Contrast-Enhanced Whole-Heart Coronary Magnetic Resonance Angiography at 3 T Using Interleaved Echo Planar Imaging

Abstract

The goal of this work was to reduce the scan time of contrast-enhanced whole-heart coronary magnetic resonance angiography (MRA) by using a gradient echo interleaved echo planar imaging (GRE-EPI) sequence at 3 T field strength. A GRE-EPI sequence was optimized to acquire contrast-enhanced whole-heart coronary MRA at 3 T. First-order phase correction was used for alignment of the odd and even echoes in the GRE-EPI echo train. Single and dual reference scan techniques for estimation of the linear phase correction parameters were evaluated using both phantom and volunteer studies. The GRE-EPI readout was combined with parallel imaging for a further reduction in scan time. To avoid image distortions, calibration signals for coil sensitivity estimation were acquired in a separate low resolution GRE scan before the whole-heart GRE-EPI scan. Eight healthy volunteers were scanned with the optimized contrast-enhanced GRE-EPI sequence. GRE-EPI images were acquired during slow infusion (0.3 mL/s) of 0.1 mmol/kg body weight of Gd-BOPTA. For comparison purposes, the same 8 volunteers were scanned again in a separate scan session using a traditional GRE sequence with double the dose (0.2 mmol/kg body weight) of the same contrast agent with the same injection rate. The contrast-enhanced GRE-EPI and contrast-enhanced GRE techniques were compared in terms of relative signal-to-noise ratio (rSNR), relative contrast-to-noise ratio (rCNR), image quality scores, and visualized vessel lengths. Both, phantom and volunteer studies demonstrated that the dual reference scan phase correction technique was a key step for obtaining satisfactory image quality using GRE-EPI at 3 T. Whole-heart coronary MRA with a spatial resolution of 1.0 x 1.0 x 2.0 mm3 was acquired with the GRE-EPI sequence in an average scan time of 2.5 +/- 0.6 minutes, compared with 8.6 +/- 2.7 minutes for the GRE technique. The GRE-EPI technique had lower rCNR compared with the GRE sequence. The image quality and coronary artery visualization with the GRE-EPI technique were adequate, and there was no statistically significant difference in the image quality scores, rSNR, and visualized coronary artery lengths between the GRE-EPI and GRE techniques. Contrast-enhanced whole-heart coronary MRA using the GRE-EPI technique resulted in excellent delineation of all the major coronary arteries and compared with current GRE techniques demonstrated a factor of 2 reduction in contrast agent dose and a factor of 3 reduction in scan time.