Spatial misregistration of vascular flow during MR imaging of the CNS: cause and clinical significance

Velocity selective spin labeling using parallel transmission

PURPOSE

Ultra-high field (UHF) provides improved SNR which greatly benefits SNR starved imaging techniques such as perfusion imaging. However, transmit field (B1 + ) inhomogeneities commonly observed at UHF hinders the excitation uniformity. Here we show how replacing standard excitation pulses with parallel transmit pulses can improve efficiency of velocity selective labeling.

METHODS

The standard tip-down and tip-up excitation pulses found in a velocity selective preparation module were replaced with tailored non-selective kT -points pulse solutions. Bloch simulations and experimental validation on a custom-built flow phantom and in vivo was performed to evaluate different pulse configurations in circularly polarized mode (CP-mode) and parallel transmit (pTx) mode.

RESULTS

Tailored pTx pulses significantly improved velocity selective labeling fidelity and signal uniformity. The transverse magnetization normalized RMS error was reduced from 0.489 to 0.047 when compared to standard rectangular pulses played in CP-mode. Simulations showed that manipulation of time symmetry in the tailored pTx pulses is vital in minimizing residual magnetization. In addition, in vivo experiments achieved a 44% lower RF power output and a shorter pulse duration when compared to using adiabatic pulses in CP-mode.

CONCLUSION

Using tailored pTx pulses for excitation within a velocity selective labeling preparation mitigated transmit field artifacts and improved SNR and contrast fidelity. The improvement in labeling efficiency highlights the potential of using pTx to improve robustness and accessibility of flow-based sequences such as velocity selective spin labeling at ultra-high field.

Characterisation of laminar and vascular spatiotemporal dynamics of CBV and BOLD signals using VASO and ME-GRE at 7T in humans

Interpretation of cortical laminar functional magnetic resonance imaging (fMRI) activity requires detailed knowledge of the spatiotemporal haemodynamic response across vascular compartments due to the well-known vascular biases (e.g. the draining veins). Further complications arise from the spatiotemporal hemodynamic response that differs depending on the duration of stimulation. This information is crucial for future studies using depth-dependent cerebral blood volume (CBV) measurements, which promise higher specificity for the cortical microvasculature than the blood oxygenation level dependent (BOLD) contrast. To date, direct information about CBV dynamics with respect to stimulus duration, cortical depth and vasculature is missing in humans. Therefore, we characterized the cortical depth-dependent CBV-haemodynamic responses across a wide set of stimulus durations with 0.9 mm isotropic spatial and 0.785 seconds effective temporal resolution in humans using slice-selective slab-inversion vascular space occupancy (SS-SI VASO). Additionally, we investigated signal contributions from macrovascular compartments using fine-scale vascular information from multi-echo gradient-echo (ME-GRE) data at 0.35 mm isotropic resolution. In total, this resulted in >7.5h of scanning per participant (n=5). We have three major findings: (I) While we could demonstrate that 1 second stimulation is viable using VASO, more than 12 seconds stimulation provides better CBV responses in terms of specificity to microvasculature, but durations beyond 24 seconds of stimulation may be wasteful for certain applications. (II) We observe that CBV responses show dilation patterns across the cortex. (III) While we found increasingly strong BOLD signal responses in vessel-dominated voxels with longer stimulation durations, we found increasingly strong CBV signal responses in vessel-dominated voxels only until 4 second stimulation durations. After 4 seconds, only the signal from non-vessel dominated voxels kept increasing. This might explain why CBV responses are more specific to the underlying neuronal activity for long stimulus durations.

Mesoscopic in vivo human T2* dataset acquired using quantitative MRI at 7 Tesla

Mesoscopic (0.1-0.5 mm) interrogation of the living human brain is critical for advancing neuroscience and bridging the resolution gap with animal models. Despite the variety of MRI contrasts measured in recent years at the mesoscopic scale, in vivo quantitative imaging of T₂^* has not been performed. Here we provide a dataset containing empirical T₂^* measurements acquired at 0.35 × 0.35 × 0.35 mm³ voxel resolution using 7 Tesla MRI. To demonstrate unique features and high quality of this dataset, we generate flat map visualizations that reveal fine-scale cortical substructures such as layers and vessels, and we report quantitative depth-dependent T₂^* (as well as R₂^*) values in primary visual cortex and auditory cortex that are highly consistent across subjects. This dataset is freely available at https://doi.org/10.17605/OSF.IO/N5BJ7, and may prove useful for anatomical investigations of the human brain, as well as for improving our understanding of the basis of the T₂^*-weighted (f)MRI signal.

Brain oxygen extraction fraction mapping in patients with multiple sclerosis

We aimed to demonstrate the feasibility of whole brain oxygen extraction fraction (OEF) mapping for measuring lesion specific and regional OEF abnormalities in multiple sclerosis (MS) patients. In 22 MS patients and 11 healthy controls (HC), OEF and neural tissue susceptibility (χn) maps were computed from MRI multi-echo gradient echo data. In MS patients, 80 chronic active lesions with hyperintense rim on quantitative susceptibility mapping were identified, and the mean OEF and χn within the rim and core were compared using linear mixed-effect model analysis. The rim showed higher OEF and χn than the core: relative to their adjacent normal appearing white matter, OEF contrast = -6.6 ± 7.0% vs. -9.8 ± 7.8% (p < 0.001) and χn contrast = 33.9 ± 20.3 ppb vs. 25.7 ± 20.5 ppb (p = 0.017). Between MS and HC, OEF and χn were compared using a linear regression model in subject-based regions of interest. In the whole brain, compared to HC, MS had lower OEF, 30.4 ± 3.3% vs. 21.4 ± 4.4% (p < 0.001), and higher χn, -23.7 ± 7.0 ppb vs. -11.3 ± 7.7 ppb (p = 0.018). Our feasibility study suggests that OEF may serve as a useful quantitative marker of tissue oxygen utilization in MS.

Quantitative time-of-flight MR angiography for simultaneous luminal and hemodynamic evaluation of the intracranial arteries

PURPOSE

To report a quantitative time-of-flight (qTOF) MRA technique for simultaneous luminal and hemodynamic evaluation of the intracranial arteries.

METHODS

Implemented using a thin overlapping slab 3D stack-of-stars based 3-echo FLASH readout, qTOF was tested in a flow phantom and for imaging the intracranial arteries of 10 human subjects at 3 Tesla. Display of the intracranial arteries with qTOF was compared to resolution-matched and scan time-matched standard Cartesian 3D time-of-flight (TOF) MRA, whereas quantification of mean blood flow velocity with qTOF, done using a computer vision-based inter-echo image analysis procedure, was compared to 3D phase contrast MRA. Arterial-to-background contrast-to-noise ratio was measured, and intraclass correlation coefficient was used to evaluate agreement of flow velocities.

RESULTS

For resolution-matched protocols of similar scan time, qTOF portrayed the intracranial arteries with good morphological correlation with standard Cartesian TOF, and both techniques provided superior contrast-to-noise ratio and arterial delineation compared to phase contrast (20.6 ± 3.0 and 37.8 ± 8.7 vs. 11.5 ± 2.2, P < .001, both comparisons). With respect to phase contrast, qTOF showed excellent agreement for measuring mean flow velocity in the flow phantom (intraclass correlation coefficient = 0.981, P < .001) and good agreement in the intracranial arteries (intraclass correlation coefficient = 0.700, P < .001). Stack-of-stars data sampling used with qTOF eliminated oblique in-plane flow misregistration artifacts that were seen with standard Cartesian TOF.

CONCLUSION

qTOF is a new 3D MRA technique for simultaneous luminal and hemodynamic evaluation of the intracranial arteries that provides significantly greater contrast-to-noise ratio efficiency than phase contrast and eliminates misregistration artifacts from oblique in-plane blood flow that occur with standard 3D TOF.

Phase-contrast acceleration mapping with synchronized encoding

PURPOSE

To develop a phase-contrast (PC) -based method for direct and unbiased quantification of the acceleration vector field by synchronization of the spatial and acceleration encoding time points. The proposed method explicitly aims at in-vitro applications, requiring high measurement accuracy, as well as the validation of clinically relevant acceleration-encoded sequences.

METHODS

A velocity-encoded sequence with synchronized encoding (SYNC SPI) was modified to allow direct acceleration mapping by replacing the bipolar encoding gradients with tripolar gradient waveforms. The proposed method was validated in two in-vitro flow cases: a rotation and a stenosis phantom. The thereby obtained velocity and acceleration vector fields were quantitatively compared to those acquired with conventional PC methods, as well as to theoretical data.

RESULTS

The rotation phantom study revealed a systematic bias of the conventional PC acceleration mapping method that resulted in an average pixel-wise relative angle between the measured and theoretical vector field of (7.8 ± 3.2)°, which was reduced to (-0.4 ± 2.7)° for the proposed SYNC SPI method. Furthermore, flow features in the stenosis phantom were displaced by up to 10 mm in the conventional PC data compared with the acceleration-encoded SYNC SPI data.

CONCLUSIONS

This work successfully demonstrates a highly accurate method for direct acceleration mapping. It thus complements the existing velocity-encoded SYNC SPI method to enable the direct and unbiased quantification of both the velocity and acceleration vector field for in vitro studies. Hence, this method can be used for the validation of conventional acceleration-encoded PC methods applicable in-vivo.

Cerebral MR oximetry during acetazolamide augmentation: Beyond cerebrovascular reactivity in hemodynamic failure

BACKGROUND

Oxygen extraction fraction (OEF) elevation predicts increased ischemic stroke incidence among patients with carotid steno-occlusive disease, and can be estimated from quantitative susceptibility mapping (QSM) MRI.

PURPOSE

To explore QSM oximetry during acetazolamide (ACZ) challenge, hypothesizing that detectable OEF alterations will reflect hemodynamic compromise in unilateral cerebrovascular disease (CVD) patients.

STUDY TYPE

Retrospective.

SUBJECTS

Fourteen unilateral CVD patients, and 24 healthy controls (HC).

FIELD STRENGTH/SEQUENCE

Multiecho gradient echo (GRE) and T₁ -weighted images at 3T.

ASSESSMENT

We constructed QSM images and R2* maps from multiecho GRE images. QSM-OEF maps were generated from the susceptibility difference between venous blood and background brain tissue. Intrasubject diseased/contralateral hemisphere OEF ratios in the middle cerebral artery (MCA) territories were calculated. Intravascular susceptibility in the straight sinus (SS) and MCA was also measured.

STATISTICAL TESTS

The result significance was determined using t-tests and Pearson's correlation.

RESULTS

Mean and standard deviation for the patient diseased/contralateral OEF ratios were 1.15 ± 0.14 at baseline and 1.23 ± 0.17 post-ACZ. Disease group R2* ratios were 0.95 ± 0.05 at baseline and 1.03 ± 0.08 post-ACZ. Left/right OEF and R2* ratios for the HC group were 0.98 ± 0.06 and 0.99 ± 0.038, respectively. Susceptibility (ppb) in the SS and MCA in patients was 162.63 ± 35.4 and -22.33 ± 13.70, respectively, at baseline, 124.56 ± 37.43 and -19.27 ± 23.14 post-ACZ. The HC group SS and MCA susceptibility was 146.10 ± 24.79 and -19.59 ± 12.37, respectively. Patient group OEF ratios were greater than 1.0 before and after ACZ challenge (P < 0.01 and < 0.001, respectively, one-sample t-test), and were greater than HC ratios (P < 0.001 unpaired t-test). OEF and R2* ratios increased from baseline to post-ACZ (P = 0.024, 0.004, respectively, paired t-test). Detectable blood oxygenation change was confirmed by finding SS susceptibility decreased from baseline to post-ACZ (P < 0.001, paired t-test), while MCA susceptibility did not change significantly (P = 0.67, paired t-test).

DATA CONCLUSION

These results suggest QSM is sensitive to dynamic OEF modulation during hemodynamic augmentation.

LEVEL OF EVIDENCE

3 Technical Efficacy: Stage 3 J. Magn. Reson. Imaging 2019;50:175-182.

Velocity encoding versus acceleration encoding for pressure gradient estimation in MR haemodynamic studies

Many methods have been proposed to extract pressure gradient maps from magnetic resonance (MR) images. They were based on the resolution of the haemodynamic model of Navier-Stokes and needed the flow acceleration to be known. Most used velocity data acquisition and computed acceleration from temporal and spatial derivatives of the velocity field. However, MR sequences have been developed in order to acquire the acceleration field directly. Here we compared direct MR measurements of acceleration field components with those calculated from MR velocity acquisitions. Two experimental phantoms were used to separately evaluate the inertial and convective components of the acceleration. Mathematical simulation of the convective phantom further explained the origin of the noise generated by the spatial and temporal derivatives of the velocity data, and the misregistration artefacts due to MR sequences. We found that direct measurement of the acceleration field generates less noise and fewer artefacts than calculation from velocity derivatives.

The need for phase-encoding flow compensation in high-resolution intracranial magnetic resonance angiography

PURPOSE

To demonstrate that the time delay between phase and frequency encoding and the presence of pulsatile blood flow in high-resolution time-of-flight (TOF) imaging of the intracranial arteries (especially near the circle of Willis) can distort the appearance of blood vessels and result in a cross-hatch-appearing artifact in surrounding tissue.

MATERIALS AND METHODS

Two techniques to reduce the artifact, tri-directional flow compensation (3DFC) and elliptical-centric (EC) phase-encoding order, are investigated in five volunteer studies.

RESULTS

3DFC eliminates the pulsation-related artifacts and the vessel distortion. A residual amplitude variation artifact is observed. EC phase encoding nearly eliminates the pulsatile motion-related artifact, but it does not eliminate vessel distortion.

CONCLUSION

The combination of 3DFC and EC phase encoding appears to provide the greatest artifact reduction in the five volunteer studies performed.

Precision of magnetic resonance velocity and acceleration measurements: theoretical issues and phantom experiments

Magnetic resonance (MR) sequences have been developed for acquiring multiple components of velocity and/or acceleration in a reasonable time and with a single acquisition. They have many parameters that influence the precision of measurements: NS, the number of flow-encoding steps; NEX, the number of signal accumulations; and ND, the number of dimensions. Our aims were to establish a general relationship revealing the precision of these measurements as a function of NS, ND, and NEX and to validate it by experiments using phantoms. Previous work on precision has been restricted to two-step (NS = 2) or 1D (ND = 1) MR velocity measurements. We describe a comprehensive approach that encompasses both multistep and multidimensional strategies. Our theoretical formula gives the precision of velocity and acceleration measurements. It was validated experimentally with measurements on a rotating disk phantom. This phantom was much easier to handle than fluid-based phantoms. It could be used to assess both velocity and acceleration sequences and provided accurate and precise assessments over a wide, adjustable range of values within a single experiment. Increasing each of the three parameters, NS, ND, and NEX, improves the precision but makes the acquisition time longer. However, if only one parameter is to be assessed, maximizing the number of steps (NS) is the most efficient way of improving the precision of measurements; if several parameters are of interest, they should be measured simultaneously. By contrast, increasing the number of signals accumulated (NEX) is the least efficient strategy.

Abbreviated moment-compensated phase encoding

To achieve correct spatial location of blood vessels, first order gradient moment nulling applied to the phase encoding axes can be used. However, gradient moment nulling prolongs echo time (TE), which may degrade the flow image in regions of complex flow. The fact that abbreviated moment compensated phase-encoding (AMCPE) can be used to apply partial flow compensation to the phase-encoding axes to prevent spatial misregistration of vessels without requiring the use of long echo times or using arbitrary chosen TE is demonstrated. AMCPE defines two cutoff lines in k-space. The flow-induced phase is completely compensated for values between the cutoff lines and partially compensated beyond the cutoff lines. The AMCPE technique has been tested on both a flow phantom and a human volunteer. The AMCPE images from both the in vivo and the in vitro study demonstrate correctly imaged flow. Computer simulations have been performed to analyze the penalty caused by the incomplete flow compensation. The result shows that the ripple artifacts due to the incomplete flow compensation are unobservable when 60%-70% of k-space is completely flow compensated.

Understanding acceleration-induced displacement artifacts in phase-contrast MR velocity measurements

A theoretical framework for understanding acceleration-induced errors in phase-contrast magnetic resonance velocity measurements has been developed. An important result of this framework is the interpretation of acceleration-induced velocity errors as displacement artifacts due to the delay between velocity and spatial encoding. A rotating-disk phantom was used to confirm the theoretically predicted displacement times (the difference between theory and experiment was 8.2%). Errors were also observed in velocity profiles measured in regions of fluid acceleration downstream from a step stenosis. The magnitude of these errors could be predicted and corrected by using the analytic framework.

Correction of partial-volume effects in phase-contrast flow measurements

Because of the relatively small size of vessels and limited magnetic resonance (MR) imaging resolution, the accuracy of volume flow rate measurements is limited. A technique that corrects the partial-volume effect in volume flow rate measurements is presented. The technique uses small-phase-shift approximation, with the assumption that blood flow in the voxels at the boundary of the vessel is slow. With the proposed correction technique, the volume flow rate in partially occupied voxels is corrected on a voxel-by-voxel basis and the accuracy of flow measurements increases. Results are shown analytically and for MR phantom data.

On the problem of geometric distortion in magnetic resonance images for stereotactic neurosurgery

In this paper, we discuss the issue of geometric distortion in magnetic resonance (MR) images used to plan stereotactic neurosurgical interventions. We analyze the process for the case of Fourier transform imaging and demonstrate that spatial misregistrations are fundamentally due to two causes: deviations of the magnetic field from its ideal value and blood flow. This enables us to relate the causes of geometric distortion to the MR imaging system, the patient and the stereotactic localizer frame. Based on the general model, we propose model refinements and discuss methods for the quantification and correction of all causes. The results of our calculations and experiments indicate that, using the proposed corrections, MRI and MR angiography should be considered valuable and reliable acquisition modalities for the planning of stereotactic neurosurgical interventions.

Accuracy of phase-contrast flow measurements in the presence of partial-volume effects

The accuracy of volume flow rate measurements obtained with phase-contrast methods was assessed by means of computer simulation and in vitro experiments. Factors studied include (a) the partial-volume effect due to voxel dimensions relative to vessel dimensions and orientation and (b) intravoxel phase dispersion. It is shown that limited resolution (partial-volume effect) is the major obstacle to accurate flow measurement for both laminar and plug flow. The results show that at least 16 voxels must cover the cross section of the vessel lumen to obtain a measurement accuracy to within 10%. Measurement accuracy also greatly depends on the relative signal intensity of stationary tissue and is better for laminar flow than plug flow.

Distortions from curved flow in magnetic resonance imaging

We present an analysis of how vessel curvature can create distortions in magnetic resonance images of flowing blood. Steady flow in curved vessels produces distortions of the vessel shape and intensity variations in the image due to motion during the interval between phase encoding or slice selection and the echo center. Even with steady flow, vessel curvature produces motion moments higher than velocity (acceleration, etc.), but use of a first order oblique flow compensated phase encoding gradient waveform reduced the distortion in the image. Numerical calculations of image distortions based on simple flow models are in good agreement with experimental results in a phantom.

Elimination of oblique flow artifacts in magnetic resonance imaging

We present an analysis of how flow oblique to the frequency-encoding direction generates displacement artifacts in MR imaging and show that for flow which has constant velocity between the start of the phase encoding and the center of the echo it is possible to eliminate these artifacts by gradient moment nulling in the phase-encoding direction. However, unlike the standard moment nulling calculations for flow compensating the frequency-encode and slice-selection gradients, the phase-encoding first moment must be nulled specifically with respect to the echo center. Limitations of this method imposed by finite gradient strengths are analyzed. In 3D volume acquisitions with two axes phase encoded it is possible to correct for oblique flow in all directions, and this is demonstrated in images of a human volunteer. Correction for oblique flow displacement artifacts may be particularly useful in quantitative flow and angiographic applications.

Analysis of flow effects in echo-planar imaging

The effects on the phase of spins moving during echo-planar imaging (EPI) acquisition were studied. Standard single-shot and interleaved multishot blipped EPI acquisitions were considered, assuming either high gradient strength and slew rates or standard gradient strength and slew rates. A spiral k-space trajectory was also considered. Flow components in the section-select and phase- and frequency-encoding directions were analyzed separately. While the effect of flow in the section-select direction is identical to that in a standard two-dimensional Fourier transform (2DFT) acquisition, flow in the phase- or frequency-encoding directions can have substantial effects on the image, different from that in 2DFT imaging. The magnitude of these effects, which include displacement, distortion, and/or ghosting of vascular structures, is analyzed and predicted for a given velocity and direction of flow, the specific acquisition sequence, and the strength and slew rate of the gradients. For example, 50-cm/sec flow along the phase-encoding direction can cause a blurring of 1.25 cm full width at half maximum for blipped EPI with high-strength gradients, assuming a 40-cm field of view and 64 x 64 matrix.