Download A feasibility study of dual contrast blood image (DCBI) using

A feasibility study of dual contrast blood image (DCBI) using
balanced steady state free precession (B-SSFP) with phase
sensitive inversion recovery (PSIR).
Poster No.:
C-0906
Congress:
ECR 2015
Type:
Scientific Exhibit
Authors:
T. Yoshida , Y. Katsumata , Y. Furukawa , M. Nozaki , T.
1
2
1
1
1
1
1
1
3
Nagasaki , M. Hirano , N. Kawauchi , T. Shirai , H. Saito ;
1
2
3
Tokyo/JP, Yokohama/JP, Sendai/JP
Keywords:
Image verification, Blood, Artifacts, Imaging sequences, MRAngiography, Vascular, Thorax, Cardiovascular system
DOI:
10.1594/ecr2015/C-0906
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Page 1 of 16
Aims and objectives
Various kinds of sequences of magnetic resonance angiography (MRA) are used to
evaluate vascular lesions. These sequences are classified into two groups: bright blood
(BriB) imaging sequences, and black blood (BlaB) ones.
BriB images visualize intravascular lumens brighter than surrounding stationary tissues,
1), 2)
and are useful for vascular morphology delineation
. Representative BriB image
sequences are time-of-flight (TOF), phase contrast angiography (PCA), contrast
3)
enhancement MRA (CE-MRA) and balanced steady state free precession (B-SSFP) .
BriB image sequences available have some problems (Table.1a). TOF is based on inflow,
and is related to flow speed. TOF could not visualize vessels with flow out of setting
4)
velocity . PC is based on the phase of blood flow. Flow velocity and flow direction affect
the image quality of PCA. And scan times of PC are longer. CE-MRA require gadolinium5)
based contrast agents . The use of gadolinium-based contrast agents in patients with
renal dysfunction is reported as the risk of developing nephrogenic systemic #brosis
6)
(NSF) .
BlaB images visualize intravascular lumens darker than surrounding stationary tissues,
and are useful for vessel wall delineation. Representative BlaB image sequences are
single or double inversion recovery (IR) pre-pulse, variable refocusing flip angle (VRFA)
and MSDE. BlaB image sequences available have some problems (Table.1b). BlaB
images with IR pre-pulse generate null points by using inversion delay time (TI). Mismatch
7)
of TI could degrade the image quality of BlaB images with IR pre-pulse . VRFA, using
spin echo sequences, needs long scan times. MSDE sequences cold be degrade by
8)
motion, such as blood flow or respiration .
B-SSFP, frequently used as a BriB image sequence, is validated for high signal intensity
9)-12)
and shorter scan times
. Furthermore, B-SSFP using IR method is reported as a BlaB
13-14)
image sequence that is not affected by blood flow velocity
. B-SSFP could provide
BriB images and BlaB images, however, there was no sequence to obtain both BriB
images and BlaB images with B-SSFP at one time yet. This study is to evaluate the
Page 2 of 16
sequence of dual contrast images (DCBI) using balanced steady state free precession
with phase-sensitive inversion-recovery (PSIR-B-SSFP).
Images for this section:
Table 1: Bright blood (BriB) image and black blood (BlaB) image sequence table. a): BriB
image sequence information and b): BlaB image sequence information.
Page 3 of 16
Methods and materials
<PSIR-B-SSFP sequence>
PSIR-B-SSFP sequence was different from PSIR on two points (Fig. 1). One is the read
out. The read out of PSIR-B-SSFP is not gradient echo, but balanced steady state free
precession (B-SSFP). The other is flip angle (FA) of the second image. The FA of the
second image is equal to the first image on PSIR-B-SSFP.
PSIR-B-SSFP sequence (Fig. 1b) required two heartbeats to obtain images. An IR prepulsed image (IR modulus image: IRm image) with effective TI was obtained on the first
heartbeat. This IR pre-pulse affected T1 value, and suppressed the signal intensity of
selective tissues intended by set TI. Then a low contrast image, the reference image,
was obtained with on the second heartbeat. The recovery of the longitudinal relaxation
of the tissues advances on the reference image, and the tissue has positive signal on
it. Then, correct real (CR) image with low phase error was obtained from first and the
second heartbeat images with phase collection (Fig.2). Therefore, CR image had a good
15) 16)
contrast image when TI null varied
.
Used MRI scanners was a 1.5 T system (Philips Achieva). SENSE 8ch Head coil
(Experiment 1) and 32ch SENSE-Cardiac Torso coil (Experiment 2) were used. Optimal
imaging parameters were evaluated on the basic evaluation using handmade blood
phantom (Experiment 1). Then the volunteer image was taken based upon the optimal
imaging parameters, and the impact of blood flow was evaluated (Experiment 2).
Used sequences on both experiments were as follows: 2D PSIR-B-SSFP TR/
TE=3.6ms/1.78ms, water fat shift=0.3, Image resolutions (M×P×S) =1.78×1.78×6mm,
Physiology cardiac trigger (+) and Scan Time = 3.6sec/slice.
Experiment 1: IR modulus (IRm), Correct Real (CR) and Modulus (Mod) image of the
blood phantom (T1:1034ms, T2:260ms) were obtained by PSIR-B-SSFP in varying flip
angle (FA), TI and Shot Interval (SI). The signal intensities of the phantom images were
evaluated. The results were used to determine the optimal parameters for DCBI.
Page 4 of 16
Experiment2: Institutional Review Board approved this study. Transverse and sagittal
mages of the thoracic aorta were taken on 10 volunteers. Transverse covered from aorta
arch to the tail end of heart, and within the limits of whole heart and aorta for sagittal.
Images were taken with various TI and SI. Signal intensities of ascending aorta, aortic
arch, descending aorta, pulmonary artery, right ventricle, and left atrium were measured.
Images for this section:
Fig. 1: Pulse sequence diagrams of (a) phase sensitive inversion recovery (PSIR) based
gradient echo and (b) phase sensitive inversion recovery balanced steady state free
precession (PSIR-B-SSFP) sequences. (a) In the PSIR sequence, 2 heart beats per
inversion recovery pre-pulse were required. RF pulse flip angle of 2nd image read out was
considerably lower than that of 1st image read out. (b) In the PSIR-B-SSFP sequence,
RF pulse flip angles of 1st and 2nd image read out were equal.
Page 5 of 16
Fig. 2: Representative real relaxation curves on phase sensitive inversion recovery
balanced steady state free precession (PSIR-B-SSFP# sequence. 1st and 2nd images
were inversion recovery modulus (IRm) image (a) and modulus (Mod) image (b).
Corrected real (CR) image was calculated from 1st and 2nd images. Magnetization of
all tissue is affected by inversion recovery pre-pulse. Magnetization of object# on 1st
and 2nd images were recovered to positive. Magnetization of object# on 1st image was
negative, and that on 2nd images was recovered to positive.
Page 6 of 16
Results
Experiment 1:
Signal intensity (SI) of the blood phantom were positive on the IRm image with TI<500ms
(Fig.3) and Mod image with any TI (Fig.4). IRm image had the highest signal intensity
when TI=shortest (Fig.3). Therefore, BriB image could be obtained on the IRm image
with TI<500ms and Mod image with any TI with PSIR-B-SSFP.
SI of the blood phantom were negative on the CR image with TI#500ms (Fig.3-4). BlaB
image could be obtainedon the CR image with TI#500ms.
Experiment 2:
Signal intensity (SI) on the images of the volunteer showed positive signal intensities on
IRm and modulus images, and negative signal intensities on CR images (Figs. 5, 6). Flow
direction had little effect on signal intensities (Figs. 5, 6).
Average scan time for PSIR-B-SSFP sequence was 70sec with 25slices transverse and
42sec with 15slices sagittal.
DCB image (i.e. BriB and BlaB) can be obtained at one time by PSIR-B-SSFP (Fig.7).
Discussion
IRm image and Mod image of PSIR-B-SSFP could provide BriB images. IRm image with
the shortest TI generated higher signal intensity than Mod image (Fig.2~4). IRm image
was influenced by IR pre-pulse because signal intensity of IRm image varied with TI.
Mod image had the constant signal intensity with increasing TI. Mod image of the second
heartbeat has little influence by IR pre-pulse, and might have the same signal intensity
as the normal B-SSFP.
Page 7 of 16
CR image could provide BlaB image. CR image is calculated from IRm and Mod images,
and this calculation might result this signal intensity decrease (Fig.3). The signal intensity
of blood phantom on IRm image decreased with IR pre-pulse, and was null at TI=500ms.
It is assumed that signal intensity of IRm image with TI<500ms is actually decreasing. As
a result, signal intensities of CR image, calculated from IRm and Mod images, become
negative.
PSIR-BSSFP provided DCB images on volunteer study (Fig.7). Flow velocities and
directions had little influence on image qualities. However, the influence of miss
registration of phase map caused by arrhythmia and free breathing has not been clarified
in this study.
Images for this section:
Page 8 of 16
Fig. 3: Signal intensity (SI) of blood phantom with various flip angles (FAs) and inversion
times (TIs). Inversion recovery modulus (IRm) and correct real (CR) image by phase
sensitive inversion recovery balanced steady state free precession (PSIR-B-SSFP).
Fig. 4: Signal intensity (SI) of blood phantom with various flip angles (FAs) and inversion
times (TIs). Modulus (Mod) and correct real (CR) image by phase sensitive inversion
recovery balanced steady state free precession (PSIR-B-SSFP).
Page 9 of 16
Fig. 5: Signal intensity (SI) of volunteer transversal images with various flow direction and
inversion times (TIs). (a): inversion recovery modulus (IRm) images by phase sensitive
inversion recovery balanced steady state free precession (PSIR-B-SSFP), (b): modulus
(Mod) image by PSIR-B-SSFP and (c): CR image by PSIR-B-SSFP. The measurement
of SI with red cross-circle is ascending aorta (asc-Ao) and yellow dot-circle is descending
aorta (dis-Ao).
Page 10 of 16
Fig. 6: Signal intensity (SI) of volunteer sagittal images with various flow direction and
inversion times (TIs). (a): inversion recovery modulus (IRm) images by phase sensitive
inversion recovery balanced steady state free precession (PSIR-B-SSFP), (b): modulus
(Mod) image by PSIR-B-SSFP and (c): CR image by PSIR-B-SSFP. The measurement
of SI with red allow is ascending aorta(asc-Ao), yellow allow is aorta arch(Ao-arch), light
blue allow is descending aorta(dis-Ao), blue cross-circle is pulmonary artery(PA), purple
dot-circle is right atrium(RA) and left atrium(LA).
Page 11 of 16
Fig. 7: Volunteer images of transversal (upper) and sagittal (lower). Right side: bright
blood images with inversion recovery modulus (IRm) images by phase sensitive inversion
recovery balanced steady state free precession (PSIR-B-SSFP), middle: black blood
images with CR image by PSIR-B-SSFP and left side: bright blood images withf modulus
(Mod) image by PSIR-B-SSFP. M2D PSIR-B-TFE single shot TR/TE (ms) =3.1/1.54
TI (ms) =150 FA=90°water fat shift=0.3 Voxel size (M*P*S: mm) =1.48*1.88*8.0 Scan
time=3.6sec/slice cardiac trigger (+) heat-rate=63bpm breath hold (+)
Page 12 of 16
Conclusion
PSIR-BSSFP is the method that provided dual contrast vessel Images at one time. PSIRB-SSFP provide bright blood image by IR modulus and modulus image, and black blood
image by correct real image. Flow directions and velocities had little effect on image
qualities of PSIR-BSSFP.
Personal information
Takashige Yoshida*, Yuki Furukawa,
Department of Radio-technology, Tokyo Metropolitan Police Hospital, Tokyo, Japan;
4-22-1 Nakano, Nakano-ku, Tokyo, 164-8541, Japan
*e-mail: [email protected]
Nobuo Kawauchi
Department of Radiology, Tokyo Metropolitan Police Hospital, Tokyo, Japan;
4-22-1 Nakano, Nakano-ku, Tokyo, 164-8541, Japan
Miho Nozaki, Tetsuro Shirai
Department of Internal Medicine, Tokyo Metropolitan Police Hospital, Tokyo, Japan;
4-22-1 Nakano, Nakano-ku, Tokyo, 164-8541, Japan
Yasutomo Katsumata
Clinical Excellence Application Div, Asia Pacific MR Application Manager, Philips
Electronics Japan, ltd;
2-13-37, Kounan, Minato-ku, Tokyo, 108-8507, Japan
Takuma Nagasaki
Nagasaki Research Institute;
Page 13 of 16
98-55, Honmoku, Manzaka, Naka-ku, Yokohma, 231-0833, Japan
Masaharu Hirano
Department of Cardiovascular Medicine, Tokyo Medical University Hospital, Tokyo,
Japan
6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan
Haruo Saito
Division of Diagnostic Image Analysis, Graduate school of Medicine, Tohoku University,
Miyagi, Japan
2-1, Seiryou-cho, Aoba-ku, Sendai-shi, Miyagi, 980-8575, Japan
References
1) Matt AB, Kevin FK, Xiaohong JZ. Hand book of MRI pulse sequences. Elsevier
Academic Press; 2004 p648~p701.
2) Edelman RR, Mattle HP, Wallner B, et al. Extracranial carotid arteries: evaluation with"
black blood" MR angiography. Radiology 1990; 177(1): 45-50.
3) Andrew JW, Miyazaki M. Non-Contrast Enhanced MR Angiography: Physical
Principles. J Mang Reson Imaging 2012; 36(2): 286-304.
4) Offerman EJ, Hodnett PA, Edelman RR, et al. Nonenhanced methods for lowerextremity MRA: a phantom study examining the effects of stenosis and pathologic #ow
waveforms at 1.5T. J Magn Reson Imaging 2011; 33(2): 401-408.
5) Lin J, Chen B, Wang JH, et al. Whole-body three-dimensional contrast-enhanced
magnetic resonance (MR) angiography with parallel imaging techniques on a
multichannel MR system for the detection of various systemic arterial diseases. Heart
Vessels 2006; 21(6): 395-398.
Page 14 of 16
6) Sadowski EA, Bennett LK, Chan MR, et al. Nephrogenic systemic #brosis: risk factors
and incidence estimation. Radiology 2007; 243(1): 148-157.
7) Mendes J, Parker D L, Kim SE, et al. Reduced Blood Flow Artifact in Intraplaque
Hemorrhage Imaging Using CineMPRAGE. Magn Reson Med 2013; 69(5): 1276-1284.
8) Yarnykh VL, Yuan C. Multislice Double Inversion-Recovery Black-Blood Imaging With
Simultaneous Slice Reinversion. J Magn Reson Imaging 2003; 17(4): 478-483.
9) Scheffler K, Lehnhardt S. Principles and applications of balanced SSFP techniques.
Eur Radiol 2003; 13(11): 2409-2418
10) Oliver MW, Alastair JM, Charles BH. Whole-Heart Steady-State Free Precession
Coronary Artery Magnetic Resonance Angiography. Magn Reson Med 2003; 50:
1223-1228.
11) Fuchs F, Laub G, Othomo K. TrueFISP - technical considerations and cardiovascular
applications. Eur J Radiol 2003; 46(1): 28-32.
12) Krishnam MS, Tomasian A, Malik S, et al. Image quality and diagnostic accuracy
of unenhanced SSFP MR Angiography compared with conventional contrast-enhanced
MR angiography for the assessment of thoracic aortic diseases. Eur Radiol 2010; 20(6):
1311- 1320.
13) Takeshi Ishimoto. The Possibility of Coronary Vessel Wall MR Imaging. Japanese
Journal of Radiological Technology 2007; 63(6): 681-688.
14) Lin K, Bi X, Liu Y, et al. Black-Blood Steady-State Free Precession (SSFP) Coronary
Wall MRI for Cardiac Allografts: A Feasibility Study. J Magn Reson Imaging 2012; 35(5):
1210-1215.
Page 15 of 16
15) Kellman P, Arai AE, McVeigh ER, et al. Phase-Sensitive Inversion Recovery for
Detecting Myocardial Infarction Using Gadolinium-Delayed Hyperenhancement. Magn
Reson Med 2002; 47(2): 372-383.
16) Setser RM, Chung YC, Weaver JA, et al. Effect of inversion time on
delayed#enhancement magnetic resonance imaging with and without phase#sensitive
reconstruction. J Magn Reson Imaging 2005; 21(5), 650-655.
Page 16 of 16