Detection of acute renal ischemia in swine using blood oxygen level-dependent magnetic resonance imaging.

PURPOSE: To determine the feasibility and sensitivity of blood oxygen level-dependent (BOLD) magnetic resonance imaging (MRI) to detect acute renal ischemia, using a swine model, and to present the causes of variability and assess techniques that minimize variability introduced during data analysis. MATERIALS AND METHODS: BOLD MRI was performed in axial and coronal planes of the kidneys of five swine. Color R2* maps were calculated and mean R2* values and 95% confidence intervals (CIs) for the cortex and medulla were determined for baseline, renal artery occlusion and reperfusion conditions. Paired Student's t-tests were used to determine significance. RESULTS: Mean R2* measurements increased from baseline during renal artery occlusion in the cortex (axial, 13.8-24.6 second(-1); coronal, 14.4-24.7 second(-1)) and medulla (axial, 19.3-32.2 second(-1); coronal, 20.1-30.7 second(-1)). These differences were significant for both the cortex (axial, P < 0.04; coronal, P < 0.005) and medulla (axial, P < 0.02; coronal, P < 0.0005). No significant change was observed in the contralateral kidney. CONCLUSION: R2* values were significantly higher than baseline for medulla and cortex during renal artery occlusion. More variability exists in R2* measurements in the medulla than the cortex and in the axial than the coronal plane.

Dual-velocity continuously moving table acquisition for contrast-enhanced peripheral magnetic resonance angiography.

Acquisition of MR angiographic data of the peripheral vasculature during continuous table motion offers certain advantages over fixed station approaches, such as the elimination of wasted time moving between stations and the ability to form a seamless image of the extended field of view. However, it has recently been demonstrated that there is an approximate twofold reduction in contrast bolus velocity as it moves from the thighs to the calves. This can potentially cause a mismatch of the moving table with the contrast peak, resulting in the table outpacing the contrast bolus distally. In this work we describe a modification to the continuous table motion technique allowing two table velocities: a high (ca. 3.6 cm/sec) velocity from the abdomen to the thighs and a low (ca. 1.6 cm/sec) velocity distally. Implications of the nonconstant velocity on k-space sampling are described, and it is shown that lateral resolution is improved for the low-velocity region. Correction for table deceleration during the transition time between high and low velocities is demonstrated. Contrast-enhanced studies in 15 volunteers are free of table-motion-related artifact and suggest improved depiction of the contrast bolus distally.

Floating table isotropic projection (FLIPR) acquisition: a time-resolved 3D method for extended field-of-view MRI during continuous table motion.

In this work, 3D vastly undersampled isotropic projection (VIPR) acquisition is used simultaneously with continuous table motion to extend the superior/inferior (S/I) FOV for MR angiograms. The new technique is termed floating table isotropic PR (FLIPR). The use of 3D PR in conjunction with table motion obviates the need to locate and prescribe imaging volumes containing the major blood vessels over the large superior-inferior (S/I) ranges encountered in whole-body imaging. In addition, the FLIPR technique provides extended anterior-posterior (A/P) abdominal coverage, isotropic spatial resolution, and temporal resolution. In volunteer studies, FLIPR MR angiograms with 1.6-mm isotropic spatial resolution that approached whole body in extent were acquired in less than 2 min.

Myocardial delayed enhancement imaging using inversion recovery single-shot steady-state free precession: initial experience.

PURPOSE: To evaluate the feasibility of using an inversion recovery single-shot steady-state free precession (SS_SSFP) sequence for myocardial delayed enhancement (MDE) imaging, and to compare SS_SSFP with the conventional inversion recovery segmented fast gradient echo (IR_FGRE) technique. MATERIALS AND METHODS: Ten subjects (four volunteers and six patients with suspected or known coronary disease) were included in this study. All subjects were scanned with both IR_FGRE and SS_SSFP sequences 15-25 minutes after gadopentetate dimeglumine injection. Overall image quality, signal-to-noise ratios (SNRs), and contrast-to-noise ratios (CNRs) between the two techniques were compared. RESULTS: Compared to IR_FGRE, SS_SSFP exhibited adequate image quality (average scores = 3.8 for IR_FGRE and 3.9 for SS_SSFP) with much shorter acquisition time (14.4 seconds for IR_FGRE and 1.3 seconds for SS_SSFP). SS_SSFP images showed higher SNRs (P < 0.05) and less motion artifact from breathing. Enhanced myocardium was detected by both techniques in three patients, but the image sharpness is compromised in SS_SSFP images. CONCLUSION: SS_SSFP provides adequate image quality compared to IR_FGRE, while requiring a much shorter acquisition time. It is feasible to use SS_SSFP as an alternative method for MDE imaging, especially in patients who have difficulty with holding their breath.

Correction for gradient nonlinearity in continuously moving table MR imaging.

Recently, a number of methods have been demonstrated for large field of view MR imaging using continuous table motion. As with conventional, fixed-table MRI, the spatial encoding is performed using magnetic field gradients. However, it is demonstrated in this work that as a consequence of every measurement being made at a slightly different displacement between the object and the gradient field, gradient nonlinearities are manifest as blurring in addition to spatial distortion. Moreover, the blurring is spatially dependent. It is also shown that correcting all phase-encoding steps individually or in groups can reduce these effects. Phantom and in vivo results are shown which demonstrate the effectiveness of the correction.

Blood oxygen level-dependent measurement of acute intra-renal ischemia.

BACKGROUND: Ischemic nephropathy is a common cause of end-stage renal disease. Exploration of the mechanisms of deterioration of renal function is limited due to lack of noninvasive techniques available to study the single kidney. The Blood Oxygen Level-Dependent (BOLD) MRI method can measure deoxyhemoglobin and therefore indirectly estimates renal oxygen content, but has never been evaluated in renal artery stenosis (RAS). This study was therefore designed to test if BOLD can detect the characteristic of renal hypoxia induced by RAS. METHODS: RAS was induced in 8 pigs using an occluder placed around the right renal artery. Renal blood flow (RBF) was measured continuously with an ultrasound probe. BOLD signal was measured bilaterally in the cortex and medulla (as the slope of the logarithm of MR signal) at baseline and at the lower limit of RBF autoregulation. The measurements were then repeated during six sequential graded decreases in RBF (80 to 0% of baseline) and during recovery. RESULTS: During the control period, BOLD signals were not significantly different between the right and the left kidneys. In the occluded kidney, BOLD signal of the cortex (19.3 +/- 1.9/s) and the medulla (17.3 +/- 2.0/s) increased during occlusion gradually and significantly (P < 0.0001) to a maximum (at total occlusion) of 33.8 +/- 2.0/s (+79%) and 29.8 +/- 2.3/s (+78%), respectively, and returned to baseline values during recovery. CONCLUSION: This study shows that the BOLD technique can noninvasively detect change in intra-renal oxygenation during an acute reduction of RBF. This study provides a strong rationale for developing the BOLD method for the detection and evaluation of renal hypoxia induced by RAS, which may be potentially applicable in humans.

Helical MR: continuously moving table axial imaging with radial acquisitions.

A technique for extended field of view MRI is presented. Similar to helical computed tomography, the method utilizes a continuously moving patient table, a 2D axial slice that remains fixed relative to the MRI magnet, and a radial k-space trajectory. A fully refocused SSFP acquisition enables spatial resolution comparable to current clinical protocols in scan times that are sufficiently short to allow a reasonable breathhold duration. RF transmission and signal reception are performed using the RF body coil and the images are reconstructed in real time. Experimental results are presented that illustrate the technique's ability to resolve small structures in the table-motion direction. Simulation experiments to study the steady-state response of the fully refocused SSFP acquisition during continuous table motion are also presented. Finally, whole body images of healthy volunteers demonstrate the high image quality achieved using the helical MRI approach.

Ventilation-perfusion ratio of signal intensity in human lung using oxygen-enhanced and arterial spin labeling techniques.

This study investigates the distribution of ventilation-perfusion (V/Q) signal intensity (SI) ratios using oxygen-enhanced and arterial spin labeling (ASL) techniques in the lungs of 10 healthy volunteers. Ventilation and perfusion images were simultaneously acquired using the flow-sensitive alternating inversion recovery (FAIR) method as volunteers alternately inhaled room air and 100% oxygen. Images of the T(1) distribution were calculated for five volunteers for both selective (T(1f)) and nonselective (T(1)) inversion. The average T(1) was 1360 ms +/- 116 ms, and the average T(1f) was 1012 ms +/- 112 ms, yielding a difference that is statistically significant (P < 0.002). Excluding large pulmonary vessels, the average V/Q SI ratios were 0.355 +/- 0.073 for the left lung and 0.371 +/- 0.093 for the right lung, which are in agreement with the theoretical V/Q SI ratio. Plots of the V/Q SI ratio are similar to the logarithmic normal distribution obtained by multiple inert gas elimination techniques, with a range of ratios matching ventilation and perfusion. This MRI V/Q technique is completely noninvasive and does not involve ionized radiation. A limitation of this method is the nonsimultaneous acquisition of perfusion and ventilation data, with oxygen administered only for the ventilation data.