This invention relates to magnetic resonance angiography.
Magnetic resonance angiography (MRA) has evolved into a powerful diagnostic tool for arterial diseases due to its minimally invasive and nontoxic natures. The most established approach for MRA uses gadolinium-based contrast agents and T1 weighted imaging sequences to generate hyperintense arterial signals. Although the contrast-enhanced (CE) approach has shown excellent diagnostic performance in diverse applications, intravenous administration of contrast agents increases patient discomfort as well as examination costs and limits the achievable spatial resolution and artery-to-background contrast due to the requirement of short acquisition at the optimal post-injection time. Also, the risk of nephrogenic systemic fibrosis has not been completely cleared particularly in patients with renal failure.
Non-contrast-enhanced (NCE) MRA is free from the aforementioned limitations and has been an active MR research area in the past decade. The main technical goal of NCE MRA is to achieve high contrast between arteries and surrounding tissues that is comparable or superior to CE methods. Other important requirements include high spatial resolution in all three dimensions and large angiographic coverage. In addition to different tissue relaxation rates, the relatively fast movement of arterial blood has been a promising source of its contrast against background materials in NCE MRA.
Time-of-flight (TOF) imaging is the most established approach, and utilizes different exposure to RF excitation between stationary tissues within the imaging volume and inflowing fresh blood. However, the saturation effect of arterial blood that resides in the imaging slab limits artery-background contrast and possible slab thickness for 3D imaging. In another example, slice-selective (SS) saturation (or inversion)-prepared imaging can generate contrast between static materials within the saturated (or inverted) volume and arterial blood flowing into the imaging volume that did not experience the SS inversion. The main drawback is the loss of arterial blood that resides within the imaging volume which limits achievable artery-background contrast and angiographic coverage in the craniocaudal direction. Another recently introduced NCE MRA method employs flow-sensitive dephasing (FSD) preparation pulse that nulls arterial signal using intra-voxel dephasing effect of the FSD pulse. The resultant black artery image can be subtracted from a reference image that is acquired without the FSD preparation to generate a bright-artery angiogram. Although this approach enables large 3D angiographic coverage, the subtractive nature involves issues of doubling scan time and motion effects compared to single acquisition approaches.
With the present invention, we provide a new MRA method that overcomes the limitations of previous methods, allowing large 3D angiographic coverage and high spatial resolution in all three directions using a single acquisition without subtraction. The method of the present invention can be used with or without contrast agent administration. The feasibility of the method is demonstrated in NCE abdominal and peripheral MRA applications.
The present invention provides a magnetic resonance imaging system and method for visualizing moving body tissue (e.g., arterial blood in MR angiography). A magnetic resonance imaging system is able to deliver a velocity-selective magnetization prepared imaging sequence to a body. This velocity-selective magnetization prepared imaging sequence includes a velocity-selective excitation pulse. This excitation pulse is played near or at a time of peak systolic arterial blood flow using cardiac triggering based on peripheral arterial pulsation or ECG signals. Following the delivery of the velocity-selective excitation pulse, imaging readouts are acquired by the magnetic resonance imaging system. The acquisition of the imaging data could employ balanced steady-state-free-precession (SSFP) readout or gradient-echo (GRE) readout or spin echo readout. In one embodiment, the method does not employ injecting a contrast agent, whereas in another embodiment the method does employ injecting a contrast agent such as gadopentetate dimeglumine (Gd-DTPA) and gadobenate dimglumine (Gd-BOPTA).
In one embodiment, the velocity-selective excitation pulse excites all spins by an excitation angle θ except arterial blood based on their velocities. In this case, the signal intensity of arterial blood is significantly higher than all other background tissues in the acquired MR image. The excitation angle θ is 90° for a velocity-selective saturation preparation, and the excitation angle θ is 180° for a velocity-selective inversion preparation.
In another embodiment, the velocity-selective magnetization pulse sequence excites all spins except arterial blood moving faster than a cut-off velocity. In this case, when the cut-off velocity is set to the maximum of normal arterial flow velocity, abnormally high arterial flow (e.g. flow jet due to stenosis or regurgitation) can be highlighted.
The velocity-selective excitation pulse in one example is defined according to a pulse sequence in a form of {A1-Gbp-A2- . . . -AN−1-Gbp-AN}, where Gbp is a bipolar gradient waveform, and Ai is a complex value representing the amplitude and phase of ith RF sub-pulse. {Ai}i=1 to N wherein N is the total number of RF sub-pulses, can be designed by a Shinnar-Le Roux algorithm or {Xi}i=1 to N can be designed by amplitude and frequency modulation functions for adiabatic full passage or a combination of adiabatic half passages.
The velocity-selective excitation pulse in another example is defined according to a pulse sequence in a form of {A1-Gup-T1-180°-T1-Gup-A2- . . . -AN−1-Gup-TN−1-180°-TN−1-Gup-AN}, where 180° represents an RF pulse for 180° spin rotation, Gup is a unipolar gradient waveform, Ai is a complex value representing the amplitude and phase of ith RF sub-pulse, and Ti is ith delay time. The {Ai}i=1 to N can be designed by a Shinnar-Le Roux algorithm or adiabatic modulation functions. The {Ti}i=1 to N−1 can be numerically optimized for the velocity-selective excitation pulse to be insensitive to field inhomogeneity and transmit RF inhomogeneity.
The MRA method according to embodiments of this invention based on velocity-selective excitation significantly relaxes the requirement of arterial inflow, and therefore allows large angiographic coverage and high spatial resolution in all three dimensions. The method generates positive angiographic contrast directly using single acquisition, and therefore reduces scan time and potential motion effects compared to all subtractive methods. Furthermore, relying on systolic arterial flow, the method is robust to arrhythmia which affects the diastolic period significantly but affects the systolic period only marginally.
An excitation pulse sequence with a desired spatial and velocity profile can be designed using the excitation k-space formalism under the small tip approximation. An excited transverse magnetization at position r with velocity v and off-resonance f can be represented by a Fourier transform of the radiofrequency (RE) B1 field deposited in kr-kv-kf space, where kr, kv, and kf are reciprocal Fourier variables of r, v, and f, respectively.
where γ, M0, and T are the gyromagnetic ratio, magnetization at equilibrium, and pulse duration, respectively. This is an extension of the conventional spatial-selective excitation by incorporating additional phase accrued by spin's velocity and off-resonance. The nominal velocity profile obtained by Eq. [1] can be shifted by vo along the velocity axis by modulating the phase of the Bi field. That is, for a shifted velocity profile.
VS and non-spatial-selective excitation can be achieved by playing many (more than one) brief RE sub-pulses between a series of bipolar gradients as illustrated in
The effect of off-resonance can be explained by the excitation k-space trajectory tilted by the ratio of Tbp/Δkv with respect to the k axis (dotted line in
Methods
Pulse Sequence
The pulse sequence for the VS MRA is triggered by peripheral arterial pulsation or ECG signals. The sequence includes a VS excitation pulse with flip angle of θ after a cardiac trigger delay (TD), a zero or positive delay (TI), a spectrally-selective fat suppression pulse, and a segmented imaging readout (
VS Excitation Pulse
A VS excitation pulse sequence involves several design parameters to be adjusted. Ideally, the velocity pass-band should have the largest possible upper bound, the smallest possible lower bound, and the narrowest possible transition-band to include various types of arterial flow. The achievable upper bound is limited by the preference to a small velocity FOV for reducing off-resonance-induced profile shifting, and the transition sharpness is traded off by a long pulse duration (or large number of RF sub-pulses). The stop-bandwidth should be minimized to increase the upper bound of the pass-band for a given velocity FOV. In designing a VS pulse, therefore, we sought the smallest possible velocity FOV and the largest possible number of RF sub-pulses that allow most of arterial blood and venous blood to be included in the pass-band and inversion-band, while limiting the pulse duration to less than 20 ms.
Another possible design of a VS excitation pulse incorporates 180° refocusing pulses between the halves of bipolar gradients. With this so-called refocused design, the phase accrued by off-resonance during the period of the first unipolar will be cancelled out by the phase accrued in the opposite direction during the period of the second unipolar, which significantly reduces the off-resonance sensitivity.
Imaging Protocol
In vivo experiments were performed on a 1.5T clinical whole-body MR system (Signa HDx; GE Healthcare, Waukesha, Wis.). The body coil was used for RF excitation. An eight-channel cardiac-array coil was used for signal reception.
NCE MRA scans were performed on human subjects using two protocols that target (i) abdominopelvic arteries and (ii) peripheral arteries.
Results
Representative coronal MIP images of abdominal VS MRA in three subjects are shown in Appendix A in the provisional application to which this application claims the benefit (referred to as
A comparison between abdominal VS and SS MRA in the same subject is shown in Appendix A in the provisional application to which this application claims the benefit (referred to as
Variations
The VS excitation flip angle and the subsequent delay time TI determine the tradeoff between inflow effects and background suppression. With 180° flip angle, for instance, we can use long TI and therefore increase arterial inflow effects. However, background suppression will be sub-optimal whenever there are multiple T1 species. In another example, the combination of 90° flip angle and zero delay can achieve T1 independent background suppression but allows no inflow time. Other combinations of VS flip angles (between 90° and 180°) and TIs (>0) will yield intermediate effects between these two cases.
The envelope of RF subpulses determines the shape of excitation profile along the velocity axis, and can be designed in different ways. One way is to use the inversion Fourier transform of a desired excitation profile over velocity. The Shinnar-Le Roux algorithm is more accurate and flexible in designing the RF envelope function particularly for large excitation flip angles. Another possibility is to use adiabatic full passage or a combination of adiabatic half passage functions, which is be robust to transmit RF inhomogeneity.
The VS excitation pulse sequence can be extended to acceleration-selective excitation by replacing the bipolar gradient waveform with a tripolar gradient waveform and depositing the B1 field along ka (=Fourier variable of acceleration) in the excitation k-space. Acceleration-selective excitation may outperform the VS excitation when arterial blood has a small velocity, but a relatively large acceleration during the systolic period.
This application claims priority from U.S. Provisional Patent Application 61/704,619 filed Sep. 24, 2012, which is incorporated herein by reference.
This invention was made with Government support under grant no. 5R01 HL075803 awarded by the National Institutes of Health (NIH). The Government has certain rights in this invention.
Number | Date | Country | |
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61704619 | Sep 2012 | US |