2D TrueFISP Research Articles

Accelerated three-dimensional susceptibility weighted imaging of the whole spine of fetus at 3T

ObjectivesTo investigate the image quality and capability of generalized auto-calibrating partially parallel acquisition (GRAPPA) accelerated Three-dimensional (3D) susceptibility weighted imaging (SWI) of the whole spine at 3T. MethodsA total of 37 pregnant women (gestation age 22 to 39 weeks, average 29 ± 3 weeks) with suspected fetal vertebral anomalies by ultrasound (US) screening underwent 3.0T MR imaging with 3D SWI, conventional two-dimensional (2D) half-flourier acquisition single-shot turbo spin-echo (HASTE) and 3D true fast imaging with steady-state precession (True FISP). The acquisition time of each protocol was recorded. Signal-to-noise ratios (SNRs) and contrast-to-noise ratios (CNRs) were determined in representative interest regions of fetal thoracic vertebrae and compared among three pulse sequences. Two radiologists rated image quality independently in random order on a 5-point scale. Kappa coefficients were computed to assess inter-observer reliability. Receiver operating characteristic curves were generated, and the area under the curve (AUC) was used to compare the diagnostic performance of each protocol in vertebral deformities. ResultsThe acquisition time was 15 s for 3D-SWI and 17 s for 3D True FISP, significantly shorter than conventional HASTE (37 s; both P < 0.01).Of the three protocols, The SNR was highest on 3D True FISP, while the CNR was highest on 3D SWI. Visualization of all segments of the whole spine by 3D SWI was comparable with 3D True FISP. In contrast, 3D SWI and 3D True FISP depicted cervical and sacrococcygeal vertebrae better than HASTE. The weighted kappa statistic was 0.70–0.89 to evaluate the image quality of all segments of the whole spine, indicating good to excellent interobserver agreement. 3D SWI had the highest diagnostic performance for detecting fetal vertebral anomalies (AUC = 0.92). Conclusions3D-SWI is feasible for improved visualization of the whole fetal vertebral column and its congenital malformations with adequate image quality and high accuracy, thereby providing a supplementary method to conventional MR imaging.

Efficacies of 3D T2 Sampling Perfection with Application-optimized Contrast with the Use of Different Flip-Angle Evolution (3D T2-SPACE) Sequences and 3D True FISP Sequences

Efficacies of 3D T2 Sampling Perfection with Application-optimized Contrast with the Use of Different Flip-Angle Evolution (3D T2-SPACE) Sequences and 3D True FISP Sequences

Analysis of different image-registration algorithms for Fourier decomposition MRI in functional lung imaging.

Motion correction is mandatory for the functional Fourier decomposition magnetic resonance imaging (FD-MRI) of the lungs. Therefore, it is important to evaluate the quality of various image-registration algorithms for pulmonary FD-MRI and to determine their impact on FD-MRI outcome. To evaluate different image-registration algorithms for FD-MRI in functional lung imaging. Fifteen healthy volunteers were examined in a 1.5-T whole-body MR scanner (Magnetom Avanto, Siemens AG) with a non-contrast enhanced 2D TrueFISP pulse sequence in coronal view and free-breathing (acquisition time 45 s, 250 images). Three image-registration algorithms were used to compensate the spatial variation of the lungs (fMRLung 3.0, ANTs, and Elastix). Quality control for image registration was performed by edge detection (ED), quotient image criterion (QI), and dice similarity coefficient (DSC). Ventilation, perfusion, and a ventilation/perfusion quotient (V/Q) were calculated using the three registered datasets. Average computing times for the three image-registration algorithms were 1.0 ± 1.6 min, 38.0 ± 13.5 min, and 354 ± 78 min for fMRLung, ANTs, and Elastix, respectively. No significant difference in the quality of motion correction provided by different image-registration algorithms occurred. Significant differences were observed between fMRLung- and Elastix-based perfusion values ​​of the left lung as well as fMRLung- and ANTs-based V/Q quotient of the right and the entire lung (P < 0.05). Other ventilation and perfusion values were not significantly different. The mandatory motion correction for functional FD-MRI of the lung can be achieved through different image-registration algorithms with consistent quality. However, a significantly difference in computing time between the image-registration algorithms still requires an optimization.

123. Evaluation of gating accuracy for a hybrid MR-guided RT system

PurposeAim of this study is to dosimetric evaluate the gating accuracy of an MRI-guided radiotherapy system (MRIdian, ViewRay), combining a 0.35 T scanner with 3 Co-60 gamma sources. MethodsAn MRI compatible phantom consisting in a piston able to slide inside a cylinder executing a periodic movement was used (CIRS Dynamic Thorax Phantom). An ion chamber (0.125 cc) was inserted inside the piston to perform absolute dose measurement. The extremity of the ion chamber housing is inserted in a 3 × 3 × 2 cm3 parallelepiped marker that allows its reliable MR visualization.A 3D MR image of the phantom in static position was acquired by using a True Fast Imaging with Steady state Precession (True FISP) sequence.A small target (18 cc) surrounding the ion chamber volume was contoured and a homogeneous dose of 2.16 Gy was prescribed (see Fig. 1). The tracking boundary was obtained expanding the target volume of 5 mm in all directions.The same treatment plan was delivered moving the piston at different speeds (6,8,10 mm/s) and for different length path (20,24,36,48 mm). The dose value measured maintaining the piston steady was considered as reference.The gating process was carried out acquiring 4 images/s on a sagittal plan (using a 2D True FISP sequence) and stopping the beam each time the target volume was outside the boundary. ResultsTable 1 summarises results obtained. The dose values measured at the different dynamic situations resulted to be very close to the dose reference: in 4 on 5 cases the dose difference resulted less than 0.5%. Even the worst result, obtained when the piston was executing large elongations in short lapses, shows an acceptable value (dose difference equal to 1.58%). ConclusionsThe system showed encouraging performances in tracking SBRT target volumes with dose differences always less than 2% at different motion length and speed.

3T MRI of the knee with optimised isotropic 3D sequences: Accurate delineation of intra-articular pathology without prolonged acquisition times.

To investigate optimised isotropic 3D turbo spin echo (TSE) and gradient echo (GRE)-based pulse sequences for visualisation of articular cartilage lesions within the knee joint. Optimisation of experimental imaging sequences was completed using healthy volunteers (n=16) with a 3-Tesla (3T) MRI scanner. Imaging of patients with knee cartilage abnormalities (n=57) was then performed. Acquired sequences included 3D proton density-weighted (PDW) TSE (SPACE) with and without fat-suppression (FS), and T2*W GRE (TrueFISP) sequences, with acquisition times of 6:51, 6:32 and 5:35 min, respectively. One hundred sixty-one confirmed cartilage lesions were detected and categorised (Grade II n=90, Grade III n=71). The highest sensitivity and specificity for detecting cartilage lesions were obtained with TrueFISP with values of 84.7% and 92%, respectively. Cartilage SNR mean for PDW SPACE-FS was the highest at 72.2. TrueFISP attained the highest CNR means for joint fluid/cartilage (101.5) and joint fluid/ligament (156.5), and the lowest CNR for cartilage/meniscus (48.5). Significant differences were identified across the three sequences for all anatomical structures with respect to SNR and CNR findings (p-value <0.05). Isotropic TrueFISP at 3T, optimised for acquisition time, accurately detects cartilage defects, although it demonstrated the lowest contrast between cartilage and meniscus. • Cartilage is better visualised with 3D TrueFISP than 3D SPACE sequences. • 3D TrueFISP is a reliable sequence for detecting low- and high-grade cartilage defects. • 3D TrueFISP at 3T provides excellent contrast between cartilage and joint fluid.

WE-FG-202-08: Assessment of Treatment Response Via Longitudinal Diffusion MRI On A MRI-Guided System: Initial Experience of Quantitative Analysis

Purpose: To report our initial experience of systematic monitoring treatment response using longitudinal diffusion MR images on a Co-60 MRI-guided radiotherapy system. Methods: Four patients, including 2 head-and-necks, 1 sarcoma and 1 GBM treated on a 0.35 Tesla MRI-guided treatment system, were analyzed. For each patient, 3D TrueFISP MRIs were acquired during CT simulation and before each treatment for treatment planning and patient setup purposes respectively. Additionally, 2D diffusion-weighted MR images (DWI) were acquired weekly throughout the treatment course. The gross target volume (GTV) and brainstem (as a reference structure) were delineated on weekly 3D TrueFISP MRIs to monitor anatomy changes, the contours were then transferred onto the corresponding DWI images after fusing with the weekly TrueFISP images. The patient-specific temporal and spatial variations during the entire treatment course, such as anatomic changes, target apparent diffusion coefficient (ADC) distribution were evaluated in a longitudinal pattern. Results: Routine MRI revealed progressive soft-tissue GTV volume changes (up to 53%) for the H&N cases during the treatment course of 5–7 weeks. Within the GTV, the mean ADC values varied from −44% (ADC decrease) to +26% (ADC increase) in a week. The gradual increase of ADC value was inversely associated with target volume variation for one H&N case. The maximal changes of mean ADC values within the brainstem were 5.3% for the H&N cases. For the large size sarcoma and GBM tumors, spatial heterogeneity and temporal variations were observed through longitudinal ADC analysis. Conclusion: In addition to the superior soft-tissue visualization, the 0.35T MR system on ViewRay showed the potential to quantitatively measure the ADC values for both tumor and normal tissues. For normal tissue that is minimally affected by radiation, its ADC values are reproducible. Tumor ADC values show temporal and spatial fluctuation that can be exploited for personalized adaptive therapy.

3D-isotropic high-resolution morphological imaging and quantitative T2 mapping as biomarkers for gender related differences after matrix-associated autologous chondrocyte transplantation (MACT).

The aim of this study was to determine in vivo high-resolution morphological and biochemical gender related differences in cartilage repair tissue (MACT). Forty patients were examined clinically and by MR scans at 3T-MRI (coronal 3D True-FISP sequence for morphologic assessment and multi-echo spin-echo T2-mapping for biochemical assessment of healthy cartilage and MACT cartilage). Mean T2 values in repair tissue in the deep zone showed significantly shorter T2 times in females (p = 0.009, female 43.5 ± 9.8 vs. male 48.2 ± 7.7 ms). The superficial zone showed higher T2 values than the deep zone in both the groups (female 48.5 ± 9.8, males 52.6 ± 11.0 ms) without significant difference between female and male patients. Native control cartilage showed no statistically significant differences for T2 between females and males. The subdivisions "structure of the repair tissue" and "subchondral bone" of the MOCART score showed statistically significant differences between females and males (p = 0.026 and p = 0.007) as well as the Lysholm score (p = 0.03). Our investigations revealed differences between female and male patients after MACT of the knee in clinical outcome and advanced morphological and biochemical MRI. The presented imaging biomarkers can depict subtle changes after cartilage regeneration procedures and might help to understand gender related differences after cartilage repair procedures.

MR imaging in Crohn's disease: correlation of MR motility measurement with histopathology in the terminal ileum

The objective of the study was to correlate MR-detectable motility alterations of the terminal ileum with biopsy-documented active and chronic changes in Crohn's disease. This IRB approved retrospective analysis of 43 patients included magnetic resonance enterography (MRE) and terminal ileum biopsies (<2weeks apart). Motility was measured at the terminal ileum using coronal 2D trueFISP pulse sequences (1.5T MRI,TR 83.8,TE1.89) and dedicated motility assessment software. Motility grading (hypermotility, normal, hypomotility, complete arrest) was agreed by two experienced readers. Motility was compared and correlated with histopathology using two-tailed Kruskal-Wallis test and paired Spearman Rank-Order Correlation tests. Motility abnormalities were present in 27/43 patients: nine hypomotility and 18 complete arrest. Active disease was diagnosed on 15 biopsies: eight moderate and seven severe inflammatory activity. Chronic changes were diagnosed on 17 biopsies: 13 moderate and four severe cases. In four patients with normal motility alterations on histopathology were diagnosed. Histopathology correlated with presence (P=0.0056 for hypomotility and P=0.0119 for complete arrest) and grade (P< 0.0001; P=0.0004) of motility alterations. A significant difference in the motility was observed in patients with active or chronic CD compared with patients without disease (P<0.001; P=0.0024). MR-detectable motility changes of the terminal ileum correlate with histopathological findings both in active and chronic CD. Motility changes may indicate the presence pathology, but do not allow differentiation of active and chronic disease.

High-Resolution In Utero 3D MR Imaging of Inner Ear Microstructures in Fetal Sheep

Developmental inner ear abnormalities can occur due to embryopathies as well as in the context of syndromal diseases like the CHARGE association. In severe cases, an early and definite in utero diagnosis is important for decision-making; here, fetal MR imaging can be a helpful tool. We present results of performing high-resolution MR imaging of the inner ear structures of fetal sheep in vivo. Six ewes carrying singleton fetuses (mean gestational age, 120 days) were examined under general anesthesia at 1.5T. A 3D true FISP sequence with isotropic voxel size (0.7 mm) was applied; acquisition time was 2:35 minutes. For a standard of reference, 1 stillborn lamb of equivalent gestation age was examined. Image analysis was performed in consensus by 2 radiologists regarding the depiction of anatomic landmarks on a 5-point scale. Motion artifacts were quantified on a 3-point scale. The turns and modiolus of the cochlea as well as the origins of all 3 semicircular canals of the vestibular system of both sides could be reliably identified in every animal. Motion artifacts due to maternal breathing excursions or movements of the fetus were minimal. In case of breech presentation, the ventilation of the ewe had to be paused during the image acquisition to achieve acceptable results. High-resolution intrauterine MR imaging of the inner ear microstructures in an animal model is feasible. However, the acquisition time of the sequence applied is still too long to perform such measurement in a clinical setting.

Optimising magnetic resonance imaging for preoperative staging and surgical planning in colon cancer at 1.5 tesla and 3.0 tesla.

395 Background: The aim of this study was to determine best technique for future preoperative staging and operative planning in colon cancer using MRI at 1.5T, and feasibility at 3.0T. Methods: 39 scans were performed in 4 healthy volunteers comparing bowel distension using different oral contrast techniques; no oral preparation, 1L of water, 1L of poly ethylene glycol (Klean-Prep), and 1L of 2.1% barium sulphate and 3.2% sorbitol solution (E-Z-Cat) at 1.5T. Bowel distension was scored blindly by 2 experienced radiologists. A further 35 scans compared image quality of T2-weighted pulse sequences; 2D-TrueFISP, 3D-TrueFISP, HASTE, 2D-TSE and 3D-TSE. Scans were scored for movement artefact, colon wall and colon mesentery visualisation. Signal to noise ratio (SNR) was calculated. Inter-observer agreement was assessed using Cohen's Kappa. Equivalent optimised protocols were derived at 3.0T and tested for feasibility. Results: Inter-observer agreement for scoring was good (kappa = 0.61-0.67). Sorbitol-barium sulphate gave significantly better small bowel distension than no oral preparation, water and Klean-Prep (mean score 3.8 vs 1.6, 2.2 and 1.9, p≤0.007). 2D TrueFISP sequences gave the highest mean score for scan quality, significantly better than 3D-TSE, 2D-TSE, 3D-TrueFISP and HASTE (mean 10.6 vs 3.2, 7.8, 7.7 and 7.4, p≤0.012). 2D-TSE sequences obtained best SNR, significantly greater than obtained using 3D-TSE (p=0.045). 3.0T sequences were comparable or superior. Conclusions: Colon imaging using MRI requires fast sequences and adequate bowel distension. Our observations indicate that 2D-TrueFISP and 2D-TSE sequences with 1L Sorbitol-Barium sulphate orally give the best T2-weighted images of the colon wall and adjacent structures for cancer staging at 1.5T; equivalent 3.0T protocols are possible. No significant financial relationships to disclose.

Contrast-enhanced CMR in patients after percutaneous closure of the left atrial appendage: a pilot study.

BackgroundTo evaluate the feasibility and value of first-pass contrast-enhanced dynamic and post-contrast 3D CMR in patients after transcatheter occlusion of left atrial appendage (LAA) to identify incorrect placement and persistent leaks.Methods7 patients with different occluder systems (n = 4 PLAATO; n = 2 Watchman; n = 1 ACP) underwent 2 contrast-enhanced (Gd-DOTA) CMR sequences (2D TrueFISP first-pass perfusion and 3D-TurboFLASH) to assess localization, artifact size and potential leaks of the devices. Perfusion CMR was analyzed visually and semi-quantitatively to identify potential leaks.ResultsAll occluders were positioned within the LAA. The ACP occluder presented the most extensive artifact size. Visual assessment revealed a residual perfusion of the LAA apex in 4 cases using first-pass perfusion and 3D-TurboFLASH indicating a suboptimal LAA occlusion.By assessing signal-to-time-curves the cases with a visually detected leak showed a 9-fold higher signal-peak in the LAA apex (567 ± 120% increase from baseline signal) than those without a leak (61 ± 22%; p < 0.03). In contrast, the signal increase in LAA proximal to the occluder showed no difference (leak 481 ± 201% vs. no leak 478 ± 125%; p = 0.48).ConclusionThis CMR pilot study provides valuable non-invasive information in patients after transcatheter occlusion of the LAA to identify correct placement and potential leaks. We recommend incorporating CMR in future clinical studies to evaluate new device types.

Detection of biliary stenoses in patients after liver transplantation: Is there a different diagnostic accuracy of MRCP depending on the type of biliary anastomosis?

Purpose Two different forms of biliary anastomosis can be created in patients undergoing liver transplantation: (a) bilio-digestive anastomoses or (b) choledocho-choledochostomy. Aim of this study was to assess the accuracy of MR cholangiopancreatography (MRCP) for the depiction of biliary stenoses in liver transplant patients depending on the type of biliary anastomosis. Method and materials 24 liver transplant patients with clinical suspicion of biliary stenosis were studied (each 12 with bilio-digestive anastomosis/choledocho-choledochostomy). MRCP was performed on a 1.5T scanner (Magnetom Avanto, Siemens) including 2D single shot RARE, 2D T2w HASTE, TrueFISP and 3D high-resolution navigator corrected sequences. Presence of (a) anastomotic stenoses (AST) and (b) NAS (non-anastomotic strictures) were assessed. Percutaneous transhepatic cholangiography (PTC) or endoscopic retrograde cholangiopancreatography (ERCP) were performed within 48 h after MRCP and served as the standard of reference. Results In patients with bilio-digestive anastomoses sensitivities of MRCP for the detection of AST and NAS amounted to 50% and 67%, respectively with specificity values of 83% and 50%. In patients with choledocho-chledochostomy sensitivities (AST: 100%, NAS: 100%) and specificities (AST: 100%, NAS: 88%) were significantly higher. Conclusion Biliary strictures after liver transplantation can be accurately detected by MRCP in patients after choledocho-chledochostomy. However, the diagnostic value of MRCP is lower if liver transplantation was performed in combination with a bilio-digestive anastomosis. This may be due to the less exact depiction of the anastomosis in the bowel wall. Thus, it is crucial to know the type of biliary anastomosis before choosing a diagnostic procedure.

Comparison of different MRCP techniques for the depiction of biliary complications after liver transplantation

Biliary strictures after liver transplantation are common. We aimed to compare different magnetic resonance cholangiopancreatography (MRCP) sequences with regard to their diagnostic accuracy in depicting anastomotic stenoses (AST), ischaemic-type biliary lesions (ITBL) and cholelithiasis. In patients with clinically suspected biliary obstruction after liver transplantation, MRCP was performed at 1.5 T using two-dimensional (2D) single-shot RARE, 2D T2-weighted (T2w) HASTE, 2D TrueFISP and 3D T2w TSE RESTORE sequences. The presence and localisation of lesions were assessed for each sequence independently and all sequences together. Endoscopic retrograde cholangiopancreatography (ERCP) served as the "gold standard". Biliary strictures were detected with a sensitivity of 96% by MRCP and most accurately depicted when all sequences were analysed together. AST was visualised with highest sensitivity on TrueFISP and 3D T2w TSE sequences (79%). For ITBL highest sensitivity was found with the HASTE sequence (81%). Highest sensitivity for filling defects was revealed by the 3D T2w TSE sequence (54%). Receiver operating characteristic (ROC) curve/area under the curve (AUC) analysis revealed the best results for the 3D T2w TSE sequence. Our results underline the value of different MRCP sequence types for the depiction of biliary lesions. A clinical protocol consisting of different sequences may be helpful depending on the clinical question and the likely underlying abnormality.

Defining juxtapapillary diverticulum with 3D segmented trueFISP MRCP: comparison with conventional MRCP sequences with an oral negative contrast agent

To compare three-dimensional segmented true fast imaging with steady-state precession magnetic resonance cholangiopancreatography (3D-trueFISP-MRCP) to conventional MRCP sequences with an oral negative contrast agent for diagnosing juxtapapillary diverticulum. A total of 42 patients with (n = 21) and without (n = 21) juxtapapillary diverticulum confirmed by endoscopic retrograde cholangiopancreatography (ERCP) were evaluated. Three MRCP sequences, 3D-trueFISP-MRCP, two-dimensional rapid acquisition with relaxation enhancement MRCP (2D-RARE-MRCP), and 3D T(2)-weighted turbo spin-echo MRCP (3D-TSE-MRCP), obtained after administering an oral negative contrast agent (FerriSeltz; Otsuka Pharmaceutical, Tokushima, Japan) were compared. Two radiologists independently and blindly interpreted the presence or absence of juxtapapillary diverticulum and its positional relationship against the papilla. The detectability of juxtapapillary diverticulum of each sequence as decided by consensus was then compared. Kappa statistics were used to measure interobserver agreement of the classifications. The sensitivity, specificity, and accuracy for detecting juxtapapillary diverticulum of 3D-trueFISPMRCP (61.9%, 85.7%, and 73.8%) were substantively higher than those of 2D-RARE-MRCP (0.0%, 100%, and 50.0%) and 3D-TSE-MRCP (9.5%, 100%, and 54.8%). Interobserver agreement of the position of juxtapapillary diverticulum by 3D-trueFISP-MRCP was good (kappa = 0.55). 3D-trueFISP-MRCP can define juxtapapillary diverticulum even with an oral negative contrast agent, whereas conventional MRCP sequences cannot.

4D-MRI analysis of lung tumor motion in patients with hemidiaphragmatic paralysis

Purpose To investigate the complex breathing patterns in patients with hemidiaphragmatic paralysis due to malignant infiltration using four-dimensional magnetic resonance imaging (4D-MRI). Patients and methods Seven patients with bronchial carcinoma infiltrating the phrenic nerve were examined using 1.5 T MRI. The motion of the tumor and of both hemi-diaphragms were measured on dynamic 2D TrueFISP and 4D FLASH MRI sequences. Results For each patient, 3–6 breathing cycles were recorded. The respiratory-induced mean cranio-caudal displacement of the tumor was 6.6 mm (±2.8 SD). The mean displacement anterior–posterior was 7.4 mm (±2.6), while right–left movement was about 7.4 mm (±4.5). The mediastinum moved sidewards during inspiration, realizing a “mediastinal shift”. The paralyzed hemidiaphragm and the tumor showed a paradox motion during respiration in five patients. In two patients, the affected hemidiaphragm had a regular, however minimal and asynchronous motion during respiration. Respiratory variability of both tumor and diaphragm motions was about 20% although patients were instructed to breath normally. The findings showed significant differences compared to breathing patterns of patients without diaphragm dysfunction. Conclusion 4D-MRI is a promising tool to analyze complex breathing patterns in patients with lung tumors. It should be considered for use in planning of radiotherapy to account for individual tumor motion.

Whole‐heart contrast‐enhanced coronary magnetic resonance angiography using gradient echo interleaved EPI

Whole-heart coronary MR angiography (MRA) is a promising method for detecting coronary artery disease. However, the imaging time is relatively long (on the order of 10-15 min). Such a long imaging time may result in patient discomfort and compromise the robustness of whole-heart coronary MRA due to increased respiratory and cardiac motion artifacts. The goal of this study was to optimize a gradient echo interleaved echo planar imaging (GRE-EPI) acquisition scheme for reducing the imaging time of contrast-enhanced whole-heart coronary MRA. Numerical simulations and phantom studies were used to optimize the GRE-EPI sequence parameters. Healthy volunteers were scanned with both the proposed GRE-EPI sequence and a 3D TrueFISP sequence for comparison purposes. Slow infusion (0.5 cc/sec) of Gd-DTPA was used to enhance the signal-to-noise ratio (SNR) of the GRE-EPI acquisition. Whole-heart images with the GRE-EPI technique were acquired with a true resolution of 1.0 x 1.1 x 2.0 mm(3) in an average scan time of 4.7 +/- 0.7 min with an average navigator efficiency of 44 +/- 6%. The GRE-EPI acquisition showed excellent delineation of all the major coronary arteries with scan time reduced by a factor of 2 compared with the TrueFISP acquisition.

On the use of steady-state signal equations for 2D TrueFISP imaging

To explain the signal behavior in 2D-TrueFISP imaging, a slice excitation profile should be considered that describes a variation of effective flip angles and magnetization phases after excitation. These parameters can be incorporated into steady-state equations to predict the final signal within a pixel. The use of steady-state equations assumes that excitation occurs instantaneously, although in reality this is a nonlinear process. In addition, often the flip angle variation within the slice excitation profile is solely considered when using steady-state equations, while TrueFISP is especially known for its sensitivity to phase variations. The purpose of this study was therefore to evaluate the precision of steady-state equations in calculating signal intensities in 2D TrueFISP imaging. To that end, steady-state slice profiles and corresponding signal intensities were calculated as function of flip angle, RF phase advance and pulse shape. More complex Bloch simulations were considered as a gold standard, which described every excitation within the sequence until steady state was reached. They were used to analyze two different methods based on steady-state equations. In addition, measurements on phantoms were done with corresponding imaging parameters. Although the Bloch simulations described the steady-state slice profile formation better than methods based on steady-state equations, the latter performed well in predicting the steady-state signal resulting from it. In certain cases the phase variation within the slice excitation profile did not even have to be taken into account.

The value of true-FISP sequence added to conventional gadolinium-enhanced MRA of abdominal aorta and its major branches

To test true-fast imaging with steady-state precession (true-FISP) added to gadolinium-based MR angiography (Gd-MRA) for imaging abdominal aorta and major abdominal vessels, 35 consecutive patients (age 67 ± 11 years) with known or suspected abdominal and/or peripheral vascular disease were studied with sagittal and axial 2D true-FISP during free breathing and coronal 3D fast low-angle shot (FLASH) Gd-MRA (breath-holding, 0.2 mmol/kg of Gd-DOTA at 2 ml/s). We evaluated: suprarenal aorta, celiac trunk, superior mesenteric artery, right renal artery, left renal artery, infrarenal aorta, inferior mesenteric artery, aortic bifurcation/common iliac arteries, lumbar arteries and aortic atheromasia. The possible presence of accessory renal arteries, collateral vasculature and vascular prosthesis/stent was evaluated. A quality four-point score was assigned to each item on both sequences, from 0 (not visible) to 3 (good-to-excellent image quality) and Wilcoxon test was used. Main diagnoses resulted: normal or atheromasic aorta ( n = 25); aortic aneurysm ( n = 2); patent aorto-iliac surgical prosthesis ( n = 2); patent vascular iliac stent ( n = 2); aneurysm of iliac artery ( n = 1); patent aortic endovascular prosthesis ( n = 1); patent aorto-femural bypass ( n = 1) and aorto-iliac surgical prosthesis endoleak ( n = 1). We also found three patients with accessory renal arteries, two with collateral circulation, and three with surgical aorto-iliac prosthesis. The score of true-FISP (25.9 ± 4.1, median 27) was significantly higher ( p = 0.003) than that of Gd-MRA (23.9 ± 3.6, median 24). True-FISP was superior for visualizing inferior mesenteric artery (score 2.5 ± 1.1 vs. 1.0 ± 1.4; p < 0.001) and atheromasic plaques (2.5 ± 1.1 vs. 1.2 ± 1.1; p < 0.001). One collateral vasculature was demonstrated only with Gd-MRA. Summarizing, true-FISP is a power and fast non-breath-hold sequence to be added to Gd-MRA, obtaining an information increase.

Contrast-Enhanced Whole-Heart Coronary Magnetic Resonance Angiography at 3.0 T

To compare contrast-enhanced whole-heart coronary MR angiography (MRA) at 3.0 T and noncontrast steady-state free precession coronary MRA at 1.5 T in the same volunteers. Nine healthy volunteers underwent both coronary MRA using 3D FLASH with slow infusion of MultiHance at 3.0 T and 3D TrueFISP sequence at 1.5 T. Neither beta-blockers nor nitroglycerine was administered in any of the imaging sessions. The same spatial resolution and heart coverage were used at both field strengths. Acquisition time, signal-to-noise ratio of coronary blood, contrast-to-noise ratio (CNR) between coronary blood and surrounding myocardium or connecting tissue, scores of image quality, coronary artery sharpness, and coverage of coronary segments for the 2 techniques were analyzed and statistically compared. There were no significant differences in heart rate (68 +/- 10 vs. 63 +/- 6 beats/min, P > 0.05) and navigator efficiency (34.1% +/- 7.7% vs. 34.8% +/- 9.2%, P > 0.05) at 3.0 T and 1.5 T coronary MRA during the data acquisition. The average acquisition time of the 3.0 T coronary MRA was significantly shorter than that of the1.5 T coronary MRA (9.7 +/- 2.3 vs. 14.6 +/- 3.5, P < 0.05). The mean score of image quality and vessel sharpness at 3.0 T was similar to that at 1.5 T (2.8 +/- 1.0 vs. 3.0 +/- 1.0 and 0.63 +/- 0.15 vs. 0.61 +/- 0.13, respectively. P > 0.05). There was no significant difference between the number of visible coronary segments of the major coronary arteries at 3.0 T and 1.5 T (64/81 vs. 62/81, P > 0.05). However, the number of visible main coronary branches at 3.0 T was significantly higher than that at 1.5 T (18/54 vs. 7/54, P < 0.05). The overall signal-to-noise ratio at 3.0 T was significantly lower than that at 1.5 T (40.9 +/- 4.7 vs. 60.9 +/- 3.4, P < 0.01), whereas the overall CNR at 3.0 T was significantly higher than that at 1.5 T (35.4 +/- 3.3 vs. 28.8 +/- 6.4, P < 0.05). Contrast-enhanced whole-heart coronary MRA at 3.0 T demonstrated less acquisition time, higher CNR, and better depiction of coronary segments compared with steady-state free precession coronary MRA at 1.5 T. Patient studies are required to evaluate the clinical value of the technique.

3D TrueFISP imaging of mouse brain at 4.7T and 9.4T

To examine the ability of TrueFISP imaging for evaluating tumor size in mouse brain at high field. Brains of healthy and glioma-implanted nude mice were imaged at 4.7T and 9.4T. 3D imaging was performed with TrueFISP and T2w-RARE. Radiofrequency pulses with alternating phase and the sum-of-squares reconstruction method were used in TrueFISP imaging. The contrast-to-noise ratio (CNR) was evaluated in healthy and in tumoral brain regions. Banding artifact was correctly suppressed in TrueFISP images thanks to the method used. The signal-to-noise ratio (SNR) and CNR were comparable in TrueFISP and T2w-RARE images at 4.7T, but acquisition was around 4 times shorter with TrueFISP. Tumor was well detected at 4.7T with TrueFISP, but CNR between tumor and healthy tissue was low at 9.4T. TrueFISP is efficient and fast to perform brain imaging at 4.7T. Multiple TrueFISP acquisitions with phase-cycled radiofrequency (RF) pulses and sum-of-squares reconstruction allow suppression of banding artifact. Tumoral regions were well detected and the method allows longitudinal studies of tumor growth.