Search

Background: View-sharing (VS) increases spatiotemporal resolution in dynamic contrast-enhanced (DCE) MRI by sharing high-frequency k-space data across temporal phases. This temporal sharing results in respiratory motion within any phase to propagate artifacts across all shared phases. Compressed sensing (CS) eliminates the need for VS by recovering missing k-space data from pseudorandom undersampling, reducing temporal blurring while maintaining spatial resolution., Purpose: To evaluate a CS reconstruction algorithm on undersampled DCE-MRI data for image quality and hepatocellular carcinoma (HCC) detection., Study Type: Retrospective., Subjects: Fifty consecutive patients undergoing MRI for HCC screening (29 males, 21 females, 52-72 years)., Field Strength/sequence: 3.0T MRI. Multiphase 3D-SPGR T 1 -weighted sequence undersampled in arterial phases with a complementary Poisson disc sampling pattern reconstructed with VS and CS algorithms., Assessment: VS and CS reconstructions evaluated by blinded assessments of image quality and anatomic delineation on Likert scales (1-4 and 1-5, respectively), and HCC detection by OPTN/UNOS criteria including a diagnostic confidence score (1-5). Blinded side-by-side reconstruction comparisons for lesion depiction and overall series preference (-3-3)., Statistical Analysis: Two-tailed Wilcoxon signed rank tests for paired nonparametric analyses with Bonferroni-Holm multiple-comparison corrections. McNemar's test for differences in lesion detection frequency and transplantation eligibility., Results: CS compared with VS demonstrated significantly improved contrast (mean 3.6 vs. 2.9, P < 0.0001) and less motion artifact (mean 3.6 vs. 3.2, P = 0.006). CS compared with VS demonstrated significantly improved delineations of liver margin (mean 4.5 vs. 3.8, P = 0.0002), portal veins (mean 4.5 vs. 3.7, P < 0.0001), and hepatic veins (mean 4.6 vs. 3.5, P < 0.0001), but significantly decreased delineation of hepatic arteries (mean 3.2 vs. 3.7, P = 0.004). No significant differences were seen in the other assessments., Data Conclusion: Applying a CS reconstruction to data acquired for a VS reconstruction significantly reduces motion artifacts in a clinical DCE protocol for HCC screening., Level of Evidence: 3 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2019;49:984-993., (© 2018 International Society for Magnetic Resonance in Medicine.)

A pedagogical review of fluid-attenuated inversion recovery (FLAIR) and double inversion recovery (DIR) imaging is conducted in this article. The basics of the two pulse sequences are first described, including the details of the inversion preparation and imaging sequences with accompanying mathematical formulae for choosing the inversion time in a variety of scenarios for use on clinical MRI scanners. Magnetization preparation (or T2prep), a strategy for improving image signal-to-noise ratio and contrast and reducing T 1 weighting at high field strengths, is also described. Lastly, image artifacts commonly associated with FLAIR and DIR are described with clinical examples, to help avoid misdiagnosis., Level of Evidence: 5 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2017;46:1590-1600., (© 2017 International Society for Magnetic Resonance in Medicine.)

Purpose: To develop a novel multiresolution MRI methodology for accurate estimation of glomerular filtration rate (GFR) in vivo., Materials and Methods: A three-dimensional golden-angle radial stack-of-stars (SoS) trajectory was used for data acquisition on a 3 Tesla MRI scanner. Multiresolution reconstruction and analysis was performed using arterial input function reconstructed at 1-s. temporal resolution and renal dynamic data reconstructed using compressed sensing (CS) with 4-s temporal resolution. The method was first validated using simulations and the clinical utility of the technique was evaluated by comparing the GFR estimates from the proposed method to the estimated GFR (eGFR) obtained from serum creatinine for 10 subjects., Results: The 4-s temporal resolution CS images minimized streaking artifacts and noise while the 1-s temporal resolution AIF minimized errors in GFR estimates. A paired t-test showed that there was no statistically significant difference between MRI based total GFR values and serum creatinine based eGFR estimates (P = 0.92)., Conclusion: We have demonstrated the feasibility of multiresolution MRI using a golden angle radial stack-of-stars scheme to accurately estimate GFR as well as produce diagnostic quality dynamic images in vivo., Level of Evidence: 1 Technical Efficacy: Stage 3 J. MAGN. RESON. IMAGING 2017;46:303-311., (© 2017 International Society for Magnetic Resonance in Medicine.)

Purpose: To assess the ability of high-resolution arterial phase imaging of hepatocellular carcinoma (HCC) to provide combined vascular characterization and parenchymal evaluation., Materials and Methods: Thirty-eight consecutive studies in cirrhotic patients with HCC scanned with a view-shared 2-point-Dixon-based Differential Subsampling with Cartesian Ordering (DISCO) sequence were analyzed. Lesion contrast relative to precontrast and adjacent parenchyma was evaluated and compared using a Fisher's exact test. Visibility of hepatic arteries and tumor feeding vessels were graded on a 5-point scale. Catheter angiography was used as a reference standard for arterial anatomy., Results: The high spatiotemporal multiphasic acquisition allowed imaging of both the angiographic and late arterial phase in 30 of 38 studies with good image quality. Maximal lesion enhancement compared to precontrast occurred more frequently during the late arterial phase compared to maximal lesion-to-adjacent, which occurred more frequently during the early arterial phase (P < 0.001). Common and proper hepatic arteries were visualized adequately in 100%, right hepatic artery in 94-97%, left hepatic artery in 94%, and segmental vessel in 83% of cases. Arterial variants were detected with sensitivity of 87-100% and specificity of 100%., Conclusion: High spatiotemporal resolution arterial phase imaging provides multiple angiographic and arterial phases in a single breath-hold, enabling accurate depiction of vascular anatomy while maintain optimal arterial phase imaging for characterization of focal lesions., (© 2015 Wiley Periodicals, Inc.)

Purpose: To develop and validate clinically a single-shot fast spin echo (SSFSE) sequence utilizing variable flip angle refocusing pulses to shorten acquisition times via reductions in specific absorption rate (SAR) and improve image quality., Materials and Methods: A variable refocusing flip angle SSFSE sequence (vrfSSFSE) was designed and implemented, with simulations and volunteer scans performed to determine suitable flip angle modulation parameters. With Institutional Review Board (IRB) approval/informed consent, patients referred for 3T abdominal magnetic resonance imaging (MRI) were scanned with conventional SSFSE and either half-Fourier (n = 25) or full-Fourier vrfSSFSE (n = 50). Two blinded radiologists semiquantitatively scored images on a scale from -2 to 2 for contrast, noise, sharpness, artifacts, cardiac motion-related signal loss, and the ability to evaluate the pancreas and kidneys., Results: vrfSSFSE demonstrated significantly increased speed (∼2-fold, P < 0.0001). Significant improvements in image quality parameters with full-Fourier vrfSSFSE included increased contrast, sharpness, and visualization of pancreatic and renal structures with higher bandwidth technique (mean scores 0.37, 0.83, 0.62, and 0.31, respectively, P ≤ 0.001), and decreased image noise and improved visualization of renal structures when used with an equal bandwidth technique (mean scores 0.96 and 0.35, respectively, P < 0.001). Increased cardiac motion-related signal loss with full-Fourier vrfSSFSE was seen in the pancreas but not the kidney., Conclusion: vrfSSFSE increases speed at 3T over conventional SSFSE via reduced SAR, and when combined with full-Fourier acquisition can improve image quality, although with some increased sensitivity to cardiac motion-related signal loss., (© 2015 Wiley Periodicals, Inc.)

Purpose: To investigate a new variable spatiotemporal resolution dynamic contrast-enhanced (DCE) MRI method termed DIfferential Subsampling with Cartesian Ordering (DISCO), for imaging of breast cancer., Materials and Methods: DISCO combines variable density, pseudorandom k-space segmentation and two-point Dixon fat-water separation for high spatiotemporal resolution breast DCE MRI. During the contrast wash-in phase, view sharing is used to achieve high temporal resolution. Forty patients referred for breast MRI were imaged, 26 using the proposed DISCO sequence and 14 using a conventional low-spatial-resolution dynamic sequence (VIBRANT-FLEX) on a 3 Tesla scanner. DISCO dynamic images from 14 patients were compared with VIBRANT-FLEX images from 14 other patients. The image quality assessed by radiologist image ranking in a blinded manner, and the temporal characteristics of the two sequences were compared., Results: A spatial resolution of 1.1 × 1.1 × 1.2 mm(3) (160 slices, 28 cm field of view) was achieved with axial bilateral coverage in 120 s. Dynamic images with ∼ 9 s effective temporal resolution were generated during the 2-min contrast wash-in phase. The image quality of DISCO dynamic images ranked significantly higher than low spatial resolution VIBRANT-FLEX images (19.5 versus 9.5, Mann-Whitney U-test P = 0.00914), with no significant differences in the maximum slope of aortic enhancement., Conclusion: DISCO is a promising variable-spatiotemporal-resolution imaging sequence for capturing the dynamics of rapidly enhancing tumors as well as structural features postcontrast. A near 1-mm isotropic spatial resolution was achieved with postcontrast static phase images in 120 s and dynamic phase images acquired in 9 s per phase., (© 2013 Wiley Periodicals, Inc.)

Purpose: To evaluate the performance of 2D versus 3D T2-weighted spin echo imaging in the breast., Materials and Methods: 2D and 3D T2-weighted images were acquired in 25 patients as part of a clinically indicated breast magnetic resonance imaging (MRI) exam. Lesion-to-fibroglandular tissue signal ratio was measured in 16 identified lesions. Clarity of lesion morphology was assessed through a blinded review by three radiologists. Instances demonstrating the potential diagnostic contribution of 3D versus 2D T2-weighted imaging in the breast were noted through unblinded review by a fourth radiologist., Results: The lesion-to-fibroglandular tissue signal ratio was well correlated between 2D and 3D T2-weighted images (R(2)  = 0.93). Clarity of lesion morphology was significantly better with 3D T2-weighted imaging for all observers based on a McNemar test (P ≤ 0.02, P ≤ 0.01, P ≤ 0.03). Instances indicating the potential diagnostic contribution of 3D T2-weighted imaging included improved depiction of signal intensity and improved alignment between DCE and T2-weighted findings., Conclusion: In this pilot study, 3D T2-weighted imaging provided comparable contrast and improved depiction of lesion morphology in the breast in comparison to 2D T2-weighted imaging. Based on these results further investigation to determine the diagnostic impact of 3D T2-weighted imaging in breast MRI is warranted., (Copyright © 2013 Wiley Periodicals, Inc.)

Purpose: To develop a breathhold three-dimensional (3D) Dixon technique for fat suppressed imaging of myocardial infarction., Materials and Methods: A pulse sequence was developed that uses a radial fan-beam k-space segmentation scheme for efficient coverage of k-space, enabling 3D scans in a single breathhold. The sequence uses a dual-echo bipolar readout to enable Dixon fat-water separation for improved visualization of epicardial and pericardial delayed enhancement. The 3D Dixon method was compared with a conventional 2D fast gradient recalled echo (FGRE) -based technique in 25 patients., Results: Pericardial visualization scores and confidence were higher while overall image quality and artifacts were slightly worse for 3D Dixon compared with 2D FGRE. Robust fat suppression was achieved in 21 of 25 cases using the 3D Dixon method., Conclusion: A 3D breathhold method for fat-water separated imaging of myocardial delayed enhancement was developed and validated., (Copyright © 2013 Wiley Periodicals, Inc.)

Purpose: To determine whether a multiphase method with high spatiotemporal resolution (STR) by means of a combination of parallel imaging, pseudorandom sampling and temporal view sharing improves the capture and intensity of gadoxetate arterial phase images as well as lesion enhancement., Materials and Methods: Thirty-seven patients were imaged with a conventional spoiled gradient echo acquisition and 48 with a high STR multiphase acquisition after the administration of gadoxetate. Arterial phase capture, image quality, and quality of fat suppression were qualitatively graded. Fourteen lesions in the conventional group and 28 in the high STR multiphase group were imaged, including 34 focal nodular hyperplasias. The ratio of lesion to parenchyma enhancement as well as relative hepatic artery enhancement were calculated. Chi-squared, Mann-Whitney U and student t-tests were used to compare differences., Results: The high STR multiphase acquisition included the arterial phase more frequently than conventional acquisitions (P < 0.001), with the arterial phase missed in 17% (95% CI of 4-28%) of patients with conventional acquisition compared with 2% (95% CI of 0-6%) with the high STR multiphase acquisition. There was no loss of image quality or degree of fat saturation. Additionally, there was increased relative intensity of the hepatic arteries (P < 0.001) as well as lesion enhancement (P = 0.01)., Conclusion: The high STR multiphase acquisition resulted in more reliable gadoxetate arterial phase capture compared with a conventional acquisition while preserving image quality with robust fat saturation., (Copyright © 2013 Wiley Periodicals, Inc.)

Purpose: To develop and evaluate a multiphasic contrast-enhanced MRI method called DIfferential Sub-sampling with Cartesian Ordering (DISCO) for abdominal imaging., Materials and Methods: A three-dimensional, variable density pseudo-random k-space segmentation scheme was developed and combined with a Dixon-based fat-water separation algorithm to generate high temporal resolution images with robust fat suppression and without compromise in spatial resolution or coverage. With institutional review board approval and informed consent, 11 consecutive patients referred for abdominal MRI at 3 Tesla (T) were imaged with both DISCO and a routine clinical three-dimensional SPGR-Dixon (LAVA FLEX) sequence. All images were graded by two radiologists using quality of fat suppression, severity of artifacts, and overall image quality as scoring criteria. For assessment of arterial phase capture efficiency, the number of temporal phases with angiographic phase and hepatic arterial phase was recorded., Results: There were no significant differences in quality of fat suppression, artifact severity or overall image quality between DISCO and LAVA FLEX images (P > 0.05, Wilcoxon signed rank test). The angiographic and arterial phases were captured in all 11 patients scanned using the DISCO acquisition (mean number of phases were two and three, respectively)., Conclusion: DISCO effectively captures the fast dynamics of abdominal pathology such as hyperenhancing hepatic lesions with a high spatio-temporal resolution. Typically, 1.1 × 1.5 × 3 mm spatial resolution over 60 slices was achieved with a temporal resolution of 4-5 s., (Copyright © 2012 Wiley Periodicals, Inc.)

Purpose: To evaluate the capability of a new breathhold non-contrast-enhanced MRA method (Non-contrast Outer Radial Inner Square k-space Scheme, NORISKS) to visualize renal arteries by comparing the method with a routine clinical but significantly longer non-contrast-enhanced (non-CE) MRA technique., Materials and Methods: Eighteen subjects referred for abdominal MRI were examined with NORISKS and a routine non-contrast-enhanced MRA technique. Two versions of NORISKS were evaluated: with and without ECG gating. The images were then scored independently and in blinded manner by two radiologists on 5-point scales for visualization of the proximal and distal renal arteries and quality of fat suppression., Results: No statistically significant difference was detected between NORISKS and routine clinical non-CE MRA in all categories except for visualization of the distal renal arteries where ungated NORISKS performed poorer than the routine non-CE MRA (P < 10(-4) )., Conclusion: We have demonstrated a promising non-CE MRA method for acquiring renal angiograms within a breathhold without any compromise in spatial resolution or coverage. ECG-gated NORISKS is able to acquire renal angiograms that are comparable to a routine clinical non-CE MRA method (Inhance IFIR, GE Healthcare), which requires approximately seven times the scan time of NORISKS., (Copyright © 2011 Wiley Periodicals, Inc.)

Purpose: To evaluate a new dynamic contrast-enhanced (DCE) imaging technique called multiecho time-resolved acquisition (META) for abdominal/pelvic imaging. META combines an elliptical centric time-resolved three-dimensional (3D) spoiled gradient-recalled echo (SPGR) imaging scheme with a Dixon-based fat-water separation algorithm to generate high spatiotemporal resolution volumes., Materials and Methods: Twenty-three patients referred for hepatic metastases or renal masses were imaged using the new META sequence and a conventional fat-suppressed 3D SPGR sequence on a 3T scanner. In 12 patients, equilibrium-phase 3D SPGR images acquired immediately after META were used for comparing the degree and homogeneity of fat suppression, artifacts, and overall image quality. In the remaining 11 of 23 patients, DCE 3D SPGR images acquired in a previous or subsequent examination were used for comparing the efficiency of arterial phase capture in addition to the qualitative analysis for the degree and homogeneity of fat suppression, artifacts, and overall image quality., Results: META images were determined to be significantly better than conventional 3D SPGR images for degree and uniformity of fat suppression and ability to visualize the arterial phase. There were no significant differences in artifact levels or overall image quality., Conclusion: META is a promising high spatiotemporal resolution imaging sequence for capturing the fast dynamics of hyperenhancing hepatic lesions and provides robust fat suppression even at 3T.

Purpose: To develop a gated single-breathhold, high temporal resolution three-dimensional (3D) CINE imaging technique and to evaluate its accuracy in volumetric and functional quantification in patients with chronic myocardial infarction., Materials and Methods: A 3D CINE steady-state free precession (SSFP) pulse sequence was developed incorporating variable temporal sampling of the low and high spatial frequency k-space data to reduce breathhold time and parallel imaging to increase temporal resolution. Reconstruction with retrospective interpolation enabled complete R-R interval coverage. Feasibility was assessed in eight patients with chronic myocardial infarction and ventricular functional values were compared to those of a 2D CINE acquisition., Results: There was no significant difference between the 3D CINE and 2D CINE for end-diastolic volume (168 +/- 73 vs. 177 +/- 59 mL, respectively; P < 0.27), end-systolic volume (81 +/- 62 vs. 79 +/- 53 mL; P < 0.81), and ejection fraction (EF) measurements (55 +/- 14% vs. 58 +/- 14%; P < 0.14). The mean difference in EF was less than 2.5%. A wall motion assessment indicated a good agreement, with a weighted kappa value of 0.62., Conclusion: High temporal resolution 3D CINE SSFP imaging of the whole heart can be obtained in a single breathhold and yield ventricular function measurements similar to 2D CINE methods., ((c) 2007 Wiley-Liss, Inc.)

Purpose: To improve the signal-to-noise ratio (SNR) of breath-held coronary magnetic resonance angiography (CMRA) without increasing the number or duration of breath holds., Materials and Methods: In this BACSPIN (Breathing AutoCorrection with SPiral INterleaves) technique, a single breath-held electrocardiogram (ECG)-gated multi-slice interleaved-spiral data set is acquired, followed by repeated imaging of the same slices during free breathing. Each spiral interleaf from the breath-held data set is used as a standard for comparison with corresponding acquisitions at the same interleaf angle during free breathing. The most closely matched acquisitions are incorporated into a multi-slice, multi-average data set with increasing SNR over time. In-plane translations of the coronary artery can be measured and compensated for each accepted acquisition before combination with the other acquisitions., Results: CMRA was performed on six volunteers, with improved SNR and minimal motional blurring. In some cases, breath holding could be dispensed with completely and the average respiratory position used as a reference., Conclusion: BACSPIN provides a promising method for CMRA with improved SNR and limited breath-holding requirements., (Copyright 2003 Wiley-Liss, Inc.)

Purpose: First, to apply a breath-hold multislice 2D spiral magnetic resonance (MR) approach in patients acquiring within 16 heartbeats (acquisition window, 116 msec) a 10-mm-thick stack of four slices (resolution, 1.3 x 1.3 mm(2)); and second, to evaluate the effect of an intravascular Fe-based contrast medium (CM) on a signal-to-noise ratio (SNR) and a contrast-to-noise ratio (CNR)., Materials and Methods: In each patient one or two coronary arteries were imaged prior to and following cumulative doses of 0.25, 0.5, and 0.75 mg of Fe/kg of body weight (bw) of an intravascular CM (CLARISCAN trade mark, Nycomed-Amersham, Princeton, NJ, USA) containing ultrasmall superparamagnetic iron oxide (USPIO) particles., Results: On precontrast maximum intensity projection (MIP) images generated from the stack of slices, 10 and 11 stenoses of 12 stenoses confirmed by coronary angiography were detected by readers 1 and 2, respectively. SNR and CNR in the coronary arteries peaked at 0.50 mg of Fe/kg of bw, yielding a slight increase of 15.5% and 18.4%, respectively (P < 0.05 vs. precontrast), which did not improve detection of coronary artery stenoses., Conclusion: The presented multislice spiral approach allows display of coronary anatomy in MIP formats for convenient display of coronary stenoses. The pulse sequence did not benefit from an intravascular USPIO-based CM, since little improvement in SNR and CNR was achieved., (Copyright 2002 Wiley-Liss, Inc.)