Yuting Wang¹, Yuncai Ran², Ming Zhu³, Xiao Wu⁴, Ajay Malhotra⁴, Xiaowen Lei², Feifei Zhang², Xiao Wang², Shanshan Xie², Jian Zhou², Jinxia Zhu⁵, Jingliang Cheng², and Chengcheng Zhu^6
1Department of Radiology, Sichuan Provincial People's Hospital, Chengdu, China, ²Department of Magnetic Resonance, The first Affiliated Hospital of Zhengzhou University, Zhengzhou, China, ³4. Interventional department, The first Affiliated Hospital of Zhengzhou University, Zhengzhou, China, ⁴Yale School of Medicine and Yale University, New Haven, CT, United States, ⁵MR Collaboration, Siemens Healthcare Ltd., Beijing, China, ⁶3. Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, United States

Middle cerebral artery plaque burden on high-resolution MR was significantly higher in recurrent stroke group than in the first-onset acute stroke and chronic stroke groups (p=0.002). Patients with acute stroke had higher enhancement ratio than patients with chronic stroke (p=0.014). After adjustment of clinical demographic factors, plaque burden was the only independent imaging feature associated with recurrent stroke (odds ratio=2.26, per 10% increase, 95% CI, 1.03-4.96, p=0.042). In conclusion, higher plaque burden of  MCA on MR is independently associated with recurrent ischemic stroke. MR vessel wall imaging may provide unique information for risk stratification of stroke patients.

Rick J van Tuijl¹, Ynte M Ruigrok², Irene C van der Schaaf¹, Gabriël J. E. Rinkel², Birgitta K Velthuis¹, and Jaco J.M. Zwanenburg^1
1Radiology, UMC Utrecht, Utrecht, Netherlands, ²Neurology and Neurosurgery, Rudolf Magnus Institute of Neuroscience, UMC Utrecht, Utrecht, Netherlands

The influence of intracranial internal carotid artery calcification (iICAC) over the whole internal carotid artery (ICA) trajectory was studied using 4D phase-contrast flow measurements (17 patients with cerebral small vessel disease (CSVD) and 17 healthy controls; 7T MRI). CT images of CSVD patients were used to calculate the iICAC from C3-C7 segments. Results showed a positive correlation between the presence and volume of iICAC with vPI in the CSVD group. iICAC contributes to an increase in vPI over the ICA from the extracranial C1 segment to the C7 segment just proximal to the circle of Willis compared to HC.

Niranjan Balu¹, Zechen Zhou², Thomas Hatsukami³, and Chun Yuan^1
1Radiology, University of Washington, Seattle, WA, United States, ²Philips Healthcare, Briarcliff Manor, NY, United States, ³Surgery, University of Washington, Seattle, WA, United States

Vessel wall MRI requires good fat suppression to delineate outer vessel boundaries. Large field-of-views required for turbo spin echo femoral vessel wall MRI do not provide good fat suppression with spectral inversion recovery. We developed a time-efficient two-point Dixon turbo spin echo method using a SNR priority variable flip angle schedule and point spread correction reconstruction to allow accelerated acquisition and demonstrate its advantages compared to an existing gradient echo vessel wall MRI method.
 

Yasuhiro Fujiwara¹ and Motohira Mio^2
1Department of Medical Image Sciences, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan, ²Department of Radiology, Fukuoka University Chikushi Hospital, Chikushi, Japan

  The purpose of this study was to investigate the correlation between the T₁ value of carotid plaque and signal intensity ratio and to evaluate the clinical usefulness of T₁ and T₂* values for carotid plaque.  Quantitative T₁ and T₂* mapping using mPSIR have potential to improve the diagnostic accuracy of vulnerability of carotid atherosclerotic plaque.

Na Zhang¹, Tingting Zhu², Lijie Ren³, Lei Zhang¹, Zhangyan Fan³, Liwen Wan¹, Hairong Zheng¹, and Xin Liu^1
1Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China, ²Department of Radiology, Tongji Hospital, Wuhan, China, ³Department of Neurology, Shenzhen Second People's Hospital, Shenzhen, China

It is generally believed small subcortical infarction (SSI) (also termed lacunar stroke) is caused by intrinsic diseases of penetrating arteries. Recent studies have shown the incidence of atherosclerosis in large arteries which is an important pathogenesis of large subcortical infarction (LSI) is also high in patients with SSI. This indicates the underlying mechanisms of SSI in patients with large artery atherosclerosis may be the same with LSI and inferred from plaque characteristics. However, the plaque characteristics ultimately leading to SSI or LSI remain unclear. This study is to explore the differences of plaque characteristics between patients with SSI and LSI.

Thanh D Nguyen¹, Jingwen Du², Yan Wen¹, Ajay Gupta¹, Pascal Spincemaille¹, Qi Yang², and Yi Wang^1
1Weill Cornell Medicine, New York, NY, United States, ²Xuanwu Hospital of Capital Medical University, Beijing, China

In this study, we used CT angiography (CTA) as a reference standard to demonstrate that carotid quantitative susceptibility mapping (QSM) provides accurate detection of calcified atherosclerotic plaques in the carotid arteries. Calcification is strongly diamagnetic and appears uniquely hypointense on carotid QSM. Inclusion of QSM in carotid MRI would aid characterization of carotid plaque.

Jasper Schoormans¹, Claudia Calcagno², Reza Indrakusuma³, Hamid Jalalzadeh³, Ron Balm³, Stefan Smorenburg⁴, Gustav J Strijkers¹, Aart J Nederveen⁵, and Bram F Coolen^1
1Department of Biomedical Engineering and Physics, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, Netherlands, ²The BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY, United States, ³Department of Surgery, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, Netherlands, ⁴Department of Vascular Surgery, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, Netherlands, ⁵Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, Netherlands

We introduced 3D black-blood DCE MRI in combination with AIF-free modeling to facilitate the measurement of pharmacokinetic parameters in the aorta vessel wall of patients with an abdominal aortic aneurysm. Our method enables 3D assessment of microvascularization and permeability which could assist a clinical risk assessment of this condition. 

Seong-Eun Kim¹, Ye Tian², Matthew Alexander¹, Dennis L Parker¹, Gerald S Treiman ^3,4, Adam de Havenon⁵, and J Scott McNally^1
1UCAIR, Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, UT, United States, ²Department of Physics and Astronomy, University of Utah, Salt Lake City, UT, United States, ³Department of Surgery, University of Utah, Salt Lake City, UT, United States, ⁴VASLCHCS, Salt Lake City, UT, United States, ⁵Department of Neurology, University of Utah, Salt Lake City, UT, United States

Carotid plaque inflammation can be measured with dynamic contrast enhanced (DCE) MRI and is a marker for plaque instability. Increased vascularity, which is one sign of plaque inflammation, can be detected from kinetic analysis of DCE images However, the trade-off between spatial and temporal resolution limits assessment to a small number of slices and ~15 seconds per time frame. To overcome this limitation, we implemented a short-TR 3D T1w Stack of Stars (SoS) sequence to enable retrospective image formation with arbitrary numbers of radial views by using Golden-angle radial sparse parallel (GRASP) reconstruction. 

 

Yuki Kanazawa¹, Masafumi Harada¹, Tosiaki Miyati², Takashi Abe¹, Mitsuharu Miyoshi³, Yuki Matsumoto¹, Hiroaki Hayashi², Yasuhisa Kanematsu⁴, and Yasushi Takagi^4
1Tokushima University, Tokushima, Japan, ²Faculty of Health Sciences, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Japan, ³Global MR Applications and Workflow, GE Healthcare Japan, Hino, Japan, ⁴Department of Neurosurgery, Tokushima University, Tokushima, Japan

To assess an activity within an atherosclerotic plaque, chemical exchange saturation transfer (CEST) imaging was demonstrated with the multi-pool model Bloch equation. This study was performed with eleven patients with carotid stenosis, was evaluated with each estimated parameters; bulk water, magnetization transfer, amide proton transfer (APT), and nuclear Overhauser effect (NOE). There was no significant difference between mean APT and NOE at 3.5 ppm. This result indicates that CEST plaque imaging should be evaluated with distinguishing APT and NOE. Multi-parametric analysis of CEST imaging may obtain detailed information for component as well as metabolite substances within an atherosclerotic plaque.

Xiaoyi Chen¹, Huimin Xu², Tao Wang³, Jin Zhang⁴, Huiyu Qiao⁵, Hualu Han⁵, and Xihai Zhao^5
1Department of Radiology, Beijing Geriatric Hospital, Beijing, China, ²Department of Radiology, Peking University Third Hospital, Beijing, China, ³Department of Neurosurgery, Peking University Third Hospital, Beijing, China, ⁴Department of Radiology, Renji Hospital, Shanghai Jiaotong University, Shanghai, China, ⁵Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University School of Medicine, Beijing, China

Carotid artery severe stenosis or occlusion will lead to ischemia within the vessel wall and diffuse wall thickening (DWT) in the downstream arterial segment. The revascularization surgery is an effective treatment for carotid artery stenosis. This study investigated the peri-revascularization change of DWT in petrous internal carotid artery (ICA) among carotid atherosclerotic patients using MR vessel wall imaging. We found that the DWT in ipsilateral petrous ICA recovered after revascularization treatment (1.68±0.68 mm vs. 1.39±0.47 mm, P =0.002) and it began to recover one month later after the revascularization.

Zechen Zhou¹, Zhensen Chen², Jie Sun², Niranjan Balu², Baocheng Chu², Peter Börnert³, Thomas S Hatsukami², and Chun Yuan^2
1Philips Research North America, Cambridge, MA, United States, ²Department of Radiology, University of Washington, Seattle, WA, United States, ³Philips Research Hamburg, Hamburg, Germany

Three-dimensional (3D) T1 weighted (T1w) turbo spin echo (TSE) sequence has demonstrated its value for intracranial vessel wall imaging (IVWI), but its long scan time has hampered wider clinical translation. In this study, a 4-minute 3D T1w TSE sequence was optimized and combined with wave encoded parallel imaging and compressed sensing (PI-CS) reconstruction for whole brain isotropic 0.6mm IVWI. This approach improved the image quality and robustness of IVWI in comparison to the Cartesian encoded PI-CS approach in healthy subjects. It demonstrated promising potential for further clinical evaluation.

Jiayu Xiao¹, Jae Song², Fang Wu³, Tao Jiang⁴, Shlee Song¹, Konrad Schlick¹, Debiao Li^1,5, Qi Yang³, and Zhaoyang Fan^1,5
1Cedars-Sinai Medical Center, Los Angeles, CA, United States, ²Hospital of the University of Pennsylvania, Philadelphia, PA, United States, ³Beijing Xuanwu Hospital, Beijing, China, ⁴Beijing Chaoyang Hospital, Beijing, China, ⁵University of California, Los Angeles, Los Angeles, CA, United States

Hypertension is associated with intracranial atherosclerosis and cerebrovascular events. However, the correlation between hypertension and atherosclerosis disease burden (the number, distribution and incidence of vulnerable features of intracranial atherosclerotic plaques) remains unclear. In this study, plaques in the large intracranial arteries of anterior circulation were analyzed in 62 ischemic stroke patients. We found that a diagnosis of hypertension was significantly associated with total number of intracranial plaques after accounting for conventional cardiovascular risk factors. This suggests that hypertension is an important mechanistic factor for diffuse intracranial atherosclerosis.

Fang Dong¹ and Jing An^1
1Siemens Magnetic Resonance Ltd., Shenzhen, China

T2-weighted MR imaging is a non-invasive way for vasculitis diagnosis. SPACE sequence has been successfully used for T1-weighted aortic wall imaging. While its application in T2w aortic wall imaging is hampered by the long scanning time, blood suppression performance and physiological movement. In this study, three black blood methods with optimized protocols have been tested and evaluated. Diffusion-Prepared SPACE sequence with diastolic acquisition was proved to be a promising way for T2w aortic wall imaging within a clinically acceptable acquisition time.
 

Zhilang Qiu^1,2, Sen Jia^1,2, Shi Su¹, Yanjie Zhu¹, Xin Liu¹, Hairong Zheng¹, Leslie Ying³, Haifeng Wang¹, and Dong Liang^1
1Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China, ²Shenzhen College of Advanced Technology, University of Chinese Academy of Sciences, Shenzhen, China, ³University at Buffalo, The State University of New York, Buffalo, NY, United States

Whole-brain intracranial vessel wall imaging (VWI) requires long scan time for high resolution and large coverage. In this study, we applied a novel three-dimensional parallel imaging technique, Wave-CAIPI, to accelerate whole-brain intracranial VWI. The highly accelerated (11×) VWI takes 3.5 minutes, at an isotropic resolution of 0.6 mm. Compared to conventional two-dimensional parallel imaging technique (2D CAIPI), Wave-CAIPI is able to achieve higher SNR and better imaging quality on vessel wall depictions.

Yina Lan¹, Ming Yang², Xin Zhou³, Ning Ma², and Xin Lou^1
1The First Medical Center of PLA General Hospital, Beijing, China, ²Beijing Tiantan Hospital, Beijing, China, ³xinzhou@wipm.ac.cn, National Center for Magnetic Resonance in Wuhan, Wuhan Institute of Physics and Mathematics, Innovation Academy of Precision Measurement Science and Technology, Chinese Academy of Sciences-Wuhan National Laboratory for Optoelectronics, Beijing, China

In this study, we aim to perform a comparative analysis of high-resolution magnetic resonance imaging (HRMRI) and noncontrast computer tomography (NCCT) in detection of arterial calcifications in V3 horizontal and V4 segment of vertebral artery in patients with posterior circulation ischemic events. We observed that, HRMRI is as accurate as NCCT in the detection of V4 segment calcifications, while HRMRI are superior in detection of V3 horizontal segment calcifications than NCCT. 

Huimin Xu¹, Ran Huo¹, Ying Liu¹, Lizhi Xie², Ruijing Xin³, Tao Wang¹, Huishu Yuan¹, and Xihai Zhao^4
1Peking University Third Hospital, Beijing, China, ²GE healthcare, Beijing, China, ³Southeastern University, Nanjing, China, ⁴Center for Biomedical Imaging Research, Beijing, China

The development of secondary collaterals can be affected by the degree of luminal stenosis, which is not parallel with plaque burden since the positive remodeling effect for elastic arteries. This study aimed to determine the association of carotid plaque burden with status of secondary collaterals in patients with severe carotid stenosis. We found that patients with poor collaterals had significantly larger Max WT than those with good collaterals (7.29 ±1.15 mm vs. 6.59 ± 0.93 mm; P=0.018) when the plaque is larger than 5.45mm.

Suvai Gunasekaran¹, Hassan Haji-Valizadeh², Bradley Allen¹, Ryan Avery¹, and Daniel Kim^1
1Northwestern University, Chicago, IL, United States, ²Harvard University, Boston, MA, United States

Current methods for contrast-enhanced thoracic MR angiography (CE-MRA) utilize suboptimal imaging practices such as breath holding or long scan time. Here we developed a 9.6-fold accelerated CE-MRA sequence using stack-of-stars k-space sampling and XD-GRASP reconstruction to produce predictable scan time (< 5 min), without significant loss in image quality. Our sequence was significantly faster than the current clinical free-breathing scan, reducing the scan time by 50%. Additionally, our accelerated CE-MRA scan produced comparable image quality that was clinically acceptable.

Camila Munoz¹, Aurelien Bustin¹, Gastao Cruz¹, Pier Giorgio Masci¹, Rene M Botnar¹, and Claudia Prieto^1
1Biomedical Engineering Department, School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom

MR angiography is a useful technique for the diagnosis, monitoring and treatment planning of thoracic aortic disease. However, clinically used contrast-free approaches based on diaphragmatic navigator gating commonly result in long and unpredictable scan times. This study extends our previously introduced technique for non-contrast enhanced (non-CE) accelerated 3D Cartesian non-rigid motion-compensated whole-heart MR angiography for the visualization of the thoracic and suprarenal abdominal aorta from a short and efficient 3-minute scan. The proposed method was tested in five healthy subjects and two patients with cardiovascular disease, resulting in high-quality depiction of the aorta, holding promise for integration in clinical routine.

Ryan Pewowaruk¹, Klarka Mendrisova², Carolina Larrain², Chris Francois², Alejandro Roldán-Alzate², and Luke Lamers^2
1Biomedical Engineering, University of Wisconsin - Madison, Madison, WI, United States, ²University of Wisconsin - Madison, Madison, WI, United States

In a swine congenital heart disease model we show strong agreement between PA dimensions from 3DRA, CA and MSCT. Non contrast-enhanced PC-MRA from PCVIPR showed good agreement with CA and MSCT for the imaging of non-stented proximal PAs.

Lenhard Pennig¹, Anton Wagner¹, Kilian Weiss², Simon Lennartz¹, Jan-Peter Grunz³, David Maintz¹, Kai Roman Laukamp¹, Tilman Hickethier¹, Claas Philip Naehle¹, Alexander Bunck¹, and Jonas Doerner^1
1Institute for Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany, Cologne, Germany, ²Philips GmbH, Hamburg, Germany, ³Department of Diagnostic and Interventional Radiology,, University Hospital Würzburg, Würzburg, Germany, Würzburg, Germany

Patients with Congenital heart disease (CHD) require repetitive imaging of the pulmonary vasculature with CE-MRA showing risks like anaphylactic reactions and uncertain long-term effects of gadolinium deposition in the brain. We adapted a Compressed SENSE (CS) accelerated 3D REACT (navigator- and ECG-triggered) to the pulmonary vessels and compared it to standard 4D CE-MRA in the clinical routine. With REACT providing significant higher image quality and slightly higher interobserver agreement in a reasonable scan time, it may be regarded as a clinically applicable alternative for patients in need of repetitive imaging of the pulmonary vasculature without the use of contrast agents.

Quentin Lebret^1,2,3, Pierre Bour^1,2,3, Valéry Ozenne^1,2,3, and Bruno Quesson^1,2,3
1IHU LIRYC, Fondation Bordeaux Université, Pessac, France, ²U1045 CRCTB, Université de Bordeaux, Bordeaux, France, ³INSERM, CRCTB, U1045, Bordeaux, France

Using Wave-CAIPI-like techniques to accelerate Balanced Steady-state Free Precession (bSSFP) sequences is a new parallel imaging technique that reduces the noise levels on the reconstructed image compared to conventional parallel imaging. On the heart, this combination of sequence has not been tested. The experiments show that the movements of the thorax are not an issue, as long as a respiratory and ECG triggering are employed. A retrospective acceleration of 5.4 on a sheep heart image with a 1.4mm isotropic resolution has been achieved.

John Heerfordt^1,2, Kevin K. Whitehead³, Jessica A.M. Bastiaansen¹, Lorenzo Di Sopra¹, Christopher W. Roy¹, Jérôme Yerly^1,4, Mark A. Fogel³, Matthias Stuber^1,4, and Davide Piccini^1,2
1Department of Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland, ²Advanced Clinical Imaging Technology, Siemens Healthcare, Lausanne, Switzerland, ³Children’s Hospital of Philadelphia, Philadelphia, PA, United States, ⁴Center for Biomedical Imaging (CIBM), Lausanne, Switzerland

SIMilarity-Based Angiography (SIMBA) is a data-driven method for fast reconstruction of static whole-heart coronary MR angiograms from free-running acquisitions. By assessing the similarity of periodically acquired k-space readouts in the superior-inferior direction, motion-consistent angiograms can be obtained without making stringent assumptions about physiological motion. SIMBA demonstrated potential to reconstruct cardiac and respiratory motion-consistent images with visible coronary arteries both from non-contrast volunteer acquisitions at different field strengths and contrast-enhanced scans of pediatric patients. SIMBA provided improved sharpness and contrast compared to images from all the acquired data and similar vessel conspicuity as end-expiratory mid-diastolic frames of motion-resolved compressed sensing reconstructions. 

Reza Hajhosseiny¹, Aurélien Bustin¹, Imran Rashid¹, Gastao Cruz¹, Radhouene Neji^1,2, Karl Kunze^1,2, Tevfik F. Ismail¹, Ronak Rajani¹, Pier Giorgio Masci¹, Claudia Prieto¹, and René M. Botnar^1
1Biomedical Engineering Department, School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom, ²MR Research Collaborations, Siemens Healthcare Limited, Frimley, United Kingdom

Conventional diaphragmatic navigator coronary magnetic resonance angiography (d1D-NAV-CMRA) is limited by long and unpredictable acquisition-times and motion related image quality degradation. To overcome these challenges, we have previously proposed an image-navigated non-rigid motion-compensated, undersampled reconstruction CMRA framework (iNAV-CMRA) with <10min acquisition times. Here we investigated the clinical feasibility of 1.2mm³ iNAV-CMRA, comparing its performance, in patients with suspected coronary artery disease, against 1.2mm³ d1D-NAV-CMRA and coronary computed tomography angiography (CCTA). Compared to the d1D-NAV-CMRA, the iNAV-CMRA had a shorter acquisition-time(7:24±0:33min vs. 21:02±7:27min, p<0.0001), with improved coronary vessel-length, vessel-sharpness and image-quality-score, and visually comparable to CCTA.
 

Li Gao¹, Xuchun Yuan¹, Weixia Nie¹, and Shutian Lai^1
1Radiology, Fuwai hospital chinese academy of medical science, shenzhen, Shenzhen, China

Non-contrast enhanced MR angiography of coronary artery is a promising imaging method. In this study, the image quality of two non-contrast enhanced coronary MRA imaging methods were compared, included 3D-mDIXON and 3D-TFE-WHCA.  3D-mDIXON and 3D-TFE-WHCA showed good image quality with high SNR, and 3D-TFE-WHCA  showed improved CNR and higher score in vascular display quality. According CTA data, T1-TFE-BB demonstrated the coronary vessel wall as medium high signal with regular margin and good contrast with the fat around the coronary artery. Combination of 3D-TFE-WHCA and T1-TFE-BB can be used as the imaging research method of coronary atherosclerosis.

Takashige Yoshida¹, Masami Yoneyama², Kohei Yuda¹, Yuki Furukawa¹, Isao Miyazaki¹, and Nobuo Kawauchi^1
1radiology, Tokyo metropolitan police hospital, Tokyo, Japan, ²Philips Japan, Tokyo, Japan

One of the problems of whole heart coronary MRA using bSSFP sequence at 3.0T is banding artifacts, caused by a long TR due to SAR limitations, resulting in degradation of image quality. A non-selective radio frequency (RF) pulse (e.g. block or hard pulse) enables to shorten the TR that leads to to reduce the banding artifacts. Hence whole heart coronary MRA using the bSSFP with non-selective RF pulse was improved image quality at 3.0T.

Kazuo Kodaira¹, Michinobu Nagao², Masami Yoneyama³, Yasuhiro Goto¹, Isao Shiina¹, Yutaka Hamatani¹, Mamoru Takeyama¹, Isao Tanaka¹, and Shuji Sakai^2
1Department of Radioligical Services, Tokyo Women's Medical University Hospital, Tokyo, Japan, ²Department of Diagnostic imaging & Nuclear Medicine, Tokyo Women's Medical University Hospital, Tokyo, Japan, ³Philips Japan, Tokyo, Japan

Improvement of fat suppression is important for whole heart coronary magnetic resonance angiography (WHC-MRA), because Unwanted signal arising from fat can compromise vessel delineation and decrease the diagnostic value of WHC-MRA. Balanced DIXON (bDIXON) can reduce fat suppression unevenness than SPIR method while maintaining high signal value. However, it is yet not applied for WHC-MRA. Furthermore, 3D non-selective bDIXON (3D NSbDIXON) with shortening TR can suppress an increase in imaging time. We propose a new sequence of 3D NSbDIXON for WHC-MRA, and examine the image quality in comparison to the conventional methods.

Pascale Aouad¹, Ioannis Koktzoglou², and Robert Edelman^2
1Northwestern University, Chicago, IL, United States, ²Northshore University Healthsystem, chicago, IL, United States

CTA and contrast-enhanced MRA (CEMRA) are routinely used to evaluate vascular anatomy prior to pulmonary vein isolation for atrial fibrillation. As potential non-contrast alternatives, we evaluated three radial techniques (breath-hold 2D radial and stack-of-stars (SOS); free-breathing nonselective SOS).  24 patients were studied using CTA as reference standard.  Consistently good image quality was obtained with all three radial techniques.  There was good-to-excellent agreement with CTA on breath-holding and free-breathing SOS MRA for PV ostial diameters.  Our results indicate that radial MRA may provide a useful non-contrast alternative to CTA and CEMRA, with the flexibility of allowing either breath-holding or free-breathing acquisitions.

Yuan QU¹, Yan WANG¹, Yuli HUANG², Li ZHU³, and Haiyang DONG^3
1Radiology, People’s Hospital of Xinjiang Uygur Autonomous Region, Urumqi, China, ²MR, Philips Healthcare (Suzhou) Co., Ltd, SUZHOU, China, ³Radiology, Shanghai Chest Hospital, Shanghai JiaoTong University, Shanghai, China

The Time-Spatial Labeling Inversion Pulses (Time-SLIP) technique was used to perform non-contrast enhanced pulmonary artery imaging using 3D TRANCE and 3D Balanced FFE respectively, and the image quality obtained by the two imaging methods and the number of branches of pulmonary artery were compared specifically. Both 3D TRANCE and 3D Balanced FFE imaging methods with Time-SLIP can be used for pulmonary artery imaging. The image quality of pulmonary artery obtained by 3D TRANCE is generally better than 3D Balanced FFE.

Akos Varga-Szemes¹, Robert E Stroud¹, Davide Piccini², John Heerfordt³, Jerome Yerly³, Lorenzo Di Sopra³, Pal Suranyi¹, and U. Joseph Schoepf^1
1Medical University of South Carolina, Charleston, SC, United States, ²Siemens Healthcare, Lausanne, Switzerland, ³Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland

Currently, CTA is the only noninvasive method with considerable evidence level for the detection and monitoring of thoracic aortic disease. However, CTA exposes patients to radiation and contrast media. The compressed-sensing whole-heart MRA technique that we evaluated addresses the limitations that prevent conventional MRA techniques to compete with CTA. Our approach eliminates the need for breath-holds or respiratory-navigation, provides a 3D volume of the chest without contrast administration, and allows for accurate anatomical evaluation of the thoracic aorta compared to CTA. Such MRA technique is a potential radiation- and contrast-free alternative for diagnosing and monitoring patients with thoracic aortic disease.

Ioannis Koktzoglou^1,2 and Robert R Edelman^1,3
1Radiology, NorthShore University HealthSystem, Evanston, IL, United States, ²The University of Chicago Pritzker School of Medicine, Chicago, IL, United States, ³Radiology, Northwestern University Feinberg School of Medicine, Chicago, IL, United States

We found that a prototype thin-slab stack-of-stars QISS sequence using a low-flip-angle FLASH readout can be used for whole-neck arterial evaluation in under 7 minutes.  The technique minimizes flow-related saturation effects similarly to 2D QISS, while providing greater scan efficiency compared with 3D TOF and much improved image quality and through-plane spatial resolution compared with 2D TOF.

Soroush Heidari Pahlavian^1,2, Oren Geri³, Jonathan Russin², Dafna Ben-Bashat⁴, Xingfeng Shao^1,2, Samantha Ma^1,2, Songlin Yu⁵, Arun Amar², Danny J.J. Wang^1,2, and Lirong Yan^1,2
1USC Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States, ²Department of Neurology, University of Southern California, Los Angeles, CA, United States, ³Razor Labs, Tel Aviv, Israel, ⁴Medicine & Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel, ⁵Peking Union Medical College Hospital, Beijing, China

Characterizing vascular territorial structures and hemodynamics from a single artery can provide crucial information for the assessment and treatment of cerebrovascular disorders such as arteriovenous malformations, Moyamoya disease, and aneurysms. In a different approach compared to vessel-selective MR angiography (MRA), here we presented a semi-automatic post-processing technique to segment vascular territories using pulsed arterial spin labeling 4D MRA. Our results demonstrated the feasibility of using 4D MRA in conjunction with arterial territorial segmentation to visualize vascular territories and quantify blood flow supply from individual arteries.

Shuo Zhang^1,2, Caroline Molavi Tabrizi², Masami Yoneyama³, Christiane Kuhl², and Alexandra Barabasch^2
1Philips GmbH DACH, Hamburg, Germany, ²Diagnostic and Interventional Radiology, University Hospital RWTH Aachen, Aachen, Germany, ³Philips Japan, Tokyo, Japan

Contrast-enhanced MR angiography (CE-MRA) permits accurate assessment of the abdominal aorta and the splanchnic arteries, including the celiac trunk and its branches. However, it is often restricted for patients undergoing dynamic-contrast-enhanced imaging of the liver in the same exam. In this study, we employ the recently introduced Relaxation-Enhanced Angiography without Contrast and Triggering (REACT) method using magnetization-prepared dual-echo Dixon for 3D free-breathing non-contrast-enhanced imaging of the celiac trunk. Initial results in healthy volunteer and patients are reported in comparison to the other techniques such as the conventional and arterial spin labeling (ASL) based balanced steady-state free precession (bSSFP) sequences.

Haruki Nonaka¹, Masami Yoneyama², Masahiro Tahara³, Tetsuya Nitta⁴, Mio Okano¹, Yuko Morikawa¹, Susumu Kariyama¹, Tomohiro Kimura¹, Yoriaki Matsumoto¹, Takanori Masuda¹, Naoyuki Imada⁵, and Tomoyasu Sato^6
1Department of Radiological Technology, Tsuchiya General Hospital, Hiroshima, Japan, ²Philips Japan, Tokyo, Japan, ³Department of Pediatrics, Tsuchiya General Hospital, Hiroshima, Japan, ⁴Nitta Pediatric Clinic, Hiroshima, Japan, ⁵Department of Health Care, North Hiroshima Hospital, Hiroshima, Japan, ⁶Department of Radiology, Tsuchiya General Hospital, Hiroshima, Japan

The purpose of this study was to demonstrate the clinical feasibility and utility of diastolic-phase only ECG-triggered non-contrast-enhanced MR angiography (TRANCE) in screening of systemic artery aneurysms (SAA) in Kawasaki disease patients. Diastolic-phase only TRANCE provided consistent high image quality for evaluating main arteries in children with the average scanning time around 155sec in addition to routine coronary MRA screening. Diastolic-phase only TRANCE could be useful in SAA screening without significant prolongation of examination time.

Bharath Ambale Venkatesh¹, Jason Ortman², Jaclyn Sesso², Yoko Kato², Elzbieta Chamera², Jennifer Wagner³, Yoshimori Kassai⁴, and Joao Lima^2
1Radiology, Johns Hopkins University, Baltimore, MD, United States, ²Johns Hopkins University, Baltimore, MD, United States, ³Canon Medical Research USA, Mayfield Village, OH, United States, ⁴Canon Medical Systems, Kanagawa, Japan

Whole body non-contrast magnetic resonance angiography and Dixon imaging hold potential for monitoring and quantitative assessment of global plaque burden and cardiometabolic disease in frailty.

Yan WANG¹, Yuli HUANG², Haiyang DONG³, and Li ZHU^3
1Department of Radiology, People’s Hospital of Xinjiang Uygur Autonomous Region, Urumqi, China, ²MR, Philips Healthcare (Suzhou) Co., Ltd, SUZHOU, China, ³Radiology, Shanghai Chest Hospital, Shanghai JiaoTong University, Shanghai, China

The Time-Spatial Labeling Inversion Pulses (Time-SLIP) technique was used to perform non-contrast enhanced hepatic portal vein imaging using 3D TRANCE and 3D Balanced FFE methods respectively, and the image quality obtained by the two imaging methods and the number of branches of hepatic portal vein were compared specifically. Both 3D TRANCE and 3D Balanced FFE imaging methods with Time-SLIP can be used for hepatic portal vein imaging. The image quality of hepatic portal vein obtained by 3D TRANCE was generally better than 3D Balanced FFE.

Hao Li¹, Martin John Graves², David John Lomas¹, and Andrew Nicholas Priest^2
1Department of Radiology, University of Cambridge, Cambridge, United Kingdom, ²Department of Radiology, Addenbrooke’s Hospital, Cambridge, United Kingdom

NCE-MRA techniques have a long acquisition time but can be accelerated by compressed sensing, parallel imaging and partial Fourier sampling using, for example, a Poisson-disk sampling pattern. In this study, we optimised the parameters in sampling pattern design with different acceleration factors for the 3D accelerated femoral fresh-blood-imaging sequence. The NCE-MRA data were reconstructed using weighted subtraction in k-space combined with phase correction. In a comparison using retrospective acceleration by subsampling of a full dataset, the optimised patterns outperformed the non-optimised patterns.

Robert R Edelman^1,2, Jianing Pang³, and Ioannis Koktzoglou^1,4
1Radiology, NorthShore University HealthSystem, Evanston, IL, United States, ²Radiology, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States, ³Siemens Medical Solutions USA, Chicago, IL, United States, ⁴Pritzker School of Medicine, University of Chicago, Chicago, IL, United States

Quiescent-interval slice-selective (QISS) MRA has become established as a simple “push button” nonenhanced alternative to CTA and contrast-enhanced MRA.  However, a fundamental drawback of QISS as currently implemented is that it uses a 2D acquisition strategy.  The inability to acquire very thin slices along with the non-rectangular slice profile predisposes QISS to artifacts from partial volume averaging and blurring of multiplanar reconstructions.  We therefore implemented and optimized a novel thin-slab stack-of-stars QISS (tsSOS-QISS) technique to provide near-isotropic high spatial resolution that rivals CTA, while maintaining the excellent arterial conspicuity, motion insensitivity and breath-hold capability of 2D QISS.

Hiroshi Hamano¹, Masami Yoneyama¹, Yasuhiro Goto², Takayuki Sakai³, Yasutomo Katsumata⁴, and Kenji Iinuma^1
1Philips Japan, Tokyo, Japan, ²Department of Radiological Services, Tokyo Women's Medical University, Tokyo, Japan, ³Radiology, Eastern Chiba Medical Center, Chiba, Japan, ⁴Philips Healthcare, Tokyo, Japan

Artery-weighted REACT (REACT-Art), which is optimized the T2prep-time and TFE factor to improve the artery-vein contrast has been proposed, and it provide good artery-dominant contrast compared to conventional REACT. In this study, we focused on the impact of patient positioning to improve the artery-vein contrast with higher robustness, such as raising patient’s heels, putting patient’s heels down, compressing the patient’s legs. we have demonstrated that the patient-positioning like the patient legs to be compressed, and wearing compression stockings might achieve improved artery-vein contrast of REACT-Art with high stability and robustness in the lower extremities without use of contrast-enhancement and ECG-triggering.

Dmytro Pylypenko¹, Yishi Wang², Le He¹, and Hua Guo^1
1Biomedical Engineering, Tsinghua University, Beijing, China, ²Philips Healthcare, Beijing, China

Non-contrast enhanced MRA of abdominopelvic arteries within a large field of view is very challenging due to rapid blood flow and variant flow speed among different subjects. Simultaneous Non-contrast Angiography and intraPlaque imaging (SNAP), a non-contrast enhanced MRA technique, provides reliable imaging for the carotid and intracranial arteries. In this study, we sought to explore the feasibility of SNAP with compressed sensing acceleration in abdominopelvic arteries imaging. The complementary information provided by different scans with different velocity sensitivities can be combined to obtain reliable abdominopelvic MRA with a large coverage.

Yutaka Hamatani¹, Kayoko Abe², Yasuhiro Goto¹, Masami Yoneyama³, Isao Shiina¹, Kazuo Kodaira¹, Mamoru Takeyama¹, Isao Tanaka¹, and Shuji Sakai^2
1Department of Radiological Services, Tokyo Women's Medical University Hospital, Tokyo, Japan, ²Department of Diagnostic imaging & Nuclear Medicine, Tokyo Women's Medical University Hospital, Tokyo, Japan, ³Philips Japan, Tokyo, Japan

In this study we demonstrated the feasibility of dual-echo balanced SSFP-DIXON sequence with REACT technique for the foot MRA at 1.5T. bREACT dramatically increased the SNR compared to conventional REACT and it could provide excellent contrast between blood vessels and background tissues with high robustness compared with other conventional non-contrast-enhanced MRA methods. This technique would be helpful to assess peripheral blood vessels in the diabetic patients.

Hua Guo¹, Yuhui Xiong^1,2, Sisi Li¹, Simin Liu¹, and Chun Yuan^3
1Center for Biomedical Imaging Research, Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing, China, ²Neusoft Medical Systems Co., Ltd., Shanghai, China, ³Vascular Imaging Laboratory, Department of Radiology, University of Washington, Seattle, WA, United States

Simultaneous Non-contrast Angiography and intraPlaque imaging (SNAP), a non-contrast enhanced MRA technique, shows great potentials for either static artery imaging or 4D time-resolved artery imaging. Arterial spin labeling (ASL) based imaging techniques can also be used for dynamic MRA, e.g., 4D time-resolved angiography non-contrast enhanced (4D-TRANCE). Both of them are compatible with parallel imaging thus practical for clinical usage. But they are based on different principles and their performance comparison is desired. This study aims to compare 4D-SNAP and 4D-TRANCE. Results show 4D-SNAP provides 4D dynamic MRA with higher SNR and fewer artifacts than 4D-TRANCE using either TFE or TFE-EPI.

Anders Gould¹, Zhensen Chen¹, Zechen Zhou², Niranjan Balu¹, Thomas Hatsukami³, and Chun Yuan^1
1Vascular Imaging Lab and Bio-Molecular Imaging Center, Radiology, University of Washington, Seattle, WA, United States, ²Philips Research North America, Cambridge, MA, United States, ³Surgery, University of Washington, Seattle, WA, United States

TOF and SNAP are both useful angiographic imaging sequences. In this study, we compared signal patterns of intracranial arteries depicted by the two techniques and explored their relationship with blood flow velocity. Twenty-four subjects with carotid atherosclerosis were imaged. The number of distal intracranial branches were scored based on the MRA images. SNAP showed more variation across subjects than TOF. TOF MRA score seems more strongly correlated with carotid velocity. This suggests TOF MRA may be more robust, while SNAP MRA may be more sensitive to flow change, although the underlying mechanism needs further clarification in the future.

Xiaoyong Hao¹, Jiang Wu¹, Chaohui Yang¹, Lina Zhu¹, Heng Niu¹, Xia Zhang¹, Xuan Li¹, and Kaiyu Wang^2
1Shanxi Cardiovascular Hospital, TaiYuan, China, ²GE Healthcare, MR Research China, BeiJing, China

This work assessed the application of cardiovascular magnetic resonance feature tracking (CMR-FT) technique in evaluation of myocardium deformation in patients with early hypertrophic cardiomyopathy and hypertensive heart disease. From the results we can see that the CMR-derived feature tracking technology could detect impairment of left ventricula myocardial deformation in patients with early hypertrophic cardiomyopathy and early hypertensive heart disease, even in patients with normal LVEF.

Delphine Perie¹, Egidie Uwase¹, Tanguy Artz¹, Marianna Gamba¹, and Daniel Curnier^2
1Mechanical Engineering, Polytechnique Montreal, Montreal, QC, Canada, ²Kinesiology, University of Montreal, Montreal, QC, Canada

Swine myocardium mechanical properties were found related to a combination of CMR relaxations times, magnetization transfer and diffusion parameters. Thus we assessed the relationships between mechanical properties and CMR parameters in childhood acute lymphoblastic leukemia survivors. The results showed that the pressure at diastasis, contractility and stiffness properties of the left ventricle can be partially predicted from the relaxation times T1 and T2 and the partition coefficient, reflecting cardiac health in childhood acute lymphoblastic leukemia. This indirect estimation of the mechanical behavior of the myocardium from multiparametric MRI could solve the challenging early cardiac sequelae detection.

Delphine Perie¹, Maxime Caru², Marianna Gamba¹, Louise Leleu¹, and Daniel Curnier^2
1Mechanical Engineering, Polytechnique Montreal, Montreal, QC, Canada, ²Kinesiology, University of Montreal, Montreal, QC, Canada

In childhood leukemia survivors, doxorubicin leads to dose-dependent cardiotoxicity, despite early diagnosis with both echocardiography and MRI investigations. Physical activity has the potential to reduce the chronic disease risk, but it is currently unknown whether a good cardiorespiratory fitness or the regular practice of physical activity is enough to induce a preventive action on the cardiac function. This study included 81 ALL survivors and found that a good cardiorespiratory fitness was associated with a better preventive fraction, similarly to a good physical activity level. It would be more than 80% of the survivors who could benefit from these long-term effects.

Eleanor F Cox¹, Latha Gullapudi^2,3, Charlotte E Buchanan¹, Kelly White³, Sebastian Coleman¹, Bernard Canaud⁴, Maarten W Taal^2,3, Nicholas M Selby^2,3, and Susan T Francis^1
1Sir Peter Mansfield Imaging Centre, University of Nottingham, Nottingham, United Kingdom, ²Centre for Kidney Research and Innovation, University of Nottingham, Derby, United Kingdom, ³Renal Unit, University Hospitals of Derby and Burton NHS Foundation Trust, Derby, United Kingdom, ⁴Fresenius Medical Care, Bad Homburg, Germany

12 patients received standard (SHD) and cooled (CHD) haemodialysis in a randomized cross-over study. Participants underwent serial cardiac and brain multiparametric MRI before, during and after dialysis. Cerebral blood flow velocities fell significantly during dialysis (carotid artery -19±2%, p<0.001; basilar artery -16±3%, p=0.004). Cardiac index and stroke volume index fell significantly during dialysis (-29±2% and -32±2%, both p<0.001). After two weeks of CHD, pre-dialysis left ventricle (LV) myocardial T1 and wall mass (WM) were lower compared to SHD (T1: 1266(37)ms vs. 1311±18ms, p=0.02; LV WM: 128±12g vs. 137±12g, p=0.003), indicating reduced myocardial tissue oedema with CHD.

Hao Li^1,2, Steffen Just³, Qinghua Lu², and Volker Rasche^1,3
1Core Facility Small Animal Imaging, Ulm University, ULM, Germany, ²Department of Cardiology, The Second Hospital of Shandong University, Jinan, China, ³Department of Internal Medicine II, Ulm University Medical Center, Ulm, Germany

Cardiac magnetic resonance imaging feature tracking (CMR-FT) is a novel non-invasive imaging technique and has been validated in clinical applications. However, there are only limited studies in small animal research. We performed biventricular strain assessment using CMR-FT in nexiline knock-out mice at rest and dobutamine stress to evaluate its feasibility and intra-observer reproducibility in preclinic research. Excellent intra-observer reproducibility could be observed for rest and stress left ventricular (LV) strain in general and right ventricular (RV) circumferential strain derived from short-axis views. An only fair reproducibility was observed for RV longitudinal strain under stress conditions derived from long-axis views.

Xue-Zhe Lu¹, Ming-Ting Wu², Ken-Pen Weng^3,4, and Hsu-Hsia Peng^1
1Department of Biomedical Engineering and Environmental Sciences, National Tsing Hua University, Hsinchu, Taiwan, ²Department of Radiology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, ³Department of Pediatrics, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, ⁴Department of Pediatrics, National Yang-Ming University, Taipei, Taiwan

We aimed to investigate the interaction between systolic myocardial and intraventricular kinetic energy (KE_myo, KE_ven) in Fontan patients. The tissue phase mapping and 4D flow datasets were acquired for calculation of KE_myo and KE_ven. The Fontan group showed decreased peak and mean systolic KE_ven, and decreased peak and mean systolic KE_myo. The KE delay, describing the subtraction of time-to-peak KEmyo from time-to-peak KE_ven, in Fontan group significantly correlated with peak and mean systolic KE_ven. In conclusion, the correlation between KE delay and KE_ven illustrated the adverse impact of abnormal energy transferring mechanism on the single functional ventricle in Fontan patients.

Ravneet Vohra¹, Guy Odom², Jeffrey S Chamberlain^2,3, and Donghoon Lee^1
1Radiology, University of Washington, Seattle, WA, United States, ²Neurology, University of Washington, Seattle, WA, United States, ³Medicine, University of Washington, Seattle, WA, United States

Cardiomyopathy is an inevitable fate for patients with Duchenne muscular dystrophy (DMD) and is one of the major causes of mortality. Cardiovascular magnetic resonance (CMR) is increasingly being performed at very high magnetic field strength for small animal models of muscular dystrophy. The mdx mouse model is one of the most commonly used animal models for DMD. Recombinant adeno-associated viral vector-mediated gene transfer represents a promising approach for DMD. The aim of this study was to elucidate the functional impact of micro-dystrophin on cardiomyopathy in mdx mice using CMR as a non-invasive biomarker.

Dongchan Kim¹, Byungjai Kim², Kyoung-Nam Kim³, Jun-Young Chung⁴, HyunWook Park², and Yeji Han^3
1Samsung Electronics, Seoul, Republic of Korea, ²Department of Electrical Engineering, Korea Advanced Institute of Science and Technology, Daejeon, Republic of Korea, ³Department of Biomedical Engineering, Gachon University, Incheon, Republic of Korea, ⁴Gachon Advanced Institute for Health Sciences and Technology, Gachon University, Incheon, Republic of Korea

Balanced steady-state free precession (bSSFP) with electrocardiogram (ECG) triggering and breath-holding is a common MRI technique for examination of ventricular function. For whole-heart imaging, resting periods are often necessary between breath-holds because many patients find it difficult to perform successive breath-holds and this eventually prolongs the entire examination time. Although self-gating (SG) techniques can relieve the discomfort that comes from multiple breath-holds, the sampling efficiency is limited because the data from inspiration phases are discarded. In this work, we propose a new sampling strategy for efficient multi-slice cardiac cine imaging that acquires data with a reduced number of breath-holds.

Hugo Klarenberg¹, Jeroen H. P. M. van der Velde², Ilona A. Dekkers³, R. de Mutsert², J. Wouter Jukema⁴, Frits R. Rosendaal², Mark Gosselink⁵, Martijn Froeling⁵, Gustav J. Strijkers¹, S. Matthijs Boekholdt⁶, and Hildo J. Lamb^3
1Biomedical Engineering and Physics, Amsterdam UMC location AMC, Amsterdam, Netherlands, ²Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, Netherlands, ³Department of Radiology, Leiden University Medical Center, Leiden, Netherlands, ⁴Department of Cardiology, Leiden University Medical Center, Leiden, Netherlands, ⁵Department of Radiology, University Medical Center Utrecht, Utrecht, Netherlands, ⁶Department of Cardiology, Amsterdam UMC location AMC, Amsterdam, Netherlands

Heart failure with preserved ejection fraction is accompanied by diastolic dysfunction. Diastolic dysfunction is associated with metabolic dysregulations, particularly obesity.  Physical Activity might reduce this process improving diastolic function and left ventricular (LV) morphology. In this cross-sectional Netherlands Epidemiology of Obesity study, individuals underwent cardiovascular MRI to asses diastolic function and LV Morphology. Physical Activity was determined via the SQUASH questionnaire. Multivariable linear regression was performed adjusting for metabolic covariates. Physical Activity was moderately associated to diastolic function and strongly to LV Morphology. Conclusively,  associations of diastolic function and LV morphology with Physical Activity can be determined accurately by MRI.

Ronald J. Beyers¹, Adil Bashir¹, and Thomas S. Denney^1
1MRI Research Center, Auburn University, Auburn University, AL, United States

Cine frame-rate quantification of myocardial strain has been previously demonstrated with 2D echo-planar and 2D/3D spiral sequence versions of Displacement Encoding with Stimulated Echoes (DENSE).  While these non-conventional methods allow fast-acquisition, they are plagued with off-resonance limitations that has hindered their integration into mainstream cardiac MRI application.  Here we present a more conventional, accelerated-x4, balanced SSFP (bSSFP) version of Cardiac Cine 2D/3D DENSE with improved phase-cycled encoding for effective artifact suppression.  In vivo human scans at 3T demonstrated good agreement of myocardial radial (Err), circumferential (Ecc) and longitudinal (Ell) strains as reported in previous literature along with lower artifact degradation compared to standard complementary-encoded DENSE.

Ashitha Pathrose¹, Hassan Haji-Valizadeh^1,2, Roberto Sarnari¹, James Carr^1,2,3, and Daniel Kim^1,2
1Radiology, Northwestern University, Chicago, IL, United States, ²Biomedical Engineering, Northwestern University, Chicago, IL, United States, ³Medicine, Northwestern University, Chicago, IL, United States

Cardiac magnetic resonance feature-tracking (CMR-FT) has emerged as a reference standard for the evaluation of cardiac morphology and function. But, the performance of CMR-FT may be affected by data undersampling as done in several real-time cardiac MRI techniques. In our study, we evaluated the performance of CMR-FT for myocardial strain quantification from real-time cardiac cine MRI when compared to standard cardiac cine in cardiac disease patients. We found that even though there is good agreement between the values derived from the real-time and standard cine MRI, care should be taken as measures from the real-time cine can be underestimated.

Sven HF Jaeschke¹ and Aaron T Hess^1
1Oxford Centre For Clinical Magnetic Resonance Research, University of Oxford, Oxford, United Kingdom

A number of retrospective Cartesian encoding strategies exist for duel gated cardio-respiratory imaging, including freebreathing cine. If respiration and cardiac motion are known prospectively while scanning, is prospective sampling more efficient? To test this we developed an algorithm to prospectively handle variable acquisition durations for each cardio-respiratory bin while acquiring pre-defined Poisson-Disk variable density sampling masks. We compared this to a retrospective spiral profile Cartesian trajectory and found the prospective method had between 10% and 25% higher efficient for matched scan time and had between 20% and 40% higher peak-to-sidelobe ratio of the point-spread-function, which is beneficial for image reconstruction.

El-Sayed H Ibrahim¹, V Emre Arpinar¹, L Tugan Muftuler¹, Andrew Nencka¹, and Kevin Koch^1
1Medical College of Wisconsin, Milwaukee, WI, United States

Cardiac functional MRI has been established in clinical practice on 1.5T and 3T scanners; nevertheless, the capabilities of ultra-high field (UHF) MRI have not been fully exploited, which are expected to significantly improve image quality and provide information not obtainable at lower-field MRI. Despite its advantages, UHF MRI is challenging due to a number of technical issues, especially B1 and B0 inhomogeneities. In this study, we provide preliminary results of using a multi-channel transceiver modular coil and a dielectric pad towards optimizing UHF cardiac functional MRI by improving image quality and minimizing imaging artifacts.

Naledi Adam¹, James Clough¹, Ronald Mooiweer¹, Phuoc Dong¹, Li Huang¹, Reza Razavi¹, Kuberan Pushparajah¹, Amedeo Chiribiri¹, Andrew King¹, and Sébastien Roujol^1
1Biomedical Engineering Department, School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom

Cardiac magnetic resonance (CMR) imaging is commonly performed using ECG-triggering to restrain acquisition to a quiescent phase of the cardiac cycle (i.e. end-systole or mid-diastole). Identification of the rest periods is commonly performed by visual inspection on CINE images and is thus operator dependent, time consuming and requires a trained operator. In this study, a fully automated method was developed to detect the quiescent cardiac periods of the cardiac cycle from CINE images using an integrated convolutional neural network (CNN) and long short-term memory (CNN-LSTM) network.

Yuan Zheng¹, Lele Zhao², Zhongqi Zhang², Zhehao Zhang², Xingxian Shou¹, Haojie Li³, Jian Xu¹, Weiguo Zhang¹, Lu Huang³, and Liming Xia^3
1UIH America, Houston, TX, United States, ²United Imaging Healthcare, Shanghai, China, ³Tongji Hospital, Wuhan, China

Simultaneous multi-slice (SMS) imaging is an efficient MRI technique that better preserves SNR than conventional parallel imaging (PI). However, single-band images usually need to be acquired to provide references for slice-unaliasing, causing an untrivial scan time overhead in some scenarios. We extended a recently reported self-calibrated SMS imaging strategy based on RF phase modulation, and propose using gradient temporal modulation to achieve auto-calibrated SMS bSSFP, which avoids the bSSFP banding shift and is preferred in cardiac Cine due to its contrast and intrinsically high SNR. In-plane PI can also be incorporated with shared auto-calibration.

Shenglei Shu¹, Jing Wang¹, Xiaoyue Zhou², Chuangsheng Zheng¹, and Xiangquan Kong^1
1Radiology, Union Hospital, Tongji Medical College, Huazhong University of Scince and Technology, Wuhan, China, ²MR Collaboration, Siemens Healthineers Ltd., Shanghai, China

Understanding of ventricular noncompaction appearance with simultaneous hypertrophic cardiomyopathy remains to be improved, as conventional used markers may not be able to distinguish subtle variation between isolated ventricular noncompaction and hypertrophic cardiomyopathy. We utilize the myocardial strain analysis based on cine images to compare different subgroups in order to find clues of underlying pathophysiology. Remarkable difference of the strain value were found in hypertrophic cardiomyopathy patients compared with the isolated ventricular noncompaction ones.

Ashitha Pathrose¹, Roberto Sarnari¹, Sabeth Essl¹, Carson Herman¹, Daniel Gordon¹, Kelvin Chow^1,2, Benjamin Freed³, Michael Cuttica³, Michael Markl^1,4, and James Carr^1,3,4
1Radiology, Northwestern University, Chicago, IL, United States, ²Siemens Medical Solutions USA, Chicago, IL, United States, ³Medicine, Northwestern University, Chicago, IL, United States, ⁴Biomedical Engineering, Northwestern University, Chicago, IL, United States

Cardiac MR provides valuable information of the cardiac structure-function, but it is underutilized in the diagnosis and monitoring patients with pulmonary hypertension. In this study, we performed a comprehensive evaluation of the left ventricle in patients with pre-capillary pulmonary hypertension including feature-tracking strain, T1 mapping, and tissue phase mapping. We also evaluated the association of these CMR-derived quantitative measures with right heart catheterization derived pressure measurements.

Ping-Chen Wu¹, Zheng-Shen Lin¹, and Teng-Yi Huang^1
1Department of Electrical Engineering, National Taiwan University of Science and Technology, Taipei, Taiwan

In this study, we evaluated the open-source toolbox for heart segmentation by using cross-institutional datasets. Furthermore, we proposed to use a quality prediction socre to provide the estimation of the qualitfy of the cardiac segmentation. The QPS values were highly correlated to the Dice coefficients of the test datasets.

Patrick Magrath^1,2, Nyasha Maforo^2,3, Mike Loecher⁴, Grace Kim⁵, Holden H. Wu ^1,2,3, Ashley Prosper², Pierangelo Renella², Nancy Halnon⁶, and Daniel B. Ennis ^4
1Bioengineering, University of California, Los Angeles, CA, United States, ²Radiology, University of California, Los Angeles, CA, United States, ³Physics and Biology in Medicine IDP, University of California, Los Angeles, CA, United States, ⁴Radiology, Stanford University, Stanford, CA, United States, ⁵Biostatistics, University of California, Los Angeles, CA, United States, ⁶Pediatrics, University of California, Los Angeles, CA, United States

Duchenne Muscular Dystrophy is a common fatal inherited genetic disorder impacting 1:3800 male births, and cardiac failure is the primary source of mortality in this cohort. Decreases in LVEF measured by CINE and fibrosis measured by LGE are late and highly variable outcomes. Herein we demonstrate that peak systolic circumferential strain (E_cc) and Twist measured by MR Tagging provide evidence of earlier changes in cardiac function in a substantial DMD cohort, holding promising applications for patient treatment and the evaluation of novel therapeutics. 

Xitong Wang¹, Namgyun Lee², Adrienne E. Campbell-Washburn³, and Krishna S. Nayak^1
1Electrical Engineering, University of Southern California, Los Angeles, CA, United States, ²Biomedical Engineering, University of Southern California, Los Angeles, CA, United States, ³National Heart, Lung, and Blood Insititute, National Institues of Health, Bethesda, MD, United States

There is renewed interest in high-performance low field imaging, especially for applications that are limited by susceptibility and SAR, such as cardiac CINE bSSFP imaging.  Here, we demonstrate a framework for realistic simulation of 3D CINE bSSFP cardiac imaging at various field strengths. This is benchmarked against in-vivo data acquired on a high-performance 0.55 Tesla MRI.  We utilize the XCAT phantom, 3D stack of spiral sampling, and realistic noise.  This setup can be used to predict minimum field strength requirements and to test data sampling and reconstruction techniques.

Felicia Seemann^1,2, Jonathan Berg^1,3, Kristian Solem³, Robert Jablonowski¹, Håkan Arheden¹, Marcus Carlsson¹, and Einar Heiberg^1,2,4
1Clinical Physiology, Lund University, Lund, Sweden, ²Biomedical Engineering, Lund University, Lund, Sweden, ³Syntach AB, Lund, Sweden, ⁴Wallenberg Center for Molecular Medicine, Lund University, Lund, Sweden

The concept of global left ventricular force-length loops is introduced as a method for quantifying the contribution to stroke work resulting from longitudinal and radial pumping mechanics, and validated in an animal model. The force-length loops can be derived noninvasively using cardiovascular magnetic resonance and a brachial cuff pressure. We found that longitudinal and radial pumping contributes equally to stroke work in healthy controls and patients with dilated ischemic cardiomyopathy, but that the longitudinal pumping is more energy efficient in delivering stroke volume compared to radial pumping. 

Hsin-Jung Yang¹, John Stager¹, Linda Azab¹, Waishing Liu¹, Meng Lu¹, Yuheng Huang¹, Ghazal Yoosefian¹, Skyler Selvin¹, Richard Handelin¹, Yujie Shan¹, Fardad Michael Serry¹, Yibin Xie¹, Anthony Christodoulou¹, Xiaoming Bi¹, Rohan Dharmakumar¹, Debiao Li¹, and Hui Han^1
1Cedars-Sinai Medical Center, Los Angeles, CA, United States

B0-field inhomogeneity caused by tissue-air interface has been a long standing challenge in high field(>=3T) cardiac MRI. Although high-order shimming methods has been proposed in recent publications using surface shimming coils, the shimming capability in deep tissue, such as the heart, is still limited due to the restrained current amplitudes and the geometry constraints of the receiving loops. In this study, we developed a cardiac high-order shimming coil based on a novel coil decoupling design to overcome the aforementioned limitations. We demonstrated the developed coil can successfully reduce B0 field variation by 50% in the whole-heart in healthy human volunteers.  

Yichen Zheng¹, Ziling Jiao¹, Aiqi Sun², Bo Zhao^3,4, and Rui Li^1
1Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University, Beijing, China, ²Neusoft Medical Systems, Shanghai, China, ³Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Chalestown, MA, United States, ⁴Department of Radiology, Harvard Medical School, Boston, MA, United States

Non gated real-time cardiac MR imaging with Partial Separable model provides a promising way to overcome the limitation of conventional cine imaging. The new method is able to capture the beat by beat variation, which is especially suitable for arrhythmia. In this study, we have 2 aims. First, to evaluate the consistency of parameters between the conventional cine method and the PS model based real-time method, and second, to capture beat by beat variation in arrhythmia patient.

Zhaoxia Yang¹, Liming Xia², and Haojie Li^2
1Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan,Hubei province, China, ²Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan,Hubei province, China

Preclinical left ventricular myocardial deformation involvement in the hypertension(HTN) patients could be detected by cardiovascular magnetic resonance feature tracking (CMR-FT). Impaired GRS,GCS,GLS and relevant diastolic longitudinal strain parameters might be associated with alterlation of left ventricular myocardial microstructure and the subtle decrease of diastolic function in the early asymptomatic HTN subjects.CMR-FT derived strain analysis has great potential to predict LVEF change and guide an appropriate treatment.

El-Sayed H Ibrahim¹, Pierre Croisille², and John LaDisa^3
1Medical College of Wisconsin, Milwaukee, WI, United States, ²Jean-Monnet University, Lyon, France, ³Marquette University, Milwaukee, WI, United States

Coarctation of the aorta (CoA) is a constriction of the descending thoracic aorta and is one of the most common congenital cardiovascular defects affecting 5,000-8,000 births annually in USA. Patients with CoA can have hyperdynamic and remodeled left ventricle from increased afterload. The mechanisms of morbidity from CoA are difficult to study in clinical setting due to the patients’ heterogeneity from confounding variables and concomitant anomalies. To remove these barriers, we adapted a novel rabbit model of CoA, which we scanned using MRI to study CoA-induced alterations in global and regional cardiac function and compare results to measurements from controls.

El-Sayed H Ibrahim¹, Dhiraj Baruah¹, Pierre Croisille², Jadranka Stojanovska³, Jason Rubenstein¹, Rachel Schlaak¹, Anne Frei¹, Elizabeth Gore¹, and Carmen Bergom^1
1Medical College of Wisconsin, Milwaukee, WI, United States, ²Jean-Monnet University, Lyon, France, ³University of Michigan, Ann Arbor, MI, United States

Lung cancer is the most frequently diagnosed cancer worldwide. Radiation therapy (RT) is standard-of-care in one-third of the patients, where the incidence of cardiac complications in lung cancer patients after RT reaches 33%. The current paradigm for cardiotoxicity detection and management relies primarily upon assessment of ejection fraction (EF). However, cardiac injury can occur without a clear change in EF. In this study, we investigate the effect of RT on global and regional cardiac function and myocardial T1/T2 values. The results show the capability of regional cardiac MRI for depicting early changes in myocardial contractility pattern and tissue characterization post-RT.

Hernán Mella^1,2,3, Julio Sotelo^1,2,3, and Sergio Uribe^1,2,3,4
1Biomedical Imaging Center, Pontificia Universidad Católica de Chile, Santiago, Chile, ²Millenium Nucleus for Cardiovascular Magnetic Resonance, Santiago, Chile, ³Department of Electrical Engineering, Pontificia Universidad Católica de Chile, Santiago, Chile, ⁴Department of Radiology, Pontificia Universidad Católica de Chile, Santiago, Chile

In this work, we introduce the Phase Complementary Spatial Modulation of Magnetization (PCSPAMM) acquisition sequence, designed to measure the tissue motion simultaneously with the flow velocity. With a pair of complementary acquisitions, PCSPAMM allows the estimation of a CSPAMM and a Phase-Contrast (PC) MR image, leading to improved tagging contrast and artifacts-free PC images at any cardiac phase.

Eric D Carruth¹, Samuel W Fielden¹, Christopher D Nevius¹, Brandon K Fornwalt¹, and Christopher M Haggerty^1
1Geisinger, Danville, PA, United States

Myocardial strain is a highly sensitive measure of heart function, but techniques to measure strain, such as displacement-encoded (DENSE) MRI, typically focus on the left ventricle, despite known clinical importance of right ventricle mechanics. The high resolution required to measure right ventricular strains is possible using navigator-based approaches; however, these are time-consuming and impractical for broad use. DENSE with outer volume suppression has been applied during a breath hold in the left ventricle, and may also enable resolving the right ventricle. We implemented DENSE with outer volume suppression and achieved similar 3D biventricular strain measurements compared to a navigator-based acquisition.

Jianing Pang¹, Pedro Itriago Leon², Xiaoming Bi³, Gary McNeal¹, Christoph Forman⁴, Christianne Leidecker¹, and Prakash M. Masand^5
1Siemens Medical Solutions USA Inc., Chicago, IL, United States, ²Siemens Medical Solutions USA Inc., Houston, TX, United States, ³Siemens Medical Solutions USA Inc., Los Angeles, CA, United States, ⁴Siemens Healthcare, Erlangen, Germany, ⁵Texas Children's Hospital, Houston, TX, United States

Free-breathing cardiac cine imaging is desirable for improving patient experience, expanding CMR eligibility, achieving robust image quality for uncooperative subjects, and simplifying CMR workflow. In this work, we propose a prototype technique, RTCSCineMoCo, that combines highly accelerated real-time acquisition, compressed sensing reconstruction, and retrospective, fully automated respiratory motion correction. In a preliminary evaluation on four volunteers, RTCSCineMoCo achieved similar spatiotemporal resolution, visually comparable image quality, and consistent LV function parameters as the reference breath-hold technique. RTCSCineMoCo is a promising option for free-breathing cardiac cine imaging, and further studies are warranted to evaluate its feasibility and utility in a clinical setting.

Xingxian Shou¹, Yuan Zheng¹, Qi Liu¹, Masoud Edalati¹, Lele Zhao², Junpu Hu², Jian Xu¹, Weiguo Zhang¹, Donel Tani³, and Nael F. Osman^3
1MR, UIH America, Inc., Houston, TX, United States, ²MR, United Imaging Healthcare, Shanghai, China, ³Myocardial Solutions, Inc., Morrisville, NC, United States

SENC MRI is an important technique for myocardium strain quantification. We proposed a modified SENC EPI sequence to only acquire about half of the total cardiac phases in order to get higher SNR strain images. The minimum strains can still be calculated with better SNR from LT/HT images. With the imaging time kept the same at one heartbeat, the SNR of the images is higher and strain calculation is more accurate. The timing of the end-systole stage can be determined by running a CINE scan prior to the SENC protocol.