Vulnerable plaque detection by 3.0 tesla magnetic resonance imaging.

RATIONALE AND OBJECTIVES: A clinical case report is presented on a 76-year-old man who volunteered for a 3.0 T magnetic resonance (MR) carotid protocol. The subject was referred for carotid endarterectomy and histology was performed on the ex vivo specimen and compared with the in vivo images. METHODS: The 3.0 and 1.5 T (obtained for comparison) MR protocol consisted of 2-dimensional (2D) and 3-dimensional (3D) multicontrast bright and black blood imaging for detecting the lumen and vessel wall. RESULTS: The combination of multicontrast black blood transverse images and the 3D time of flight transverse images provided visualization of a narrowed internal carotid artery lumen 4 mm above of the bifurcation and the presence of a complex atherosclerotic plaque containing a large lipid pool, calcification, and intact fibrous cap. Quantitative comparisons including vessel lumen and plaque area, signal-to-noise (SNR) and contrast-to-noise (CNR) ratios were obtained for 1.5 and 3.0 T image data. Plaque composition was verified with histology. Macrophages were also detected in the shoulders of the plaque as demonstrated by CD68 staining and corresponded with a small hyperintense area in the T2W images at 3.0 T, but not observed in comparable 1.5 T images. CONCLUSIONS: High field 3.0 T multicontrast MRI of atherosclerotic plaque has been validated with histology comparison and provides improved detection of complex atherosclerotic plaque with increased SNR and CNR compared with 1.5 T. Further studies validating contrast mechanisms of plaque at 3.0 T are required, but atherosclerotic plaque imaging has clear benefit from application at the higher magnetic field strength.

Bright and black blood imaging of the carotid bifurcation at 3.0T.

PURPOSE: The aim of this study was to evaluate our preliminary experience at 3.0 T with imaging of the carotid bifurcation in healthy and atherosclerotic subjects. Application at 3.0 T is motivated by the signal-to-noise gain for improving spatial resolution and reducing signal averaging requirements. MATERIALS AND METHODS: We utilized a dual phased array coil and applied 2D, 3D time of flight (TOF) and turbo spin echo (TSE) sequences with comparison of two lumen signal suppression methods for black blood (BB) TSE imaging including double inversion preparation (DIR) and spatial presaturation pulses. The signal-to-noise ratios (SNR) of healthy carotid vessel walls were compared in 2D and 3D BB TSE acquisitions. The bright and black blood multi-contrast exam was demonstrated for a complex carotid plaque. RESULTS: Contrast-to-noise (CNR) greater than 150 was achieved between the lumen and suppressed background for 3D TOF. For BB, both methods provided sufficient lumen signal suppression but slight residual flow artifacts remained at the bifurcation level. As expected 3D TSE images had higher SNR compared to 2D, but increased motion sensitivity is a significant issue for 3D at high field. For multi-contrast imaging of atherosclerotic plaque, fibrous, calcified and lipid components were resolved. The CNR ratio of fibrous (bright on PDW, T2W) and calcified (dark in T1W, T2W, PDW) plaque components was maximal in the T2W images. The 3D TOF angiogram indicating a 40% stenosis was complemented by 3D multi-planar reformat of BB images that displayed plaque extent. Detection of intimal thickening, the earliest change associated with atherosclerotic progression was observed in BB PDW images at 3.0 T. CONCLUSIONS: High SNR and CNR images have been demonstrated for the healthy and diseased carotid. Improvements in RF coils along with pulse sequence optimization, and evaluation of endogenous and exogenous contrast mechanisms will further enhance carotid imaging at 3.0T.

Comparison of cardiac MRI on 1.5 and 3.0 Tesla clinical whole body systems.

RATIONALE AND OBJECTIVES: A cardiac imaging pilot study was performed on 1.5 and 3.0 Tesla (T) whole body magnetic resonance units equipped with identical gradient sets and geometrically equivalent body coils. The goals were to compare the signal-to-noise (SNR) and contrast-to-noise (CNR) ratios on matched studies conducted at both field strengths and demonstrate the potential for functional and morphologic cardiac evaluation at 3.0 T. METHODS: Short axis cine true fast imaging with steady precession (True FISP) was compared at 1.5 and 3.0 T using the body coil in transmit-receive mode and transmit-only with single loop and phased array receiver coils. SNR of the myocardium and CNR of the ventricular blood and myocardium were calculated from a quantitative region of interest analysis of these data. Additionally at 3.0 T, long axis and 4-chamber cine as well as "dark blood" imaging are demonstrated with sequence and parameter settings comparable to current state of the art for cardiac evaluation at 1.5 T. RESULTS: The 3.0 T data consistently demonstrates increases in SNR when all imaging conditions are closely matched but the increase has a large variability ranging from 20 to 85% depending on the radiofrequency coil configuration. Ventricular blood-myocardium CNR greater than 30 is obtained at 3.0 T, which is comparable to an optimized 1.5 T acquisition despite the specific absorption rate limitation of flip angle to nearly one half the value. The increased SNR at 3.0 T improves detection of fine anatomic detail, such as the chordae tendineae and mitral valve structure. CONCLUSIONS: Increased specific absorption rate can be a limiting fact; however, we have demonstrated that 3.0 T cardiac imaging shows gains in SNR while maintaining the CNR. The SNR gain is advantageous, and phased array coil technology is key for improving cardiac magnetic resonance imaging at 3.0 T.