Noncontrast dynamic MRA in intracranial arteriovenous malformation (AVM), comparison with time of flight (TOF) and digital subtraction angiography (DSA)

Digital subtraction angiography (DSA) remains the gold standard to diagnose intracranial arteriovenous malformations (AVMs) but is invasive. Existing magnetic resonance angiography (MRA) is suboptimal for assessing the hemodynamics of AVMs. The objective of this study was to evaluate the clinical utility of a novel noncontrast four-dimensional (4D) dynamic MRA (dMRA) in the evaluation of intracranial AVMs through comparison with DSA and time-of-flight (TOF) MRA. Nineteen patients (12 women, mean age 26.2±10.7 years) with intracranial AVMs were examined with 4D dMRA, TOF and DSA. Spetzler-Martin grading scale was evaluated using each of the above three methods independently by two raters. Diagnostic confidence scores for three components of AVMs (feeding artery, nidus and draining vein) were also rated. Kendall's coefficient of concordance was calculated to evaluate the reliability between two raters within each modality (dMRA, TOF, TOF plus dMRA). The Wilcoxon signed-rank test was applied to compare the diagnostic confidence scores between each pair of the three modalities. dMRA was able to detect 16 out of 19 AVMs, and the ratings of AVM size and location matched those of DSA. The diagnostic confidence scores by dMRA were adequate for nidus (3.5/5), moderate for feeding arteries (2.5/5) and poor for draining veins (1.5/5). The hemodynamic information provided by dMRA improved diagnostic confidence scores by TOF MRA. As a completely noninvasive method, 4D dMRA offers hemodynamic information with a temporal resolution of 50-100 ms for the evaluation of AVMs and can complement existing methods such as DSA and TOF MRA.     

Flow properties of fast three-dimensional sequences for MR angiography

To reduce the scan time of time of flight or phase contrast angiography sequences, fast three-dimensional k-space trajectories can be employed. The best 3D trajectory depends on tolerable scan time, readout time, geometric flexibility, flow/motion properties and others. A formalism for flow/motion sensitivity comparison based on the velocity k-space behavior is presented. It consists in finding the velocity k-space position as a function of the spatial k-space position. The trajectories are compared graphically by their velocity k-space maps, with simulations and with an objective computed index. The flow/motion properties of various 3D trajectories (cones, spiral-pr hybrid, spherical stack of spirals, 3DFT, 3D echo-planar, and shells) were determined. In terms of flow/motion sensitivity the cones trajectory is the best, however, it is difficult to use it for anisotropic resolutions or fields of view. Tolerating more flow sensitivity, the stack of spirals trajectory offers more geometric flexibility.     

Automated imaging to track the 3D motion of particles

An automated 3D tracking technique for studying the motion of particles deep within the tumbling ball charge of an experimental grinding mill is described. The use of a Biplanar angioscope for the accurate location of objects moving in three dimensions is a novel application of this X-ray equipment. The X-ray beam used to produce the image data was parameterized using an accurately measured control frame. Preliminary experiments were conducted on a Perspex mill with a length and diameter of 140 mm. The digitally acquired X-ray images of the tumbling mill were processed using a fully automated imaging technique. The final 3D coordinates of the tracked particle trajectories are accurate to within 0.40 mm. This indicates that the technique is robust and thus capable of providing accurate verification data for the numerical modeling of the tumbling motion in mills.     

The application of total vertical projections for the unbiased estimation of the length of blood vessels and other structures by magnetic resonance imaging

A new stereological method has recently been developed to estimate the total length of a bounded curve in 3D from a sample of projections about a vertical axis. Unlike other methods based on serial section reconstructions, the new method is unbiased (i.e., it has zero systematic error). A basic requirement, not difficult to fulfill in many cases, is that the masking of one structure by another is not appreciable. The application of the new method to real curvilinear structures using a clinical magnetic resonance (MR) imager is illustrated. The first structure measured was a twisted water-filled glass tube of known length. The accuracy of the method was assessed: With six vertical projections, the tube length was measured to within 2% of the true value. The second example was a living bonsai tree, and the third was a clinical application of MR angiography. The possibility of applying the method to other scientific disciplines, for example, the monitoring of plant root growth, is discussed.     

Non-Contrast Enhanced 3D SSFP MRA of the Renal Allograft Vasculature: A Comparison Between Radial Linear Combination and Cartesian Inflow-Weighted Acquisitions

Renal transplant patients often require imaging to ensure appropriate graft placement, to assess integrity of transplant vessel anastomosis and to evaluate for stenosis that can be a cause of graft failure. Because there is risk for nephrogenic systemic fibrosis in the setting of renal insufficiency, the use of non-contrast MRA in these patients is helpful. In this study, the ability of two non-contrast MRA methods – 3D radial linear combination balanced SSFP (VIPR-SSFP) and inflow-weighted Cartesian SSFP (IFIR) – to visualize the transplant renal vessels is compared. Twenty-one renal transplant patients were scanned using the VIPR-SSFP and IFIR sequences. Diagnostic efficacy of the sequences was scored using a four point Likert scale according to the following criteria: overall image quality, fat suppression, and arterial/venous visualization quality. Average scores for each criterion were compared using the Wilcoxon signed-rank test. In addition to significantly improved venous visualization, the VIPR-SSFP sequence provided significantly improved fat suppression quality (p < 0.03) compared to IFIR. VIPR-SSFP also identified several pathologies such as renal arterial pseudoaneurysm that were not visible on the IFIR images. However, IFIR afforded superior quality of arterial visualization (p < 0.005). These two methods of non-contrast MR imaging each have significant strengths and are complementary to each other in evaluating the vasculature of renal allografts.     

双源CT4D-CTA联合灌注成像在急性脑缺血性疾病中的应用价值

目的：探讨双源CT 4维血管造影（4D- CTA）及灌注成像（CTPI）在急性脑缺血性疾病中的应用价值。方法对30例临床拟诊为急性脑缺血性疾病的患者于发病2-24h内行头颅CT平扫和全脑CTPI检查,获得脑血流量、脑血容量、平均通过时间、达峰时间等参数图,同时获得4D- CTA图像;于发病的1-3d后行MRI检查,分析CT平扫、CTPI、4D- CTA、MRI表现。结果 CT平扫发现12例有16个缺血病灶,CTPI发现26例32个缺血病灶,MRI发现25例28个缺血病灶,4D- CTA显示有20例责任血管有不同程度的狭窄或闭塞。结论双源CT 4D- CTA联合灌注成像能为急性脑缺血患者提供全面、详细的影像学信息,对急性缺血性脑梗死的早期诊断和治疗有重要价值。