Realignment capability of the nCPMG sequence

Portable, low-field magnetic resonance imaging enables highly accessible and dynamic bedside evaluation of ischemic stroke

Brain imaging is essential to the clinical management of patients with ischemic stroke. Timely and accessible neuroimaging, however, can be limited in clinical stroke pathways. Here, portable magnetic resonance imaging (pMRI) acquired at very low magnetic field strength (0.064 T) is used to obtain actionable bedside neuroimaging for 50 confirmed patients with ischemic stroke. Low-field pMRI detected infarcts in 45 (90%) patients across cortical, subcortical, and cerebellar structures. Lesions as small as 4 mm were captured. Infarcts appeared as hyperintense regions on T2-weighted, fluid-attenuated inversion recovery and diffusion-weighted imaging sequences. Stroke volume measurements were consistent across pMRI sequences and between low-field pMRI and conventional high-field MRI studies. Low-field pMRI stroke volumes significantly correlated with stroke severity and functional outcome at discharge. These results validate the use of low-field pMRI to obtain clinically useful imaging of stroke, setting the stage for use in resource-limited environments.

Reliable, high-quality suppression of NMR signals arising from water and macromolecules: application to bio-fluid analysis

Analysis of metabolites in biofluids using nuclear magnetic resonance often requires the suppression of obscuring signals arising from water and macromolecules. This paper analyses the limitations of the pulse sequence most commonly used to achieve such suppression (presat-CPMG) and proposes new pulse sequences that do not share those limitations. The utility of these improved pulse sequences is demonstrated in a metabolomic study of multiple sclerosis (MS) patients.

Body diffusion-weighted imaging using magnetization prepared single-shot fast spin echo and extended parallel imaging signal averaging

PURPOSE

This work demonstrates a magnetization prepared diffusion-weighted single-shot fast spin echo (SS-FSE) pulse sequence for the application of body imaging to improve robustness to geometric distortion. This work also proposes a scan averaging technique that is superior to magnitude averaging and is not subject to artifacts due to object phase.

THEORY AND METHODS

This single-shot sequence is robust against violation of the Carr-Purcell-Meiboom-Gill (CPMG) condition. This is achieved by dephasing the signal after diffusion weighting and tipping the MG component of the signal onto the longitudinal axis while the non-MG component is spoiled. The MG signal component is then excited and captured using a traditional SS-FSE sequence, although the echo needs to be recalled prior to each echo. Extended Parallel Imaging (ExtPI) averaging is used where coil sensitivities from the multiple acquisitions are concatenated into one large parallel imaging (PI) problem. The size of the PI problem is reduced by SVD-based coil compression which also provides background noise suppression. This sequence and reconstruction are evaluated in simulation, phantom scans, and in vivo abdominal clinical cases.

RESULTS

Simulations show that the sequence generates a stable signal throughout the echo train which leads to good image quality. This sequence is inherently low-SNR, but much of the SNR can be regained through scan averaging and the proposed ExtPI reconstruction. In vivo results show that the proposed method is able to provide diffusion encoded images while mitigating geometric distortion artifacts compared to EPI.

CONCLUSION

This work presents a diffusion-prepared SS-FSE sequence that is robust against the violation of the CPMG condition while providing diffusion contrast in clinical cases. Magn Reson Med 79:3032-3044, 2018. © 2017 International Society for Magnetic Resonance in Medicine.

Robust Self-Calibrating nCPMG Acquisition: Application to Body Diffusion-Weighted Imaging

This paper demonstrates a robust diffusion-weighted single-shot fast spin echo (SS-FSE) sequence in the presence of significant off-resonance, which includes a variable-density acquisition and a self-calibrated reconstruction as improvements. A non-Carr-Purcell-Meiboom-Gill (nCPMG) SS-FSE acquisition stabilizes both the main and parasitic echo families for each echo. This preserves both the in-phase and quadrature components of the magnetization throughout the echo train. However, nCPMG SS-FSE also promotes aliasing of the quadrature component, which complicates reconstruction. A new acquisition and reconstruction approach is presented here, where the field-of-view is effectively doubled, but a partial k-space and variable density sampling is used to improve scan efficiency. The technique is presented in phantom scans to validate SNR and robustness against rapidly varying object phase. In vivo healthy volunteer examples and the clinical cases are demonstrated in abdominal imaging. This new approach provides comparable SNR to previous nCPMG acquisition techniques as well as providing more uniform apparent diffusion coefficient maps in phantom scans. In vivo scans suggest that this method is more robust against motion than previous approaches. The proposed reconstruction is an improvement to the nCPMG sequence as it is auto-calibrating and is justified to accurately treat the signal model for the nCPMG SS-FSE sequence.

Slice profile effects on nCPMG SS-FSE

PURPOSE

To determine the effects of the RF refocusing pulse profile on the magnitude of the transverse signal smoothness throughout the echo train in non-Carr-Purcell-Meiboom-Gill (nCPMG) single-shot fast spin echo (SS-FSE) imaging and to design an RF refocusing pulse that provides improved signal stability. THEORY AND METHODS: nCPMG SS-FSE quadratic phase modulation requires sufficiently high and uniform refocusing flip angle to achieve a stable signal. Typically, refocusing pulses used in SS-FSE sequences are designed for minimum duration to minimize echo spacing and as a consequence have poor selectivity. However, delay-insensitive variable rate excitation Shinnar-Le Roux (DV-SLR) refocusing pulses can achieve both improved selectivity as well as a short duration. This class of RF pulse is compared against a traditional low time-bandwidth refocusing pulse in a nCPMG SS-FSE in simulation, phantom, and in vivo.

RESULTS

DV-SLR pulses achieve a more stable signal in simulation, phantom, and in vivo cases while maintaining an appropriately short duration as well as not dramatically increasing specific absorption rate (SAR) accumulation.

CONCLUSION

The nCPMG SS-FSE method demonstrates improved robustness when a more selective refocusing pulse is used. Refocusing pulses that use a time-varying excitation gradient can achieve this selectivity while maintaining short echo spacing. Magn Reson Med 79:430-438, 2018. © 2017 International Society for Magnetic Resonance in Medicine.

Body Diffusion Weighted Imaging Using Non-CPMG Fast Spin Echo

SS-FSE is a fast technique that does not suffer from off-resonance distortions to the degree that EPI does. Unlike EPI, SS-FSE is ill-suited to diffusion weighted imaging (DWI) due to the Carr-Purcell-Meiboom-Geill (CPMG) condition. Non-CPMG phase cycling does accommodate SS-FSE and DWI but places constraints on reconstruction, which are resolved here through parallel imaging. Additionally, improved echo stability can be achieved by using short duration and highly selective DIVERSE radiofrequency pulses. Here, signal-to-noise ratio (SNR) comparisons between EPI and nCPMG SS-FSE acquisitions and reconstruction techniques give similar values. Diffusion imaging with nCPMG SS-FSE gives similar SNR to an EPI acquisition, though apparent diffusion coefficient values are higher than seen with EPI. In vivo images have good image quality with little distortion. This method has the ability to capture distortion-free DWI images near areas of significant off-resonance as well as preserve adequate SNR. Parallel imaging and DIVERSE refocusing RF pulses allow shorter ETL compared to previous implementations and thus reduces phase encode direction blur and SAR accumulation.