Spoiling without additional gradients: Radial FLASH MRI with randomized radiofrequency phases

T1 mapping in patients with cervical spinal canal stenosis with and without decompressive surgery: A longitudinal study

BACKGROUND AND PURPOSE

Cervical spinal canal stenosis (cSCS) is a common cause of spinal impairment in the elderly. With conventional magnetic resonance imaging (MRI) suffering from various limitations, high-resolution single-shot T1 mapping has been proposed as a novel MRI technique in cSCS diagnosis. In this study, we investigated the effect of conservative and surgical treatment on spinal cord T1 relaxation times in cSCS.

METHODS

T1-mapping was performed in 54 patients with cSCS at 3 Tesla MRI at the maximum-, above and below the stenosis. Subsequently, intraindividual T1-differences (ΔT1) intrastenosis were calculated. Twenty-four patients received follow-up scans after 6 months.

RESULTS

Surgically treated patients showed higher ΔT1 at baseline (154.9 ± 81.6 vs. 95.3 ± 60.7), while absolute T1-values within the stenosis were comparable between groups (863.7 ± 89.3 milliseconds vs. 855.1 ± 62.2 milliseconds). In surgically treated patients, ΔT1 decreased inverse to stenosis severity. After 6 months, ΔT1 significantly decreased in the surgical group (154.9 ± 81.6 milliseconds to 85.7 ± 108.9 milliseconds, p = .021) and remained unchanged in conservatively treated patients. Both groups showed clinical improvement at the 6-month follow-up.

CONCLUSIONS

Baseline difference of T1 relaxation time (ΔT1) might serve as a supporting marker for treatment decision and change of T1 relaxation time might reflect relief of spinal cord narrowing indicating regenerative processes. Quantitative T1-mapping represents a promising additional imaging method to indicate a surgical treatment plan and to validate treatment success.

Self-gated cine phase-contrast balanced SSFP flow quantification at 0.55 T

PURPOSE

To implement cine phase-contrast balanced SSFP (PC-bSSFP) for low-field 0.55T cardiac MRI by exploiting the intrinsic flow sensitivity of the bSSFP slice-select gradient and the in-plane phase-cancelation properties of radial trajectories, enabling self-gated and referenceless PC-bSSFP flow quantification at 0.55 T.

METHODS

A free-running, tiny golden-angle radial PC-bSSFP approach was implemented on 0.55T and 1.5T systems. Cardiac and respiratory self-gating was incorporated to enable electrocardiogram-free scanning during breath-hold and free-breathing. By exploiting the intrinsic in-plane phase-cancelation properties of radial acquisitions and background phase fitting, referenceless single-point PC-bSSFP was realized. In vivo data were acquired in the ascending aorta of healthy subjects at 0.55 T and 1.5 T during breath-hold and free-breathing. Flow data, SNR, and velocity-to-noise ratio were compared relative to data obtained with phase-contrast spoiled gradient-echo variants.

RESULTS

Velocities acquired with PC-bSSFP compared well with data from phase-contrast spoiled gradient-echo (RMSEv  = 5.8 cm/s). PC-bSSFP at 0.55 T resulted in high-quality cine magnitude images and phase maps with sufficient SNR and velocity-to-noise ratio. Breath-hold and free-breathing PC-bSSFP performed very similarly, with comparable flow quantification (RMSEv  = 5.7 cm/s). Referenceless single-point PC-bSSFP results agreed well with two-point PC-bSSFP (-1.8 ± 5.2 cm/s) while reducing scan times 2-fold.

CONCLUSION

PC-bSSFP is feasible on low-field 0.55T systems, producing high-quality cine images while permitting simultaneous aortic flow measurements during breath-hold and free-breathing and without the need for electrocardiogram gating.

T1 Mapping of the Prostate Using Single-Shot T1FLASH: A Clinical Feasibility Study to Optimize Prostate Cancer Assessment

PURPOSE

The aim of this study was to assess the clinical feasibility of magnetic resonance imaging (MRI) T1 mapping using T1FLASH for assessment of prostate lesions.

METHODS

Participants with clinical suspicion for prostate cancer (PCa) were prospectively enrolled between October 2021 and April 2022 with multiparametric prostate MRI (mpMRI) acquired on a 3 T scanner. In addition, T1 mapping was accomplished using a single-shot T1FLASH technique with inversion recovery, radial undersampling, and iterative reconstruction. Regions of interest (ROIs) were manually placed on radiologically identified prostate lesions and representative reference regions of the transitional zone (TZ), benign prostate hyperplasia nodules, and peripheral zone (PZ). Mean T1 relaxation times and apparent diffusion coefficient (ADC) values (b = 50/b = 1400 s/mm 2 ) were measured for each ROI. Participants were included in the study if they underwent ultrasound/MRI fusion-guided prostate biopsy for radiologically or clinically suspected PCa. Histological evaluation of biopsy cores served as reference standard, with grading of PCa according to the International Society of Urological Pathology (ISUP). ISUP grades 2 and above were considered clinically significant PCa for the scope of this study. Histological results of prostate biopsy cores were anatomically mapped to corresponding mpMRI ROIs using biopsy plans. T1 relaxation times and ADC values were compared across prostate regions and ISUP groups. Across different strata, T1 relaxation time, ADC values, and diagnostic accuracy (area under the curve [AUC]) were compared using statistical methods accounting for clustered data.

RESULTS

Of 67 eligible participants, a total of 40 participants undergoing ultrasound/MRI fusion-guided prostate biopsy were included. Multislice T1 mapping was successfully performed in all participants at a median acquisition time of 2:10 minutes without evident image artifacts. A total of 71 prostate lesions was radiologically identified (TZ 49; PZ 22). Among those, 22 were histologically diagnosed with PCa (ISUP groups 1/2/3/4 in n = 3/15/3/1 cases, respectively). In the TZ, T1 relaxation time was statistically significantly lower for PCa compared with reference regions ( P = 0.029) and benign prostate hyperplasia nodules ( P < 0.001). Similarly, in the PZ, PCa demonstrated shorter T1 relaxation times versus reference regions ( P < 0.001). PCa also showed a trend toward shorter T1 relaxation times (median, 1.40 seconds) compared with radiologically suspicious lesions with benign histology (median, 1.47 seconds), although statistical significance was not reached ( P = 0.066). For discrimination of PCa from reference regions and benign prostate lesions, T1 relaxation times and ADC values demonstrated AUC = 0.80 and AUC = 0.83, respectively ( P = 0.519). Discriminating PCa from radiologically suspicious lesions with benign histology, T1 relaxation times and ADC values showed AUC = 0.69 and AUC = 0.62, respectively ( P = 0.446).

CONCLUSIONS

T1FLASH-based T1 mapping yields robust results for quantification of prostate T1 relaxation time at a short examination time of 2:10 minutes without evident image artifacts. Associated T1 relaxation times could aid in discrimination of significant and nonsignificant PCa. Further studies are warranted to confirm these results in a larger patient cohort, to assess the additional benefit of T1FLASH maps in conjunction with mpMRI sequences in the setting of deep learning, and to evaluate the robustness of T1FLASH maps compared with potentially artifact-prone diffusion-weighted imaging sequences.

Free-breathing myocardial T1 mapping using inversion-recovery radial FLASH and motion-resolved model-based reconstruction

PURPOSE

To develop a free-breathing myocardialT 1 $$ {\mathrm{T}}_1 $$ mapping technique using inversion-recovery (IR) radial fast low-angle shot (FLASH) and calibrationless motion-resolved model-based reconstruction.

METHODS

Free-running (free-breathing, retrospective cardiac gating) IR radial FLASH is used for data acquisition at 3T. First, to reduce the waiting time between inversions, an analytical formula is derived that takes the incompleteT 1 $$ {\mathrm{T}}_1 $$ recovery into account for an accurateT 1 $$ {\mathrm{T}}_1 $$ calculation. Second, the respiratory motion signal is estimated from the k-space center of the contrast varying acquisition using an adapted singular spectrum analysis (SSA-FARY) technique. Third, a motion-resolved model-based reconstruction is used to estimate both parameter and coil sensitivity maps directly from the sorted k-space data. Thus, spatiotemporal total variation, in addition to the spatial sparsity constraints, can be directly applied to the parameter maps. Validations are performed on an experimental phantom, 11 human subjects, and a young landrace pig with myocardial infarction.

RESULTS

In comparison to an IR spin-echo reference, phantom results confirm goodT 1 $$ {\mathrm{T}}_1 $$ accuracy, when reducing the waiting time from 5 s to 1 s using the new correction. The motion-resolved model-based reconstruction further improvesT 1 $$ {\mathrm{T}}_1 $$ precision compared to the spatial regularization-only reconstruction. Aside from showing that a reliable respiratory motion signal can be estimated using modified SSA-FARY, in vivo studies demonstrate that dynamic myocardialT 1 $$ {\mathrm{T}}_1 $$ maps can be obtained within 2 min with good precision and repeatability.

CONCLUSION

Motion-resolved myocardialT 1 $$ {\mathrm{T}}_1 $$ mapping during free-breathing with good accuracy, precision and repeatability can be achieved by combining inversion-recovery radial FLASH, self-gating and a calibrationless motion-resolved model-based reconstruction.

High Periventricular T1 Relaxation Times Predict Gait Improvement After Spinal Tap in Patients with Idiopathic Normal Pressure Hydrocephalus

PURPOSE

The diagnosis of idiopathic normal pressure hydrocephalus (iNPH) can be challenging. Aim of this study was to use a novel T1 mapping method to enrich the diagnostic work-up of patients with suspected iNPH.

METHODS

Using 3T magnetic resonance imaging (MRI) we prospectively evaluated rapid high-resolution T1 mapping at 0.5 mm resolution and 4 s acquisition time in 15 patients with suspected iNPH and 8 age-matched, healthy controls. T1 mapping in axial sections of the cerebrum, clinical and neuropsychological testing were performed prior to and after cerebrospinal fluid tap test (CSF-TT). T1 relaxation times were measured in 5 predefined periventricular regions.

RESULTS

All 15 patients with suspected iNPH showed gait impairment, 13 (86.6%) showed signs of cognitive impairment and 8 (53.3%) patients had urinary incontinence. Gait improvement was noted in 12 patients (80%) after CSF-TT. T1 relaxation times in all periventricular regions were elevated in patients with iNPH compared to controls with the most pronounced differences in the anterior (1006 ± 93 ms vs. 911 ± 77 ms; p = 0.023) and posterior horns (983 ± 103 ms vs. 893 ± 68 ms; p = 0.037) of the lateral ventricles. Montreal cognitive assessment (MoCA) scores at baseline were negatively correlated with T1 relaxation times (r < -0.5, p < 0.02). Higher T1 relaxation times were significantly correlated with an improvement of the 3‑m timed up and go test (r > 0.6 and p < 0.03) after CSF-TT.

CONCLUSION

In iNPH-patients, periventricular T1 relaxation times are increased compared to age-matched controls and predict gait improvement after CSF-TT. T1 mapping might enrich iNPH work-up and might be useful to indicate permanent shunting.

Direct imaging of white matter ultrashort T2∗ components at 7 Tesla

PURPOSE

To demonstrate direct imaging of the white matter ultrashort T₂^∗ components at 7 Tesla using inversion recovery (IR)-enhanced ultrashort echo time (UTE) MRI. To investigate its characteristics, potentials and limitations, and to establish a clinical protocol.

MATERIAL AND METHODS

The IR UTE technique suppresses long T₂^∗ signals within white matter by using adiabatic inversion in combination with dual-echo difference imaging. Artifacts arising at 7 T from long T₂^∗ scalp fat components were reduced by frequency shifting the IR pulse such that those frequencies were inverted likewise. For 8 healthy volunteers, the T₂^∗ relaxation times of white matter were then quantified. In 20 healthy volunteers, the UTE difference and fraction contrast were evaluated. Finally, in 6 patients with multiple sclerosis (MS), the performance of the technique was assessed.

RESULTS

A frequency shift of -1.2 ppm of the IR pulse (i.e. towards the fat frequency) provided a good suppression of artifacts. With this, an ultrashort compartment of (68 ± 6) % with a T₂^∗ time of (147 ± 58) μs was quantified with a chemical shift of (-3.6 ± 0.5) ppm from water. Within healthy volunteers' white matter, a stable ultrashort T₂^∗ fraction contrast was calculated. For the MS patients, a significant fraction reduction in the identified lesions as well as in the normal-appearing white matter was observed.

CONCLUSIONS

The quantification results indicate that the observed ultrashort components arise primarily from myelin tissue. Direct IR UTE imaging of the white matter ultrashort T₂^∗ components is thus feasible at 7 T with high quantitative inter-subject repeatability and good detection of signal loss in MS.

Dark blood cardiovascular magnetic resonance of the heart, great vessels, and lungs using electrocardiographic-gated three-dimensional unbalanced steady-state free precession

BACKGROUND

Recently, we reported a novel neuroimaging technique, unbalanced T1 Relaxation-Enhanced Steady-State (uT1RESS), which uses a tailored 3D unbalanced steady-state free precession (3D uSSFP) acquisition to suppress the blood pool signal while minimizing bulk motion sensitivity. In the present work, we hypothesized that 3D uSSFP might also be useful for dark blood imaging of the chest. To test the feasibility of this approach, we performed a pilot study in healthy subjects and patients undergoing cardiovascular magnetic resonance (CMR).

MAIN BODY

The study was approved by the hospital institutional review board. Thirty-one adult subjects were imaged at 1.5 T, including 5 healthy adult subjects and 26 patients (44 to 86 years, 10 female) undergoing a clinically indicated CMR. Breath-holding was used in 29 subjects and navigator gating in 2 subjects. For breath-hold acquisitions, the 3D uSSFP pulse sequence used a high sampling bandwidth, asymmetric readout, and single-shot along the phase-encoding direction, while 3 shots were acquired for navigator-gated scans. To minimize signal dephasing from bulk motion, electrocardiographic (ECG) gating was used to synchronize the data acquisition to the diastolic phase of the cardiac cycle. To further reduce motion sensitivity, the moment of the dephasing gradient was set to one-fifth of the moment of the readout gradient. Image quality using 3D uSSFP was good-to-excellent in all subjects. The blood pool signal in the thoracic aorta was uniformly suppressed with sharp delineation of the aortic wall including two cases of ascending aortic aneurysm and two cases of aortic dissection. Compared with variable flip angle 3D turbo spin-echo, 3D uSSFP showed improved aortic wall sharpness. It was also more efficient, permitting the acquisition of 24 slices in each breath-hold versus 16 slices with 3D turbo spin-echo and a single slice with dual inversion 2D turbo spin-echo. In addition, lung and mediastinal lesions appeared highly conspicuous compared with the low blood pool signals within the heart and blood vessels. In two subjects, navigator-gated 3D uSSFP provided excellent delineation of cardiac morphology in double oblique multiplanar reformations.

CONCLUSION

In this pilot study, we have demonstrated the feasibility of using ECG-gated 3D uSSFP for dark blood imaging of the heart, great vessels, and lungs. Further study will be required to fully optimize the technique and to assess clinical utility.

Optimizing trajectory ordering for fast radial ultra-short TE (UTE) acquisitions

PURPOSE

Additional spoiler gradients are required in 3D UTE sequences with random view ordering to suppress magnetization refocusing. By leveraging the encoding gradient induced spoiling effect, the spoiler gradients could potentially be reduced or removed to shorten the TR and increase encoding efficiency. An analysis framework is built that models the gradient spoiling effects and a new ordering scheme is proposed for fast 3D UTE acquisition.

THEORY AND METHODS

UTE signal evolution and spatial encoding gradient induced spoiling effect are derived from the Bloch equations. And the concept is validated in 2D radial UTE simulation. Then an optimized ordering scheme, named reordered 2D golden angle (r2DGA) scheme, for 3D UTE acquisition is proposed. The r2DGA scheme is compared to the sequential and 3D golden angle schemes in both phantom and volunteer studies.

RESULTS

The proposed r2DGA ordering scheme was applied to two applications, single breath-holding and free breathing 3D lung MRI. With r2DGA ordering scheme, breath-holding lung MRI scan increased 60% scan efficiency by removing the spoiler gradients and the free breathing scan reduced 20% scan time compared to the 3D golden angle scheme by reducing the spoiler gradients.

CONCLUSIONS

The proposed r2DGA ordering scheme UTE acquisition reduces the need of spoiler gradients and increases the encoding efficiency, and shows improvements in both breath-holding and free breathing lung MRI applications.

Quantitative T1 mapping of the normal brain from early infancy to adulthood

BACKGROUND

Quantitative mapping of MRI relaxation times is expected to uncover pathological processes in the brain more subtly than standard MRI techniques with weighted contrasts. So far, however, most mapping techniques suffer from a long measuring time, low spatial resolution or even sensitivity to magnetic field inhomogeneity.

OBJECTIVE

To obtain T1 relaxation times of the normal brain from early infancy to adulthood using a novel technique for fast and accurate T1 mapping at high spatial resolution.

MATERIALS AND METHODS

We performed whole-brain T1 mapping within less than 3 min in 100 patients between 2 months and 18 years of age with normal brain at a field strength of 3 T. We analyzed T1 relaxation times in several gray-matter nuclei and white matter. Subsequently, we derived regression equations for mean value and confidence interval.

RESULTS

T1 relaxation times of the pediatric brain rapidly decrease in all regions within the first 3 years of age, followed by a significantly weaker decrease until adulthood. These characteristics are more pronounced in white matter than in deep gray matter.

CONCLUSION

Regardless of age, quantitative T1 mapping of the pediatric brain is feasible in clinical practice. Normal age-dependent values should contribute to improved discrimination of subtle intracerebral alterations.

T1 Mapping Quantifies Spinal Cord Compression in Patients With Various Degrees of Cervical Spinal Canal Stenosis

Age-related degeneration of the cervical spinal column is the most common cause of spinal cord lesions. T1 mapping has been shown to indicate the grade and site of spinal cord compression in low grade spinal canal stenosis (SCS). Aim of our study was to further investigate the diagnostic potential of a novel T1 mapping method at 0.75 mm resolution and 4 s acquisition time in 31 patients with various grades of degenerative cervical SCS. T1 mapping was performed in axial sections of the stenosis as well as above and below. Included subjects received standard T2-weighted MRI of the cervical spine (including SCS-grading 0-III), electrophysiological, and clinical examination. We found that patients with cervical SCS showed a significant difference in T1 relaxation times within the stenosis (727 ± 66 ms, mean ± standard deviation) in comparison to non-stenotic segments above (854 ± 104 ms, p < 0.001) and below (893 ± 137 ms, p < 0.001). There was no difference in mean T1 in non-stenotic segments in patients (p = 0.232) or between segments in controls (p = 0.272). Mean difference of the T1 relaxation times was significantly higher in grade III stenosis (234 ± 45) vs. in grade II stenosis (176 ± 45, p = 0.037) vs. in grade I stenosis (90 ± 87 ms, p = 0.010). A higher difference in T1 relaxation time was associated with a central efferent conduction deficit. In conclusion, T1 mapping may be useful as a tool for SCS quantification in all grades of SCS, including high-grade stenosis with myelopathy signal in conventional T2-weighted imaging.

Cardiac and Respiratory Self-Gating in Radial MRI Using an Adapted Singular Spectrum Analysis (SSA-FARY)

Cardiac Magnetic Resonance Imaging (MRI) is time-consuming and error-prone. To ease the patient's burden and to increase the efficiency and robustness of cardiac exams, interest in methods based on continuous steady-state acquisition and self-gating has been growing in recent years. Self-gating methods extract the cardiac and respiratory signals from the measurement data and then retrospectively sort the data into cardiac and respiratory phases. Repeated breathholds and synchronization with the heart beat using some external device as required in conventional MRI are then not necessary. In this work, we introduce a novel self-gating method for radially acquired data based on a dimensionality reduction technique for time-series analysis (SSA-FARY). Building on Singular Spectrum Analysis, a zero-padded, time-delayed embedding of the auto-calibration data is analyzed using Principle Component Analysis. We demonstrate the basic functionality of SSA-FARY using numerical simulations and apply it to in-vivo cardiac radial single-slice bSSFP and Simultaneous Multi-Slice radiofrequency-spoiled gradient-echo measurements, as well as to Stack-of-Stars bSSFP measurements. SSA-FARY reliably detects the cardiac and respiratory motion and separates it from noise. We utilize the generated signals for high-dimensional image reconstruction using parallel imaging and compressed sensing with in-plane wavelet and (spatio-)temporal total-variation regularization.

Whole-heart, ungated, free-breathing, cardiac-phase-resolved myocardial perfusion MRI by using Continuous Radial Interleaved simultaneous Multi-slice acquisitions at sPoiled steady-state (CRIMP)

PURPOSE

To develop a whole-heart, free-breathing, non-electrocardiograph (ECG)-gated, cardiac-phase-resolved myocardial perfusion MRI framework (CRIMP; Continuous Radial Interleaved simultaneous Multi-slice acquisitions at sPoiled steady-state) and test its quantification feasibility.

METHODS

CRIMP used interleaved radial simultaneous multi-slice (SMS) slice groups to cover the whole heart in 9 or 12 short-axis slices. The sequence continuously acquired data without magnetization preparation, ECG gating or breath-holding, and captured multiple cardiac phases. Images were reconstructed by a motion-compensated patch-based locally low-rank reconstruction. Bloch simulations were performed to study the signal-to-noise ratio/contrast-to-noise ratio (SNR/CNR) for CRIMP and to study the steady-state signal under motion. Seven patients were scanned with CRIMP at stress and rest to develop the sequence. One human and two dogs were scanned at rest with a dual-bolus method to test the quantification feasibility of CRIMP. The dual-bolus scans were performed using both CRIMP and an ungated radial SMS saturation recovery (SMS-SR) sequence with injection dose = 0.075 mmol/kg to compare the sequences in terms of SNR, cardiac phase resolution and quantitative myocardial blood flow (MBF).

RESULTS

Perfusion images with multiple cardiac phases in all image slices with a temporal resolution of 72 ms/frame were obtained. Simulations and in-vivo acquisitions showed CRIMP kept the inner slices in steady-state regardless of motion. CRIMP outperformed SMS-SR in slice coverage (9 over 6), SNR (mean 20% improvement), and provided cardiac phase resolution. CRIMP and SMS-SR sequences provided comparable MBF values (rest systolic CRIMP = 0.58 ± 0.07, SMS-SR = 0.61 ± 0.16).

CONCLUSION

CRIMP allows for whole-heart, cardiac-phase-resolved myocardial perfusion images without ECG-gating or breath-holding. The sequence can provide MBF if an accurate arterial input function is obtained separately.

Real-Time Magnetic Resonance Imaging: Radial Gradient-Echo Sequences With Nonlinear Inverse Reconstruction

OBJECTIVE

The aim of this study is to evaluate a real-time magnetic resonance imaging (MRI) method that not only promises high spatiotemporal resolution but also practical robustness in a wide range of scientific and clinical applications.

MATERIALS AND METHODS

The proposed method relies on highly undersampled gradient-echo sequences with radial encoding schemes. The serial image reconstruction process solves the true mathematical task that emerges as a nonlinear inverse problem with the complex image and all coil sensitivity maps as unknowns. Extensions to model-based reconstructions for quantitative parametric mapping further increase the number of unknowns, for example, by adding parameters for phase-contrast flow or T1 relaxation. In all cases, an iterative numerical solution that minimizes a respective cost function is achieved with use of the iteratively regularized Gauss-Newton method. Convergence is supported by regularization, for example, to the preceding frame, whereas temporal fidelity is ensured by downsizing the regularization strength in comparison to the data consistency term in each iterative step. Practical implementations of highly parallelized algorithms are realized on a computer with multiple graphical processing units. It is "invisibly" integrated into a commercial 3-T MRI system to allow for conventional usage and to provide online reconstruction, display, and storage of regular DICOM image series.

RESULTS

Depending on the application, the proposed method offers serial imaging, that is, the recording of MRI movies, with variable spatial resolution and up to 100 frames per second (fps)-corresponding to 10 milliseconds image acquisition times. For example, movements of the temporomandibular joint during opening and closing of the mouth are visualized with use of simultaneous dual-slice movies of both joints at 2 × 10 fps (50 milliseconds per frame). Cardiac function may be studied at 30 to 50 fps (33.3 to 20 milliseconds), whereas articulation processes typically require 50 fps (20 milliseconds) or orthogonal dual-slice acquisitions at 2 × 25 fps (20 milliseconds). Methodological extensions to model-based reconstructions achieve improved quantitative mapping of flow velocities and T1 relaxation times in a variety of clinical scenarios.

CONCLUSIONS

Real-time gradient-echo MRI with extreme radial undersampling and nonlinear inverse reconstruction allows for direct monitoring of arbitrary physiological processes and body functions. In many cases, pertinent applications offer hitherto impossible clinical studies (eg, of high-resolution swallowing dynamics) or bear the potential to replace existing MRI procedures (eg, electrocardiogram-gated cardiac examinations). As a consequence, many novel opportunities will require a change of paradigm in MRI-based radiology. At this stage, extended clinical trials are needed.

Inferior vena cava revisited - Real-time flow MRI of respiratory maneuvers

Recent MRI studies of blood flow in the inferior vena cava (IVC) resulted in findings which are inconsistent with earlier observations by invasive procedures - most likely because ECG-gated MRI techniques are unable to resolve dynamic adjustments due to respiration. The purpose of this work was to apply real-time phase-contrast MRI at 50 ms resolution to re-evaluate IVC flow in response to normal and deep breathing as well as breath holding and Valsalva maneuver (11 young healthy subjects). Real-time flow MRI relied on highly undersampled radial gradient-echo sequences and a model-based nonlinear inverse reconstruction. A frequency analysis of the predominant pulsatility classified IVC flow in individual subjects as "cardiac", "respiratory" or "mixed" type. Peak flow velocities during free breathing ranged from 30 to 58 cm s^-1 , while flow rates varied from 15 to 37 ml s^-1 . The subject-specific IVC flow pattern persists during deep breathing although the enhanced respiratory influence may shift subjects form "cardiac" to "mixed" or from "mixed" to "respiratory" type. Peak velocities increased relative to normal breathing but led to similar flow rates of 16 to 34 ml s^-1 . Inspiration during deep breathing elicited brief periods of flow reversal in all subjects with mean peak velocities of -21 cm s^-1 . The observation of only mildly flattened parabolic velocity distributions within the IVC indicated mostly laminar flow. Breath holding reduced blood flow velocities and rates by more than 40% on average, while Valsalva maneuvers completely abolished venous return. In conclusion, IVC blood flow is dominated by the acquired respiratory behavior of individual subjects and its pressure-induced alterations relative to cardiac pulsation. The responses to breath holding and Valsalva maneuver are in full agreement with previous invasive observations of reduced or even ceased flow, respectively.

Real-time multi-directional flow MRI using model-based reconstructions of undersampled radial FLASH - A feasibility study

The purpose of this work was to develop an acquisition and reconstruction technique for two- and three-directional (2d and 3d) phase-contrast flow MRI in real time. A previous real-time MRI technique for one-directional (1d) through-plane flow was extended to 2d and 3d flow MRI by introducing in-plane flow sensitivity. The method employs highly undersampled radial FLASH sequences with sequential acquisitions of two or three flow-encoding datasets and one flow-compensated dataset. Echo times are minimized by merging the waveforms of flow-encoding and radial imaging gradients. For each velocity direction individually, model-based reconstructions by regularized nonlinear inversion jointly estimate an anatomical image, a set of coil sensitivities and a phase-contrast velocity map directly. The reconstructions take advantage of a dynamic phase reference obtained by interpolating consecutive flow-compensated acquisitions. Validations include pulsatile flow phantoms as well as in vivo studies of the human aorta at 3 T. The proposed method offers cross-sectional 2d and 3d flow MRI of the human aortic arch at 53 and 67 ms resolution, respectively, without ECG synchronization and during free breathing. The in-plane resolution was 1.5 × 1.5 mm² and the slice thickness 6 mm. In conclusion, real-time multi-directional flow MRI offers new opportunities to study complex human blood flow without the risk of combining differential phase (i.e., velocity) information from multiple heartbeats as for ECG-gated data. The method would benefit from a further reduction of acquisition time and accelerated computing to allow for extended clinical trials.

Rapid and motion-robust volume coverage using cross-sectional real-time MRI

PURPOSE

To develop a rapid and motion-robust technique for volumetric MRI, which is based on cross-sectional real-time MRI acquisitions with automatic advancement of the slice position.

METHODS

Real-time MRI with a frame-by-frame moving cross-section is performed with use of highly undersampled radial gradient-echo sequences offering spin density, T₁ , or T₂ /T₁ contrast. Joint reconstructions of serial images and coil sensitivity maps from spatially overlapping sections are accomplished by nonlinear inversion with regularization to the preceding section-formally identical to dynamic real-time MRI. Shifting each frame by 20% to 25% of the section thickness ensures 75% to 80% overlap of successive sections. Acquisition times of 40 to 67 ms allow for rates of 15 to 25 sections per second, while volumes are defined by the number of cross-sections times the section shift.

RESULTS

Preliminary realizations at 3T comprise studies of the human brain, carotid arteries, liver, and prostate. Typically, coverage of a 90- to 180-mm volume at 0.8- to 1.2-mm in-plane resolution, 4- to 6-mm section thickness, and 0.8- to 1.5-mm section shift is accomplished within total measuring times of 4 to 6 seconds and a section speed of 15 to 37.5 mm per second. However, spatiotemporal resolution, contrast including options such as fat saturation and total measuring time are highly variable and may be adjusted to clinical needs. Promising volumetric applications range from fetal MRI to dynamic contrast-enhanced MRI.

CONCLUSION

The proposed method allows for rapid and motion-robust volume coverage in a variety of imaging scenarios.

Simultaneous dual-plane, real-time magnetic resonance imaging of oral cavity movements in advanced trombone players

Background

This paper describes the use of real-time magnetic resonance imaging to simultaneously obtain magnetic resonance imaging (MRI) videos in both a sagittal and coronal plane during the performance of a musical exercise in five advanced trombone players.

Methods

Dual-slice recordings were implemented in a frame-interleaved manner with 20 ms acquisitions per frame to achieve two interleaved videos at a rate of 25 frames per second. A customized MATLAB toolkit was used for the extraction of line profiles from MRI videos to quantify tongue movements associated with exercise performance from both perspectives.

Results

Across all subjects, the analyses revealed precise coupling of vertical movements of the dorsal tongue surface (DTS), viewed from a sagittal perspective, with reduction in the vertical and horizontal dimensions of the air channel formed between the DTS and the hard palate, viewed from a coronal perspective. The cross-correlation between these movements was very strong (mean R=0.967).

Conclusions

These results demonstrate the unique utility of this dual-slice technology in describing the coordination of complex tongue movements occurring in two planes (i.e., three directions) simultaneously, lending a deeper understanding of lingual motor control during trombone performance.

Dynamic water/fat separation and B 0 inhomogeneity mapping-joint estimation using undersampled triple-echo multi-spoke radial FLASH

PURPOSE

To achieve dynamic water/fat separation and B 0 field inhomogeneity mapping via model-based reconstructions of undersampled triple-echo multi-spoke radial FLASH acquisitions.

METHODS

This work introduces an undersampled triple-echo multi-spoke radial FLASH sequence, which uses (i) complementary radial spokes per echo train for faster spatial encoding, (ii) asymmetric echoes for flexible and nonuniform echo spacing, and (iii) a golden angle increment across frames for optimal k-space coverage. Joint estimation of water, fat, B 0 inhomogeneity, and coil sensitivity maps from undersampled triple-echo data poses a nonlinear and non-convex inverse problem which is solved by a model-based reconstruction with suitable regularization. The developed methods are validated using phantom experiments with different degrees of undersampling. Real-time MRI studies of the knee, liver, and heart are conducted without prospective gating or retrospective data sorting at temporal resolutions of 70, 158, and 40 ms, respectively.

RESULTS

Up to 18-fold undersampling is achieved in this work. Even in the presence of rapid physiological motion, large B 0 field inhomogeneities, and phase wrapping, the model-based reconstruction yields reliably separated water/fat maps in conjunction with spatially smooth inhomogeneity maps.

CONCLUSIONS

The combination of a triple-echo acquisition and joint reconstruction technique provides a practical solution to time-resolved and motion robust water/fat separation at high spatial and temporal resolution.

Multi-slice real-time MRI of temporomandibular joint dynamics

OBJECTIVES

The purpose of this work was to improve the clinical versatility of high-speed real-time MRI studies of temporomandibular joint (TMJ) dynamics by simultaneous recordings of multiple MRI movies in different sections.

METHODS

Real-time MRI at 3 T was realized using highly undersampled radial FLASH acquisitions and image reconstruction by regularized nonlinear inversion (NLINV). Multi-slice real-time MRI of two, three or four slices at 0.75 mm resolution and 6 to 8 mm thickness was accomplished at 50.0 ms, 33.3 ms or 25.5 ms temporal resolution, respectively, yielding simultaneous movies at 2 × 10, 3 × 10 or 4 × 10 frames per second in a frame-interleaved acquisition mode. Real-time MRI movies were evaluated by three blinded raters for visibility of the anterior and posterior border of disc, shape of the disk body and condyle head as well as movement of the disc and condyle (1 = excellent, 5 = no visibility).

RESULTS

Effective delineation of the disk atop the mandibular condyle was achieved by T1-weighted images with opposed-phase water-fat contrast. Compared to 8 mm sections, multi-slice recordings with 6 mm thickness provided sharper delineation of relevant structures as confirmed by inter-rater evaluation. Respective dual-slice and triple-slice recordings of a single TMJ as well as dual-slice recordings of both joints (one slice per TMJ) received the highest visibility ratings of ≤ 2 corresponding to high confidence in diagnostic content.

CONCLUSIONS

The improved access to TMJ dynamics by multi-slice real-time MRI will contribute to more effective treatment of temporomandibular disorders.

Quantification of spinal cord compression using T1 mapping in patients with cervical spinal canal stenosis - Preliminary experience

Background

Degenerative changes of the cervical spinal column are the most common cause of spinal cord lesions in the elderly. Conventional clinical, electrophysiological and radiological diagnostics of spinal cord compression are often inconsistent.

Materials and methods

The feasibility and diagnostic potential of a novel T1 mapping method at 0.5 mm resolution and 4 s acquisition time was evaluated in 14 patients with degenerative cervical spinal canal stenosis (SCS) and 6 healthy controls. T1 mapping was performed in axial sections of the stenosis as well as above and below. All subjects received standard T2-weighted MRI of the cervical spine (including SCS-grading 0-III), electrophysiological and clinical examinations.

Results

Patients revealed significantly decreased T1 relaxation times of the compressed spinal cord within the SCS (912 ± 53 ms, mean ± standard deviation) in comparison to unaffected segments above (1027 ± 39 ms, p < .001) and below (1056 ± 93 ms, p < .001). There was no difference in mean T1 in unaffected segments in patients (p = .712) or between segments in controls (p = .443). Moreover, T1 values were significantly lower in grade II (881 ± 46 ms, p = .005) than in grade I SCS (954 ± 29 ms). Patients with central conduction deficit tended to have lower T1 values within the SCS than patients without (909 ± 50 ms vs 968 ± 7 ms, p = .069).

Conclusion

Rapid high-resolution T1 mapping is a robust MRI method for quantifying spinal cord compression in patients with cervical SCS. It promises additional diagnostic insights and warrants more extended patient studies.

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Rapid T1 mapping at 0.5 mm resolution was tested in cervical spinal canal stenosis (SCS).

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T1 relaxation times significantly decreased within the SCS.

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T1 relaxation times were significantly lower in grade II vs grade I SCS.

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Central conduction deficits were inversely correlated with T1 relaxation time.

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Rapid T1 mapping robustly and accurately quantifies spinal cord compression.

Fast Interleaved Multislice T1 Mapping: Model-Based Reconstruction of Single-Shot Inversion-Recovery Radial FLASH

Purpose

To develop a high-speed multislice T1 mapping method based on a single-shot inversion-recovery (IR) radial FLASH acquisition and a regularized model-based reconstruction.

Methods

Multislice radial k-space data are continuously acquired after a single nonselective inversion pulse using a golden-angle sampling scheme in a spoke-interleaved manner with optimized flip angles. Parameter maps and coil sensitivities of each slice are estimated directly from highly undersampled radial k-space data using a model-based nonlinear inverse reconstruction in conjunction with joint sparsity constraints. The performance of the method has been validated using a numerical and experimental T1 phantom as well as demonstrated for studies of the human brain and liver at 3T.

Results

The proposed method allows for 7 simultaneous T1 maps of the brain at 0.5 × 0.5 × 4 mm³ resolution within a single IR experiment of 4 s duration. Phantom studies confirm similar accuracy and precision as obtained for a single-slice acquisition. For abdominal applications, the proposed method yields three simultaneous T1 maps at 1.25 × 1.25 × 6 mm³ resolution within a 4 s breath hold.

Conclusion

Rapid, robust, accurate, and precise multislice T1 mapping may be achieved by combining the advantages of a model-based nonlinear inverse reconstruction, radial sampling, parallel imaging, and compressed sensing.

Model-based T1 mapping with sparsity constraints using single-shot inversion-recovery radial FLASH

PURPOSE

To develop a model-based reconstruction technique for single-shot T₁ mapping with high spatial resolution, accuracy, and precision using an inversion-recovery (IR) fast low-angle shot (FLASH) acquisition with radial encoding.

METHODS

The proposed model-based reconstruction jointly estimates all model parameters, that is, the equilibrium magnetization, steady-state magnetization, 1/ T1*, and all coil sensitivities from the data of a single-shot IR FLASH acquisition with a small golden-angle radial trajectory. Joint sparsity constraints on the parameter maps are exploited to improve the performance of the iteratively regularized Gauss-Newton method chosen for solving the nonlinear inverse problem. Validations include both a numerical and experimental T₁ phantom, as well as in vivo studies of the human brain and liver at 3 T.

RESULTS

In comparison to previous reconstruction methods for single-shot T₁ mapping, which are based on real-time MRI with pixel-wise fitting and a model-based approach with a predetermination of coil sensitivities, the proposed method presents with improved robustness against phase errors and numerical precision in both phantom and in vivo studies.

CONCLUSION

The comprehensive model-based reconstruction with L1 regularization offers rapid and robust T₁ mapping with high accuracy and precision. The method warrants accelerated computing and online implementation for extended clinical trials. Magn Reson Med 79:730-740, 2018. © 2017 International Society for Magnetic Resonance in Medicine.

High-resolution myocardial T1 mapping using single-shot inversion recovery fast low-angle shot MRI with radial undersampling and iterative reconstruction

OBJECTIVE

To develop a novel method for rapid myocardial T₁ mapping at high spatial resolution.

METHODS

The proposed strategy represents a single-shot inversion recovery experiment triggered to early diastole during a brief breath-hold. The measurement combines an adiabatic inversion pulse with a real-time readout by highly undersampled radial FLASH, iterative image reconstruction and T₁ fitting with automatic deletion of systolic frames. The method was implemented on a 3-T MRI system using a graphics processing unit-equipped bypass computer for online application. Validations employed a T₁ reference phantom including analyses at simulated heart rates from 40 to 100 beats per minute. In vivo applications involved myocardial T₁ mapping in short-axis views of healthy young volunteers.

RESULTS

At 1-mm in-plane resolution and 6-mm section thickness, the inversion recovery measurement could be shortened to 3 s without compromising T₁ quantitation. Phantom studies demonstrated T₁ accuracy and high precision for values ranging from 300 to 1500 ms and up to a heart rate of 100 beats per minute. Similar results were obtained in vivo yielding septal T₁ values of 1246 ± 24 ms (base), 1256 ± 33 ms (mid-ventricular) and 1288 ± 30 ms (apex), respectively (mean ± standard deviation, n = 6).

CONCLUSION

Diastolic myocardial T₁ mapping with use of single-shot inversion recovery FLASH offers high spatial resolution, T₁ accuracy and precision, and practical robustness and speed. Advances in knowledge: The proposed method will be beneficial for clinical applications relying on native and post-contrast T₁ quantitation.

Sinogram-based coil selection for streak artifact reduction in undersampled radial real-time magnetic resonance imaging

BACKGROUND

Streak artifacts are a common problem in radial magnetic resonance imaging (MRI). We therefore developed a method for automatically excluding receiver coil elements which lead to these artifacts.

METHODS

The proposed coil selection relates to real-time MRI data based on highly undersampled radial acquisitions. It exploits differences between high- and low-resolution sinograms reconstructed from datasets acquired during preparatory scans. Apart from phantom validations, the performance was assessed for real-time MRI studies of different human organ systems in vivo.

RESULTS

The algorithm greatly reduces streak artifact strength without compromising image quality in other parts of the image. It is robust with respect to different experimental settings and fast to be included in the online reconstruction pipeline for real-time MRI.

CONCLUSIONS

The proposed method enables a fast reduction of streak artifacts in radial real-time MRI.

Rapid and robust variable flip angle T1 mapping using interleaved two-dimensional multislice spoiled gradient echo imaging

PURPOSE

Conventional T₁ mapping using three-dimensional (3D) radiofrequency (RF) spoiled gradient echo (SPGR) imaging with short repetition times (TR) is adversely affected by incomplete spoiling (i.e. residual T₂ dependency). In this work, an optimized interleaved 2D multislice SPGR sequence scheme and an adapted postprocessing procedure are evaluated for highly T₂ -insensitive T₁ quantification of human brain tissues.

METHODS

An efficient 2D multislice SPGR protocol including a relatively long TR of 200 ms is investigated with careful consideration of cross talk and magnetization transfer effects. Based on the derived scan protocol, T₁ is quantified from the signal ratio of two SPGR datasets acquired at different flip angles. The effect of nonideal RF excitation profiles is incorporated into the SPGR signal model by performing Bloch simulations.

RESULTS

Simulations showed that the parameters of the SPGR protocol (such as TR and the spoiler gradient moments) guarantee virtually complete spoiling. This result was confirmed by T₁ measurements both in vitro using a 2% agar probe doped with 0.1 mM Gd (Gadovist) and in vivo in the human brain.

CONCLUSION

The derived 2D multislice SPGR protocol offers efficient, highly reproducible, and in particular T₂ -insensitive T₁ quantification of human brain tissues. Magn Reson Med 77:1606-1611, 2017. © 2016 International Society for Magnetic Resonance in Medicine.