Pushing functional MRI spatial and temporal resolution further: High-density receive arrays combined with shot-selective 2D CAIPIRINHA for 3D echo-planar imaging at 7 T.

To be able to examine dynamic and detailed brain functions, the spatial and temporal resolution of 7 T MRI needs to improve. In this study, it was investigated whether submillimeter multishot 3D EPI fMRI scans, acquired with high-density receive arrays, can benefit from a 2D CAIPIRINHA sampling pattern, in terms of noise amplification (g-factor), temporal SNR and fMRI sensitivity. High-density receive arrays were combined with a shot-selective 2D CAIPIRINHA implementation for multishot 3D EPI sequences at 7 T. In this implementation, in contrast to conventional inclusion of extra kz gradient blips, specific EPI shots are left out to create a CAIPIRINHA shift and reduction of scan time. First, the implementation of the CAIPIRINHA sequence was evaluated with a standard receive setup by acquiring submillimeter whole brain T2 *-weighted anatomy images. Second, the CAIPIRINHA sequence was combined with high-density receive arrays to push the temporal resolution of submillimeter 3D EPI fMRI scans of the visual cortex. Results show that the shot-selective 2D CAIPIRINHA sequence enables a reduction in scan time for 0.5 mm isotropic 3D EPI T2 *-weighted anatomy scans by a factor of 4 compared with earlier reports. The use of the 2D CAIPIRINHA implementation in combination with high-density receive arrays, enhances the image quality of submillimeter 3D EPI scans of the visual cortex at high acceleration as compared to conventional SENSE. Both the g-factor and temporal SNR improved, resulting in a method that is more sensitive to the fMRI signal. Using this method, it is possible to acquire submillimeter single volume 3D EPI scans of the visual cortex in a subsecond timeframe. Overall, high-density receive arrays in combination with shot-selective 2D CAIPIRINHA for 3D EPI scans prove to be valuable for reducing the scan time of submillimeter MRI acquisitions.

Network analysis of EEG related functional MRI changes due to medication withdrawal in focal epilepsy.

Anti-epileptic drugs (AEDs) have a global effect on the neurophysiology of the brain which is most likely reflected in functional brain activity recorded with EEG and fMRI. These effects may cause substantial inter-subject variability in studies where EEG correlated functional MRI (EEG-fMRI) is used to determine the epileptogenic zone in patients who are candidate for epilepsy surgery. In the present study the effects on resting state fMRI are quantified in conditions with AED administration and after withdrawal of AEDs. EEG-fMRI data were obtained from 10 patients in the condition that the patient was on the steady-state maintenance doses of AEDs as prescribed (condition A) and after withdrawal of AEDs (condition B), at the end of a clinically standard pre-surgical long term video-EEG monitoring session. Resting state networks (RSN) were extracted from fMRI. The epileptic component (ICE) was identified by selecting the RSN component with the largest overlap with the EEG-fMRI correlation pattern. Changes in RSN functional connectivity between conditions A and B were quantified. EEG-fMRI correlation analysis was successful in 30% and 100% of the cases in conditions A and B, respectively. Spatial patterns of ICEs are comparable in conditions A and B, except for one patient for whom it was not possible to identify the ICE in condition A. However, the resting state functional connectivity is significantly increased in the condition after withdrawal of AEDs (condition B), which makes resting state fMRI potentially a new tool to study AED effects. The difference in sensitivity of EEG-fMRI in conditions A and B, which is not related to the number of epileptic EEG events occurring during scanning, could be related to the increased functional connectivity in condition B.

Subtractionless first-pass single contrast medium dose peripheral MR angiography using two-point Dixon fat suppression.

OBJECTIVE: To investigate the feasibility of subtractionless first-pass single contrast medium dose (0.1 mmol/kg) peripheral magnetic resonance angiography (MRA) at 1.5 T using two-point Dixon fat suppression and compare it with conventional subtraction MRA in terms of image quality. METHODS: Twenty-eight patients (13 male, 15 female; mean age ± standard deviation, 66 ± 16 years) with known or suspected peripheral arterial disease underwent subtractionless and subtraction first-pass MRA at 1.5 T using two-point Dixon fat suppression. Results were compared with regard to vessel-to-background contrast. A phantom study was performed to assess the signal-to-noise ratio (SNR) of both MRA techniques. Two experienced observers scored subjective image quality. Agreement regarding subjective image quality was expressed in quadratic weighted κ values. RESULTS: Vessel-to-background contrast improved in all anatomical locations with the subtractionless method versus the subtraction method (all P < 0.001). Subjective image quality was uniformly higher with the subtractionless method (all P < 0.03, except for the aorto-iliac arteries for observer 1, P = 0.052). SNR was 15 % higher with the subtractionless method (31.9 vs 27.6). CONCLUSION: This study demonstrates the feasibility of subtractionless first-pass single contrast medium dose lower extremity MRA. Moreover, both objective and subjective image quality are better than with subtraction MRA. KEY POINTS: • MRA is increasingly used for vascular applications. • Dixon imaging offers an alternative to image subtraction for fat suppression. • Subtractionless first-pass peripheral MRA is possible using two-point Dixon fat suppression. • Subtractionless peripheral MRA is possible at 1.5 T a single contrast medium dose. • Subtractionless first-pass peripheral MRA provides good image quality with few non-diagnostic studies.

Accuracy and precision of vessel area assessment: manual versus automatic lumen delineation based on full-width at half-maximum.

PURPOSE: To evaluate the accuracy and precision of manual and automatic blood vessel diameter measurements, a quantitative comparison was conducted, using both phantom and clinical 3D magnetic resonance angiography (MRA) data. Since diameters are often manually measured, which likely is influenced by operator dependency, automatic lumen delineation, based on the full-width at half-maximum (FWHM), could improve these measurements. MATERIALS AND METHODS: Manual and automatic diameter assessments were compared, using MRA data from a vascular phantom (geometry obtained with µCT) and clinical MRA data. The diameters were manually assessed by 15 MRA experts, using both caliper and contour tools. To translate the experimental results to clinical practice, the precision obtained using phantom data was compared to the precision obtained with clinical data. RESULTS: A diameter error <10% was obtained with resolutions above 2, 3, and 5 pixels/diameter for the automatic FWHM, contour, and caliper methods, respectively. Using phantom data, precision of the manual methods was low (error >20%), even at high resolutions, while precision for the automatic method was high (error <3%) when using more than 2 pixels/diameter. A similar trend was found with clinical data. CONCLUSION: The results obtained clearly demonstrate improvement in the accuracy and precision of vessel diameter measurements with use of the automatic FWHM-based method.

View-sharing in keyhole imaging: Partially compressed central k-space acquisition in time-resolved MRA at 3.0 T.

INTRODUCTION: Time-resolved contrast-enhanced magnetic resonance (MR) angiography (CEMRA) of the intracranial vasculature has proved its clinical value for the evaluation of cerebral vascular disease in cases where both flow hemodynamics and morphology are important. The purpose of this study was to evaluate a combination of view-sharing with keyhole imaging to increase spatial and temporal resolution of time-resolved CEMRA at 3.0 T. METHODS: Alternating view-sharing was combined with randomly segmented k-space ordering, keyhole imaging, partial Fourier and parallel imaging (4DkvsMRA). 4DkvsMRA was evaluated using varying compression factors (80-100) resulting in spatial resolutions ranging from (1.1×1.1×1.4) to (0.96×0.96×0.95) mm3 and temporal resolutions ranging from 586 ms/dynamic scan--288 ms/dynamic scan in three protocols in 10 healthy volunteers and seven patients (17 subjects). DSA correlation was available in four patients with cerebral arteriovenous malformations (cAVMs) and one patient with cerebral teleangiectasia. RESULTS: 4DkvsMRA was successfully performed in all subjects and showed clear depiction of arterial and venous phases with diagnostic image quality. At the maximum view-sharing compression factor (=100), a "flickering" artefact was observed. CONCLUSION: View-sharing in keyhole imaging allows for increased spatial and temporal resolution in time-resolved MRA.

4D time-resolved magnetic resonance angiography for noninvasive assessment of pulmonary arteriovenous malformations patency.

PURPOSE: To assess the capability of four-dimensional (4D) time-resolved magnetic resonance angiography (MRA) to assess pulmonary arteriovenous malformations (PAVMs) patency by analyzing pulmonary arterial and venous enhancement kinetics. MATERIALS AND METHODS: Seven patients with eight documented patent PAVMs underwent a 4D-MRA with keyhole and viewsharing compression at 3T with the following parameters: spatial resolution 0.87 × 0.87 × 1.4 mm(3); field of view 500 × 350 × 238 mm(3); dynamic scan time (temporal resolution) 1.2 seconds; total acquisition time 18.1 seconds for six dynamic datasets (6 × 1.2 sec + reference scan: 10.9 sec). All images were reviewed by two experienced radiologists. Image quality was rated on a qualitative 5-point scale (1: not assessable to 5: excellent). Signal value was measured on cross-sectional planes for the afferent arteries and efferent veins of the PAVM, and for normal reference healthy arteries and veins. The difference in time to peak for each coupled artery/vein (dTTPav) was calculated and compared with a Mann-Whitney test between PAVMs and reference vessels. RESULTS: Mean image quality was 3.2 ± 0.9. dTTPav was significantly smaller in PAVMs (0.15 ± 0.76 sec) than in reference vessels (3.75 ± 1.62 sec), P < 0.001. CONCLUSION: 4D-MRA is a promising tool for noninvasive assessment of PAVM patency.

Technical principles of MR angiography methods.

Magnetic resonance provides a wide variety of possibilities for arterial and venous blood vessel imaging in all vascular territories. This article provides a brief review of the technical principles of MR angiography. The first section is dedicated to non-contrast-enhanced angiography techniques and includes several distinct approaches: time-of-flight, phase contrast, triggered angiography non-contrast-enhanced, and balanced steady-state free precession. The second section relates to the contrast-enhanced and time-resolved contrast-enhanced MR angiography methods. The latest technical developments in MR imaging hardware, sequences and software, coil technology, and reconstruction capability allow dynamic MR angiography performance similar to CT angiography, without risks of iodine contrast agent and ionizing radiation exposure.

Neuroradiologic applications of dynamic MR angiography at 3 T.

Four-dimensional time-resolved MR angiography (4D-MRA) using keyhole imaging techniques is a new method of performing contrastenhanced vascular imaging. Combining parallel imaging and keyhole imaging techniques, it is possible to obtain dynamic MRA scans up to 60 times faster, thereby achieving subsecond sampling of the contrast hemodynamics. Furthermore, imaging at 3 T gives higher signal, thus affording higher spatial resolution and allowing dynamic 3D MRA to approach the diagnostic performance of conventional digital subtraction angiography. This article presents the authors' clinical experience using 4D-MRA to evaluate various vascular abnormalities in the brain, spine, orbits, and neck at 3 T, demonstrates the imaging findings of this novel technique, and discusses its advantages and use in current neuroradiology practice.