Combination of 2D sensitivity encoding and 2D partial fourier techniques for improved acceleration in 3D contrast-enhanced MR angiography

Magnetic resonance-enhanced high-resolution three-dimensional water-selective cartilage sequence visualization of hip vessels in children

PURPOSE

Hip vessel examination provides key information on many hip-related pediatric diseases, and it has an important role in the evaluation of femoral head (FH) blood supply and diagnosis of avascular necrosis (AVN). The aim of this study was to investigate the feasibility of MR-enhanced high-resolution three-dimensional water-selective cartilage (3D-WATSc) sequence in visualizing the vessels of the hip joint in children.

PATIENTS AND METHODS

Children with hip disease were randomly enrolled prospectively at our hospital from January 2021 to August 2022. We performed our institution's hip MRI protocol and enhanced high-resolution 3D-WATSc sequence. The 3D-WATSc images were reconstructed and analyzed, and images of the normal hip were categorized into grades 0-3. The abnormal hip images were compared with those of the normal side using the χ2 test.

RESULTS

Twenty-four patients with unilateral hip abnormalities were included in this study. The cartilaginous vascular canal and ossification centre vessels of normal FHs were observed in 18 patients (75%) and met the grade 3 standard. An abnormal cartilaginous canal was observed in 16 patients (67%); meanwhile, 18 patients (75%) had abnormal extrachondral vessels. Comparison of high-resolution 3D-WATSc images with those of the normal side provided effective abnormal vascular information in 95.8% of patients.

CONCLUSIONS

Enhanced high-resolution 3D-WATSc can visualize the blood vessels of the hip in children. This may provide a new method for the vascular study of various pediatric hip diseases.

MR Angiography: Contrast-Enhanced Acquisition Techniques

Contrast-enhanced MR angiography (CE-MRA) is a frequently used MR imaging technique for evaluating cardiovascular structures. In many ways, it is similar to contrast-enhanced computed tomography (CT) angiography, except a gadolinium-based contrast agent (instead of iodinated contrast) is injected. Although the physiological principles of contrast injection overlap, the technical factors behind enhancement and image acquisition are different. CE-MRA provides an excellent alternative to CT for vascular evaluation and follow-up without requiring nephrotoxic contrast and ionizing radiation. This review describes the physical principles, limitations, and technical applications of CE-MRA techniques.

Technical Aspects of Contrast-enhanced MR Angiography: Current Status and New Applications

This article is based on a presentation at the meeting of the Japanese Society of Magnetic Resonance in Medicine in September 2016. The purpose is to review the technical developments which have contributed to the current status of contrast-enhanced magnetic resonance angiography (CE-MRA) and to indicate related emerging areas of study. Technical developments include MRI physics-based innovations as well as improvements in MRI engineering. These have collectively addressed not only early issues of timing and venous suppression but more importantly have led to an improvement in spatiotemporal resolution of CE-MRA of more than two orders of magnitude compared to early results. This has allowed CE-MRA to be successfully performed in virtually all vascular territories of the body. Contemporary technical areas of study include improvements in implementation of high rate acceleration, extension of high performance first-pass CE-MRA across multiple imaging stations, expanded use of compressive sensing techniques, integration of Dixon-based fat suppression into CE-MRA sequences, and application of CE-MRA sequences to dynamic-contrast-enhanced perfusion imaging.

Acceleration apportionment: a method of improved 2D SENSE acceleration applied to 3D contrast-enhanced MR angiography

PURPOSE

In 2D SENSE-accelerated 3D Cartesian acquisition, the net acceleration factor R is the product of the two individual accelerations, R = RY × RZ. Acceleration Apportionment tailors acceleration parameters (RY, RZ) to improve parallel imaging performance on a patient- and coil-specific basis and is demonstrated in contrast-enhanced MR angiography.

METHODS

A performance metric is defined based on coil sensitivity information which identifies the (RY, RZ) pair that optimally trades off image quality with scan time reduction on a patient-specific basis. Acceleration Apportionment is evaluated using retrospective analysis of contrast-enhanced MR angiography studies, and prospective studies in which optimally apportioned parameters are compared with standard acceleration parameters.

RESULTS

The retrospective studies show strong variability in optimal acceleration parameters between anatomic regions and between patients. Prospective application of apportionment to foot contrast-enhanced MR angiography with an 8-channel receiver array provides a 20% increase in net acceleration with improved contrast-to-noise ratio. Application to 16-channel contrast-enhanced MR angiography of the feet and calves suggests 10% acceleration increase to R > 13 and no contrast-to-noise ratio loss. The specific implementation allows the optimum (RY, RZ) pair to be determined within one minute.

CONCLUSION

Optimum 2D SENSE acceleration parameters can be automatically chosen on a per-exam basis to allow improved performance without disrupting the clinical workflow.

Partial fourier and parallel MR image reconstruction with integrated gradient nonlinearity correction

PURPOSE

To describe how integrated gradient nonlinearity (GNL) correction can be used within noniterative partial Fourier (homodyne) and parallel (SENSE and GRAPPA) MR image reconstruction strategies, and demonstrate that performing GNL correction during, rather than after, these routines mitigates the image blurring and resolution loss caused by postreconstruction image domain based GNL correction.

METHODS

Starting from partial Fourier and parallel magnetic resonance imaging signal models that explicitly account for GNL, noniterative image reconstruction strategies for each accelerated acquisition technique are derived under the same core mathematical assumptions as their standard counterparts. A series of phantom and in vivo experiments on retrospectively undersampled data were performed to investigate the spatial resolution benefit of integrated GNL correction over conventional postreconstruction correction.

RESULTS

Phantom and in vivo results demonstrate that the integrated GNL correction reduces the image blurring introduced by the conventional GNL correction, while still correcting GNL-induced coarse-scale geometrical distortion. Images generated from undersampled data using the proposed integrated GNL strategies offer superior depiction of fine image detail, for example, phantom resolution inserts and anatomical tissue boundaries.

CONCLUSION

Noniterative partial Fourier and parallel imaging reconstruction methods with integrated GNL correction reduce the resolution loss that occurs during conventional postreconstruction GNL correction while preserving the computational efficiency of standard reconstruction techniques. Magn Reson Med 75:2534-2544, 2016. © 2015 Wiley Periodicals, Inc.

Recent advances in 3D time-resolved contrast-enhanced MR angiography

Contrast-enhanced magnetic resonance angiography (CE-MRA) was first introduced for clinical studies approximately 20 years ago. Early work provided 3-4 mm spatial resolution with acquisition times in the 30-second range. Since that time there has been continuing effort to provide improved spatial resolution with reduced acquisition time, allowing high resolution 3D time-resolved studies. The purpose of this work is to describe how this has been accomplished. Specific technical enablers have been: improved gradients allowing reduced repetition times, improved k-space sampling and reconstruction methods, parallel acquisition, particularly in two directions, and improved and higher count receiver coil arrays. These have collectively made high-resolution time-resolved studies readily available for many anatomic regions. Depending on the application, ∼1 mm isotropic resolution is now possible with frame times of several seconds. Clinical applications of time-resolved CE-MRA are briefly reviewed.

Sparse-CAPR: highly accelerated 4D CE-MRA with parallel imaging and nonconvex compressive sensing

Cartesian Acquisition with Projection-Reconstruction-like sampling is a SENSE-type parallel 3DFT acquisition paradigm for 4D contrast-enhanced magnetic resonance angiography that has been demonstrated capable of providing high spatial and temporal resolution, diagnostic-quality images at very high acceleration rates. However, Cartesian Acquisition with Projection-Reconstruction-like sampling images are typically reconstructed online using Tikhonov regularization and partial Fourier methods, which are prone to exhibit noise amplification and undersampling artifacts when operating at very high acceleration rates. In this work, a sparsity-driven offline reconstruction framework for Cartesian Acquisition with Projection-Reconstruction-like sampling is developed and demonstrated to consistently provide improvements over the currently-employed reconstruction strategy against these ill-effects. Moreover, the proposed reconstruction strategy requires no changes to the existing Cartesian Acquisition with Projection-Reconstruction-like sampling acquisition protocol, and an efficient numerical optimization and hardware system are described that allow for a 256 × 160 × 80 volume contrast-enhanced magnetic resonance angiography volume to be reconstructed from an eight-channel data set in less than 2 min.

Max CAPR: high-resolution 3D contrast-enhanced MR angiography with acquisition times under 5 seconds

High temporal and spatial resolution is desired in imaging of vascular abnormalities having short arterial-to-venous transit times. Methods that exploit temporal correlation to reduce the observed frame time demonstrate temporal blurring, obfuscating bolus dynamics. Previously, a Cartesian acquisition with projection reconstruction-like (CAPR) sampling method has been demonstrated for three-dimensional contrast-enhanced angiographic imaging of the lower legs using two-dimensional sensitivity-encoding acceleration and partial Fourier acceleration, providing 1mm isotropic resolution of the calves, with 4.9-sec frame time and 17.6-sec temporal footprint. In this work, the CAPR acquisition is further undersampled to provide a net acceleration approaching 40 by eliminating all view sharing. The tradeoff of frame time and temporal footprint in view sharing is presented and characterized in phantom experiments. It is shown that the resultant 4.9-sec acquisition time, three-dimensional images sets have sufficient spatial and temporal resolution to clearly portray arterial and venous phases of contrast passage. It is further hypothesized that these short temporal footprint sequences provide diagnostic quality images. This is tested and shown in a series of nine contrast-enhanced MR angiography patient studies performed with the new method.

Time-resolved bolus-chase MR angiography with real-time triggering of table motion

Time-resolved bolus-chase contrast-enhanced MR angiography with real-time station switching is demonstrated. The Cartesian acquisition with projection reconstruction-like sampling (CAPR) technique and high 2D sensitivity encoding (SENSE) (6x or 8x) and 2D homodyne (1.8x) accelerations were used to acquire 3D volumes with 1.0-mm isotropic spatial resolution and frame times as low as 2.5 sec in two imaging stations covering the thighs and calves. A custom real-time system was developed to reconstruct and display CAPR frames for visually guided triggering of table motion upon passage of contrast through the proximal station. The method was evaluated in seven volunteers. High-spatial-resolution arteriograms with minimal venous contamination were consistently acquired in both stations. Real-time stepping table contrast-enhanced MR angiography is a method for providing time-resolved images with high spatial resolution over an extended field-of-view.

Peripheral vasculature: high-temporal- and high-spatial-resolution three-dimensional contrast-enhanced MR angiography

PURPOSE

To prospectively evaluate the feasibility of performing high-spatial-resolution (1-mm isotropic) time-resolved three-dimensional (3D) contrast material-enhanced magnetic resonance (MR) angiography of the peripheral vasculature with Cartesian acquisition with projection-reconstruction-like sampling (CAPR) and eightfold accelerated two-dimensional (2D) sensitivity encoding (SENSE).

MATERIALS AND METHODS

All studies were approved by the institutional review board and were HIPAA compliant; written informed consent was obtained from all participants. There were 13 volunteers (mean age, 41.9; range, 27-53 years). The CAPR sequence was adapted to provide 1-mm isotropic spatial resolution and a 5-second frame time. Use of different receiver coil element sizes for those placed on the anterior-to-posterior versus left-to-right sides of the field of view reduced signal-to-noise ratio loss due to acceleration. Results from eight volunteers were rated independently by two radiologists according to prominence of artifact, arterial to venous separation, vessel sharpness, continuity of arterial signal intensity in major arteries (anterior and posterior tibial, peroneal), demarcation of origin of major arteries, and overall diagnostic image quality. MR angiographic results in two patients with peripheral vascular disease were compared with their results at computed tomographic angiography.

RESULTS

The sequence exhibited no image artifact adversely affecting diagnostic image quality. Temporal resolution was evaluated to be sufficient in all cases, even with known rapid arterial to venous transit. The vessels were graded to have excellent sharpness, continuity, and demarcation of the origins of the major arteries. Distal muscular branches and the communicating and perforating arteries were routinely seen. Excellent diagnostic quality rating was given for 15 (94%) of 16 evaluations.

CONCLUSION

The feasibility of performing high-diagnostic-quality time-resolved 3D contrast-enhanced MR angiography of the peripheral vasculature by using CAPR and eightfold accelerated 2D SENSE has been demonstrated.

Controlled experimental study depicting moving objects in view-shared time-resolved 3D MRA

Various methods have been used for time-resolved contrast-enhanced magnetic resonance angiography (CE-MRA), many involving view sharing. However, the extent to which the resultant image time series represents the actual dynamic behavior of the contrast bolus is not always clear. Although numerical simulations can be used to estimate performance, an experimental study can allow more realistic characterization. The purpose of this work was to use a computer-controlled motion phantom for study of the temporal fidelity of three-dimensional (3D) time-resolved sequences in depicting a contrast bolus. It is hypothesized that the view order of the acquisition and the selection of views in the reconstruction can affect the positional accuracy and sharpness of the leading edge of the bolus and artifactual signal preceding the edge. Phantom studies were performed using dilute gadolinium-filled vials that were moved along tabletop tracks by a computer-controlled motor. Several view orders were tested using view-sharing and Cartesian sampling. Compactness of measuring the k-space center, consistency of view ordering within each reconstruction frame, and sampling the k-space center near the end of the temporal footprint were shown to be important in accurate portrayal of the leading edge of the bolus. A number of findings were confirmed in an in vivo CE-MRA study.

Viewing the effective k-space coverage of MR images: phantom experiments with fast Fourier transform

The purpose of this experimental study was to evaluate whether the effective k-space coverage of MR images can in principle be viewed after multidimensional Fourier transform back to k-space. A water-soaked sponge phantom providing homogeneous k-space pattern was imaged with different standard MR sequences, utilizing elliptic acquisitions, partial-Fourier acquisitions and elliptic filtering as imaging examples. The resulting MR images were Fourier-transformed to the spatial frequency domain (the k-space) to visualize their effective k-space coverage. These frequency domain images are named "backtransformed k-space images." For a quantitative assessment, the sponge phantom was imaged with three-dimensional partial-Fourier sequences while varying the partial acquisition parameters in slice and phase direction. By linear regression analysis, the k-space coverage as expected from the sequence menu parameters was compared to the effective k-space coverage as observed in the backtransformed k-space images. The k-space coverage of elliptic and partial-Fourier acquisitions became visible in the backtransformed k-space images, as well as the effect of elliptic filtering. The expected and the observed k-space coverage showed a highly significant correlation (r=.99, P<.001). In conclusion, the effective k-space coverage of MR images becomes visible when Fourier-transforming MR images of a sponge phantom back to k-space. This method could be used for several purposes including sequence parameter optimization, basic imaging research, and to enhance a visual understanding of k-space, especially in three-dimensional MR imaging.

Improved matrix inversion in image plane parallel MRI

A new 3D parallel magnetic resonance imaging (MRI) method named Generalized Unaliasing Incorporating Support constraint and sensitivity Encoding (GUISE) is presented. GUISE allows direct image recovery from arbitrary Cartesian k-space trajectories. However, periodic k-space sampling patterns are considered for reconstruction efficiency. Image recovery methods such as 2D SENSE (SENSitivity Encoding) and 2D CAIPIRINHA (Controlled Aliasing In Parallel Imaging Results IN Higher Acceleration) are special instances of GUISE where specific restrictions are placed on the k-space sampling patterns used. It is shown that the sampling pattern has large impacts on the image reconstruction error due to noise. An efficient sampling pattern design method that incorporates prior knowledge of object support and coil sensitivity profile is proposed. It requires no experimental trials and could be used in clinical imaging. Comparison of the proposed sampling pattern design method with 2D SENSE and 2D CAIPIRINHA are made based on both simulation and experiment results. It is seen that this new adaptive sampling pattern design method results in a lower noise level in reconstructions due to better exploitation of the coil sensitivity variation and object support constraint. In addition, elimination of the non-object region from reconstruction potentially allows an acceleration factor higher than the number of receiver coils used.

3D high temporal and spatial resolution contrast-enhanced MR angiography of the whole brain

Sensitivity encoding (SENSE) and partial Fourier techniques have been shown to reduce the acquisition time and provide high diagnostic quality images. However, for time-resolved acquisitions there is a need for both high temporal and spatial resolution. View sharing can be used to provide an increased frame rate but at the cost of acquiring spatial frequencies over a duration longer than a frame time. In this work we hypothesize that a CArtesian Projection Reconstruction-like (CAPR) technique in combination with 2D SENSE, partial Fourier, and view sharing can provide 1-2 mm isotropic resolution with sufficient temporal resolution to distinguish intracranial arterial and venous phases of contrast passage in whole-brain angiography. In doing so, the parameter of "temporal footprint" is introduced as a descriptor for characterizing and comparing time-resolved view-shared pulse sequences. It is further hypothesized that short temporal footprint sequences have higher temporal fidelity than similar sequences with longer temporal footprints. The tradeoff of temporal footprint and temporal acceleration is presented and characterized in numerical simulations. Results from 11 whole-brain contrast-enhanced MR angiography studies with the new method with SENSE acceleration factors R = 4 and 5.3 are shown to provide images of comparable or higher diagnostic quality than the unaccelerated reference.

[Contrast enhanced MR angiography: evolving towards whole-body real time acquisitions]

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.

Highly undersampled magnetic resonance image reconstruction via homotopic l(0) -minimization

In clinical magnetic resonance imaging (MRI), any reduction in scan time offers a number of potential benefits ranging from high-temporal-rate observation of physiological processes to improvements in patient comfort. Following recent developments in compressive sensing (CS) theory, several authors have demonstrated that certain classes of MR images which possess sparse representations in some transform domain can be accurately reconstructed from very highly undersampled K-space data by solving a convex l(1) -minimization problem. Although l(1)-based techniques are extremely powerful, they inherently require a degree of over-sampling above the theoretical minimum sampling rate to guarantee that exact reconstruction can be achieved. In this paper, we propose a generalization of the CS paradigm based on homotopic approximation of the l(0) quasi-norm and show how MR image reconstruction can be pushed even further below the Nyquist limit and significantly closer to the theoretical bound. Following a brief review of standard CS methods and the developed theoretical extensions, several example MRI reconstructions from highly undersampled K-space data are presented.

Improved image reconstruction for partial Fourier gradient-echo echo-planar imaging (EPI)

The partial Fourier gradient-echo echo planar imaging (EPI) technique makes it possible to acquire high-resolution functional MRI (fMRI) data at an optimal echo time. This technique is especially important for fMRI studies at high magnetic fields, where the optimal echo time is short and may not be achieved with a full Fourier acquisition scheme. In addition, it has been shown that partial Fourier EPI provides better anatomic resolvability than full Fourier EPI. However, the partial Fourier gradient-echo EPI may be degraded by artifacts that are not usually seen in other types of imaging. Those unique artifacts in partial Fourier gradient-echo EPI, to our knowledge, have not yet been systematically evaluated. Here we use the k-space energy spectrum analysis method to understand and characterize two types of partial Fourier EPI artifacts. Our studies show that Type 1 artifact, originating from k-space energy loss, cannot be corrected with pure postprocessing, and Type 2 artifact can be eliminated with an improved reconstruction method. We propose a novel algorithm, that combines images obtained from two or more reconstruction schemes guided by k-space energy spectrum analysis, to generate partial Fourier EPI with greatly reduced Type 2 artifact. Quality control procedures for avoiding Type 1 artifact in partial Fourier EPI are also discussed.

Intracranial contrast-enhanced magnetic resonance venography with 6.4-fold sensitivity encoding at 1.5 and 3.0 Tesla

PURPOSE

To prospectively compare vessel conspicuity and diagnostic image quality between three-dimensional intracranial contrast-enhanced MR venography acquired at 1.5 Tesla (T) and 3.0T, with 6.4-fold sensitivity encoding.

MATERIALS AND METHODS

Ten healthy volunteers were imaged on 1.5T and 3.0T MR scanners using eight-element head coil arrays. The intracranial venous vasculature was divided into five groups for evaluation based on vessel size and anatomical location. Two radiologists independently assessed vessel conspicuity, level of artifacts, and diagnostic image quality. Informed consent was obtained, and the study was approved by the institutional review board.

RESULTS

With the exception of large cerebral sinuses where 1.5T and 3.0T results were rated as equivalent, 3.0T images demonstrated superior vessel continuity, sharpness, and signal contrast to background tissue than 1.5T for all other intracranial venous vasculature (P < 0.01). No statistical significance in overall image quality was found between 1.5T and 3.0T venograms, and all data sets were deemed sufficient for diagnostic interpretation.

CONCLUSION

Whole brain contrast-enhanced venography with 6.4-fold sensitivity encoding is robust and has the potential to become the method of choice for fast visualization of the intracranial venous vasculature. At 3.0T, demonstration of small cerebral vessels is superior to 1.5T.

Internal Carotid Artery Stenosis: Accuracy of Subjective Visual Impression for Evaluation with Digital Subtraction Angiography and Contrast-enhanced MR Angiography

PURPOSE

To prospectively determine, for both digital subtraction angiography (DSA) and contrast material-enhanced magnetic resonance (MR) angiography, the accuracy of subjective visual impression (SVI) in the evaluation of internal carotid artery (ICA) stenosis, with objective caliper measurements serving as the reference standard.

MATERIALS AND METHODS

Local ethics committee approval and written informed patient consent were obtained. A total of 142 symptomatic patients (41 women, 101 men; mean age, 70 years; age range, 44-89 years) suspected of having ICA stenosis on the basis of Doppler ultrasonographic findings underwent both DSA and contrast-enhanced MR angiography. With each modality, three independent neuroradiologists who were blinded to other test results first visually estimated and subsequently objectively measured stenoses. Diagnostic accuracy and percentage misclassification for correct categorization of 70%-99% stenosis were calculated for SVI, with objective measurements serving as the reference standard. Interobserver variability was determined with kappa statistics.

RESULTS

After exclusion of arteries that were unsuitable for measurement, 180 vessels remained for analysis with DSA and 159 vessels remained for analysis with contrast-enhanced MR angiography. With respect to 70%-99% stenosis, SVI was associated with average misclassification of 8.9% for DSA (8.9%, 7.8%, and 10.0% for readers A, B, and C, respectively) and of 11.7% for contrast-enhanced MR angiography (11.3%, 8.8%, and 15.1% for readers A, B, and C, respectively). Negative predictive values were excellent (92.3%-100%). Interobserver variability was higher for SVI (DSA, kappa = 0.62-0.71; contrast-enhanced MR angiography, kappa = 0.57-0.69) than for objective measurements (DSA, kappa = 0.75-0.80; contrast-enhanced MR angiography, kappa = 0.66-0.72).

CONCLUSION

SVI alone is not recommended for evaluation of ICA stenosis with both DSA and contrast-enhanced MR angiography. SVI may be acceptable as an initial screening tool to exclude the presence of 70%-99% stenosis, but caliper measurements are warranted to confirm the presence of such stenosis.

Parallel imaging technique for the external carotid artery and its branches: Comparison of balanced turbo field echo, phase contrast, and time-of-flight sequences

PURPOSE

To evaluate the parallel imaging technique in the external carotid artery and its branches using 3D balanced turbo field echo (3D bTFE), 3D phase-contrast (3D PC), and 3D time-of-flight (3D TOF) MR angiography (MRA) sequences.

MATERIALS AND METHODS

A total of 26 healthy volunteer subjects underwent 3D bTFE, 3D PC, and 3D TOF MRA with the parallel imaging sensitivity encoding (SENSE) technique. The obtained images were read in a blinded fashion by three radiologists. Interreader and intersequence statistical analyses were performed to compare the visibility of the arteries.

RESULTS

Friedman's ranking test demonstrated that there was no significant difference in visibility between any two pairs of sequences for the external carotid artery and its first branches. However, of the three techniques, 3D PC MRA performed the best for the second-order branches (P < 0.01) and for overall visibility of the external carotid artery and its branches (P < 0.01). The 3D bTFE sequence is superior to 3D TOF; however, an effective means of separating arteries from veins and salivary ducts is needed.

CONCLUSION

The combination of parallel imaging and the 3D PC technique is a promising approach for face and neck MRA.

3D contrast-enhanced MR angiography

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.

Accelerated time-resolved 3D contrast-enhanced MR angiography at 3T: clinical experience in 31 patients

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.