Synopsis
Over the last decades, many methodological
advances have been introduced to expand the capabilities of anatomical and
functional MRA beyond the basic MR acquisition principles. These innovations
provide new opportunities and challenges. Here we will review several key
concepts with a special focus on their terminology, protocol choices available
to the clinical and research user, and implications on the resulting images in
the context of contrast-enhanced MRA and flow MRI.Highlights
- Terminology relevant to contrast-enhanced MR
Angiography and flow-sensitive MRA will be introduced in theory and by
examples.
-
Concepts relevant to the spatio-temporal
resolution of MRA acquisitions will be reviewed for standard and for advanced
sampling schemes , including acquired and reconstructed spatial resolution,
temporal resolution, view ordering, temporal interpolation, temporal footprint,
k-space corner sampling.
-
Concepts and terms relevant to conducting
flow-sensitive MRI will be discussed including Velocity encoding sensitivity
(VENC); 1,2, and 3-directional velocity encoding; balanced vs unbalanced velocity
encoding, reference-based velocity encoding; background phase corrections, velocity
aliasing, and velocity-to-noise ratio.
Target Audience
Those with interest in methodology and clinical
applications of MR Angiography including physicians and scientists and current
users of cardiovascular MR. No basic knowledge of cardiovascular MRI is needed,
but basic knowledge of MRI in general is advised.
Objectives
- Understand
the available choices for acquisition/reconstruction schemes and scan parameters
in MRA as well as their implications on the temporal and spatial resolution of
the final data set.
-
Understand
the theory and practical implications of available choices in setting up 2D and
4D Flow MRI scans.
Purpose
Obtaining high quality MR Angiography (MRA) data
requires exquisite spatial and often also high temporal resolution. However,
MRI is a relatively slow modality and dynamic processes such as the passage of
a contrast bolus, cardiac pulsatility, and respiratory motion complicate this
task. Over the last decades, many methodological advances have been introduced
to expand the capabilities of anatomical and functional MRA beyond the basic MR
acquisition principles. Here we will review several of these key concepts with
a special focus on their terminology and choices available to the clinical and
research user.
Methods
Contrast-enhanced MR Angiography (CE MRA) has become a
widely used clinical tool. In its basic form, the acquisition is conducted as a
single, pseudo-static exam. The venously injected Gadolinium-based contrast
agent will cause T1 changes in the blood pool that change with concentration of
the bolus. Therefore, timing of the acquisition is essential and the type of
view ordering (linear vs centric vs elliptical centric [1]) of the 3D k-space sampling
pattern will have an impact on the signal modulation across k-space and hence
on the resulting image.
The need for speed has been a driving force behind MRA
acquisition schemes. Even with T1-weighted gradient echo sequences that permit
very short TR times (<5 ms) it is challenging to provide large volumetric
coverage and high spatial resolution in a single breathhold without advanced
sampling methodology. Parallel imaging with the use of multi-receiver coils is
widely used but comes at the expense of a reduced SNR [2]. Zero-filling and the cutting
of k-space corners [3] have been introduced to
accelerate 3D acquisitions, but necessitate a closer differentiation between
the acquired and the reconstructed spatial resolution.
Dynamic CE MRA has many advantages over static MRA but
necessitates even faster acquisition times per imaging volume. Many
fundamentally very different approaches have been successfully introduced
including temporal interpolation schemes (e.g. keyhole [4], TRICKS [5]); kt acceleration [6], and compressed sensing [7]. Traditional concepts to
characterize properties of the reconstructed data sets such as true spatial and
temporal resolution are more challenging when using such non-linear
reconstruction approaches.
Phase contrast MRI has found widespread application for
assessing vascular velocities and flow. While its clinical use is predominantly
a 2D cine acquisition with one-directional velocity encoding, a new research
field has emerged around ‘4D Flow MRI’ [8]. With acceleration methods such as described
above, volumetric data sets with three-directional velocity encoding throughout
the cardiac cycle can be acquired in clinically feasible scan times. The
resulting dataset is a dynamic velocity vector field covering a large vascular
territory, thus enabling advanced hemodynamic analysis. Details to consider when setting up 2D or 4D
Flow MRI acquisitions include the Velocity sensitivity setting (VENC), the
velocity encoding scheme (balanced vs unbalanced, reference-based encoding),
how to distribute the repeated velocity encodes (within one cardiac cycle or
over multiple cardiac cycles). Also, the data processing chain includes crucial
steps such as how background phase errors are corrected for.
Discussion
The field of MR Angiography has evolved
quickly over the last decade and introduced many novel acquisition and reconstruction
approaches. Reports should include detailed descriptions and concise
terminology on their methodologies to avoid confusion or ambiguity. The field
is still somewhat struggling on linking traditional concepts such as acquired temporal
and spatial resolution to novel approaches such as compressed sensing.
Acknowledgements
No acknowledgement found.References
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