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Background and Purpose: If magnetic resonance imaging (MRI) is to compete with computed tomography for evaluation of patients with acute ischemic stroke, there is a need for further improvements in acquisition speed., Methods: Inclusion criteria for this prospective, single institutional study were symptoms of acute ischemic stroke within 24 hours onset, National Institutes of Health Stroke Scale ≥3, and absence of MRI contraindications. A combination of echo-planar imaging (EPI) and a parallel acquisition technique were used on a 3T magnetic resonance (MR) scanner to accelerate the acquisition time. Image analysis was performed independently by 2 neuroradiologists., Results: A total of 62 patients met inclusion criteria. A repeat MRI scan was performed in 22 patients resulting in a total of 84 MRIs available for analysis. Diagnostic image quality was achieved in 100% of diffusion-weighted imaging, 100% EPI-fluid attenuation inversion recovery imaging, 98% EPI-gradient recalled echo, 90% neck MR angiography and 96% of brain MR angiography, and 94% of dynamic susceptibility contrast perfusion scans with interobserver agreements (k) ranging from 0.64 to 0.84. Fifty-nine patients (95%) had acute infarction. There was good interobserver agreement for EPI-fluid attenuation inversion recovery imaging findings (k=0.78; 95% confidence interval, 0.66-0.87) and for detection of mismatch classification using dynamic susceptibility contrast-Tmax (k=0.92; 95% confidence interval, 0.87-0.94). Thirteen acute intracranial hemorrhages were detected on EPI-gradient recalled echo by both observers. A total of 68 and 72 segmental arterial stenoses were detected on contrast-enhanced MR angiography of the neck and brain with k=0.93, 95% confidence interval, 0.84 to 0.96 and 0.87, 95% confidence interval, 0.80 to 0.90, respectively., Conclusions: A 6-minute multimodal MR protocol with good diagnostic quality is feasible for the evaluation of patients with acute ischemic stroke and can result in significant reduction in scan time rivaling that of the multimodal computed tomographic protocol., (© 2014 American Heart Association, Inc.)

Objectives: The goal of this work was to reduce the scan time of contrast-enhanced whole-heart coronary magnetic resonance angiography (MRA) by using a gradient echo interleaved echo planar imaging (GRE-EPI) sequence at 3 T field strength., Materials and Methods: A GRE-EPI sequence was optimized to acquire contrast-enhanced whole-heart coronary MRA at 3 T. First-order phase correction was used for alignment of the odd and even echoes in the GRE-EPI echo train. Single and dual reference scan techniques for estimation of the linear phase correction parameters were evaluated using both phantom and volunteer studies. The GRE-EPI readout was combined with parallel imaging for a further reduction in scan time. To avoid image distortions, calibration signals for coil sensitivity estimation were acquired in a separate low resolution GRE scan before the whole-heart GRE-EPI scan. Eight healthy volunteers were scanned with the optimized contrast-enhanced GRE-EPI sequence. GRE-EPI images were acquired during slow infusion (0.3 mL/s) of 0.1 mmol/kg body weight of Gd-BOPTA. For comparison purposes, the same 8 volunteers were scanned again in a separate scan session using a traditional GRE sequence with double the dose (0.2 mmol/kg body weight) of the same contrast agent with the same injection rate. The contrast-enhanced GRE-EPI and contrast-enhanced GRE techniques were compared in terms of relative signal-to-noise ratio (rSNR), relative contrast-to-noise ratio (rCNR), image quality scores, and visualized vessel lengths., Results: Both, phantom and volunteer studies demonstrated that the dual reference scan phase correction technique was a key step for obtaining satisfactory image quality using GRE-EPI at 3 T. Whole-heart coronary MRA with a spatial resolution of 1.0 x 1.0 x 2.0 mm3 was acquired with the GRE-EPI sequence in an average scan time of 2.5 +/- 0.6 minutes, compared with 8.6 +/- 2.7 minutes for the GRE technique. The GRE-EPI technique had lower rCNR compared with the GRE sequence. The image quality and coronary artery visualization with the GRE-EPI technique were adequate, and there was no statistically significant difference in the image quality scores, rSNR, and visualized coronary artery lengths between the GRE-EPI and GRE techniques., Conclusions: Contrast-enhanced whole-heart coronary MRA using the GRE-EPI technique resulted in excellent delineation of all the major coronary arteries and compared with current GRE techniques demonstrated a factor of 2 reduction in contrast agent dose and a factor of 3 reduction in scan time.

Objectives: To prospectively evaluate a 3-dimensional spoiled gradient-dual-echo (3D SPGR-DE) magnetic resonance imaging (MRI) sequence for the qualitative and quantitative analysis of liver fat content (LFC) in patients with the suspicion of fatty liver disease using histopathology as the standard of reference., Materials and Methods: Thirty-four adult patients (15 women; mean age, 67 +/- 13 years) underwent hepatic 1.5-Tesla 3D SPGR-DE MRI including in-/out-of-phase (IP/OP) and fat-only sequences prior to hepatic surgery with biopsy. Histopathological analyses of total and macrovesicular LFC could be made from biopsies of 39 segments in 23 patients. Two radiologists independently classified steatosis visually using a 4-point scale for IP/OP and fat-only images. Additionally, fat signal fractions (FSF) were calculated from signal intensities on IP/OP (FSF(ip/op)) and fat-only images (FSF(fat-only)). Pearson correlation analysis and Student t test were used to study the relationship between the FSF and LFC as determined by histopathology. The accuracy of MRI in detecting pathologically elevated LFC was assessed by receiver operating characteristic analysis., Results: Histopathology revealed steatosis in 29/39 (74%) segments in 15/23 patients (65%), with a total LFC ranging from <5% to 90%. Inter-reader agreement for visual steatosis grading was moderate (k = 0.53) for IP/OP images and good (k = 0.68) for fat-only images. FSF calculated from IP/OP and fat-only images significantly correlated with LFC from histopathology (both, P < 0.0001). Mean FSF(fat-only) and FSF(ip/op) values significantly differed from total LFC (both, P < 0.0001), whereas mean FSF(fat-only) showed no significant differences to macrovesicular LFC (P = 0.46). Both FSF(fat-only) and FSF(ip/op) performed accurately in discriminating between normal LFC and elevated LFC according to histopathology with good diagnostic accuracy (AUC: 0.85; 95% CI: 0.73-0.89 vs. AUC 0.90, 95% CI: 0.7-1.00)., Conclusions: FSF(fat-only) and FSF(ip/op) derived from 3D SPGR-DE MRI mostly reflect the macrovesicular as opposed to the total LFC from histopathology, whereas both discriminate healthy and fatty liver. Analysis of fat-only images improves interreader-agreement for visual liver steatosis grading.

Objective: With the introduction of ultrashort echo time (UTE) sequences solid polymeric materials might become visible on clinical whole-body magnetic resonance (MR) scanners. The aim of this study was to characterize solid polymeric materials typically used for instruments in magnetic resonance guided interventions and implants. Relaxation behavior and signal yield were evaluated on a 3-Tesla whole-body MR unit., Materials and Methods: Nine different commonly used solid polymeric materials were investigated by means of a 3-dimensional (3D) UTE sequence with radial k-space sampling. The investigated polymeric samples with cylindrical shape (length, 150 mm; diameter, 30 mm) were placed in a commercial 8-channel knee coil. For assessment of transverse signal decay (T2*) images with variable echo times (TE) ranging from 0.07 milliseconds to 4.87 milliseconds were recorded. Spin-lattice relaxation time (T1) was calculated for all MR visible polymers with transverse relaxation times higher than T2* = 300 mus using an adapted method applying variable flip angles. Signal-to-noise ratio (SNR) was calculated at the shortest achievable echo time (TE = 0.07 milliseconds) for standardized sequence parameters. All relaxation times and SNR data are given as arithmetic mean values with standard deviations derived from 5 axially oriented slices placed around the isocenter of the coil and magnet., Results: Six of the 9 investigated solid polymers were visible at TE = 0.07 milliseconds. Visible solid polymers showed markedly different SNR values, ie, polyethylene SNR = 1146 +/- 41, polypropylene SNR = 60 +/- 6. Nearly mono-exponential echo time dependent signal decay was observed: Transverse relaxation times differed from T2*=36 +/- 5 mus for polycarbonate to T2*=792 +/- 7 mus for polyvinylchloride (PVC). Two of the investigated solid polymers were applicable to T1 relaxation time calculation. Polyurethane had a spin-lattice relaxation time of T1 = 172 +/- 1 milliseconds, whereas PVC had T1 = 262 +/- 7 milliseconds, respectively., Conclusions: A variety of solid polymers can be visualized by means of clinical whole-body MR scanners and 3D ultrashort echo time (UTE) sequences. The investigated polymers differ substantially in signal yield, signal-decay, and spin-lattice relaxation time. The knowledge of the signal behavior of solid polymers on whole-body clinical MR scanners may help to select suitable polymeric materials for instruments and implants which are visible using UTE sequences.

Functional imaging of human sleep has been performed with nuclear medicine methods, but MRI has been difficult to implement, in part because of the noise associated with echo-planar imaging as well as the difficulty in reading physiologic signals in the MRI environment. We describe a silent MR sequence that can record brain activation over many hours with simultaneous acquisition of an EEG. This shows activation of occipital cortex and deactivation of frontal cortex during REM sleep, in agreement with previous studies using other techniques. MRI-Sleep-REM sleep.

Purpose: The purpose of this study was to compare the response in contractility of the right (RV) and left (LV) ventricle of the heart to beta-adrenergic stimulation using an echo planar MR technique., Method: In six sheep, RV and LV pressure-volume (P-V) relationships were constructed simultaneously using intraventricular pressures and volumes measured with echo planar MRI at rest and during dobutamine stress. Contractility changes were quantified by assessment of the end-systolic P-V relationship (ESPVR) and the preload recruitable stroke work (PRSW)., Results: Both the ESPVR the the PRSW showed a significant increase in contractility for both ventricles after dobutamine administration. The increase in contractility was significantly larger for the LV than for the RV, both measured wit the ESPVR (p < 0.0003) and the PRSW (p < 0.007)., Conclusion: This study shows the usefulness of echo planar MRI to assess myocardial contractility of both ventricles simultaneously. Furthermore, the study shows that beta-adrenergic stimulation has a significantly greater positive inotropic effect on LV contractility than on RV contractility.

Purpose: We measured the time lags between the start or end of tasks and signal changes in functional MRI (fMRI) for various age groups and evaluated the age correlation of the time lags., Methods: Forty subjects, 20-76 years old, were evaluated. fMRI was performed with and echo planar imaging sequence at 0.5 s intervals. We measured the time for the signal of the precentral gyrus to make a half-maximal increase after starting the task (T-inc) and the time to reach the initial level after ceasing the task (T-dec)., Results: Average T-inc was 3.09 s and T-dec was 6.63 s. The values of T-inc could be correlated to age. T-dec had no age correlation., Conclusion: The time lag in fMRI was revealed to be prolonged with increasing age. Our results suggest that the time lag in fMRI is influenced by some factors associated with aging.

Purpose: Our goal was to determine the effects of acoustic echoplanar scanner noise on pure tone hearing thresholds in normal volunteers and to determine the influence of echoplanar sequence repetition time on threshold effects., Method: With use of a calibrated audiometer, pure tones ranging from 125 to 8,000 Hz were delivered monaurally to 10 normal-hearing volunteers in a quiet MR scanner suite and in the presence of acoustic scanner noise produced by three separate single shot blipped echoplanar pulse sequences varying only in repetition time (TR = 1,000, 2,000, or 3,000 ms), with all other parameters including the number of slices held constant. The magnitude of noise-induced threshold changes and the slopes of the threshold curves produced by each of the three echoplanar pulse sequences were then analyzed using multiple comparisons and a least significant difference method. The shapes of the threshold curves produced in each background state were best fit using a quadratic effect for frequency in a mixed effects linear model and compared using F test statistics., Results: All of the volunteers demonstrated entirely normal hearing thresholds throughout the full range of tonal frequencies tested (< 25 dB) when no acoustic scanner noise was present in the scanner suite. Pure tone hearing thresholds significantly increased (p < 0.01) in the presence of acoustic scanner noise, with the magnitude of change inversely proportional to the repetition time and therefore the rate of periodic noise production by the echoplanar sequence used. The shape of the threshold curve in the presence of noise produced by the 1,000 ms TR sequence was not equivalent across the frequency spectrum tested but had a quadratic distribution with peak effects at 750-2,000 Hz. As the repetition time was increased and the periodic noise rate decreased, the magnitude of the noise-induced threshold changes significantly lessened (p < 0.01) and the quadratic distributions of the threshold curves changed significantly (p < 0.01), tending toward a more planar configuration., Conclusion: Background acoustic echoplanar scanner noise can significantly increase pure tone thresholds in the optimal frequency hearing range (125-8,000 Hz). However, the threshold effects are not equivalent across the frequency spectrum, and the magnitude of threshold changes is dependent on the rate at which periodic acoustic scanner noises are produced for a given sequence repetition time.

Objective: Our goal was to validate cardiac measurements derived from multishot echo planar MRI (EPI) as compared with the well validated conventional GRE technique., Method: Ten healthy subjects underwent breath-hold EPI and non-breath-hold GRE imaging in the short axis orientation of the left ventricle (LV) on a standard 1.5 T MR system. Ten section levels were obtained to encompass the entire LV. Measurements were obtained of end-diastolic volume (EDV), end-systolic volume (ESV), stroke volume (SV), ejection fraction (EF), LV mass, time to end-systole (TES), and peak filling rate (PFR). Analysis of variance was performed to determine agreement between GRE- and EPI-derived measurements., Results: The acquisition time for EPI was much shorter than that for GRE (2.5 vs. 15 min). Both imaging techniques yielded good quality images allowing LV volumetrics. Agreement between GRE and EPI was best for measurements of EDV, SV, and LV mass; somewhat less agreement was found for ESV, EF, TES, and PFR. The intraobserver variability for measuring TES and PFR was higher for GRE than EPI (one sided F test; critical values at p = 0.05 were > 3.18)., Conclusion: Multishot EPI of the heart provides accurate measurements of LV function and mass in a time-efficient manner.

Objective: Echoplanar MRI (EPI) with data acquisition times as short as 36 ms has been advocated for imaging body areas where gross physiologic motion degrades images. In this study we investigated the effect of various operator-defined parameters on image quality in EPI of the abdomen using a commercially available scanner., Materials and Methods: Specifically, we assessed the effect of breathholding, slice thickness, k-space coverage (raw data size), and high resolution EPI in volunteers. The effect of these parameters on signal-to-noise ratio (SNR) and image quality of liver, spleen, kidney, and pancreas was evaluated to propose guidelines for clinical EPI of the abdomen. The requirements for contiguous imaging were analyzed in a phantom experiment., Results: Our study suggests that optimum clinical EPI requires a minimum slice thickness of 7 mm. Breathhold single shot techniques are preferred to avoid spatial misregistrations and to optimize the signal yield for segmented techniques. Maximum k-space coverage at a given TE should be implemented. High resolution techniques (128 x 512) suffer from low SNR and are clinically not useful for routine EPI. Contiguous imaging requires a scan time of > 6 s to eliminate effects of cross-talk., Conclusion: The results suggest that clinical EPI requires careful attention to the choice of imaging parameters. The practical recommendations may help other investigators to optimize their clinical EPI studies.