMRI

Global head motion occurring between successive image acquisitions during a functional MRI time series can corrupt the signal of physiologic brain activation, potentially invalidating interpretation of the final activation map from that particular fMRI time series. By approximating the head as a rigid body, multiaxial global head motion can be decomposed into orthogonal linear and rotational components. This paper describes a method using orbital navigator echoes to provide prospective correction for both through-plane and in-plane inter-image head rotation in functional MRI. The dynamic detection and correction of rotation can be performed in <100 ms. Phantom experiments demonstrate accurate correction of rotational motion over a range of +/-0.36 degrees to +/-12 degrees. Imaging studies in volunteers document the feasibility of real-time prospective correction of rotational motion in vivo. Using a modified receiver operating characteristic method, motion-corrected functional MRI sensorimotor studies incorporating deliberate head rotations are shown to be superior to functional MRI time series acquired under similar conditions but without motion correction.

Phase alignment of multiple surface coil data for reduced bandwidth and reconstruction requirements

Multiple element surface coils are often used in clinical MRI to increase the image signal-to-noise ratio (S/N). Use of multicoils typically requires increased net sampling bandwidth and data processing for each coil element. A phase-alignment technique is described which combines the signals from all coil elements before image reconstruction, greatly relaxing the technical requirements of the standard multicoil methods. Hardware and software implementations allow reduction of the reconstruction requirement to that of a single coil. The hardware implementation additionally allows a significant reduction in the net sampling bandwidth. The method is applicable to high speed MRI techniques, as demonstrated in phantoms and volunteers.

Real-time interactive MRI on a conventional scanner

A real-time interactive MRI system capable of localizing coronary arteries and imaging arrhythmic hearts in real-time is described. Non-2DFT acquisition strategies such as spiral-interleaf, spiral-ring, and circular echo-planar imaging provide short scan times on a conventional scanner. Real-time gridding reconstruction at 8-20 images/s is achieved by distributing the reconstruction on general-purpose UNIX workstations. An X-windows application provides interactive control. A six-interleaf spiral sequence is used for cardiac imaging and can acquire six images/s. A sliding window reconstruction achieves display rates of 16-20 images/s. This allows cardiac images to be acquired in real-time, with minimal motion and flow artifacts, and without breath holding or cardiac gating. Abdominal images are acquired at over 2.5 images/s with spiral-ring or circular echo-planar sequences. Reconstruction rates are 8-10 images/s. Rapid localization in the abdomen is demonstrated with the spiral-ring acquisition, whereas peristaltic motion in the small bowel is well visualized using the circular echo-planar sequence.

3D MR angiography of pulmonary arteries using real-time navigator gating and magnetization preparation

An ECG-triggered magnetization-prepared segmented 3D fast gradient echo sequence was developed to perform pulmonary arterial MR angiography. A selective inversion recovery pulse was used in the magnetization preparation to suppress venous vasculature. A real-time gating technique based on navigator echoes was implemented to reduce respiration effects. Pencil-beam navigator echoes were acquired immediately before and after the readout train and processed in real-time to dynamically measure the diaphragm position, which was used to control data acquisition with an accept-or-reject-reacquire logic. In a study of 10 volunteers, a gated 3D acquisition with 28 slices required on average approximately 4 min of acquisition time, and six to seven segmental arteries related to the interlobar trunk of the pulmonary artery were depicted. The use of SIR pulse reduced venous signal by 99%. The gated acquisitions were superior to the ungated acquisitions (n = 10, P < 0.005). The real-time navigator gating technique is effective for reduction of respiration effects and thereby makes high resolution 3D MRA of the pulmonary arteries feasible.

Cardiac magnetic resonance fluoroscopy

A technique is described for high speed interactive imaging of the heart with either white or black blood contrast. Thirty-two views of a segmented, magnetization-prepared gradient echo sequence are acquired during diastole. Using three-quarter partial Fourier sampling, data for a complete 128 x 128 image are acquired in three cardiac cycles. High speed reconstruction provides an image update of each cardiac cycle 159 ms after measurement. An independent graphical user interface facilitates interactive control of section localization and contrast by permitting pulse sequence parameter modification during scanning. The efficiency and image quality of the cardiac MR fluoroscopy technique were evaluated in 11 subjects. Compared with the conventional graphic prescription method, the cardiac fluoroscopy technique provides an approximate eightfold reduction in the time required to obtain subject-specific double oblique sections. Image quality for these scout acquisitions performed during free breathing was sufficient to identify small cardiac structures.

A real-time reconstruction system for magnetic resonance imaging

A digital-electronic reconstruction system for MRI has been designed and demonstrated. The system is capable of reconstructing a 128 x 128 pixel image from complex-valued data in approximately 8 ms (122 frames per second) or a 256 x 256 pixel image in 32 ms (30 frames per second) using the standard 2D FFT reconstruction algorithm. Real-time MR imaging can be obtained when this reconstruction system is coupled with fast continuous echo-planar type data acquisition. This provides the unique potential for real-time monitoring of interventional procedures or for rapid patient positioning. The real-time reconstruction system presented here consists of four main subsystems: an analog to digital converter, an interface memory, the Fourier processor, and the display processor. The basic design of this reconstruction system is presented along with results, demonstrating the capability of the system.

Magnetic resonance fluoroscopy using spirals with variable sampling densities

The imaging of dynamic processes in the body is of considerable interest in interventional examinations as well as kinematic studies, and spiral imaging is a fast magnetic resonance imaging technique ideally suited for such fluoroscopic applications. In this manuscript, magnetic resonance fluoroscopy pulse sequences in which interleaved spirals are used to continuously acquire data and reconstruct one movie frame for each repetition time interval are implemented. For many applications, not all of k-space needs to be updated each frame, and nonuniform k-space sampling can be used to exploit this rapid imaging strategy by allowing variable update rates for different spatial frequencies. Using the appropriate reconstruction algorithm, the temporal updating rate for each spatial frequency is effectively proportional to the corresponding k-space sampling density. Results from a motion phantom as well as in in vivo gadolinium diethylenetriaminopentaacetic acid (Gd-DTPA) bolus tracking studies in a rat model demonstrate the high temporal resolution achievable using these techniques as well as the tradeoffs available with nonuniform sampling densities. This paper focuses on the acquisition of real-time dynamic information, and all images presented are reconstructed retrospectively. The issues of real-time data reconstruction and display are not addressed.

3D coronary MR angiography in multiple breath-holds using a respiratory feedback monitor

To reduce respiratory blur and ghosts in 3D coronary imaging, a data acquisition scheme using consistent multiple breath-holds was implemented. A navigator echo was acquired and processed in real time to dynamically measure diaphragm position. This information was provided as a visual prompt to the patient to maintain consistency in breath-hold levels such that the variation range of diastolic heart position was less than 2 mm. Preliminary results indicate that this multiple breath-hold acquisition scheme, compared with acquisition under respiration, can significantly reduce blur and ghost artifacts in 3D coronary imaging.

Continuous update with random encoding (CURE): a new strategy for dynamic imaging

Although dynamic imaging is presently used for various applications, it is still limited by the temporal resolution. In this paper, we present a new technique that uses a random phase-encoding strategy to facilitate faster and smoother update of images and to improve the temporal resolution in dynamic studies. The technique was implemented on a conventional clinical scanner and demonstrated with various in vivo studies. Technical details, simulations, and experimental results are described. Images from experimental studies indicate that the new technique is robust in generating dynamic images and can be potentially utilized for clinical applications.

A monitoring, feedback, and triggering system for reproducible breath-hold MR imaging

A technique is described that provides improved reproducibility of breath-holding for MR image acquisition by monitoring the superior-inferior (S/I) position of the diaphragm. The method incorporates detection of the level of inspiration using an MR signal, rapid display to the patient of diaphragm position to enable breath-hold adjustment, and triggering of image data acquisition once appropriate position is attained. The response time of the system is short, approximately 10 ms. Studies in six volunteers using this method demonstrate a considerable decrease in the S/I range of diaphragm position over 10 consecutive periods of suspended respiration. The mean range is 1.3 mm with the system, while it is 8.3 mm without using it. It is expected that this method will be of assistance in many abdominal and cardiothoracic studies that use breath-hold techniques.

Real-time acquisition, display, and interactive graphic control of NMR cardiac profiles and images

A highly interactive MRI scanner interface has been developed that allows, for the first time, real-time graphic control of one-dimensional (1D) and two-dimensional (2D) cardiac MRI exams. The system comprises a Mercury array processor (AP) in a Sun SPARCserver with two connections to the MRI scanner, a data link that passes the NMR data directly to the AP as they are collected, and a control link that passes commands from the Sun to the scanner to redirect the imaging pulse sequence in real time. In the 1D techniques, a cylinder or "pencil" of magnetization is repeatedly excited using gradient-echo or spin-echo line-scan sequences, with the magnetization read out each time along the length of the cylinder, and a scrolling display generated on the Sun monitor. Rubber-band lines drawn on the scout image redirect the pencil or imaging slice to different locations, with the changes immediately visible in the display. M-mode imaging, 1D flow imaging, and 2D fast cardiac imaging have been demonstrated on normal volunteers using this system. This platform represents an operator-"friendly" way of directing real-time imaging of the heart.

Phase velocity mapping with a real time line scan technique

A real-time, 20-Hz, one-dimensional MR velocity imaging technique is described. A two-dimensional RF pulse excites a 3-cm diameter column. Velocity maps are formed from the phase difference between successive flow encoded and compensated acquisitions. A three-point subtraction variation provides reduced sensitivity to static spins.

Color flow-encoded MR imaging

Magnetic resonance phase images can enable identification of any type of motion, including the velocity and direction of flow, and thus provide valuable supplements to magnitude images, which depict stationary tissue most effectively. A method is described for the simultaneous display of phase and magnitude by color encoding the phase data and superimposing it on the magnitude image to facilitate clinical interpretation. Color-encoded data not only depict the location and direction of flow along specific axes but can also provide relative velocity information through shades of color. Implementation of the technique is described, and the factors to be considered during interpretation of color flow-encoded images are discussed.

Low-field 3-DFT MRI: conceptual, analytical, and experimental aspects

Three-dimensional Fourier transform (3-DFT) magnetic resonance imaging (MRI) offers advantages in terms of signal-to-noise (S/N) per unit of time for the case where a large number of slices is desired. This advantage is enhanced when the relaxation time, T(1 ), is short. Because time limitations in 3-DFT imaging force the use of short time intervals, TR, between excitations of a slice, lesion contrast is often undesirable at mid-and high-field strength even when the S/N is good. At low fields, where T(1) values are short, high S/N and contrast can both be achieved with 3-DFT MR images. The conceptual and analytical aspects of low-field 3-DFT MRI are presented and demonstrated at 640 G.

Fluoroscopic MR imaging at 0.064 Tesla

The authors developed a system for ultrafast magnetic resonance imaging (MRI) protocols at low field. The system design permits the acquisition of the raw data in the background while the reconstruction and display steps repeat as fast as they can in the foreground. The performance speeds depends partly on the desired use. By collecting raw data at a rate of 20 ms per echo with an echo delay of 9 ms, a complete data cycle for a 128x64 image takes 1.28 s. However, once half of that data is incorporated into the reconstruction, the image appears complete. Using this set of parameters the authors were able to get the rate of the recon/display loop to paint about two times per completed raw data cycle, showing an entirely new image at least once per second with an apparent frame rate of two per second. Interleaving of two or three orthogonal scans reduces the speed of update but provides better information. The authors discuss the system design for rapid scan/recon/display and demonstrate the image quality available at low field strength with scan times below one second.

High-speed line scan MR angiography

We describe a system which forms MR angiographic images at high speed. Multiple axial sections are imaged sequentially using a 2DFT GRASS sequence with TR/TE 50/15 ms, 64 phase encodings per image. Reconstruction and projection of each image are performed immediately (within 220 ms) after data for that image are acquired. The projection angiogram is constructed line by line as the scan progresses, thereby totally eliminating any additional time required for reconstruction and projection.

Real-time interactive magnetic resonance imaging

We describe a system for performing interactive MRI in real time. Using a TR/TE 7.1/3.5 ms sequence, the operator may alter a scan parameter and observe the effects of the alteration on the image within a few hundred milliseconds. With this system, we can interactively control the oblique scan slice orientation and, using inversion pulses, the image contrast.