Aiqi Sun1, Bo Zhao2, Yunduo Li1, Qiong He1, Zechen Zhou1, Shuo Chen1, Rui Li1, and Chun Yuan1,3
1Center for Biomedical Imaging Research, Department of Biomedical Engineering, School of Medicine, Tsinghua Universiy, Beijing, China, People's Republic of, 2Martinos Center for Biomedical Imaging, Harvard Medical School, Chalestown, MA, United States, 3Department of Radiology, University of Washington, Seattle, WA, United States
Synopsis
Conventional phase-contrast
(PC) MRI method relies on ECG-synchronized cine acquisition to acquire data over
multiple cardiac cycles. The
underlying spatiotemporal averaging limits this method to studying pathological
irregularities. Real-time PC-MRI is a promising approach to overcome these
limitations. Although several techniques have been developed to real-time
PC-MRI, few have been fully validated due to the difficulty of acquiring a reference
data set as gold standard. This study aims at validating the accuracy of a novel
real-time PC-MRI technique through both flow phantom experiments and in vivo experiments. Purpose
Phase-contrast (PC) MRI is a powerful tool
for quantitative assessment of blood flow, and it has been widely used in
clinical practice
[1, 2]. However, the conventional approach relies
on electro-cardiogram (ECG)-synchronized cine acquisition, which is not well
suited to assess hemodynamic variabilities. Additionally, its practical utility
can often be constrained by cardiac arrhythmias. Real-time evaluation of blood
flow has shown great potential to overcome these issues
[3, 4]. Recently,
we have developed a novel method
[5] for real-time PC-MRI based on
low-rank modeling
[6] (without ECG gating and respiration control). Here,
we evaluate its accuracy with flow phantom experiments and illustrate its key advantages
over the conventional cine-based approach. Moreover, we present a preliminary assessment
of in vivo real-time flow imaging of thoracic aorta.
Methods
All
the experiments were performed on a 3.0T whole body system (Achieva, Philips
Medical System, Best, The Netherlands) with a 32-channel cardiovascular coil. We
first performed three sets of flow phantom experiments with different flow
profiles to evaluate the performance of the cine and real-time acquisitions. A
15 mm-diameter stiff tube was used to simulate the aorta. The flow rates were
set by a computer-programed pump (CompuFlow 100 MR, Toronto, Canada). Here we
designed three classes of flow profiles to simulate different blood flow variations.
The first one was generated by a repetitive pump protocol with a Gaussian
profile (with duration of 0.5 s), followed by a constant flow for a total cycle
time of 1 s (shown in Fig. 2a). Note that this mimics the flow profile of
healthy subjects. The second one consists of two Gaussian profiles with
different maximum flows, followed by a constant flow with the same duration to
imitate flow variability. This results in a total repetition time of 2 s (Fig.
2b). The third one consists of four Gaussian profiles, each of which is followed
by a constant flow with different durations (Fig. 2c). This simulates the flow
profile of patients with cardiac arrhythmia. Here the first and second flow
profiles were used for both the PC-MRI cine and real-time acquisitions, while
the third one was used for real-time imaging because the period irregularity is
not well suited for cine acquisition. The relevant imaging parameters are listed in Table 1. Lastly, in vivo data of thoracic aorta were acquired from a
healthy volunteer with no symptoms of cardiovascular disease and informed
written consent obtained. Both the PC-MRI cine and real-time acquisitions were
performed in the transverse orientation, covering a FOV of 240×220 mm
2
at an in-plane resolution of 2.2 mm and with a slice thickness of 5 mm.
Results
For
the flow phantom experiments, the reconstructed magnitude and phase images at a
peak flow time instant are shown in Fig. 1a and 1b. For the first set of experiments,
the consistency between the flow profiles from PC-MRI cine (Fig. 2d) and
real-time (Fig. 2f) acquisitions is observed. Further, notice that both
derived peak flows are close to the pre-designed one (Fig. 2a). For the second
group, the reconstructed real-time flow profile (shown in Fig. 2g) well captures
the high peak flow and low peak flow. In contrast, the flow profile from cine
acquisition (in Fig. 2e) is only able to capture an averaged peak flow. With
respect to the third group, the reconstructed real-time flow profile (Fig. 2h) reveals
the similar flow profile variations in both period duration and amplitude to
the pre-designed one. In terms of the in vivo experiments, the reconstructed
magnitude and phase images at a systolic time frame are shown in Figs. 3a and 3b.
The mean flow in the ascending aorta for 13 consecutive heartbeats using
real-time PC-MRI is shown in Fig. 3c. By averaging these 13 consecutive
heartbeats, the derived mean flow profile closely matches the one derived from
cine acquisition (Fig. 3d).
Discussion and Conclusions
In this work, we demonstrated via phantom
experiments that real-time PC-MRI with low-rank modeling is capable to well capture
the hemodynamic variabilities and irregular flow variations. The excellent correlation
between PC-MRI cine and real-time method has been observed in vivo experiments
in healthy subject as well. For future study, we are going to evaluate the
feasibility of applying the proposed real-time PC-MRI technique for patients
with arrhythmia.
Acknowledgements
This work was supported by Beijing Municipal Science & Technology Commission (No. Z131100005213001and No. D111107003111007). Aiqi Sun would like to thank Ding Ding for her help with the ultrasonic velocity measurements in flow phantom experiments.References
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