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Anne Spakman¹, Eric M Schrauben¹, Renske Merton¹, Gustav J Strijkers², Aart J Nederveen¹, Marco JW Götte³, and Bram F Coolen^2
1Department of Radiology & Nuclear Medicine, Amsterdam UMC, Amsterdam, Netherlands, ²Department of Biomedical Engineering & Physics, Amsterdam UMC, Amsterdam, Netherlands, ³Department of Cardiology, Amsterdam UMC, Amsterdam, Netherlands

Keywords: Arrhythmia, MR-Guided Interventions, Real-time imaging

We propose Cardiac Library Based Real-time Imaging (CALIBRI), which allows the use of the same data for both catheter tracking and real-time visualization of cardiac motion states. This is achieved by matching the acquired k-lines with a library of pre-acquired cardio/respiratory gated 3D CINE data. In this study, we implemented our novel method on a 3T MRI system and showed the feasibility of this approach in multiple healthy volunteers.

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Qingle Kong¹, Zhe Zhang^2,3, and Jing Jing^2,3,4
1MR Collaboration, Siemens Healthineers Ltd., Beijing, China, ²Tiantan Neuroimaging Center of Excellence, Beijing, China, ³Beijing Tiantan Hospital, Capital Medical University, China National Clinical Research Centre for Neurological Diseases, Beijing, China, ⁴Beijing Tiantan Hospital, Capital Medical University, Neurology Department, Beijing, China

Keywords: Vessels, Segmentation, perforating arteries segmentation

The evaluation of perforating arteries is important for the diagnosis of small vessel disease. It’s challenging to image perforating arteries because of their small caliber size, which requires an extremely high resolution. Moreover, to determine pathological changes, the vessel trees need to be segmented and quantified. In this study, an automatic 3D Segmentation method was introduced and perforating arteries around the Circle of Willis were segmented and quantified. The number of stems of perforators was counted and compared based on segmentation results and MIPs images. The results revealed that the segmentation method robustly achieved the segmentation of perforators.

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Thekla Helene Oechtering^1,2, AMK Muntasir Shamim³, David Harris⁴, Nikolaos Panagiotopoulos^1,2, Alma Spahic⁵, Oliver Wieben^1,6, Kevin M Johnson^1,3, Alejandro Roldán-Alzate^1,7,8, and Scott B Reeder^1,6,7,8,9
1Department of Radiology, University of Wisconsin-Madison, Madison, USA, WI, United States, ²Department of Radiology and Nuclear Medicine, Universität zu Lübeck, Lübeck, Germany, ³Department of Electrical and Computer Engineering, University of Wisconsin-Madison, Madison, USA, WI, United States, ⁴University of Wisconsin-Madison, Madison, USA, WI, United States, ⁵Department of Medical Physics, University of Wisconsin-Madison, Madison, USA, WI, United States, ⁶Department of Medical Physics, University of Wisconsin-Madison, Madison, WI, United States, ⁷Department of Mechanical Engineering, University of Wisconsin-Madison, Madison, WI, United States, ⁸Department of Biomedical Engineering, University of Wisconsin-Madison, Madison, WI, United States, ⁹Department of Emergency Medicine, University of Wisconsin-Madison, Madison, WI, United States

Keywords: Flow, Liver

Constant, non-pulsatile flow in the portal venous system offers the possibility of time-averaged reconstruction for shortening the acquisition time. We acquired both a 10min and 3min radial 4D flow MRI (PCVIPR) in 10 subjects in a test-retest paradigm. Time-averaged 10min and 3min exams were compared to the reference standard, i.e., cardiac-phase resolved 10min exam (14 timeframes). All datasets were analyzable with quality rated as “good” for all 3min exams. Small vessels were best visualized in the time-averaged 10min data. Conservation of mass analysis and test-retest repeatability yielded excellent results for all reconstructions. Quantitative results agreed well between reconstructions. 

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Verónica Aramendía-Vidaurreta^1,2, Sergio M. Solís-Barquero^1,2, Marta Vidorreta³, Ana Ezponda^1,2, Gorka Bastarrika^1,2, and María A. Fernández-Seara^1,2
1Radiology, Clínica Universidad de Navarra, Pamplona, Spain, ²IdiSNA, Instituto de Investigación Sanitaria de Navarra, Pamplona, Spain, ³Siemens Healthineers, Madrid, Spain

Keywords: Heart, Perfusion

Myocardial perfusion can be quantitatively measured noninvasively using arterial spin labeling (ASL). Motion due to the cardiac cycle is tackled with the use of single- or double-ECG gating. The goals of this study were to investigate the performance of double-gating, in synchronized breathing myocardial ASL with presaturation pulses by comparison with single-gating, and to compare the different quantification strategies for double-gated data. This study showed that double-gating is more robust to heart rate variability than single-gating in synchronized breathing ASL sequences with presaturation pulses, but accurate saturation-recovery fitting requires the acquisition of several baseline images.

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Michael Loecher^1,2, Priya J Nair³, and Daniel B Ennis^1,2
1Radiological Sciences Laboratory, Stanford University, Stanford, CA, United States, ²Radiology, Veterans Administration Health Care System, Palo Alto, CA, United States, ³Bioengineering, Stanford University, Stanford, CA, United States

Keywords: Flow, Velocity & Flow

In this work, we introduce an optimized motion encoding strategy for flow measurements that simultaneously and non-colinearly encodes velocity and acceleration into data phase. This enables velocity-based flow measurements and improves pressure gradient mapping derived from the acceleration data.  The method is tested in a stenotic flow phantom, where the proposed method shows good velocity agreement with conventional 4D-flow methods, while also producing improved pressure gradient maps when compared to both 4D-flow and a CFD reference.

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Masami Yoneyama¹, Takayuki Sakai², Yasuhiro Goto³, Masanobu Nakamura¹, Daichi Murayama², Michinobu Nagao⁴, Shuo Zhang⁵, Kayoko Abe⁴, Yutaka Hamatani³, Kazuo Kodaira³, Takumi Ogawa³, Mana Kato³, Isao Shiina³, and Marc Van Cauteren^6
1Philips Japan, Tokyo, Japan, ²Department of Radiology, Eastern Chiba Medical Center, Chiba, Japan, ³Department of Radiological Services, Tokyo Women's Medical University, Tokyo, Japan, ⁴Department of Diagnostic Imaging and Nuclear Medicine, Tokyo Women’s Medical University, Tokyo, Japan, ⁵Philips Healthcare, Hamburg, Germany, ⁶Philips Healthcare, Best, Netherlands

Keywords: Vessels, Blood vessels

A new non-contrast-enhanced, relaxation-based, flow-independent MRA method, called Relaxation-Enhanced Angiography without ContrasT (REACT) has recently been proposed for vascular imaging. One of the major limitations of REACT is that bright signal of long-T1 fluids such as CSF is visible, which can obscure vascular structure in the intracranial vessels. We developed a new sequence, called DIRECT (Dual-Inversion REaCT) with modified magnetization preparation scheme of REACT to suppress CSF signals while maintain the high signal intensity from vessels. DIRECT enables robust and high-quality whole-brain intracranial MR angiography with uniform fat, CSF and brain parenchyma suppression within clinically feasible scan time.

Zheng Tan¹, Mingming Lu², Shuai Liu¹, Shitong Liu², Hongtao Zhang², Xiaoying Tang¹, Jianming Cai², and Fei Shang^1
1Department of Biomedical Engineering, School of Life Science, Beijing Institute of Technology, Beijing, China, ²Department of Radiology, The Fifth Medical Center of PLA General Hospital, Beijing, China

Keywords: Vessels, Stroke

Moyamoya disease (MMD) is a rare chronic progressive cerebrovascular disease that causes strokes. For the diagnosis of MMD, time-of-flight magnetic resonance angiography (TOF-MRA) can be an alternative to digital subtraction angiography (gold standard) owing to its non-invasive and radiation-free attributes. In this study, the deep learning method (ResNet-50) was used for MMD automatic diagnosis on the maximum intensity projection images from 3D TOF-MRA, and five-fold cross-validation was used for validation. The method exhibits the accurate ability (AUC: 0.990 ± 0.008, accuracy: 0.933 ± 0.063) to identify MMD and has the potential to improve the clinical management of MMD.

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Zhiliang Wei^1,2, Yuguo Li^1,2, Adnan Bibic², Jiadi Xu^1,2, and Hanzhang Lu^1,2,3
1Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, United States, ²F. M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Research Institute, Baltimore, MD, United States, ³Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, MD, United States

Keywords: Flow, Animals

CBF measurements in mice were often confounded by the utilizations of anesthesia, which are generally vasoactive. Here, we aimed to systematically understand the relationships between CBF and related physiological factors, not only the anesthesia dose but also respiratory rate (RR), heart rate (HR), and exposure time to anesthesia. We found that CBF measurements in mice were affected by anesthesia dose and time, but can be corrected by using respiratory rate and heart rate. The correction scheme will facilitate applications of CBF measurements in mechanistic understanding of vascular diseases and preclinical therapeutic trials by providing anesthesia-independent CBF measurements.

Ping Tian¹, Ying Liu¹, Jianxiu Lian², Minwen Zheng¹, Jingji Xu¹, and Jianmin Zheng^1
1Department of Radiology, The First Affiliated Hospital of Air Force Medical University, Xi’an, China, ²Philips Healthcare, Beijing, China

Keywords: Vessels, Myocardium, Coronary magnetic resonance angiography

Atherosclerotic lesions in coronary vessels cause vascular lumen stenosis or obstruction, resulting in myocardial ischemia, hypoxia or necrosis, which is an important cause of coronary heart disease. This study was designed to evaluate the performance of coronary magnetic resonance angiography(CMRA) sequence in volunteer subjects. The ability visualization of coronary Main Branch segments were no statistically significant difference in MRA coronary quality scores compared with CTA(p＞0.05) with sensitivity, specificity for per patient were 86%, 85%, respectively. The coronary artery visualization by CMRA can be used to detect clinically significant coronary artery stenosis in patients with suspected coronary heart disease.

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Preethi S Chandrasekaran¹, Chong Chen², Yingmin Liu¹, Christopher Crabtree³, Syed Murtaza Arshad⁴, Matthew Tong⁵, Yuchi Han⁵, and Rizwan Ahmad^2
1Davis Heart and Lung Research Institute, Ohio State University, Columbus, OH, United States, ²Biomedical Engineering, Ohio State University, Columbus, OH, United States, ³Department of Human Sciences, Ohio State University, Columbus, OH, United States, ⁴Electrical and Computer Engineering, Ohio State University, Columbus, OH, United States, ⁵Cardiovascular Medicine, Ohio State University, Columbus, OH, United States

Keywords: Heart, Velocity & Flow, Exercise CMR

A comprehensive exercise stress cardiovascular MRI (Ex-CMR) was performed in twelve healthy subjects. Biventricular quantification was performed from real-time cine, while hemodynamic parameters in the ascending aorta and main pulmonary artery were estimated using real-time flow. The acquisition process was repeated two to three times at increasing exercise intensities. The highly accelerated (R = 7-8 for cine and R = 16 for flow) real-time data were reconstructed inline using Gadgetron-based compressed sensing reconstruction. In agreement with the literature, the ejection fraction and cardiac output correlated positively with exercise intensity.

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Elizabeth Weiss¹, Justin Baraboo¹, Liliana Ma¹, Mariana B. L. Falcão², Christopher W. Roy², Matthias Stuber², and Michael Markl^1
1Radiology, Northwestern University, Chicago, IL, United States, ²University of Lausanne (CHUV), Lausanne, Switzerland

Keywords: Flow, Pulse Sequence Design

We illustrate a pilot study of the first implementation of dual-venc 5D flow MRI. We found excellent voxel-wise agreement with single-venc 5D flow in a pulsatile phantom. In two healthy controls, we find good agreement, but identify unexpected aliasing in the dual venc 5D flow which requires further investigation.

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Marianne Nabbout¹, Michael C Langham¹, Alessandra S Caporale^1,2,3, Wensheng Guo⁴, and Felix W Wehrli^1
1Department of Radiology, University of Pennsylvania, Philadelphia, PA, United States, ²Department of Neurosciences, Imaging and Clinical Sciences, G. d’Annunzio University’ of Chieti-Pescara, Chieti, Italy, ³Institute for Advanced Biomedical Technologies (ITAB), G. d’Annunzio University’ of Chieti-Pescara, Chieti, Italy, ⁴Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania, Philadelphia, PA, United States

Keywords: Vessels, Blood vessels, Vascular Reactivity, Oxygenation, Blood Velocity

To assess the acute effects of tobacco and electronic cigarette inhalation on vascular function, multiple MRI markers were analyzed in a study targeting peripheral, central and neurovascular beds of healthy young subjects. Smokers and vapers (9 subjects for a total N=15 study visits), ages 22 to 45 years, underwent two MRI scans, with a smoking or vaping challenge in between. Data from smoking/vaping challenges were combined to assess for their pooled effect. Smoking/vaping had significant acute effects on peripheral reactivity, notably on the superficial femoral artery flow-mediated dilation, baseline velocity and superficial femoral vein baseline oxygen saturation, among others.

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Yuehong Liu¹, Bin Sun², Xinyu Wang¹, Chen Zhang³, Xuewei Fan⁴, Zhenyu Li⁴, Jing An⁵, and Qi Yang^1
1Beijing Chaoyang Hospital, Capital Medical University, Beijing, China, Beijing, China, ²Fujian Medical University Union Hospital, Fuzhou, China, ³MR Scientific Marketing, Siemens Healthcare, Beijing, China, ⁴Central Hospital Affiliated to Xinxiang Medical University, Xinxiang, China, ⁵Siemens Shenzhen Magnetic Resonance Ltd., Shenzhen, China

Keywords: Vessels, Blood vessels, Ferumoxytol

This study suggested the feasibility of combining low-dose ferumoxytol (2.0-3.0 mg/kg) with ECG-triggered, navigator-gated, inversion-recovery prepared, segmented gradient-echo sequence to obtain high-quality sub-millimeter 3D whole-heart CMRA images under free-breathing for approximately 7 mins on MR 3.0T scanner. Compared to gadobenate, ferumoxytol produced more intense and prolonged cardiac vessel enhancement (24-36 hours) Ferumoxytol could help to reduce acquisition time of CMRA while maintaining a high signal-to-noise ratio, great image quality, and clear delineation of the coronary arteries. This study of healthy volunteers also suggested that ferumoxytol-enhanced CMRA has the potential to identify patients without coronary artery disease. 

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Kaiyu Zhang¹, Zhensen Chen², Yin Guo¹, Xin Wang³, Gador Canton⁴, Niranjan Balu⁴, Thomas Hatsukami⁵, Chun Yuan^4,6, and Xiaodong Ma^6
1Department of Bioengineering, University of Washington, Seattle, WA, United States, ²Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China, ³Department of Electrical Engineering, University of Washington, Seattle, WA, United States, ⁴Department of Radiology, University of Washington, Seattle, WA, United States, ⁵Department of Surgery, University of Washington, Seattle, WA, United States, ⁶Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, UT, United States

Keywords: Vessel Wall, Blood vessels

Acquiring multi-contrast images of intracranial vessels from one single MRI sequence is beneficial for comprehensive neurovascular disease diagnosis. Vessel wall (VW) images and dynamic MRA (dMRA) can be obtained from a time-efficient multi-contrast sequence named iSNAP. However, the previously adopted k-space sharing reconstruction method generated high-quality dMRA but low-quality VW images. In this study, we aim to develop a novel low-rank-based image reconstruction method to reconstruct VW and dMRA from highly undersampled 4D MRI. High quality VW images with sharper wall delineation are obtained, while hemodynamic information from dMRA is preserved.

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Bastien Milani¹, Christopher Roy¹, Jean-Baptist Ledoux¹, David C. Rotzinger¹, Salim Si-mohamed^1,2,3, Ambra Masi¹, Jerome Yerly^1,4, Tobias Rutz¹, Milan Prsa¹, Jurg Schwitter¹, and Matthias Stuber^1,4
1Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland, ²INSA-Lyon, CNRS, Inserm, CREATIS, Université de Lyon,, Villeurbanne, France, ³Louis Pradel Hospital, Hospices Civils de Lyon, Bron, France, ⁴Center for Biomedical Imaging (CIBM), Lausanne, Switzerland

Keywords: Heart, Cardiovascular, ejection fraction

We present in this work a 3D-CINE whole-heart reconstruction that we developed for free-running 3D‑radial fully self-gated acquisitions. The reconstruction is compressed-sensing-based with temporal-total-variation (tTV) regularization, which is known to corrupt or compress motion and to blur moving structures. In order to solve these drawbacks, we regularize by an improved tTV equal to the one-norm of the sum of the motion-corrected-residuals between adjacent frames. While this strategy has already been applied for various trajectories, it has never been applied for 3D-radial in free-running. In this study, we demonstrate quantitatively and qualitatively that this strategy in fact improves image quality.

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Sanja Dzelebdzic¹, Maher Abadeer¹, Gerald Greil¹, and Tarique Hussain^1
1Cardiac MRI, Children's Medical Center, UT Southwestern, Dallas, TX, United States

Keywords: Heart, Cardiovascular, image quality, ferumoxytol, contrast

With its concomitant ability to shorten the T1 relaxivity of blood and long intravascular half-life, ferumoxytol has become a popular “blood pool” contrast agent. The optimum contrast dose is not known. Reducing the ferumoxytol dose to 2 mg/kg is an efficient method to optimize the image quality, diagnostic performance, and achieve reduction in Gibbs’ truncation artefact. 

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Brandon K. Hardy¹, Judith Zimmermann², Nicholas S. Burris^1,3, Daniel B. Ennis⁴, David Marlevi^5,6, and David A. Nordsletten^1
1Dept. of Biomedical Engineering, University of Michigan, Ann Arbor, MI, United States, ²Dept. of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, United States, ³Dept. of Radiology, University of Michigan, Ann Arbor, MI, United States, ⁴Dept. of Radiology, Stanford University, Stanford, CA, United States, ⁵Dept. Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden, ⁶Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, MA, United States

Keywords: Quantitative Imaging, Blood vessels, Pressure Estimation

False lumen (FL) growth rate in type B aortic dissection (TBAD) is correlated with FL pressurization. 4D flow MRI allows for quantitative assessment of three-dimensional flow, including spatial mapping of relative pressure. Despite its promise, 4D flow relative pressure mapping has not yet been validated in a TBAD-specific context. Here, we validate a state-of-the-art proposed Stokes Estimator (STE) of relative pressure against catheter measurements using three physiologically accurate TBAD flow phantoms and subsequently analyze the method’s sensitivity to image noise. STE pressure estimates closely matched catheter data and were robust to noise, indicating STE’s potential for TBAD treatment planning.

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Sara Boccalini¹, Marta Beghella², Loic Boussel^1,2, Philippe Douek^2,3, Philippe Chevalier⁴, Claudia Prieto⁵, and Monica Sigovan^6
1Department of Radiology, HCL, Lyon, France, ²CREATIS, Lyon, France, ³Departement of Radiology, HCL, Lyon, France, ⁴Department of Cardiac Rythm, HCL, Lyon, France, ⁵School of Biomedical Engineering and Imaging Sciences, King’s College London, London, United Kingdom, ⁶CNRS, CREATIS Lab, Lyon, France

Keywords: Quantitative Imaging, Velocity & Flow

Respiratory motion effects thoracic blood flow mainly by intrathoracic pressure changes. In addition, deep-inspirations strongly increase the systemic venous return with immediate repercussions on right ventricular stroke volume. Simultaneously, pulmonary resistance is increased leading to decreased inflow in the left chambers, which is compensated in the following heartbeats. In patients with atrial myopathy (ex. atrial fibrillation), these adjustments might be more difficult. Our aim was to assess the impact of deep breathing on hemodynamic parameters in patients with atrial fibrillation, paroxysmal and permanent, and in a healthy population as compared to normal breathing.

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Syed Murtaza Arshad¹, Chong Chen², Yingmin Liu³, Preethi Chandrasekaran³, Christopher Crabtree⁴, Ning Jin⁵, and Rizwan Ahmad^2
1Department of Electrical & Computer Engineering, The Ohio State University, Columbus, OH, United States, ²Department of Biomedical Engineering, The Ohio State University, Columbus, OH, United States, ³Davis Heart and Lung Research Institute, The Ohio State University, Columbus, OH, United States, ⁴Department of Human Sciences, The Ohio State University, Columbus, OH, United States, ⁵Cardiovascular MR R&D, Siemens Medical Solutions Inc, Columbus, OH, United States

Keywords: Flow, Image Reconstruction, 4D Flow

Free-breathing self-gated CMR 4D flow imaging using traditional Compressed Sensing (CS) methods invariably contains motion artifacts due to the inaccuracy of self-gating signal. Self-gating signal degrades even further in the case of exercise stress imaging due to excessive movement of the subject. We propose Compressive recovery with Outlier Rejection (CORe) to reduce the motion artifacts. Using data from a 2D digital phantom and 4D flow data under rest and stress conditions, we demonstrate that CORe is effective in suppressing motion artifacts while maintaining agreement with 2D-PC based flow quantification.

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Satoshi Higuchi¹, Hideki Ota¹, Ryuichi Mori², Yuki Ichinoseki², Hiroki Kamada¹, and Kei Takase^1
1Diagnostic Radiology, Tohoku University Hospital, Sendai, Japan, ²Radiology, Tohoku University Hospital, Sendai, Japan

Keywords: Flow, Vessels, Aortic Dissection

Uncomplicated type B aortic dissection (AD) has a poor long-term outcome and further optimization of predictors for aortic expansion is required. Seventeen patients with chronic type B AD who underwent 4D flow MRI were included and divided into two groups based on the aortic growth rate. The morphological and hemodynamic parameters in each group were retrospectively analyzed. The forward flow and volume in true lumen and ratio of these parameters at entry and false lumen to true lumen were significantly higher in the fast growth-rate group than in the slow one; no morphological parameters showed a significant difference.