Oliver Wieben

Highly constrained backprojection for time‐resolved MRI

Recent work in k‐t BLAST and undersampled projection angiography has emphasized the value of using training data sets obtained during the acquisition of a series of images. These techniques have used iterative algorithms guided by the training set information to reconstruct time frames sampled at well below the Nyquist limit. We present here a simple non‐iterative unfiltered backprojection algorithm that incorporates the idea of a composite image consisting of portions or all of the acquired data to constrain the backprojection process. This significantly reduces streak artifacts and increases the overall SNR, permitting decreased numbers of projections to be used when acquiring each image in the image time series. For undersampled 2D projection imaging applications, such as cine phase contrast (PC) angiography, our results suggest that the angular undersampling factor, relative to Nyquist requirements, can be increased from the present factor of 4 to about 100 while increasing SNR per individual time frame. Results are presented for a contrast‐enhanced PR HYPR TRICKS acquisition in a volunteer using an angular undersampling factor of 75 and a TRICKS temporal undersampling factor of 3 for an overall undersampling factor of 225. Magn Reson Med, 2006.

4D flow MRI.

Traditionally, magnetic resonance imaging (MRI) of flow using phase contrast (PC) methods is accomplished using methods that resolve single‐directional flow in two spatial dimensions (2D) of an individual slice. More recently, three‐dimensional (3D) spatial encoding combined with three‐directional velocity‐encoded phase contrast MRI (here termed 4D flow MRI) has drawn increased attention. 4D flow MRI offers the ability to measure and to visualize the temporal evolution of complex blood flow patterns within an acquired 3D volume. Various methodological improvements permit the acquisition of 4D flow MRI data encompassing individual vascular structures and entire vascular territories such as the heart, the adjacent aorta, the carotid arteries, abdominal, or peripheral vessels within reasonable scan times. To subsequently analyze the flow data by quantitative means and visualization of complex, three‐directional blood flow patterns, various tools have been proposed. This review intends to introduce currently used 4D flow MRI methods, including Cartesian and radial data acquisition, approaches for accelerated data acquisition, cardiac gating, and respiration control. Based on these developments, an overview is provided over the potential this new imaging technique has in different parts of the body from the head to the peripheral arteries. J. Magn. Reson. Imaging 2012;36:1015–1036.

Fat and water magnetic resonance imaging

A wide variety of fat suppression and water–fat separation methods are used to suppress fat signal and improve visualization of abnormalities. This article reviews the most commonly used techniques for fat suppression and fat–water imaging including 1) chemically selective fat suppression pulses “FAT‐SAT”; 2) spatial‐spectral pulses (water excitation); 3) short inversion time (TI) inversion recovery (STIR) imaging; 4) chemical shift based water–fat separation methods; and finally 5) fat suppression and balanced steady‐state free precession (SSFP) sequences. The basic physical background of these techniques including their specific advantages and disadvantages is given and related to clinical applications. This enables the reader to understand the reasons why some fat suppression methods work better than others in specific clinical settings. J. Magn. Reson. Imaging 2010;31:4–18.

Diagnostic value of high-resolution MR imaging in giant cell arteritis.

BACKGROUND AND PURPOSE: Clinical indications of giant cell arteritis may be unspecific, and noninvasive diagnosis is often difficult. This study investigated the hypothesis that high-resolution MR imaging of the superficial cranial arteries is a noninvasive imaging technique that can detect the occurrence of giant cell arteritis. MATERIALS AND METHODS: Contrast-enhanced, high-resolution MR imaging was performed on 64 consecutive patients with suspected giant cell arteritis. Mural thickness, lumen diameter, and a mural contrast enhancement score were assessed with T1-weighted spin-echo images with submillimeter in-plane spatial resolution. The final rheumatologists diagnosis according to the clinical criteria of the American College of Rheumatology including laboratory tests and results of temporal artery biopsies from 32 patients was used as a “gold standard” for the evaluation of the MR imaging findings. RESULTS: All of the examinations provided diagnostic image quality. Evaluation of the mural inflammatory MR imaging signs for diagnosing vasculitis resulted in a sensitivity of 80.6% and a specificity of 97.0%. In comparison, histology results alone showed a sensitivity of 77.8% and specificity of 100%. The mean wall thickness increased significantly from 0.39 mm (±0.18 mm) to 0.74 mm (±0.32 mm; P < .001), and the lumen diameter decreased significantly from 0.84 mm (±0.29 mm) to 0.65 mm (±0.38 mm; P < .05) for patients with giant cell arteritis. CONCLUSION: Contrast-enhanced, high-resolution MR imaging allows noninvasive assessment of mural inflammation in giant cell arteritis with good diagnostic certainty. Measures of mural thickening and contrast enhancement can be obtained in these small vessels and provide valuable vasculitic MR imaging findings.

Improved 3D phase contrast MRI with off-resonance corrected dual echo VIPR

Phase contrast (PC) magnetic resonance imaging with a three‐dimensional, radially undersampled acquisition allows for the acquisition of high resolution angiograms and velocimetry in dramatically reduced scan times. However, such an acquisition is sensitive to blurring and artifacts from off‐resonance and trajectory errors. A dual‐echo trajectory is proposed with a novel trajectory calibration from prescan data coupled with a multi‐frequency reconstruction to correct for these errors. Comparisons of phantom data and in vivo results from volunteer, and patients with arteriovenous malformations patients are presented with and without these corrections and show significant improvement of image quality when both corrections are applied. The results demonstrate significantly improved visualization of vessels, allowing for highly accelerated PC acquisitions without sacrifice in image quality. Magn Reson Med 60:1329–1336, 2008.

Review of MRI-based measurements of pulse wave velocity: a biomarker of arterial stiffness

Atherosclerosis is the leading cause of cardiovascular disease (CVD) in the Western world. In the early development of atherosclerosis, vessel walls remodel outwardly such that the vessel luminal diameter is minimally affected by early plaque development. Only in the late stages of the disease does the vessel lumen begin to narrow-leading to stenoses. As a result, angiographic techniques are not useful for diagnosing early atherosclerosis. Given the absence of stenoses in the early stages of atherosclerosis, CVD remains subclinical for decades. Thus, methods of diagnosing atherosclerosis early in the disease process are needed so that affected patients can receive the necessary interventions to prevent further disease progression. Pulse wave velocity (PWV) is a biomarker directly related to vessel stiffness that has the potential to provide information on early atherosclerotic disease burden. A number of clinical methods are available for evaluating global PWV, including applanation tonometry and ultrasound. However, these methods only provide a gross global measurement of PWV-from the carotid to femoral arteries-and may mitigate regional stiffness within the vasculature. Additionally, the distance measurements used in the PWV calculation with these methods can be highly inaccurate. Faster and more robust magnetic resonance imaging (MRI) sequences have facilitated increased interest in MRI-based PWV measurements. This review provides an overview of the state-of-the-art in MRI-based PWV measurements. In addition, both gold standard and clinical standard methods of computing PWV are discussed.

4D cardiovascular magnetic resonance velocity mapping of alterations of right heart flow patterns and main pulmonary artery hemodynamics in tetralogy of Fallot

BackgroundTo assess changes in right heart flow and pulmonary artery hemodynamics in patients with repaired Tetralogy of Fallot (rTOF) we used whole heart, four dimensional (4D) velocity mapping (VM) cardiovascular magnetic resonance (CMR).MethodsCMR studies were performed in 11 subjects with rTOF (5M/6F; 20.1 ± 12.4 years) and 10 normal volunteers (6M/4F; 34.2 ± 13.4 years) on clinical 1.5T and 3.0T MR scanners. 4D VM-CMR was performed using PC VIPR (Phase Contrast Vastly undersampled Isotropic Projection Reconstruction). Interactive streamline and particle trace visualizations of the superior and inferior vena cava (IVC and SVC, respectively), right atrium (RA), right ventricle (RV), and pulmonary artery (PA) were generated and reviewed by three experienced readers. Main PA net flow, retrograde flow, peak flow, time-to-peak flow, peak acceleration, resistance index and mean wall shear stress were quantified. Differences in flow patterns between the two groups were tested using Fishers exact test. Differences in quantitative parameters were analyzed with the Kruskal-Wallis rank sum test.Results4D VM-CMR was successfully performed in all volunteers and subjects with TOF. Right heart flow patterns in rTOF subjects were characterized by (a) greater SVC/IVC flow during diastole than systole, (b) increased vortical flow patterns in the RA and in the RV during diastole, and (c) increased helical or vortical flow features in the PAs. Differences in main PA retrograde flow, resistance index, peak flow, time-to-peak flow, peak acceleration and mean wall shear stress were statistically significant.ConclusionsWhole heart 4D VM-CMR with PC VIPR enables detection of both normal and abnormal right heart flow patterns, which may allow for comprehensive studies to evaluate interdependencies of post-surgically altered geometries and hemodynamics.

Improved Waveform Fidelity Using Local HYPR Reconstruction (HYPR LR)

The recently introduced HYPR (HighlY constrained backPRojection) method allows reconstruction of serial images from highly undersampled data. In HYPR, individual timeframes are obtained via unfiltered backprojections of normalized sinograms using anatomical constraints provided by a composite image. Here we develop the idea of constraining the backprojected data further to a series of local regions of interest in order to decrease the corruption of local information by distant signals. HYPR LR (local reconstruction) permits the use of a longer temporal window in the formation of the composite image, resulting in increased signal‐to‐noise ratio and quantitative reconstruction accuracy. Unlike HYPR, the new HYPR LR method can be applied to images acquired with arbitrary k‐space trajectories. It is suitable for a broad range of medical imaging applications involving serial changes in image sequence, offering exciting new opportunities in the future. Magn Reson Med 59:456–462, 2008.

Does Aneurysmal Wall Enhancement on Vessel Wall MRI Help to Distinguish Stable From Unstable Intracranial Aneurysms

Background and Purpose— Arterial wall enhancement on vessel wall MRI was described in intracranial inflammatory arterial disease. We hypothesized that circumferential aneurysmal wall enhancement (CAWE) could be an indirect marker of aneurysmal wall inflammation and, therefore, would be more frequent in unstable (ruptured, symptomatic, or undergoing morphological modification) than in stable (incidental and nonevolving) intracranial aneurysms. Methods— We prospectively performed vessel wall MRI in patients with stable or unstable intracranial aneurysms. Two readers independently had to determine whether a CAWE was present. Results— We included 87 patients harboring 108 aneurysms. Interreader and intrareader agreement for CAWE was excellent (&kgr;=0.85; 95% confidence interval, 0.75–0.95 and &kgr;=0.90; 95% confidence interval, 0.83–0.98, respectively). A CAWE was significantly more frequently seen in unstable than in stable aneurysms (27/31, 87% versus 22/77, 28.5%, respectively; P<0.0001). Multivariate logistic regression, including CAWE, size, location, multiplicity of aneurysms, and daily aspirin intake, revealed that CAWE was the only independent factor associated with unstable status (odds ratio, 9.20; 95% confidence interval, 2.92–29.0; P=0.0002). Conclusions— CAWE was more frequently observed in unstable intracranial aneurysms and may be used as a surrogate of inflammatory activity in the aneurysmal wall.

In vivo three-dimensional MR wall shear stress estimation in ascending aortic dilatation

To estimate surface‐based wall shear stress (WSS) and evaluate flow patterns in ascending aortic dilatation (AscAD) using a high‐resolution, time‐resolved, three‐dimensional (3D), three‐directional velocity encoded, radially undersampled phase contrast MR sequence (4D PC‐MRI).