Simultaneous magnetic resonance gadolinium-enhanced 2D perfusion and 3D angiographic imaging

A method was implemented and tested that allows the simultaneous acquisition of magnetic resonance 2D slice selective perfusion and 3D angiographic data during a single bolus injection of a contrast agent. High quality contrast-enhanced perfusion images and angiograms of the lung, kidney and heart were obtained in healthy volunteers. Combined perfusion and angiography provided additional information with an acceptable increase in acquisition time. No image artifacts were attributed to the technique. The combined information may be useful in detecting, as well as characterizing, vascular abnormalities.     

Clinical evaluation of subtracted pointwise encoding time reduction with radial acquisition-based magnetic resonance angiography compared to 3D time-of-flight magnetic resonance angiography for improved flow dephasing at 3 Tesla

ObjectiveFlow dephasing artifacts within intracranial internal carotid artery (ICA) have been problematic for 3D time-of-flight magnetic resonance angiography (3D-TOF-MRA). This study aimed to evaluate pointwise encoding time reduction with radial acquisition subtraction-based MR angiography (PETRA-MRA) for decreasing flow dephasing artifacts compared to 3D-TOF-MRA in intracranial segments of ICA at 3 T.MethodsSixty healthy participants and seven patients with intracranial ICA aneurysms were enrolled to undergo 3D-TOF-MRA and PETRA-MRA. Two radiologists each evaluated the image quality of healthy participants using a 4-point scale (1: the best and 4: the worst). Quantitative analysis of the extent of homogeneity in signal intensity within the ICA and intracranial aneurysms was conducted using a parameter d: the higher the d value, the greater the signal homogeneity. Wilcoxon signed rank test, Chi-square test and the weighted kappa (κ) statistic were used for statistical analyses.ResultsThe image quality of PETRA-MRA with an overall score of 1.35 ± 0.53 was significantly better than that obtained with 3D-TOF-MRA, with an overall score of 3.50 ± 0.62 (Z = -9.56, p < 0.001). The parameter d of PETRA-MRA was higher than that of 3D-TOF-MRA for both 60 healthy participants (0.97 ± 0.05, 0.87 ± 0.11; z = -13.21, p < 0.001) and 7 patients with intracranial aneurysms (0.81 ± 0.18, 0.74 ± 0.16; z = -2.37, p = 0.018).ConclusionCompared with conventional 3D-TOF-MRA, PETRA-MRA remarkably improved the image quality with reduced flow dephasing artifacts in segments of intracranial ICA.     

Radiofrequency magnetic resonance coils and communication antennas: Simulation and design strategies

Coils simulation and design is a fundamental task to maximize Signal-to-Noise Ratio in Magnetic Resonance applications. In the meantime, in the last years the issue of accurate communication antennas analysis has grown. Coil design techniques take advantage of computer simulations in dependence on the magnetic field wavelength and coil sizes. In particular, since at high frequencies coils start to behave as antennas, modern Magnetic Resonance coil development exploits numerical methods typically employed for antennas simulation.This paper reviews coil and antenna performance parameters and focuses on the different simulation approaches in dependence on the near/far field zones and operating frequency.     

Accelerated free-breathing 3D whole-heart magnetic resonance angiography with a radial phyllotaxis trajectory,compressed sensing,and curvelet transform

PurposeTo develop and validate an accelerated free-breathing 3D whole-heart magnetic resonance angiography (MRA) technique using a radial k-space trajectory with compressed sensing and curvelet transform.MethodA 3D radial phyllotaxis trajectory was implemented to traverse the centerline of k-space immediately before the segmented whole-heart MRA data acquisition at each cardiac cycle. The k-space centerlines were used to correct the respiratory-induced heart motion in the acquired MRA data. The corrected MRA data were then reconstructed by a novel compressed sensing algorithm using curvelets as the sparsifying domain. The proposed 3D whole-heart MRA technique (radial CS curvelet) was then prospectively validated against compressed sensing with a conventional wavelet transform (radial CS wavelet) and a standard Cartesian acquisition in terms of scan time and border sharpness.ResultsFifteen patients (females 10, median age 34-year-old) underwent 3D whole-heart MRA imaging using a standard Cartesian trajectory and our proposed radial phyllotaxis trajectory. Scan time for radial phyllotaxis was significantly shorter than Cartesian (4.88 ± 0.86 min. vs. 6.84 ± 1.79 min., P-value = 0.004). Radial CS curvelet border sharpness was slightly lower than Cartesian and, for the majority of vessels, was significantly better than radial CS wavelet (P-value < 0.050).ConclusionThe proposed technique of 3D whole-heart MRA acquisition with a radial CS curvelet has a shorter scan time and slightly lower vessel sharpness compared to the Cartesian acquisition with radial profile ordering, and has slightly better sharpness than radial CS wavelet. Future work on this technique includes additional clinical trials and extending this technique to 3D cine imaging.     

Novel methodology for 3D reconstruction of carotid arteries and plaque characterization based upon magnetic resonance imaging carotid angiography data

In this study, we present a novel methodology that allows reliable segmentation of the magnetic resonance images (MRIs) for accurate fully automated three-dimensional (3D) reconstruction of the carotid arteries and semiautomated characterization of plaque type. Our approach uses active contours to detect the luminal borders in the time-of-flight images and the outer vessel wall borders in the T(1)-weighted images. The methodology incorporates the connecting components theory for the automated identification of the bifurcation region and a knowledge-based algorithm for the accurate characterization of the plaque components. The proposed segmentation method was validated in randomly selected MRI frames analyzed offline by two expert observers. The interobserver variability of the method for the lumen and outer vessel wall was -1.60%±6.70% and 0.56%±6.28%, respectively, while the Williams Index for all metrics was close to unity. The methodology implemented to identify the composition of the plaque was also validated in 591 images acquired from 24 patients. The obtained Cohen's k was 0.68 (0.60-0.76) for lipid plaques, while the time needed to process an MRI sequence for 3D reconstruction was only 30 s. The obtained results indicate that the proposed methodology allows reliable and automated detection of the luminal and vessel wall borders and fast and accurate characterization of plaque type in carotid MRI sequences. These features render the currently presented methodology a useful tool in the clinical and research arena.     

Curvilinear reconstruction of 3D magnetic resonance imaging in patients with partial epilepsy: A pilot study

In an attempt to better delineate the abnormalities associated with focal cortical dysgenesis, we performed curvilinear reformatting of the cortex from 3D magnetic resonance (MR) images. Illustrative patients with partial seizures and conventional orthogonal MRI evaluation show that small regions of cortical thickening suggestive of focal dysplastic lesions may not be recognized. In three such patients the curvilinear reformatting demonstrated two additional focal abnormalities of the cortical gyri and better defined the two focal lesions found on conventional orthogonal MR images. This method promises to a be useful tool in the evaluation of epileptic patients with proven or suspected subtle structural cortical abnormalities, particularly focal neuronal migration disorders where cortical thickening, abnormal gyral pattern, and poor delineation of the gray-white matter transition are the main findings.     

Central neurocytoma: typical magnetic resonance spectroscopy findings and atypical ventricular dissemination

PURPOSE: Central neurocytomas (CNCs) are rare neuronal tumors that have a favorable prognosis and lower rate of recurrence compared with other intraventricular neoplasms. Although it may be difficult to distinguish CNC on conventional neuroimaging, typical MR spectroscopy (MRS) features have been reported. We describe the MRI and MRS features of CNC. MATERIALS AND METHODS: Eight patients with CNC were reviewed. Three patients underwent presurgical in vivo single-voxel MRS at short echo time (TE, 35 ms) and multi-voxel MR spectroscopic imaging at long TE (144 ms). The surgically resected tumor specimen of one of these patients was also studied ex vivo using high-resolution magic angle spinning (HRMAS) nuclear magnetic resonance. RESULTS: All eight tumors were located in the lateral ventricles. In six patients, CNC extended into the third ventricle, and in two patients the tumor showed further contiguous intraventricular dissemination into the fourth ventricle. In all three patients who underwent MRS, a characteristic metabolite peak was detected at 3.55 parts per million (ppm) at both long and short TE. HRMAS confirmed the presence of elevated glycine (Gly) at 3.55 ppm, without increase in the concentration of myo-inositol found at the same chemical shift. Elevated choline (at 3.2 ppm) was also seen in all three patients. CONCLUSION: On MRS, CNCs have a typical appearance with a metabolite peak at 3.55 ppm due to increased Gly, and this feature may be helpful in presurgical diagnosis. Although they are rare benign intraventricular tumors, in atypical cases, CNCs can show extensive intraventricular dissemination into the fourth ventricle.     

Free-breathing 3-dimensional steady-state free precession coronary magnetic resonance angiography: comparison of four navigator gating techniques

This work compared the performance of four navigator gating algorithms [accept/reject (A/R), diminishing variance algorithm (DVA), phase ordering with automatic window selection (PAWS) and retrospective gating (RETRO)] in suppressing respiratory motion artifacts in free-breathing 3D balanced steady-state free precession coronary MRA. In 10 volunteers, the right coronary artery (RCA) or the left anterior descending artery (LAD) was imaged (both if time permitted) at 1.5 T with the four gating techniques in random order. Vessel signal, vessel contrast and motion suppression were scored by the consensus of two blinded readers. In 15 imaged vessels (nine RCA and six LAD), PAWS provided significantly better image quality than A/R (P<.05), DVA (P=.02) and RETRO (P=.002). While the quality difference between A/R and DVA was not statistically significant, both algorithms yielded significantly better image quality than RETRO. PAWS and DVA were the most efficient algorithms, providing an approximately 20% and 40% relative increase in average navigator efficiency compared to A/R and RETRO, respectively.     

Fast 3D coronary artery contrast-enhanced magnetic resonance angiography with magnetization transfer contrast, fat suppression and parallel imaging as applied on an anthropomorphic moving heart phantom

A magnetic resonance sequence for high-resolution imaging of coronary arteries in a very short acquisition time is presented. The technique is based on fast low-angle shot and uses fat saturation and magnetization transfer contrast prepulses to improve image contrast. GeneRalized Autocalibrating Partially Parallel Acquisitions (GRAPPA) is implemented to shorten acquisition time. The sequence was tested on a moving anthropomorphic silicone heart phantom where the coronary arteries were filled with a gadolinium contrast agent solution, and imaging was performed at varying heart rates using GRAPPA. The clinical relevance of the phantom was validated by comparing the myocardial relaxation times of the phantom's homogeneous silicone cardiac wall to those of humans. Signal-to-noise ratio and contrast-to-noise ratio were higher when parallel imaging was used, possibly benefiting from the acquisition of one partition per heartbeat. Another advantage of parallel imaging for visualizing the coronary arteries is that the entire heart can be imaged within a few breath-holds.     

Phase contrast and time-of-flight magnetic resonance angiography of the intracerebral arteries at 1.5, 3 and 7 T

Purpose

Time-of-flight (ToF) and phase contrast (PC) magnetic resonance angiographies (MRAs) are noninvasive applications to depict the cerebral arteries. Both approaches can image the cerebral vasculature without the administration of intravenous contrast. Therefore, it is used in routine clinical evaluation of cerebrovascular diseases, e.g., aneurysm and arteriovenous malformations. However, subtle microvascular disease usually cannot be resolved with standard, clinical-field-strength MRA. The purpose of this study was to compare the ability of ToF and PC MRA to visualize the cerebral arteries at increasing field strengths.

Materials and Methods

The Institutional Review Board-approved study included eight healthy volunteers (age: 36±10 years; three female, five male). All subjects provided written informed consent. ToF and PC MRAs were obtained at 1.5, 3 and 7 T. Signal intensities of the large, primary vessels of the Circle of Willis were measured, and signal-to-noise ratios were calculated. Visualization of smaller first- and second-order branch arteries of the Circle of Willis was also evaluated.

Results

The results show that both ToF and PC MRAs allow the depiction of the large primary vessels of the Circle of Willis at all field strengths. Ultrahigh field (7 T) provides only small increases in the signal-to-noise ratio in these primary vessels due to the smaller voxel size acquired. However, ultrahigh-field MRA provides better visualization of the first- and second-order branch arteries with both ToF and PC approaches. Therefore, ultrahigh-field MRA may become an important tool in future neuroradiology research and clinical care.     

Fluoroscopically triggered contrast-enhanced 3D MR DSA and 3D time-of-flight turbo MRA of the carotid arteries: first clinical experiences in correlation with ultrasound, x-ray angiography, and endarterectomy findings

The aim of this article was to obtain initial experiences with fluoroscopically triggered contrast-enhanced (CE) 3D MR DSA with elliptical centric k-space order and 3D time-of-flight (TOF) turbo MRA of the carotid arteries. In this prospective study we examined 16 consecutive patients with suspicion of atherosclerotic disease involving the carotid arteries. Ultrasound was available in all, x-ray angiography in 12, surgical correlation in 9, and intraoperative x-ray angiography in 4 patients. All examinations were done on a 1.5 T unit applying: transverse plain 3D TOF turbo MRA and coronal CE MRA with fluoroscopic triggering. Combining head and neck array coils allowed the visualization of supraaortic arteries from the aortic arch to the circle of Willis. MRA results (maximum intensity projections) were compared with x-ray angiography, ultrasound, and inspection of endarterectomy specimens. Volume rendering was performed in selected cases additionally. Agreement between CE MRA, 3D TOF turbo MRA and x-ray angiography regarding stenoses of the internal and external carotid artery was very good. CE MRA was able to detect correctly intracranial stenoses, but delineation of the aortic arch and proximal common carotid arteries was sometimes reduced. Volume rendering was suited for visualization of MRA images providing a realistic three-dimensional impression. In conclusion, high-resolution fluoroscopically triggered CE MRA as non-invasive technique is another important step on the way to replace invasive x-ray angiography for the evaluation of atherosclerotic carotid artery disease. High resolution 3D TOF turbo MRA might be a helpful adjunct to increase the diagnostic reliability for the carotid bifurcation.     

Quantification of synovistis by MRI: correlation between dynamic and static gadolinium-enhanced magnetic resonance imaging and microscopic and macroscopic signs of synovial inflammation

Dynamic and static gadolinium-diethylenetriaminepentaacetic acid(Gd-DTPA)-enhanced magnetic resonance imaging (MRI) were evaluated as measures of joint inflammation in arthritis, by a comparison with macroscopic and microscopic signs of synovitis. Furthermore, the importance of the size of the evaluated synovial areas was investigated, as was the optimal time for enhancement measurements. Seventeen rheumatoid arthritis knees and 25 osteoarthritis knees, scheduled for arthroscopy or arthrotomy, were included. Macroscopic and microscopic synovial inflammation as well as nine histologic tissue characteristics were graded at four preselected biopsy sites. Preoperative T₁-weighted dynamic fast low angle shot and static spin-echo Gd-enhanced MRI were performed. The dynamic enhancement rate and the static enhancement were measured in the entire synovial membrane of a preselected slice as well as at the four biopsy sites, and compared to synovial pathology. The rate of early enhancement of the total synovial membrane of the preselected slice, determined by dynamic MRI, was highly correlated with microscopic evidence of active inflammation (Spearman ρ = 0.73; p < 10⁻⁷. Dynamic MRI could distinguish knees with and without synovial inflammation with a high predictive value (0.81–0.90). Moderate and severe inflammation could not be differentiated. The early enhancement rate was correlated with histologic features of active inflammation, particularly vessel proliferation and mononuclear leucocyte infiltration. Dynamic evaluation of small synovial sections at the biopsy sites and static spin-echo MRI resulted in considerably weaker correlations to histologic inflammation than dynamic evaluation of the total synovium. The optimal time for enhancement measurements was one-half to one minute after Gd injection, as the highest correlation coefficients to histologic inflammation were observed in this interval. Dynamic MRI can be used to determine synovial inflammation. Evaluation of large synovial areas one-half to one minute after Gd injection best reflects joint inflammation.     

Proton and deuteron magnetic resonance of methanes,silanes and GeH3D dissolved in nematic liquid crystals

The proton and deuteron magnetic resonance spectra of CH₄, CH₃D, CH₂D₂, CHD₃, CD₄, SiH₄, SiH₃D, SiH₂D₂, SiH₃D, SiD₄, GeH₃D, dissolved in nematic liquid crystals, are reported. It was found that these molecules, which are essentially tetrahedral, exhibit anisotropic interactions and are partially oriented in the nematic phase. This effect is presumably due to slight deformations induced by the anisotropic medium. Some of the aspects related to the interpretation of the results are discussed.     

Congenitally corrected transposition of the great arteries (L-TGA) with situs inversus totalis in adulthood: findings with magnetic resonance imaging

Diagnosis of congenitally corrected transposition of the great arteries (L-TGA) with situs inversus totalis in two adult patients was made by magnetic resonance imaging (MRI). Visualization of the complete anatomy and quantification of ventricular function was possible. Relevant concomitant disease such as perimembraneous ventricular septal defect, atrial secundum septal defect, tricuspid regurgitation, valvular pulmonic stenosis, and pulmonary artery dilatation were clearly depicted by MRI using standard spin-echo and gradient-echo techniques. Findings were confirmed by cardiac catheterization in both patients. In this rare and complex congenital cardiac anomaly, MRI is an excellent imaging modality as echocardiography may be difficult to interpret due to restricted imaging windows. MRI may help in the decision about the necessity to undergo further invasive evaluation and may help to make cardiac catheterization a straightforward procedure.