Generation of 4D access corridors from real-time multislice MRI for guiding transapical aortic valvuloplasties.

Real-time image-guided cardiac procedures (manual or robot-assisted) are emerging due to potential improvement in patient management and reduction in the overall cost. These minimally invasive procedures require both real-time visualization and guidance for maneuvering an interventional tool safely inside the dynamic environment of a heart. In this work, we propose an approach to generate dynamic 4D access corridors from the apex to the aortic annulus for performing real-time MRI guided transapical valvuloplasties. Ultrafast MR images (collected every 49.3 ms) are processed on-the-fly using projections to extract a conservative dynamic trace in form of a three-dimensional access corridor. Our experimental results show that the reconstructed corridors can be refreshed with a delay of less than 0.5ms to reflect the changes inside the left ventricle caused by breathing motion and the heartbeat.

Noninvasive measurements of transmural myocardial metabolites using 3-D (31)P NMR spectroscopy.

A completely noninvasive three-dimensional (3-D) static magnetic field magnitude spatially localized (31)P spectroscopy technique has been developed and applied to study the in vivo canine myocardium at 9.4 T. The technique incorporates both Fourier series windows and selective Fourier transform methods utilizing all three orthogonal gradients for 3-D phase encoding. The number of data acquisitions for each phase-encoding step was weighted according to the Fourier coefficients to define cylindrical voxels. Spatially localized (31)P spectra can be generated for voxels of desired location within the field of view as a postprocessing step. The quality of localization was first demonstrated by using a three-compartment phantom. The technique was then applied to in vivo canine models and yielded (31)P cardiac spectra with an excellent signal-to-noise ratio. The in vivo validation experiments, using an implanted 2-phosphoenolpyruvate-containing marker, demonstrated that the technique is capable of measuring at least two transmural layers of left ventricular myocardium representing the subepicardium and subendocardium.

Quantitative measurements of cerebral blood flow in rats using the FAIR technique: correlation with previous iodoantipyrine autoradiographic studies.

Flow-sensitive alternating inversion recovery (FAIR) is a recently introduced MRI technique for assessment of perfusion that uses blood water as an endogenous contrast agent. To characterize the FAIR signal dependency on spin tagging time (inversion time (TI)) and to validate FAIR for cerebral blood flow (CBF) quantification, studies were conducted on the rat brain at 9.4 T using a conventional gradient-recalled echo sequence. The T1 of cerebral cortex and blood was found to be 1.9 and 2.2 s, respectively, and was used for CBF calculations. At short TIs (<0.8 s), the FAIR signal originates largely from vascular components with fast flows, resulting in an overestimation of CBF. For TI > 1.5 s, the CBF calculated from FAIR is independent of the spin tagging time, suggesting that the observed FAIR signal originates predominantly from tissue/capillary components. CBF values measured by FAIR with TI of 2.0 s were found to be in good agreement with those measured by the iodoantipyrine technique with autoradiography in rats under the same conditions of anesthesia and arterial pCO2. The measured pCO2 index on the parietal cortex using the FAIR technique was 6.07 ml/100 g/min per mmHg, which compares well with the pCO2 index measured by other techniques. The FAIR technique was also able to detect the regional reduction in CBF produced by middle cerebral artery occlusion in rats.

Multi-slice perfusion-based functional MRI using the FAIR technique: comparison of CBF and BOLD effects.

Perfusion-weighted imaging techniques employing blood water protons as an endogenous tracer have poor temporal resolution because each image should be acquired with an adequate spin 'tagging' time. Thus, perfusion-based functional magnetic resonance imaging studies are typically performed on a single slice. To alleviate this problem, a multi-slice flow-sensitive alternating inversion recovery technique has been developed. Following a single inversion pulse and a delay time, multi-slice echo-planar images are acquired sequentially without any additional inter-image delay. Thus, the temporal resolution of multi-slice FAIR is almost identical to that of single slice techniques. The theoretical background for multi-slice FAIR is described in detail. The multi-slice FAIR technique has been successfully applied to obtain three-slice cerebral blood flow based functional images during motor tasks. The relative CBF change in the contralateral motor/sensory area during unilateral thumb-digit opposition is 45.0+/-12.2% (n=9), while the blood oxygenation level dependent signal change is 1.5+/-0.4 SD%. Relative changes of the oxygen consumption rate can be estimated from CBF and BOLD changes using FAIR. The BOLD signal change is not correlated with the relative CBF increase, and thus caution should be exercised when interpreting the BOLD change as a quantitative index of the CBF change, especially in inter-subject comparisons.

Perfusion imaging by a flow-sensitive alternating inversion recovery (FAIR) technique: application to functional brain imaging.

Perfusion is a crucial physiological parameter for tissue function. To obtain perfusion-weighted images and consequently to measure cerebral blood flow (CBF), a newly developed flow-sensitive alternating inversion recovery (FAIR) technique was used. Dependency of FAIR signal on inversion times (TI) was examined; signal is predominantly located in large vessels at short TI, whereas it is diffused into gray matter areas at longer TI. CBF of gray matter areas in the human brain is 71 +/- 15 SD ml/100 g/min (n = 6). In fMRI studies, micro- and macrovessel inflow contributions can be obtained by adjusting TIs. Signal changes in large vessel areas including the scalp were seen during finger opposition at a TI of 0.4 s; however, these were not observed at a longer TI of 1.4 s. To compare with commonly used BOLD and slice selective inversion recovery techniques, FAIR and BOLD images were acquired at the same time during unilateral finger opposition. Generally, activation sites determined by three techniques are consistent. However, activation of some areas can be detected only by FAIR, not by BOLD, suggesting that the oxygen consumption increase couples with the CBF change completely. Relative and absolute CBF changes in the contralateral motor cortex are 53 +/- 17% SD (n = 9) and 27 +/- 11 SD ml/100 g/min (n = 9), respectively.

Fast anatomical imaging of the heart and assessment of myocardial perfusion with arrhythmia insensitive magnetization preparation.

A new contrast preparation based on modified driven equilibrium Fourier transfer is introduced and evaluated for generation of T1-weighted images for assessment of the myocardial perfusion with contrast agent first-pass kinetics. The new preparation scheme produces T1 contrast with insensitivity to arrhythmias in prospectively triggered sequential imaging thereby eliminating one of the major sources of problems in potential patient studies with previously employed contrast preparations schemes.

Myocardial tagging with B1 insensitive adiabatic DANTE inversion sequences.

A new technique, based on adiabatic delays alternating with mutations for tailored excitation (DANTE) inversion sequences, is presented for generating uniform contrast tags across the myocardial wall even in the presence of B1 inhomogeneities. The utility of this pulse was demonstrated using a surface coil for both transmission and signal reception in phantom and animal heart tagging studies. The experimental data demonstrated uniform grid contrast over a sixfold variation of B1 magnitude, sharp tagging profiles, and the ability to follow the cardiac wall motion through the deformation of the fine rectangular tagging grid at different phases throughout the cardiac cycle.