Ning Jin1, Chong Chen2, Juliet Varghese2, Katherine Binzel3,4, Yingmin Liu3, Rizwan Ahmad2, and Orlando P. Simonetti2,3,4,5,6
1Siemens Medical Solutions USA, Inc, Solon, OH, United States, 2Department of Biomedical Engineering, The Ohio State University, Columbus, OH, United States, 3Dorothy M. Davis Heart and Lung Research Institute, The Ohio State University, Columbus, OH, United States, 4Department of Radiology, The Ohio State University, Columbus, OH, United States, 5Division of Cardiovascular Medicine, The Ohio State University, Columbus, OH, United States, 6Department of Internal Medicine, Columbus, OH, United States
Synopsis
Keywords: Flow, Low-Field MRI
Motivation: Free-breathing (FB) real-time phase contrast (RT-PC) MR is very useful to resolve the beat-by-beat variations and for patients for whom breath-holding poses a challenge; however its feasibility remains to be tested at low-field.
Goal(s): To develop a FB RT-PC MR technique on a clinical wide-bore 0.55T MR scanner with reduced gradient performance.
Approach: FB RT-PC was developed using a dual-density spiral readout with a modified golden-angle rotation strategy and compressed sensing reconstruction. Flow quantifications were compared with the conventional BH segmented PC approach.
Results: Our proposed method yielded flow measurements of comparable accuracy and effectively captured the peak flow dynamics at low-field.
Impact: The proposed RT PC MR technique for low-field
systems could enable flow imaging for patients with arrhythmias, critical
illnesses, or claustrophobia, potentially making cardiac MRI more accessible
and patient-friendly in a variety of clinical settings.
Introduction
Low-field, ultra-wide bore MRI systems offer several
advantages that could potentially expand the accessibility of cardiac MRI [1].
Conventional phase-contrast (PC) MR [2] relies on ECG synchronization with
respiratory control to measure blood flow averaged over multiple heartbeats. The
technique fails to resolve the beat-by-beat variations that occur with
arrhythmia [3]. Furthermore, for young or critically ill patients, or those
with shortness of breath or severe claustrophobia, breath-holding (BH) can be
challenging. Real-time (RT) PC MR, without ECG gating or BH, has been shown to
address these limitations on 1.5T and 3T clinical scanners [4-6];
however, its feasibility remains to be tested at low-field. The aim of the
study was to develop a RT-PC MR technique using a modified golden-angle spiral
acquisition and compressed sensing (CS) reconstruction on a clinical 0.55T MR scanner
(MAGNETOM Free.Max, Siemens Healthineers AG, Erlangen, Germany) with 80 cm bore and reduced gradient performance of 26 mT/m
amplitude, 45/T/m/s slew rate.Methods
The free-breathing (FB) spiral RT-PC research sequence was
implemented using a dual-density spiral trajectory with the first 30% of the spiral
readout sampled at twice the Nyquist rate, and the remaining 70% sampled at 60%
of Nyquist rate [7]. The imaging parameters were: FOV = 300x300 mm2,
voxel size = 2.3x2.3x8 mm3, TR/TE = 11.0/3.0 ms, flip angle = 20°, VENC
= 150/200 cm/s, acquisition time = 4 s. Two spiral interleaves were acquired
for each frame resulting in 6-fold undersampling (12 interleaves if fully
sampled) and a temporal resolution of 44 ms.
Flow compensated (FC) and flow encoded (FE) readouts were interleaved in
each frame. From one frame to the next, the spiral readouts were continuously rotated
by the golden angle (~137.5°). Within each frame, the 2nd interleave
was rotated by 180° relative to the first one to maximize the k-space coverage in
each frame (Figure. 1).
RT-PC images were reconstructed offline using SENSE based CS,
with non-decimated wavelet (NWT) along both temporal and spatial dimensions as
the sparsity transformation. The regularization parameters were tuned individually
for each NWT band using a single dataset, and then fixed for all other
subjects. The density compensation function was calculated following the method
presented in [8] and the 2D NUFFT implementation provided in [9] was utilized.
The coil sensitivity maps were estimated from the time-averaged FC image using
ESPIRiT [10].
For comparison, a BH retrospective ECG-gated Cartesian PCMR
sequence was acquired with the following parameters: voxel size = 1.7x2x8 mm3,
TR/TE = 6.7/3.71 ms, flip angle = 12°, GRAPPA = 2, temporal resolution = 53
ms, acquisition time = 10 heart beats.
Nine healthy volunteers (4 males, 32±17 years) were scanned
on a 0.55T using FB spiral RT-PC and BH Cartesian PC, with 2D flow measured
perpendicular to the ascending aorta (AO) in all volunteers and the main
pulmonary artery (MPA) in 7 volunteers. The flow waveforms from RT-PC were
averaged over consecutive cardiac cycles into one waveform to compare it with
the reference standard.Results
Figures 2 and 3 show the representative PC
images in the AO and MPA from one healthy volunteer acquired by BH Cartesian PC
and FB spiral RT-PC. Although both methods can resolve the vessel structure, Cartesian
PC is visually noisier while the CS reconstruction improves SNR for RT flow. The
flow curves from one subject show that spiral RT-PC (Figure 4a,b) was
able to resolve beat-to-beat variations, and that the averaged flow curves for
AO and MPA correlate well with Cartesian PC, with both methods yielding similar
peak flow (Figure 4c,d). Correlations (Figure 5a,b) and
Bland-Altman plots (Figure 5c,d) of net flow and peak flow reveal good agreement
between the two methods. Conclusion
We demonstrated the feasibility of FB spiral RT-PC using a
dual-density spiral readout with a modified golden-angle rotation strategy and
CS reconstruction on a wide-bore 0.55T clinical system. Our proposed technique
yielded flow measurements of comparable accuracy and effectively captured the
peak flow dynamics, relative to the traditional BH segmented PC method. FB
spiral RT-PC can be a valuable tool in the assessment of flow hemodynamics,
particularly for patients for whom breath-holding poses a challenge.Acknowledgements
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