1
|
Hu Z, van der Kouwe A, Han F, Xiao J, Chen J, Han H, Bi X, Li D, Fan Z. Motion-compensated 3D turbo spin-echo for more robust MR intracranial vessel wall imaging. Magn Reson Med 2021; 86:637-647. [PMID: 33768617 DOI: 10.1002/mrm.28777] [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: 09/23/2020] [Revised: 01/31/2021] [Accepted: 02/27/2021] [Indexed: 12/31/2022]
Abstract
PURPOSE (1) To investigate the effect of internal localized movement on 3DMR intracranial vessel wall imaging and (2) to develop a novel motion-compensation approach combining volumetric navigator (vNav) and self-gating (SG) to simultaneously compensate for bulk and localized movements. METHODS A 3D variable-flip-angle turbo spin-echo (ie, SPACE) sequence was modified to incorporate vNav and SG modules. The SG signals from the center k-space line are acquired at the beginning of each TR to detect localized motion-affected TRs. The vNavs from low-resolution 3D EPI are acquired to identify bulk head motion. Fifteen healthy subjects and 3 stroke patients were recruited in this study. Overall image quality (0-poor to 4-excellent) and vessel wall sharpness were compared among the scenarios with and without bulk and/or localized motion and/or the proposed compensation strategies. RESULTS Localized motion reduced wall sharpness, which was significantly mitigated by SG (ie, outer boundary of basilar artery: 0.68 ± 0.27 vs 0.86 ± 0.17; P = .037). When motion occurred, the overall image quality and vessel wall sharpness obtained with vNav-SG SPACE were significantly higher than those obtained with conventional SPACE (ie, basilarartery outer boundary sharpness: 0.73 ± 0.24 vs 0.94 ± 0.24; P = .033), yet comparable to those obtained in motion-free scans (ie, basilarartery outer boundary sharpness: 0.94 ± 0.24 vs 0.96 ± 0.31; P = .815). CONCLUSION Localized movements can induce considerable artifacts in intracranial vessel wall imaging. The vNav-SG approach is capable of compensating for both bulk and localized motions.
Collapse
Affiliation(s)
- Zhehao Hu
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA.,Department of Bioengineering, University of California, Los Angeles, California, USA
| | - Andre van der Kouwe
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, Massachusetts, USA.,Department of Radiology, Harvard Medical School, Brookline, Massachusetts, USA
| | - Fei Han
- Siemens Medical Solutions USA, Inc., Los Angeles, California, USA
| | - Jiayu Xiao
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Junzhou Chen
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA.,Department of Bioengineering, University of California, Los Angeles, California, USA
| | - Hui Han
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Xiaoming Bi
- Siemens Medical Solutions USA, Inc., Los Angeles, California, USA
| | - Debiao Li
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA.,Department of Bioengineering, University of California, Los Angeles, California, USA
| | - Zhaoyang Fan
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA.,Department of Radiology, University of Southern California Keck School of Medicine, Los Angeles, California, USA
| |
Collapse
|
2
|
Hirai K, Kido T, Kido T, Ogawa R, Tanabe Y, Nakamura M, Kawaguchi N, Kurata A, Watanabe K, Yamaguchi O, Schmidt M, Forman C, Mochizuki T. Feasibility of contrast-enhanced coronary artery magnetic resonance angiography using compressed sensing. J Cardiovasc Magn Reson 2020; 22:15. [PMID: 32050982 PMCID: PMC7017458 DOI: 10.1186/s12968-020-0601-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Accepted: 01/09/2020] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Coronary magnetic resonance angiography (CMRA) is a promising technique for assessing the coronary arteries. However, a disadvantage of CMRA is the comparatively long acquisition time. Compressed sensing (CS) can considerably reduce the scan time. The aim of this study was to verify the feasibility of CS CMRA scanning during the waiting time between contrast injection and late gadolinium enhancement (LGE) scan in a clinical protocol. METHODS Fifty clinical patients underwent contrast-enhanced CS CMRA and conventional CMRA on a 3 T CMR scanner. After contrast injection, CS CMRA was scanned during the waiting time for LGE CMR. A conventional CMRA scan was performed after LGE CMR. We assessed acquisition times and coronary artery image quality for each segment on a 4-point scale. Visible vessel length, sharpness and diameter of right (RCA), left anterior descending (LAD), and left circumflex (LCX) coronary arteries were also quantitatively compared among the scans. RESULTS All CS CMRA scans were successfully performed within the LGE waiting time. The median total scan time was 207 s (163, 259 s) for CS and 785 s (698, 975 s) for conventional CMRA (p < 0.001). No significant differences were observed in image quality scores, vessel length measurements, sharpness, and diameter between CS and conventional CMRA. CONCLUSIONS We could achieve all CS CMRA scans within the LGE waiting time. Contrast-enhanced CS CMRA could considerably shorten the scan time while maintaining image quality compared with conventional CMRA.
Collapse
Affiliation(s)
- Kuniaki Hirai
- Department of Radiology, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime 791-0295 Japan
| | - Teruhito Kido
- Department of Radiology, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime 791-0295 Japan
| | - Tomoyuki Kido
- Department of Radiology, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime 791-0295 Japan
| | - Ryo Ogawa
- Department of Radiology, Saiseikai Matsuyama Hospital, 880-2, Yamanishi, Matsuyama, Ehime 791-8026 Japan
| | - Yuki Tanabe
- Department of Radiology, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime 791-0295 Japan
| | - Masashi Nakamura
- Department of Radiology, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime 791-0295 Japan
| | - Naoto Kawaguchi
- Department of Radiology, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime 791-0295 Japan
| | - Akira Kurata
- Department of Radiology, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime 791-0295 Japan
| | - Kouki Watanabe
- Department of Cardiology, Saiseikai Matsuyama Hospital, 880-2, Yamanishi, Matsuyama, Ehime 791-8026 Japan
| | - Osamu Yamaguchi
- Department of Cardiology, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime 791-0295 Japan
| | - Michaela Schmidt
- Siemens Healthcare GmbH, Allee am Roethelheimpark 2, 91052 Erlangen, Germany
| | - Christoph Forman
- Siemens Healthcare GmbH, Allee am Roethelheimpark 2, 91052 Erlangen, Germany
| | - Teruhito Mochizuki
- Department of Radiology, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime 791-0295 Japan
| |
Collapse
|
3
|
O'Driscoll BR, Howard LS, Earis J, Mak V. BTS guideline for oxygen use in adults in healthcare and emergency settings. Thorax 2017; 72:ii1-ii90. [DOI: 10.1136/thoraxjnl-2016-209729] [Citation(s) in RCA: 316] [Impact Index Per Article: 45.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2016] [Revised: 02/03/2017] [Accepted: 02/12/2017] [Indexed: 12/15/2022]
|
4
|
Fan Z, Yang Q, Deng Z, Li Y, Bi X, Song S, Li D. Whole-brain intracranial vessel wall imaging at 3 Tesla using cerebrospinal fluid-attenuated T1-weighted 3D turbo spin echo. Magn Reson Med 2016; 77:1142-1150. [PMID: 26923198 DOI: 10.1002/mrm.26201] [Citation(s) in RCA: 85] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2015] [Revised: 01/20/2016] [Accepted: 02/12/2016] [Indexed: 11/11/2022]
Abstract
PURPOSE Although three-dimensional (3D) turbo spin echo (TSE) with variable flip angles has proven to be useful for intracranial vessel wall imaging, it is associated with inadequate suppression of cerebrospinal fluid (CSF) signals and limited spatial coverage at 3 Tesla (T). This work aimed to modify the sequence and develop a protocol to achieve whole-brain, CSF-attenuated T1 -weighted vessel wall imaging. METHODS Nonselective excitation and a flip-down radiofrequency pulse module were incorporated into a commercial 3D TSE sequence. A protocol based on the sequence was designed to achieve T1 -weighted vessel wall imaging with whole-brain spatial coverage, enhanced CSF-signal suppression, and isotropic 0.5-mm resolution. Human volunteer and pilot patient studies were performed to qualitatively and quantitatively demonstrate the advantages of the sequence. RESULTS Compared with the original sequence, the modified sequence significantly improved the T1 -weighted image contrast score (2.07 ± 0.19 versus 3.00 ± 0.00, P = 0.011), vessel wall-to-CSF contrast ratio (0.14 ± 0.16 versus 0.52 ± 0.30, P = 0.007) and contrast-to-noise ratio (1.69 ± 2.18 versus 4.26 ± 2.30, P = 0.022). Significant improvement in vessel wall outer boundary sharpness was observed in several major arterial segments. CONCLUSIONS The new 3D TSE sequence allows for high-quality T1 -weighted intracranial vessel wall imaging at 3 T. It may potentially aid in depicting small arteries and revealing T1 -mediated high-signal wall abnormalities. Magn Reson Med 77:1142-1150, 2017. © 2016 International Society for Magnetic Resonance in Medicine.
Collapse
Affiliation(s)
- Zhaoyang Fan
- Biomedical Imaging Research Institute, Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Qi Yang
- Biomedical Imaging Research Institute, Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, California, USA.,Department of Radiology, Xuanwu Hospital, Beijing, China
| | - Zixin Deng
- Biomedical Imaging Research Institute, Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, California, USA.,Department of Bioengineering, University of California, Los Angeles, California, USA
| | - Yuxia Li
- Department of Neurology, Xuanwu Hospital, Beijing, China
| | - Xiaoming Bi
- MR R&D, Siemens Healthcare, Los Angeles, California, USA
| | - Shlee Song
- Department of Neurology, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Debiao Li
- Biomedical Imaging Research Institute, Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, California, USA.,Department of Bioengineering, University of California, Los Angeles, California, USA
| |
Collapse
|
5
|
Di Leo G, Fisci E, Secchi F, Alì M, Ambrogi F, Sconfienza LM, Sardanelli F. Diagnostic accuracy of magnetic resonance angiography for detection of coronary artery disease: a systematic review and meta-analysis. Eur Radiol 2015; 26:3706-18. [DOI: 10.1007/s00330-015-4134-0] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2015] [Revised: 11/16/2015] [Accepted: 11/23/2015] [Indexed: 01/20/2023]
|
6
|
Pediatric Body MR Angiography: Principles, Techniques, and Current Status in Body Imaging. AJR Am J Roentgenol 2015; 205:173-84. [DOI: 10.2214/ajr.14.13795] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
|
7
|
Lin K, Carr JC. MR imaging of the coronary vasculature: imaging the lumen, wall, and beyond. Radiol Clin North Am 2015; 53:345-53. [PMID: 25726999 DOI: 10.1016/j.rcl.2014.11.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The characteristics of coronary artery disease are gradual thickening of the coronary walls and narrowing of the vascular lumen by the buildup of atherosclerosis plaques. These morphologic changes can be noninvasively detected by coronary magnetic resonance (MR) imaging/MR angiography (MRA). In addition, functional changes, such as coronary wall distensibility and flow changes, may also be evaluated with MR imaging. However, the application of current MR imaging/MRA techniques is limited in clinical practice because of several adverse technical and physiologic factors, such as cardiac and respiratory motion. Many technical innovations have been adopted to address these problems from multiple aspects.
Collapse
Affiliation(s)
- Kai Lin
- Department of Radiology, Northwestern University Feinberg School of Medicine, 737 North Michigan Avenue, Suite 1600, Chicago, IL 60611, USA.
| | - James C Carr
- Department of Radiology, Northwestern University Feinberg School of Medicine, 737 North Michigan Avenue, Suite 1600, Chicago, IL 60611, USA
| |
Collapse
|
8
|
|
9
|
Roujol S, Basha TA, Akçakaya M, Foppa M, Chan RH, Kissinger KV, Goddu B, Berg S, Manning WJ, Nezafat R. 3D late gadolinium enhancement in a single prolonged breath-hold using supplemental oxygenation and hyperventilation. Magn Reson Med 2013; 72:850-7. [PMID: 24186772 DOI: 10.1002/mrm.24969] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2013] [Revised: 08/28/2013] [Accepted: 09/04/2013] [Indexed: 11/07/2022]
Abstract
PURPOSE To evaluate the feasibility of three-dimensional (3D) single breath-hold late gadolinium enhancement (LGE) of the left ventricle (LV) using supplemental oxygen and hyperventilation and compressed-sensing acceleration. METHODS Breath-hold metrics [breath-hold duration, diaphragmatic/LV position drift, and maximum variation of R wave to R wave (RR) interval] without and with supplemental oxygen and hyperventilation were assessed in healthy adult subjects using a real-time single shot acquisition. Ten healthy subjects and 13 patients then underwent assessment of the proposed 3D breath-hold LGE acquisition (field of view = 320 × 320 × 100 mm(3) , resolution = 1.6 × 1.6 × 5.0 mm(3) , acceleration rate of 4) and a free-breathing acquisition with right hemidiaphragm navigator (NAV) respiratory gating. Semiquantitative grading of overall image quality, motion artifact, myocardial nulling, and diagnostic value was performed by consensus of two blinded observers. RESULTS Supplemental oxygenation and hyperventilation increased the breath-hold duration (35 ± 11 s to 58 ± 21 s; P < 0.0125) without significant impact on diaphragmatic/LV position drift or maximum variation of RR interval (both P > 0.01). LGE images were of similar quality when compared with free-breathing acquisitions, but with reduced total scan time (85 ± 22 s to 35 ± 6 s; P < 0.001). CONCLUSIONS Supplemental oxygenation and hyperventilation allow for prolonged breath-holding and enable single breath-hold 3D accelerated LGE with similar image quality as free breathing with NAV.
Collapse
Affiliation(s)
- Sébastien Roujol
- Department of Medicine (Cardiovascular Division), Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, USA
| | | | | | | | | | | | | | | | | | | |
Collapse
|
10
|
|
11
|
Abstract
Considerable progress has been made in cardiac magnetic resonance imaging (MRI). Cine MRI is recognized as the most accurate method for evaluating ventricular function. Late gadolinium-enhanced MRI can clearly delineate subendocardial infarction, and the assessment of transmural extent of infarction on MRI is widely useful for predicting myocardial viability. Stress myocardial perfusion MRI allows for detection of subendocardial myocardial ischemia, and the diagnostic accuracy of stress perfusion MRI is superior to stress perfusion single-photon emission computed tomography in patients with multivessel coronary artery disease (CAD). In recent years, image quality, volume coverage, acquisition speed and arterial contrast of 3-dimensional coronary magnetic resonance angiography (MRA) have been substantially improved with use of steady-state free precession sequences and parallel imaging techniques, permitting the acquisition of high-quality, whole-heart coronary MRA within a reasonably short imaging time. It is now widely recognized that cardiac MRI has tremendous potential for the evaluation of ischemic heart disease. However, cardiac MRI is technically complicated and its use in clinical practice is relatively limited. With further improvements in education and training, as well as standardization of appropriate study protocols, cardiac MRI will play a central role in managing patients with CAD.
Collapse
Affiliation(s)
- Masaki Ishida
- Department of Radiology, Mie University Hospital, Tsu, Japan
| | | | | |
Collapse
|
12
|
Abstract
Modern rapid magnetic resonance (MR) imaging techniques have led to widespread use of the modality in cardiac imaging. Despite this progress, many MR studies suffer from image degradation due to involuntary motion during the acquisition. This review describes the type and extent of the motion of the heart due to the cardiac and respiratory cycles, which create image artifacts. Methods of eliminating or reducing the problems caused by the cardiac cycle are discussed, including electrocardiogram gating, subject-specific acquisition windows, and section tracking. Similarly, for respiratory motion of the heart, techniques such as breath holding, respiratory gating, section tracking, phase-encoding ordering, subject-specific translational models, and a range of new techniques are considered.
Collapse
Affiliation(s)
- Andrew D Scott
- Cardiovascular Magnetic Resonance Unit, the Royal Brompton Hospital, London, England.
| | | | | |
Collapse
|
13
|
Feuerlein S, Klass O, Pasquarelli A, Brambs HJ, Wunderlich A, Duerk JL, Aschoff AJ, Hoffmann MHK. Coronary MR imaging: navigator echo biofeedback increases navigator efficiency--initial experience. Acad Radiol 2009; 16:374-9. [PMID: 19201367 DOI: 10.1016/j.acra.2008.08.015] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2008] [Revised: 08/23/2008] [Accepted: 08/25/2008] [Indexed: 11/29/2022]
Abstract
RATIONALE AND OBJECTIVES The aim of this study was to investigate whether a respiratory biofeedback system could increase navigator efficiency and maintain image quality compared to conventional respiratory-gated magnetic resonance coronary angiography (MRCA). MATERIALS AND METHODS Eighteen healthy volunteers underwent MRCA using three different respiratory-gating protocols. A conventional expiratory free-breathing (FB) sequence was compared to two approaches using navigator echo biofeedback (NEB), a midinspiratory approach (NEBin) and an expiratory approach (NEBex). Navigator data reflecting the position of the diaphragm relative to a 3-mm gating window were made available to the subject using a video projector in combination with a Plexiglas screen and mirror goggles. Image quality was graded by two radiologists in consensus using a visual score ranging from 1 (not visible) to 4 (excellent vessel depiction). RESULTS The NEB approaches improved navigator efficiency (71.1% with NEBex and 68.0% with NEBin vs 42.2% with FB), thus reducing total imaging time. This difference was statistically significant (P(NEBin)=.007; P(NEBex)=.001). Image quality in the NEBex group was comparable to that in the FB group (median score, 2.44 vs 2.52), but it proved to be significantly lower (median score, 1.94 vs 2.52) for the right coronary artery and the left anterior descending coronary artery in the NEBin group. CONCLUSION NEB maintains image quality and significantly increases navigator efficiency, thereby decreasing total imaging time by about 40% compared to a conventional FB acquisition strategy.
Collapse
Affiliation(s)
- Sebastian Feuerlein
- Department of Diagnostic and Interventional Radiology, University of Ulm, Steinhoevelstrasse 9, 89075 Ulm, Germany.
| | | | | | | | | | | | | | | |
Collapse
|
14
|
Three-dimensional breathhold magnetization-prepared TrueFISP: a pilot study for magnetic resonance imaging of the coronary artery disease. Invest Radiol 2007; 42:665-70. [PMID: 17984762 DOI: 10.1097/rli.0b013e3180661a77] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
PURPOSE X-ray angiography is currently the standard test for the assessment of coronary artery disease. A substantial minority of patients referred for coronary angiography have no significant coronary artery disease. The purpose of this work was the evaluation of the accuracy of a three-dimensional (3D) breathhold coronary magnetic resonance angiography (MRA) technique in detecting hemodynamically significant coronary artery stenoses in a patient population with x-ray angiographic correlation. MATERIALS AND METHODS Sequential subjects (n = 33, M/F = 22/11, average age = 57) who were referred for conventional coronary angiography were enrolled in the study. The study protocol was approved by our institutional review board. Each subject gave written informed consent. Volume-targeted 3D breathhold coronary artery scans with ECG-triggered, segmented True Fast Imaging with Steady-state Precession (TrueFISP) were acquired for the left main (LM), left anterior descending (LAD), and right coronary arteries (RCAs). Coronary MRA was evaluated with conventional angiography as the gold standard. RESULTS The overall sensitivity, specificity, accuracy, positive predictive value (PPV), and negative predictive value (NPV) for diagnosing any hemodynamically significant coronary artery disease (> or =50% diameter reduction) with coronary MRA was 87%, 57%, 72%, 68%, and 80%, respectively. The sensitivity of the technique in the LM, LAD, and RCA was 100%, 83%, and 100%, respectively. The NPV of the technique in the LM, LAD, and RCA was 100%, 82%, and 100%, respectively. CONCLUSIONS Three-dimensional breathhold True Fast Imaging with Steady-state Precession is a promising technique for coronary artery imaging. It has a relatively high sensitivity and NPV. Results of this study warrant further technical improvements and clinical evaluation of the technique.
Collapse
|
15
|
Abstract
Cardiac MRI has long been recognized as an accurate and reliable means of evaluating cardiac anatomy and ventricular function. Considerable progress has been made in the field of cardiac MRI, and cardiac MRI can provide accurate evaluation of myocardial ischemia and infarction (MI). Late gadolinium (Gd)-enhanced MRI can clearly delineate subendocardial infarction, and the assessment of transmural extent of infarction on late enhanced MRI has been shown to be useful in predicting functional recovery of dysfunctional myocardium in patients after MI. Stress first-pass contrast-enhanced (CE) myocardial perfusion MRI can be used to detect subendocardial ischemia, and recent studies have demonstrated the high diagnostic accuracy of stress myocardial perfusion MRI for detecting significant coronary artery disease (CAD). Free-breathing, whole-heart coronary MR angiography (MRA) was recently introduced as a method that can provide visualization of all three major coronary arteries within a single three-dimensional (3D) acquisition. With further improvements in MRI techniques and the establishment of a standardized study protocol, cardiac MRI will play a pivotal role in managing patients with ischemic heart disease.
Collapse
Affiliation(s)
- Hajime Sakuma
- Department of Diagnostic Radiology, Mie University Hospital, Mie, Japan.
| |
Collapse
|
16
|
Niendorf T, Hardy CJ, Giaquinto RO, Gross P, Cline HE, Zhu Y, Kenwood G, Cohen S, Grant AK, Joshi S, Rofsky NM, Sodickson DK. Toward single breath-hold whole-heart coverage coronary MRA using highly accelerated parallel imaging with a 32-channel MR system. Magn Reson Med 2006; 56:167-76. [PMID: 16755538 DOI: 10.1002/mrm.20923] [Citation(s) in RCA: 107] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Coronary MR angiography (CMRA) is generally confined to the acquisition of multiple targeted slabs with coverage dictated by the competing constraints of signal-to-noise ratio (SNR), physiological motion, and scan time. This work addresses these obstacles by demonstrating the technical feasibility of using a 32-channel coil array and receiver system for highly accelerated volumetric breath-hold CMRA. The use of the 32-element array in unaccelerated CMRA studies provided a baseline SNR increase of as much as 40% over conventional cardiac-optimized phased array coils, which resulted in substantially enhanced image quality and improved delineation of the coronary arteries. Modest accelerations were used to reduce breath-hold durations for tailored coverage of the coronary arteries using targeted multi-oblique slabs to as little as 10 s. Finally, high net accelerations were combined with the SNR advantages of a 3D steady-state free precession (SSFP) technique to achieve previously unattainable comprehensive volumetric coverage of the coronary arteries in a single breath-hold. The merits and limitations of this simplified volumetric imaging approach are discussed and its implications for coronary MRA are considered.
Collapse
Affiliation(s)
- Thoralf Niendorf
- Applied Science Laboratory, GE Healthcare Technologies, Boston, Massachusetts, USA.
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
17
|
Yang CW, Carr JC, Francois CJ, Shea SM, Deshpande VS, Meyers SN, Beohar N, Finn JP, Li D. Coronary magnetic resonance angiography using magnetization-prepared contrast-enhanced breath-hold volume-targeted imaging (MPCE-VCATS). Invest Radiol 2006; 41:639-44. [PMID: 16829747 DOI: 10.1097/01.rli.0000226030.12061.b1] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Coronary artery x-ray angiography (XRA) is currently the gold standard for the assessment of coronary artery disease. A substantial minority of patients referred for coronary angiography have no significant coronary artery disease. The purpose of this study is to evaluate magnetization-prepared contrast-enhanced breath-hold volume-targeted imaging (MPCE-VCATS), a new 3-dimensional breath-hold coronary magnetic resonance angiography (MRA) technique, in detecting hemodynamically significant coronary artery stenoses in a patient population, with XRA correlation. MATERIALS AND METHODS A total of 19 subjects who were referred for conventional coronary angiography were enrolled in the study. ECG-triggered MPCE-VCATS coronary artery scans were acquired for the left main coronary artery (LCA), left anterior descending (LAD), and right coronary artery (RCA). Coronary MRA and XRA results were compared. RESULTS The overall sensitivity, accuracy, and negative predictive value for diagnosing any hemodynamically significant coronary artery disease (> or =50% diameter reduction) was 91%, 80%, and 90%, respectively. The sensitivity of the technique in the LCA, LAD, and RCA was 100%, 100% and 78%, respectively. The negative predictive value of the technique was 100%, 100%, and 71%, respectively. DISCUSSION MPCE-VCATS is a promising technique for coronary artery imaging. It has a relatively high sensitivity as well as a high NPV. The results of the study may indicate a future role for the technique in obviating the need for some patients to undergo XRA.
Collapse
Affiliation(s)
- Carina W Yang
- Radiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois 60611, USA.
| | | | | | | | | | | | | | | | | |
Collapse
|
18
|
Niendorf T, Sodickson DK. Parallel imaging in cardiovascular MRI: methods and applications. NMR IN BIOMEDICINE 2006; 19:325-41. [PMID: 16705633 DOI: 10.1002/nbm.1051] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
Cardiovascular MR imaging (CVMR) has become a valuable modality for the non-invasive detection and characterization of cardiovascular diseases. CVMR requires high imaging speed and efficiency, which is fundamentally limited in conventional cardiovascular MRI studies. With the introduction of parallel imaging, alternative means for increasing acquisition speed beyond these limits have become available. In parallel imaging some image data are acquired simultaneously, using RF detector coil sensitivities to encode simultaneous spatial information that complements the information gleaned from sequential application of magnetic field gradients. The resulting improvements in imaging speed can be used in various ways, including shortening long examinations, improving spatial resolution and/or anatomic coverage, improving temporal resolution, enhancing image quality, overcoming physiological constraints, detecting and correcting for physiologic motion, and streamlining work flow. Examples of each of these strategies will be provided in this review. First, basic principles and key concepts of parallel MR are described. Second, practical considerations such as coil array design, coil sensitivity calibrations, customized pulse sequences and tailored imaging parameters are outlined. Next, cardiovascular applications of parallel MR are reviewed, ranging from cardiac anatomical and functional assessment to myocardial perfusion and viability to MR angiography of the coronary arteries and the large vessels. Finally, current trends and future directions in parallel CVMR are considered.
Collapse
Affiliation(s)
- Thoralf Niendorf
- Department of Diagnostic Radiology, University Hospital, RWTH Aachen, Pauwelsstrasse 30, 52057 Aachen, Germany
| | | |
Collapse
|
19
|
Zagrosek A, Noeske R, Abdel-Aty H, Friedrich MG, Dietz R, Schulz-Menger J. MR Coronary Angiography Using 3D-SSFP With and Without Contrast Application. J Cardiovasc Magn Reson 2005; 7:809-14. [PMID: 16353441 DOI: 10.1080/10976640500287786] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
We compared the performance of a contrast-enhanced with a non-contrast breath-hold 3D-SSFP-sequence for Magnetic Resonance Coronary Angiography in seven healthy subjects and 14 patients. Visibility of coronary segments, vessel length, image quality and the influence of an extracellular contrast agent (Gadolinium-DTPA) were assessed. Overall, the performance of the sequence was better in healthy subjects than in patients. Although the application of Gadolinium-DTPA increased the contrast-to-noise-ratio of the right coronary artery, the overall performance was not significantly improved. We conclude that a 3D-SSFP-technique depicts extensive parts of the coronary arteries and does not require contrast application.
Collapse
Affiliation(s)
- Anja Zagrosek
- Franz-Volhard-Klinik, Helios-Klinikum Berlin, Kardiologie, Charité Campus Berlin-Buch, Humboldt-Universität zu Berlin, Berlin, Germany.
| | | | | | | | | | | |
Collapse
|
20
|
Niendorf T, Saranathan M, Lingamneni A, Pedrosa I, Spencer M, Cline H, Foo TKF, Rofsky NM. Short breath-hold, volumetric coronary MR angiography employing steady-state free precession in conjunction with parallel imaging. Magn Reson Med 2005; 53:885-94. [PMID: 15799036 DOI: 10.1002/mrm.20446] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
An ECG-gated, 3D steady-state free precession (SSFP) technique in conjunction with sensitivity encoding (SENSE)-based parallel imaging was implemented for short breath-hold, volumetric coronary MR angiograpy (CMRA). Two parallel imaging acquisition strategies (employing 1 R-R and 2 R-R intervals, respectively) were developed to achieve 1) very short breath-hold times (12 s for a heart rate of 60 bpm), and 2) small acquisition windows to minimize sensitivity to physiologic motion. Both strategies were examined in CMRA applications over a range of heart rates. A four-point scale blinded reading (with 4 indicating the most desirable features) revealed substantial image quality improvements for the accelerated data as compared to the nonaccelerated approach. The 1 R-R interval scheme yielded an image score of 3.39 +/- 0.60, and was found to be particularly suitable for low heart rates (P = 0.0008). The 2 R-R interval strategy yielded an image score of 3.35 +/- 0.64, and was more appropriate for higher heart rates (P = 0.03). The results demonstrate that 3D SSFP combined with parallel imaging is a versatile method for short breath-hold CMRA while maintaining high spatial resolution. This strategy permits imaging of the major coronary artery distributions in two to three breath-holds using targeted slabs, and offers the potential for single breath-hold, large-volume CMRA.
Collapse
Affiliation(s)
- Thoralf Niendorf
- Applied Science Laboratory, GE Healthcare, Boston, Massachusetts, USA
| | | | | | | | | | | | | | | |
Collapse
|
21
|
Abstract
This article reviews the current MR imaging literature with respect to ischemic heart disease and focuses on the clinical practicalities of cardiac MR imaging today.
Collapse
|
22
|
Abstract
Coronary magnetic resonance angiography (coronary MRA) continues to advance rapidly from both a technical and clinical perspective. Coronary MRA has benefited directly from improvements in spatial resolution, contrast definition, and advances in motion correction, which have furthered its routine use in evaluating coronary artery bypass grafts and anomalous coronary arteries. Work in refining the techniques for more accurate identification of coronary artery disease (CAD) continues, with advances in navigator-gated and breath-hold motion correction techniques, novel k-space strategies (e.g., spiral and radial k-space filling), development and application of intravascular contrast agents, and imaging at higher field strengths. Ultimately, these developments may lead to the routine application of coronary MRA as a screening tool for CAD. This article reviews the development of coronary MRA, discusses the requirements and tools necessary for optimal visualization of the coronary arteries, and describes the application of coronary MRA to acquired and congenital CAD.
Collapse
Affiliation(s)
- Scott D Flamm
- Department of Radiology, St. Luke's Episcopal Hospital and Texas Heart Institute, Houston, Texas 77030, USA.
| | | |
Collapse
|