Iulius Dragonu

Magnetic properties of materials for MR engineering, micro-MR and beyond.

We present the results of a systematic measurement of the magnetic susceptibility of small material samples in a 9.4 T MRI scanner. We measured many of the most widely used materials in MR engineering and MR micro technology, including various polymers, optical and substrate glasses, resins, glues, photoresists, PCB substrates and some fluids. Based on our data, we identify particularly suitable materials with susceptibilities close to water. For polyurethane resins and elastomers, we also show the MR spectra, as they may be a good substitute for silicone elastomers and good casting resins.

Prevalence of Potential Retrograde Embolization Pathways in the Proximal Descending Aorta in Stroke Patients and Controls

Background: Retrograde diastolic blood flow in the proximal descending aorta (DAo) connecting complex plaques (≥4 mm thick) with brain-supplying supra-aortic arteries may constitute a source of stroke. Yet, data only from high-risk populations (cryptogenic stroke patients with aortic atheroma ≥3 mm) regarding the prevalence of this potential stroke mechanism are available. We aimed to quantify the frequency of this mechanism in unselected patients with cryptogenic stroke after routine diagnostics and controls without a history of stroke. Methods: 88 patients (67 stroke patients, 21 cardiac controls) were prospectively included. 3D T1-weighted bright blood MRI of the aorta was applied for the detection of complex DAo atheroma. ECG-triggered and navigator-gated 4D flow MRI allowed measuring time-resolved 3D blood flow in vivo. Potential retrograde embolization pathways were defined as the co-occurrence of complex plaques and retrograde blood flow in the DAo reaching the outlet of (a) the left subclavian artery, (b) the left common carotid artery, or/and (c) the brachiocephalic trunk. The frequency of these pathways was analyzed by importing 2D plaque images into 3D blood flow visualization software. Results: Complex DAo plaques were more frequent in stroke patients (44 in 31/67 patients (46.3%) vs. 5 in 4/21 controls (19.1%); p = 0.039), especially in older patients (29/46 (63.04%) patients ≥60 years of age with 41 plaques vs. 2/21 (9.14%) patients <60 years of age with 3 plaques; p < 0.001). Contrary to our assumption, retrograde diastolic blood flow at the DAo occurred in every patient irrespective of the existence of plaques with a similar extent in both groups (26 ± 14 vs. 32 ± 18 mm; p = 0.114). Therefore, only the higher prevalence of complex DAo plaques in stroke patients resulted in a three times higher frequency of potential retrograde embolization pathways compared to controls (22/67 (32.8%) vs. 2/21 (9.5%) controls; p = 0.048). Conclusions: This study revealed that retrograde flow in the descending aorta is a common phenomenon not only in stroke patients. The existence of potential retrograde embolization pathways depends mainly on the occurrence of complex plaques in the area 0 to ∼30 mm behind the outlet of the left subclavian artery, which is exposed to flow reversal. In conclusion, we have shown that the frequency of potential retrograde embolization pathways was significantly higher in stroke patients suggesting that this mechanism may play a role in retrograde brain embolism.

Three‐dimensional arbitrary voxel shapes in spectroscopy with submillisecond TEs

A novel spectroscopic method for submillisecond TEs and three‐dimensional arbitrarily shaped voxels was developed and applied to phantom and in vivo measurements, with additional parallel excitation (PEX) implementation. A segmented spherical shell excitation trajectory was used in combination with appropriate radiofrequency weights for target selection in three dimensions. Measurements in a two‐compartment phantom realized a TE of 955 µs, excellent spectral quality and comparable signal‐to‐noise ratios between accelerated (R = 2) and nonaccelerated modes. The two‐compartment model allowed a comparison of the spectral suppression qualities of the method and, although outer volume signals were suppressed by factors of 1434 and 2246 compared with the theoretical unsuppressed case for the clinical and PEX modes, respectively, incomplete suppression of the outer volume (935 cm3 compared with a target volume of 5.86 cm3) resulted in a spectral contamination of 10.2% and 6.5% compared with the total signal. The method was also demonstrated in vivo in human brain on a clinical system at TE = 935 µs with good signal‐to‐noise ratio and spatial and spectral selection, and included LCModel relative quantification analysis. Eight metabolites showed significant fitting accuracy, including aspartate, N‐acetylaspartylglutamate, glutathione and glutamate. Copyright

Accelerated point spread function mapping using signal modeling for accurate echo-planar imaging geometric distortion correction.

Echo‐planar imaging is a fast and commonly used magnetic resonance imaging technique with applications in diffusion weighted and functional MRI. Fast data acquisition in echo‐planar imaging is accomplished by the extended readout, which also introduces sensitivity to off‐resonance effects such as amplitude of static (polarizing) field inhomogeneities and eddy‐currents. These off‐resonance effects produce geometric distortions in the corresponding echo‐planar images. To correct for these distortions, an acceleration of point spread function (PSF) acquisition using a special sampling pattern is presented in this work. The proposed technique allows for reliable and fully automated distortion correction of echo‐planar images at a field strength of 3 T. Additionally, a new approach to visualize and determine the distortions in a hybrid (x, y, kPSF) three‐dimensional space is proposed. The accuracy and robustness of the proposed technique is demonstrated in phantom and in vivo experiments. The accuracy of the presented method here is compared to previous techniques for echo‐planar imaging distortion correction such as PLACE. Magn Reson Med, 2013.

Quantification of Retrograde Blood Flow in the Descending Aorta Using Transesophageal Echocardiography in Comparison to 4D Flow MRI

Background: Retrograde diastolic blood flow in the proximal descending aorta (DAo), which connects plaques ≥4 mm thickness with brain-supplying arteries, has previously been identified as a possible source of brain embolism. Currently, only 4D flow MRI is able to visualize and quantify potential retrograde embolization pathways in the DAo in-vivo. Hence, it was our aim to test if the extent of retrograde flow could be estimated by routine 2D transesophageal echocardiography (TEE). Methods: Forty-eight acute stroke patients were prospectively included and they underwent Doppler examinations of the transition zone between the aortic arch and the DAo using a 20 mm 2D sample volume in longitudinal section at 90-140° Doppler angle during routine TEE. Velocity-time-integrals (VTI) were studied for antegrade and retrograde velocities and the ratio (VTIratio) was calculated and correlated with the length of retrograde pathlines at that site, which were visualized using 4D flow MRI at 3-Tesla. A receiver operating characteristic (ROC) curve was used to evaluate a threshold value of VTIratio in differentiating large (≥3 cm) from small (<3 cm) retrograde flow extent. Results: At the TEE measurement site, the mean VTIratio was 0.53 ± 0.16 and the mean length of retrograde pathlines reaching back into the aortic arch was 3.1 ± 1.4 cm. VTIratio was an independent predictor of retrograde pathline length (r = 0.44; p = 0.002). ROC analysis identified a VTIratio threshold value of 0.6012 with a sensitivity of 0.5, a specificity of 0.92, and positive and negative predictive values of 0.84 and 0.68, respectively. Accordingly, 11 (22.91%) patients had a VTIratio cutoff value ≥0.6012 and corresponding retrograde pathline length ≥3 cm in 4D flow MRI. Conclusions: TEE allows predicting the length of retrograde pathlines. Hence, it may offer a cost-effective way to investigate independent predictors of DAo flow reversal in large-scale studies. However, TEE is only of limited value as a screening tool for high retrograde flow in a clinical setting, as only ∼23% of patients can be spared 4D flow MRI, which remains indispensable for the exact assessment of individual embolization pathways from plaques of the DAo in-vivo.

Multi-contrast and three-dimensional assessment of the aortic wall using 3 T MRI

OBJECTIVES To develop a 3D-multi-contrast MRI protocol allowing for high resolution imaging of the wall and of atheroma in the thoracic aorta. METHODS Eleven healthy volunteers and eleven acute stroke patients with aortic plaques detected by TEE underwent MRI at 3T. The MRI-protocol consisted of a T1w-bright-blood, a T2w- and a PDw-black-blood sequence (spatial resolution=1.15mm3). Image quality was assessed by two blinded investigators using a 3-point score and intra- and inter-rater agreement was tested. In patients, atherosclerotic plaques were graded according to the modified American Heart Association (AHA) classification. RESULTS Total examination time was 35:42±7:48min in volunteers and 41:07±3:15min in patients. Image quality was graded with the highest score in 80-94% of T1w, 89-96% of T2w and 79-86% of PDw datasets. Intra- and inter-rater reliability regarding image quality grading was high. Five stroke patients showed AHA type III lesions, three had AHA type VII and two had type VIII plaques. One patient had a vulnerable appearing AHA VI plaque. CONCLUSIONS 3D-multi-contrast MR-imaging of the aorta was performed with high image quality and in reasonable time. It allows evaluation of atherosclerotic plaque composition throughout the aortic arch and can be used to identify vulnerable plaques in acute stroke patients.

Using a whole-body 31P birdcage transmit coil and 16-element receive array for human cardiac metabolic imaging at 7T.

Purpose Cardiac phosphorus magnetic resonance spectroscopy (31P-MRS) provides unique insight into the mechanisms of heart failure. Yet, clinical applications have been hindered by the restricted sensitivity of the surface radiofrequency-coils normally used. These permit the analysis of spectra only from the interventricular septum, or large volumes of myocardium, which may not be meaningful in focal disease. Löring et al. recently presented a prototype whole-body (52 cm diameter) transmit/receive birdcage coil for 31P at 7T. We now present a new, easily-removable, whole-body 31P transmit radiofrequency-coil built into a patient-bed extension combined with a 16-element receive array for cardiac 31P-MRS. Materials and methods A fully-removable (55 cm diameter) birdcage transmit coil was combined with a 16-element receive array on a Magnetom 7T scanner (Siemens, Germany). Electro-magnetic field simulations and phantom tests of the setup were performed. In vivo maps of B1+, metabolite signals, and saturation-band efficiency were acquired across the torsos of eight volunteers. Results The combined (volume-transmit, local receive array) setup increased signal-to-noise ratio 2.6-fold 10 cm below the array (depth of the interventricular septum) compared to using the birdcage coil in transceiver mode. The simulated coefficient of variation for B1+ of the whole-body coil across the heart was 46.7% (surface coil 129.0%); and the in vivo measured value was 38.4%. Metabolite images of 2,3-diphosphoglycerate clearly resolved the ventricular blood pools, and muscle tissue was visible in phosphocreatine (PCr) maps. Amplitude-modulated saturation bands achieved 71±4% suppression of phosphocreatine PCr in chest-wall muscles. Subjects reported they were comfortable. Conclusion This easy-to-assemble, volume-transmit, local receive array coil combination significantly improves the homogeneity and field-of-view for metabolic imaging of the human heart at 7T.