Two-dimensional Gradient-echo Sequence Research Articles

Assessment of Cerebrovascular Reactivity Using CO2 -BOLD MRI: A 15-Year, Single Center Experience.

Cerebrovascular reactivity (CVR) is a measure of the change in cerebral blood flow (CBF) in response to a vasoactive challenge. It is a useful indicator of the brain's vascular health. To evaluate the factors that influence successful and unsuccessful CVR examinations using precise arterial and end-tidal partial pressure of CO2 control during blood oxygen level-dependent (BOLD) MRI. Retrospective. Patients that underwent a CVR between October 2005 and May 2021 were studied (total of 1162 CVR examinations). The mean (±SD) age was 46.1 (±18.8) years, and 352 patients (43%) were female. 3 T; T1-weighted images, T2*-weighed two-dimensional gradient-echo sequence with standard echo-planar readout. Measurements were obtained following precise hypercapnic stimuli using BOLD MRI as a surrogate of CBF. Successful CVR examinations were defined as those where: 1) patients were able to complete CVR testing, and 2) a clinically useful CVR map was generated. Unsuccessful examinations were defined as those where patients were not able to complete the CVR examination or the CVR maps were judged to be unreliable due to, for example, excessive head motion, and poor PET CO2 targeting. Successful and unsuccessful CVR examinations between hypercapnic stimuli, and between different patterns of stimulus were compared with Chi-Square tests. Interobserver variability was determined by using the intraclass correlation coefficient (P < 0.05 is significant). In total 1115CVR tests in 662 patients were included in the final analysis. The success rate of generating CVR maps was 90.8% (1012 of 1115). Among the different hypercapnic stimuli, those containing a step plus a ramp protocol was the most successful (95.18%). Among the unsuccessful examinations (9.23%), most were patient related (89.3%), the most common of which was difficulty breathing. CO2 -BOLD MRI CVR studies are well tolerated with a high success rate. 4 TECHNICAL EFFICACY: Stage 3.

Measurement of Cerebrospinal Fluid Flow Dynamics Using Phase Contrast MR Imaging with Bilateral Jugular Vein Compression: A Feasibility Study in Healthy Volunteers.

We measured the changes in the cerebrospinal fluid (CSF) flow dynamics after compression of the bilateral jugular veins using phase contrast-magnetic resonance imaging (PC-MRI). PC-MRI was performed in 10 healthy male volunteers using a 3T clinical scanner with a two-dimensional gradient echo sequence. We successfully measured the changes in CSF flow velocity using PC-MRI with and without compression of the bilateral jugular veins. The relative velocity range decreased by about 30% when the bilateral jugular veins were compressed.

Usefulness of breath-hold inversion recovery-prepared T1-weighted two-dimensional gradient echo sequence for detection of hepatocellular carcinoma in Gd-EOB-DTPA-enhanced MR imaging

The aim is to evaluate the diagnostic performance and the added value of breath-hold inversion recovery-prepared T1-weighted two-dimensional gradient echo (IR-2D-GRE) sequence for detection of hepatocellular carcinoma (HCC) in patients with insufficient liver parenchymal enhancement during the hepatobiliary phase (HBP) of Gd-EOB-DTPA-enhanced magnetic resonance imaging (MRI). Seventeen patients with a quantitative liver-to-spleen contrast ratio of ≤1.5 on HBP images and 36 HCCs were included. Liver-to-lesion contrast ratios on HBP images obtained with IR-2D-GRE sequence were significantly higher than those with three-dimensional gradient echo sequence. The addition of IR-2D-GRE sequence during HBP of Gd-EOB-DTPA-enhanced MRI yielded higher diagnostic accuracy and improved sensitivity.

Temperature-dependent MR signals in cortical bone: potential for monitoring temperature changes during high-intensity focused ultrasound treatment in bone.

Because existing magnetic resonance thermometry techniques do not provide temperature information within bone, high-intensity focused ultrasound (HIFU) exposures in bone are monitored using temperature changes in adjacent soft tissues. In this study, the potential to monitor temperature changes in cortical bone using a short TE gradient echo sequence is evaluated. The feasibility of this proposed method was initially evaluated by measuring the temperature dependence of the gradient echo signal during cooling of cortical bone samples implanted with fiber-optic temperature sensors. A subsequent experiment involved heating a cortical bone sample using a clinical MR-HIFU system. A consistent relationship between temperature change and the change in magnitude signal was observed within and between cortical bone samples. For the two-dimensional gradient echo sequence implemented in this study, a least-squares linear fit determined the percentage change in signal to be (0.90 ± 0.01)%/°C. This relationship was used to estimate temperature changes observed in the HIFU experiment and these temperatures agreed well with those measured from an implanted fiber-optic sensor. This method appears capable of displaying changes related to temperature in cortical bone and could improve the safety of MR-HIFU treatments. Further investigations into the sensitivity of the technique in vivo are warranted.

Model predictive filtering for improved temporal resolution in MRI temperature imaging.

A novel method for reconstructing MRI temperature maps from undersampled data is presented. The method, model predictive filtering, combines temperature predictions from a preidentified thermal model with undersampled k-space data to create temperature maps in near real time. The model predictive filtering algorithm was implemented in three ways: using retrospectively undersampled k-space data from a fully sampled two-dimensional gradient echo (GRE) sequence (reduction factors R = 2.7 to R = 7.1), using actually undersampled data from a two-dimensional GRE sequence (R = 4.8), and using actually undersampled data from a three-dimensional GRE sequence (R = 12.1). Thirty-nine high-intensity focused ultrasound heating experiments were performed under MRI monitoring to test the model predictive filtering technique against the current gold standard for MR temperature mapping, the proton resonance frequency shift method. For both of the two-dimensional implementations, the average error over the five hottest voxels from the hottest time frame remained between +/-0.8 degrees C and the temperature root mean square error over a 24 x 7 x 3 x 25-voxel region of interest remained below 0.35 degrees C. The largest errors for the three-dimensional implementation were slightly worse: -1.4 degrees C for the mean error of the five hottest voxels and 0.61 degrees C for the temperature root mean square error.

Magnetic resonance imaging measurements of vascular permeability and extracellular volume fraction of breast tumors by dynamic Gd-DTPA-enhanced relaxometry

Vascular permeability (k(ep), min(-1)) and extracellular volume fraction (v(e)) are tissue parameters of great interest to characterize malignant tumor lesions. Indeed, it is well known that tumors with high blood supply better respond to therapy than poorly vascularized tumors, and tumors with large extracellular volume tend to be more malignant than tumors showing lower extracellular volume. Furthermore, the transport of therapeutic agents depends on both extracellular volume fraction and vessel permeability. Thus, before treatment, these tissue parameters may prove useful to evaluate tumor aggressiveness and to predict responsiveness to therapy and variations during cytotoxic therapies could allow to assess treatment efficacy and early modified therapy schedules in case of poor responsiveness. As a consequence, there is a need to develop methods that could be routinely used to determine these tissue parameters. In this work, blood-tissue permeability and extracellular volume fraction information were derived from magnetic resonance imaging dynamic longitudinal relaxation rate (R(1)) mapping obtained after an intravenous bolus injection of Gd-DTPA in a group of 92 female patients with breast lesions, 68 of these being histologically proven to be with carcinoma. For the sake of comparison, 24 benign lesions were studied. The measurement protocol based on two-dimensional gradient echo sequences and a monoexponential plasma kinetic model was that validated in the occasion of previous animal experiments. As a consequence of neoangiogenesis, results showed a higher permeability in malignant than in benign lesions, whereas the extracellular volume fraction value did not allow any discrimination between benign and malignant lesions. The method, which can be easily implemented whatever the imaging system used, could advantageously be used to quantify lesion parameters (k(ep) and v(e)) in routine clinical imaging. Because of its large reproducibility, the method could be useful for intersite comparisons and follow-up studies.

Generalized self‐navigated motion detection technique: Preliminary investigation in abdominal imaging

Patient motion remains a primary obstacle to diagnostic image quality, especially in the abdomen, despite the existence of various motion artifact reduction techniques. This work presents a self-navigated motion detection method that can be generalized for most pulse sequences and k-space trajectories. Motion information is extracted directly from raw MR data, requiring no additional gradient or RF pulses, no physiologic monitoring equipment, and minimal--if any--impact on scan time. Initial feasibility results with a two-dimensional gradient echo sequence are shown in phantom studies and in vivo volunteer abdominal studies, demonstrating the sensitivity of the method to both respiratory motion and cardiovascular pulsatility. Prospectively gated images were acquired using the self-navigated data to synchronize image acquisition with motion. These preliminary results suggest that the self-navigated method is a promising technique for reducing motion artifacts in clinical abdominal and cardiac applications.

Three-dimensional isotropic contrast-enhanced MR angiography of the carotid artery using sensitivity-encoding and random elliptic centric k-space filling: technique optimization

We present a study that helped optimize a three-dimensional isotropic contrast-enhanced MR angiographic (CE-MRA) technique, using sensitivity encoding (SENSE) and random elliptic centric k-space filling. Two-dimensional gradient-echo sequence (TR/TE/flip angle 3.4/0.97/40 degrees ) was used to generate time-intensity curves in porcine carotid arteries for a fixed dose of Gd-DTPA (0.02 mmol/kg) at the following intravenous injection rates: 0.1, 0.3, 0.5, 1.0, 1.5, 2.0, and 3.0 ml/s. The time of contrast arrival and time to peak were recorded. Based on the time-intensity curves, three-dimensional high-resolution isotropic (1 mm3) CE-MRA sequence (TR/TE/flip angle: 4.9/2.4/30 degrees ), using SENSE (reduction factor of 2) and random elliptic centric k-space filling, was initiated twice for each of the above injection rates: first at the time of contrast arrival and second at the time of peak contrast. The three-dimensional CE-MRA images were analyzed for artifacts, signal-to-noise ratio, and venous contamination. For the three-dimensional CE-MRA acquisitions that were initiated at the time of contrast arrival, there was a gradual improvement in signal-to-noise ratio (SNR) in the carotid arteries with increasing injection rate. The same trend was not observed for the acquisitions that were initiated at the time of peak contrast. SENSE combined with random elliptic k-space acquisition in CE-MRA allows for higher SNR with fewer ringing artifacts at faster contrast injection rates.

MR imaging in the presence of vascular stents: A systematic assessment of artifacts for various stent orientations, sequence types, and field strengths.

A systematic evaluation of the potential quality of magnetic resonance images recorded in the presence of metallic stents was performed on a low-field open imager operating at 0.2 T and on a high-field closed unit operating at 1.0 T. Eight different stent types were examined by two-dimensional gradient-echo sequences with echo times of 4 and 10 msec and by a fast spin-echo technique. In addition, a three-dimensional gradient-echo sequence was applied with an echo time of 2.4 msec. A set of sequence and slice parameters was used on both scanners. Thus, artifacts due to susceptibility effects depending on the magnetic field strength could be distinguished from radiofrequency shielding effects in the lumen of the stents (independent of the field strength). Nine different orthogonal orientations of the stent axis and the image (in terms of slice, read, and phase-encoding direction) were tested, and the artifacts (extension of signal void and visibility of the lumen) were compared. The optimal strategy for visualization of vascular and perivascular regions outside the stents was fast spin-echo imaging with the stent axis and read direction parallel to the static field. Susceptibility-induced signal void in gradient-echo images was minimal using the three-dimensional approach. Increased transmitter amplitudes above usual values provided clearly improved insight in the lumen using gradient-echo sequences.

3-dimensional MR coronary angiography with navigator technique: imaging of the proximal course of a coronary artery anomaly

Congenital coronary artery anomalies are found in 0.3 to 1.3% of patients and can cause ischemic heart disease or sudden cardiac death, especially if the anomalous coronary artery courses between the aortic root and the pulmonary artery. Identification of the anatomic course of the anomalous vessel is not always feasible by conventional radiographic coronary angiography. With MR coronary angiography not only flowing blood but also the vessel anatomy can be imaged. In previous studies, a two-dimensional gradient-echo sequence during breathhold was used demanding both cooperation of the patient and operator skill. The navigator technique reduces respiratory artifacts by retrospective respiratory gating on the diaphragm's position, obviating the need for breathhold studies. Furthermore, the three-dimensional MR coronary angiography enables post-processing using the Volume Rendering Technique for evaluation of three-dimensional view. We report on the use of this technique for the identification of the course of anomalous coronary arteries in two patient cases.

Flow velocity of the cortical vein and its effect on functional brain MRI at 1.5T: preliminary results by cine-MR venography.

The purpose of this study is to demonstrate the effect of altering flow velocity of cerebral cortical veins as the source of the signal change observed in functional magnetic resonance imaging (fMRI) of the brain. 10 healthy volunteers were examined after instructions in self-paced hand grasping. Experiments were performed using a 1.5-Tesla whole body MR scanner with a conventional two-dimensional gradient echo sequence (TR/TE/flip angle 400/60/40, first order flow rephased, reduced band width 8 Hz/pixel). Flow velocity measurements were performed for the cortical veins which corresponded to the activated areas depicted on fMRI. Velocity was estimated from the cine-MR venography (cine-MRV) with a tagging technique. Flow phantom studies were performed to delineate the effect of flow velocity differences upon the subtraction images of fMRI. The cine-MRV revealed increased flow velocity of the cortical veins during activation in seven volunteers, with a mean velocity difference of 15 mm/sec. Flow phantom studies suggested that the increased flow velocity may result in changes of the flow signal profile due to oblique flow displacement. Subtraction of the two images with different flow profiles produces flow signal enhancement. Increased flow velocity of the cortical veins during the activation is an important factor which contributes to the signal of fMRI.

Magnetic resonance of the disk of the temporomandibular joint MR imaging protocol

Disk displacement can be well detected using proton density—weighted and T2 ∗-weighted two-dimensional gradient-echo sequences. In uncertain cases, especially if the bilaminar zone is not sufficiently represented, a contrast-enhanced T1-weighted spin-echo sequence should also be performed. Also in patients with disk degeneration and osteoarthritis of the temporomandibular joint, proton density-weighted and T2 ∗-weighted two-dimensional gradient-echo sequences are of great diagnostic value. In this collective, however, T1-weighted contrast-enhanced spin-echo sequences should be generally performed, to demonstrate inflammatory reaction of the synovia.

Factors influencing flow-induced signal loss in MR angiography: an in vitro study.

Signal loss due to poststenotic turbulence is one remaining limitation in the clinical use of MRA. The objective of this study was to determine the factors influencing poststenotic signal loss (PSL) in a stenotic tube system. With use of a two-dimensional gradient echo sequence (FLASH), the influence of (a) the degree of stenosis (50, 75, and 91% cross-sectional area reduction), (b) flow velocity (12, 47, 71, and 94 cm/s), (c) TE (3, 6, 13, and 20 ms), and (d) flip angle (5, 10, 20, ... , 90 degrees) on the length of PSL was measured in a nonpulsatile stenotic tube system. To quantify the effect of first-order gradient motion refocusing (GMR), the signal intensity ratio from flow-compensated and -uncompensated images was calculated. For statistical analysis, multiple regression analysis and unpaired Student t test were used. In the flow model used, the length of PSL increased significantly with the degree of stenosis (beta ST' = 0.483 mm/%, beta ST" = 0.447 mm/%, p < 0.0001), flow velocity (beta v' = 0.297 s, beta v" = 0.213 s, p < 0.0001), and TE (beta TE = 1.88 mm/ms, p < 0.0001), respectively, whereas no correlation emerged for varying flip angles (beta alpha = 0.0214, p = 0.29). First-order GMR reduced significantly PSL in through-plane measurements (p < 0.0001). Maximal signal-enhancing effects of first-order GMR were observed 1-3 cm distal to the stenosis. Flow model parameters (i.e., degree of stenosis, flow velocity) markedly influenced the length of PSL that could be compensate for by use orf shortened TEs and first-order GMR. Varying flip angles had no significant influence on PSL.

Gradient-echo MR imaging of the temporomandibular joint: diagnostic pitfall caused by the superficial temporal artery.

In routine MR imaging of the temporomandibular joints, a low-signal structure posterosuperior to the mandibular condyle is occasionally seen on the two-dimensional gradient-echo sequence. The structure is ovoid and may have a higher-signal core, simulating a loose body within the joint. We undertook a clinical and cadaveric study to determine the cause of this finding. In a clinical study, we reviewed the MR images of 100 temporomandibular joints. We scored each joint for the presence and appearance of a low-signal structure posterosuperior to the mandibular condyle: type 1 was ovoid with a low-signal rim and a higher-signal core, type 2 was ovoid with uniformly low signal, type 3 was a low-signal structure inseparable from the posterior wall of the glenoid fossa, and type 4 was normal. Using this scoring system, we determined the appearance and frequency of the finding on two-dimensional gradient-echo, T1-, T2-, and proton density-weighted images. To determine the cause of the finding, we correlated the imaging and anatomic findings in a cadaveric specimen. Of the 100 MR images of joints reviewed, 22 showed a type 1 structure, 24 a type 2 structure, 11 a type 3 structure, and 43 were normal. The finding was seen only on the two-dimensional gradient-echo sequences, never on the spin-echo sequences. Correlation between the imaging and anatomic findings in the cadaveric specimen showed that the finding was caused by the superficial temporal artery. The variability in its appearance is thought to result from the complex manifestations of flowing blood within this artery. The finding posterosuperior to the mandibular condyle seen on two-dimensional gradient-echo MR images is a flow phenomenon within the superficial temporal artery. Recognition of the nature of this finding will avoid mistaking it for disease, such as an intraarticular loose body.