Fast and accurate multi-channel B1+ mapping based on the TIAMO technique for 7T UHF body MRI.

PURPOSE: Current methods for mitigation of transmit field B1+ inhomogeneities at ultrahigh field (UHF) MRI by multi-channel radiofrequency (RF) shimming rely on accurate B1+ mapping. This can be time consuming when many RF channels have to be mapped for in vivo body MRI, where the B1 maps should ideally be acquired within a single breath-hold. Therefore, a new B1+ mapping technique (B1TIAMO) is proposed. METHODS: The performance of this technique is validated against an established method (DREAM) in phantom measurements for a cylindrical head phantom with an 8-channel transmit/receive (Tx/Rx) array. Furthermore, measurements for a 32-channel Tx/Rx remote array are conducted in a large body phantom and the |B1+| map reliability is validated against simulations of the transmit RF field distribution. Finally, in vivo results of this new mapping technique for human abdomen are presented. RESULTS: For the head phantom (8-channel Tx/Rx coil), the single |B1+| comparison between B1 TIAMO, the direct DREAM measurements, and simulation data showed good agreement with 10-19% difference. For the large body phantom (32-channel Tx/Rx coil), B1TIAMO matched the RF field simulations well. CONCLUSION: The results demonstrate the potential to acquire 32 accurate single-channel B1+ maps for large field-of-view body imaging within only a single breath-hold of 16 s at 7T UHF MRI. Magn Reson Med 79:2652-2664, 2018. © 2017 International Society for Magnetic Resonance in Medicine.

Non-enhanced magnetic resonance imaging of unruptured intracranial aneurysms at 7 Tesla: Comparison with digital subtraction angiography.

PURPOSE: To prospectively evaluate non-contrast-enhanced 7-Tesla (T) MRA for delineation of unruptured intracranial aneurysms (UIAs) in comparison with DSA. MATERIAL AND METHODS: Forty patients with single or multiple UIAs were enrolled in this IRB-approved trial. Sequences acquired at 7 T were TOF MRA and non-contrast-enhanced MPRAGE. All patients additionally underwent 3D rotational DSA. Two neuroradiologists individually analysed the following aneurysm and image features on a five-point scale in 2D and 3D image reconstructions: delineation of parent vessel, dome and neck; overall image quality; presence of artefacts. Interobserver accordance was assessed by the kappa coefficient. RESULTS: A total of 64 UIAs were detected in DSA and in all 2D and 3D MRA image reconstructions. Ratings showed comparable results for DSA and 7-T MRA when considering all image reconstructions. Highest ratings for individual image reconstructions were given for 2D MPRAGE and 3D TOF MRA. Interobserver accordance was almost perfect for the majority of ratings. CONCLUSION: This study demonstrates excellent delineation of UIAs using 7-T MRA within a clinical setting comparable to the gold standard, DSA. The combination of 7-T non-enhanced MPRAGE and TOF MRA for assessment of untreated UIAs is a promising clinical application of ultra-high-field MRA. KEY POINTS: • Non-enhanced 7-T MRA allowed excellent delineation of unruptured intracranial aneurysms (UIAs). • Image quality at 7-T was comparable with DSA considering both sequences. • Assessment of UIAs is a promising clinical application of ultra-high-field MRA.

Variable slice thickness (VAST) EPI for the reduction of susceptibility artifacts in whole-brain GE-EPI at 7 Tesla.

OBJECTIVE: A new technique for 2D gradient-recalled echo echo-planar imaging (GE-EPI) termed 'variable slice thickness' (VAST) is proposed, which reduces signal losses caused by through-slice susceptibility artifacts, while keeping the volume repetition time (TR) manageable. The slice thickness is varied across the brain, with thinner slices being used in the inferior brain regions where signal voids are most severe. MATERIALS AND METHODS: Various axial slice thickness schemes with identical whole-brain coverage were compared to regular EPI, which may either suffer from unfeasibly long TR if appropriately thin slices are used throughout, or signal loss if no counter-measures are taken. Evaluation is based on time-course signal-to-noise (tSNR) maps from resting state data and a statistical group-level region of interest (ROI) analysis on breath-hold fMRI measurements. RESULTS: The inferior brain region signal voids with static B0 inhomogeneities could be markedly reduced with VAST GE-EPI in contrast to regular GE-EPI. ROI-averaged event-related signal changes showed 48% increase in VAST compared to GE-EPI with regular "thick" slices. tSNR measurements proved the comparable signal robustness of VAST in comparison to regular GE-EPI with thin slices. CONCLUSION: A novel acquisition strategy for functional 2D GE-EPI at ultrahigh magnetic field is presented to reduce susceptibility-induced signal voids and keep TR sufficiently short for whole-brain coverage.

7 Tesla quantitative hip MRI: T1, T2 and T2* mapping of hip cartilage in healthy volunteers.

OBJECTIVES: To evaluate the technical feasibility and applicability of quantitative MR techniques (delayed gadolinium-enhanced MRI of cartilage (dGEMRIC), T2 mapping, T2* mapping) at 7 T MRI for assessing hip cartilage. METHODS: Hips of 11 healthy volunteers were examined at 7 T MRI with an 8-channel radiofrequency transmit/receive body coil using multi-echo sequences for T2 and T2* mapping and a dual flip angle gradient-echo sequence before (T10) and after intravenous contrast agent administration (T1Gd; 0.2 mmol/kg Gd-DTPA(2-) followed by 0.5 h of walking and 0.5 h of rest) for dGEMRIC. Relaxation times of cartilage were measured manually in 10 regions of interest. Pearson's correlations between R1delta = 1/T1Gd - 1/T10 and T1Gd and between T2 and T2* were calculated. Image quality and the delineation of acetabular and femoral cartilage in the relaxation time maps were evaluated using discrete rating scales. RESULTS: High correlations were found between R1delta and T1Gd and between T2 and T2* relaxation times (all p < 0.01). All techniques delivered diagnostic image quality, with best delineation of femoral and acetabular cartilage in the T2* maps (mean 3.2 out of a maximum of 4 points). CONCLUSIONS: T1, T2 and T2* mapping of hip cartilage with diagnostic image quality is feasible at 7 T. To perform dGEMRIC at 7 T, pre-contrast T1 mapping can be omitted. KEY POINTS: • dGEMRIC of hip cartilage with diagnostic image quality is feasible at 7 T. • To perform dGEMRIC at 7 T, pre-contrast T1 mapping can be omitted. • T2(*) mapping of hip cartilage with diagnostic image quality is feasible at 7 T. • T2 and T2* relaxation times of cartilage were highly correlated at 7 T. • Best delineation of femoral and acetabular cartilage was found in T2* maps.

Microanatomy of the subcallosal artery: an in-vivo 7 T magnetic resonance angiography study.

OBJECTIVES: To investigate in-vivo microanatomy of the subcallosal artery branching from the anterior communicating artery (ACoA) using time-of-flight (TOF) magnetic resonance angiography (MRA) at 7 Tesla. METHODS: Seventy-five subjects, including 15 healthy volunteers and 60 patients, were included in this prospective study. Three raters characterized branches from ACoA in maximum intensity projections of TOF MRA at 7 Tesla acquired with 0.22 × 0.22 × 0.41 mm(3) resolution. Furthermore, course patterns and anatomical features of the subcallosal artery (maximum diameter, length, and branching angle from ACoA) were measured. RESULTS: Branches from the anterior communicating artery were visualized in 63 of 74 (85.1 %) subjects and were identified as the subcallosal artery (93.7 %) and the accessory anterior cerebral artery (6.3 %). The course of the subcallosal artery was classified into 3 groups; C-shaped (55.9 %), straight (16.9 %), and S-shaped (27.2 %). There was a significant difference between the branching angles of C-shaped and straight (p < 0.0001), between C-shaped and S-shaped (p < 0.0001), as well as between straight and S-shaped (p = 0.0113) course patterns. CONCLUSIONS: High-resolution in-vivo 7 T TOF MRA can delineate the microanatomy of the subcallosal artery. Three main variants of course patterns and branching angles from ACoA could be identified. KEY POINTS: • In-vivo 7 Tesla TOF MRA can delineate the subcallosal artery microanatomy • Three distinct course patterns of the subcallosal artery were identified • Branching angles from ACoA significantly differed between subcallosal artery course patterns.

Morphological imaging and T2 and T2* mapping of hip cartilage at 7 Tesla MRI under the influence of intravenous gadolinium.

OBJECTIVES: To investigate the influence of intravenous gadolinium on cartilage T2 and T2* relaxation times and on morphological image quality at 7-T hip MRI. METHODS: Hips of 11 healthy volunteers were examined at 7 T. Multi-echo sequences for T2 and T2* mapping, 3D T1 volumetric interpolated breath-hold examination (VIBE) and double-echo steady-state (DESS) sequences were acquired before and after intravenous application of gadolinium according to a delayed gadolinium-enhanced MRI of cartilage (dGEMRIC) protocol. Cartilage relaxation times were measured in both scans. Morphological sequences were assessed quantitatively using contrast ratios and qualitatively using a 4-point Likert scale. Student's t-test, Pearson's correlation (ρ) and Wilcoxon sign-rank test were used for statistical comparisons. RESULTS: Pre- and post-contrast T2 and T2* values were highly correlated (T2: acetabular: ρ = 0.76, femoral: ρ = 0.77; T2*: acetabular: ρ = 0.80, femoral: ρ = 0.72). Gadolinium enhanced contrasts between cartilage and joint fluid in DESS and T1 VIBE according to the qualitative (p = 0.01) and quantitative (p < 0.001) analysis. The delineation of acetabular and femoral cartilage and the labrum predominantly improved with gadolinium. CONCLUSIONS: Gadolinium showed no relevant influence on T2 or T2* relaxation times and improved morphological image quality at 7 T. Therefore, morphological and quantitative sequences including dGEMRIC can be conducted in a one-stop-shop examination. KEY POINTS: • Hip cartilage T2 values correlate highly before and after gadolinium at 7 T • Hip cartilage T2* values correlate highly before and after enhancement at 7 T • Morphological hip cartilage imaging benefits from intravenous gadolinium at 7 T • The delineation of acetabular and femoral cartilage can be improved by gadolinium • Morphological and quantitative sequences including dGEMRIC can be combined as a one-stop-shop examination.

Non-Enhanced MR Imaging of Cerebral Arteriovenous Malformations at 7 Tesla.

OBJECTIVE: To evaluate prospectively 7 Tesla time-of-flight (TOF) magnetic resonance angiography (MRA) and 7 Tesla non-contrast-enhanced magnetization-prepared rapid acquisition gradient-echo (MPRAGE) for delineation of intracerebral arteriovenous malformations (AVMs) in comparison to 1.5 Tesla TOF MRA and digital subtraction angiography (DSA). METHODS: Twenty patients with single or multifocal AVMs were enrolled in this trial. The study protocol comprised 1.5 and 7 Tesla TOF MRA and 7 Tesla non-contrast-enhanced MPRAGE sequences. All patients underwent an additional four-vessel 3D DSA. Image analysis of the following five AVM features was performed individually by two radiologists on a five-point scale: nidus, feeder(s), draining vein(s), relationship to adjacent vessels, and overall image quality and presence of artefacts. RESULTS: A total of 21 intracerebral AVMs were detected. Both sequences at 7 Tesla were rated superior over 1.5 Tesla TOF MRA in the assessment of all considered AVM features. Image quality at 7 Tesla was comparable with DSA considering both sequences. Inter-observer accordance was good to excellent for the majority of ratings. CONCLUSION: This study demonstrates excellent image quality for depiction of intracerebral AVMs using non-contrast-enhanced 7 Tesla MRA, comparable with DSA. Assessment of untreated AVMs is a promising clinical application of ultra-high-field MRA. KEY POINTS: • Non-contrast-enhanced 7 Tesla MRA demonstrates excellent image quality for intracerebral AVM depiction. • Image quality at 7 Tesla was comparable with DSA considering both sequences. • Assessment of intracerebral AVMs is a promising clinical application of ultra-high-field MRA.

Mitigation of B1(+) inhomogeneity on single-channel transmit systems with TIAMO.

In magnetic resonance imaging, there has been a constant drive to higher static magnetic field strengths (B0) to achieve a higher signal-to-noise ratio and new or enhanced contrasts. In today's high-field systems, severe problems regarding the homogeneity of the transmission field are encountered. Recently, an acquisition scheme called Time-Interleaved Acquisition of Modes has been proposed to tackle the inhomogeneity problems in high-field magnetic resonance imaging. The basic premise is to excite two (or more) different B1(+) modes using static radiofrequency shimming in an interleaved acquisition, where the complementary radiofrequency patterns of the two modes can be exploited to improve overall signal homogeneity. In its usual implementation, a multichannel transmit system is required. In this work, the goal is to present a simple and inexpensive hardware setup which makes it possible to use time-interleaved acquisition of modes on any single-channel transmit system while making use of the vendor-provided single-channel radiofrequency safety system. To demonstrate the efficacy of this setup, spin echo images from the pelvis are acquired at 7 T exhibiting no complete signal dropouts.

Contrast enhancement in TOF cerebral angiography at 7 T using saturation and MT pulses under SAR constraints: impact of VERSE and sparse pulses.

Cerebral three-dimensional time of flight (TOF) angiography significantly benefits from ultrahigh fields, mainly due to higher signal-to-noise ratio and to longer T(1) relaxation time of static brain tissues; however, specific absorption rate (SAR) significantly increases with B(0). Thus, additional radiofrequency pulses commonly used at lower field strengths to improve TOF contrast such as saturation of venous signal and improved background suppression by magnetization transfer typically cannot be used at higher fields. In this work, we aimed at reducing SAR for each radiofrequency pulse category in a TOF sequence. We use the variable-rate selective excitation principle for the slab selective TOF excitation as well as the venous saturation radiofrequency pulses. In addition, magnetization transfer pulses are implemented by sparsely applying the pulses only during acquisition of the central k-space lines to limit their SAR contribution. Image quality, angiographic contrast, and SAR reduction were investigated as a function of variable-rate selective excitation parameters and of the total number of magnetization transfer pulses applied. Based on these results, a TOF protocol was generated that increases the angiographic contrast by more than 50% and reduces subcutaneous fat signal while keeping the resulting SAR within regulatory limits.

A 32-channel parallel transmit system add-on for 7T MRI.

PURPOSE: A 32-channel parallel transmit (pTx) add-on for 7 Tesla whole-body imaging is presented. First results are shown for phantom and in-vivo imaging. METHODS: The add-on system consists of a large number of hardware components, including modulators, amplifiers, SAR supervision, peripheral devices, a control computer, and an integrated 32-channel transmit/receive body array. B1+ maps in a phantom as well as B1+ maps and structural images in large volunteers are acquired to demonstrate the functionality of the system. EM simulations are used to ensure safe operation. RESULTS: Good agreement between simulation and experiment is shown. Phantom and in-vivo acquisitions show a field of view of up to 50 cm in z-direction. Selective excitation with 100 kHz sampling rate is possible. The add-on system does not affect the quality of the original single-channel system. CONCLUSION: The presented 32-channel parallel transmit system shows promising performance for ultra-high field whole-body imaging.

Morphological and Quantitative 7 T MRI of Hip Cartilage Transplants in Comparison to 3 T-Initial Experiences.

OBJECTIVES: The aims of this study were to evaluate morphological and quantitative 7 T magnetic resonance imaging (MRI) hip sequences in patients after acetabular cartilage transplantation and to compare image quality with 3 T MRI. MATERIALS AND METHODS: Following approval from the local institutional ethics committee and signing informed consent, 9 patients with history of autologous acetabular cartilage transplantation were imaged at 7 T and 3 T MRI. Sequences (3-dimensional dual echo steady state, 3-dimensional T1 volume interpolated breath-hold examination, sagittal proton density [PD] turbo spin echo and coronal fat-saturated PD turbo spin echo, sagittal T1 mapping in dual flip angle technique, and multiecho spin echo/gradient echo sequences for T2 and T2* mapping) were applied after the intravenous application of Gd-DTPA according to a protocol for delayed gadolinium-enhanced MRI of cartilage and manual B1 shimming at 7 T. Images were compared intraindividually regarding image quality and assessability of cartilage structures using 5-point scales (1 = 3 T clearly superior, 5 = 7 T clearly superior) in consensus with 2 radiologists. Contrast ratios were calculated between articular cartilage, joint fluid, and subchondral bone. An adapted MOCART (MR observation of cartilage repair tissue) score was assessed independently at 3 T and 7 T. Relaxation times were measured in the transplanted acetabular region and in 2 reference regions by 2 readers independently to calculate interreader reliability. Statistical significances of field strength comparisons were calculated using Student t test and t test for dependent measurements. RESULTS: A 7 T MRI was superior to 3 T MRI in the majority of the sequences regarding subjective ratings. Furthermore, 7 T yielded comparable or better contrast ratios compared with 3 T. The criteria of the MOCART score matched totally at 3 T and 7 T, apart from the signal intensity of the repair tissue in PDw, which was rated higher at 7 T in 5 patients. Interreader reliability of all relaxation times was excellent. T1 and T2* relaxation times were significantly shorter at 7 T compared with 3 T. T2 relaxation times were longer at 7 T compared with 3 T without statistical significance. No significant difference could be seen when comparing the relaxation ratios (relaxation times after standardization to reference regions) of the cartilage transplant between the 2 field strengths. CONCLUSIONS: This study shows the feasibility of morphological and quantitative 7 T hip MRI in patients after acetabular cartilage transplantation and its predominant superiority regarding image quality, assessment of cartilage transplants, and contrast over 3 T MRI. To compare relaxation times between the field strengths, the calculation of intraindividual ratios is recommended.

Optimized selective lactate excitation with a refocused multiple-quantum filter.

Selective detection of lactate signals in in vivo MR spectroscopy with spectral editing techniques is necessary in situations where strong lipid or signals from other molecules overlap the desired lactate resonance in the spectrum. Several pulse sequences have been proposed for this task. The double-quantum filter SSel-MQC provides very good lipid and water signal suppression in a single scan. As a major drawback, it suffers from significant signal loss due to incomplete refocussing in situations where long evolution periods are required. Here we present a refocused version of the SSel-MQC technique that uses only one additional refocussing pulse and regains the full refocused lactate signal at the end of the sequence.

Investigation of the saturation pulse artifact in non-enhanced MR angiography of the lower extremity arteries at 7 Tesla.

When performing non-enhanced time-of-flight MR angiography of the lower extremity arteries at 7 T with cardiac triggering, the acquisition time is a crucial consideration. Therefore, in previous studies, saturation RF pulses were applied only every second TR. In the axial source images a slight artifact with an appearance similar to aliasing could be observed. The purpose of this study was to investigate the origin of this artifact. The reason for the artifact is supposed to be related to the two effective TRs during acquisition caused by the sparsely applied saturation RF pulse. Several sequence variants were simulated and implemented within the sequence source code to examine this hypothesis. An adaptation of the excitation flip angles for each TR as well as a correction factor for the k-space data was calculated. Additionally, a different ordering of the k-space data during acquisition was implemented as well as the combination of the latter with the k-space correction factor. The observations from the simulations were verified using both a static and a flow phantom and, finally, in a healthy volunteer using the same measurement setup as in previous volunteer and patient studies. Of all implemented techniques, only the reordering of the k-space was capable of suppressing the artifact almost completely at the cost of creating a ringing artifact. The phantom measurements showed the same results as the simulations and could thus confirm the hypothesis regarding the origin of the artifact. This was additionally verified in the healthy volunteer. The origin of the artifact could be confirmed to be the periodic signal variation caused by two effective TRs during acquisition.

Comparison of fat saturation techniques for single-shot fast spin echo sequences for 7-T body imaging.

OBJECTIVES: For T2-weighted abdominal images, homogenous fat suppression (FS) is crucial for diagnosis, but inherent B0/B1 inhomogeneities at 7 T lead to inhomogeneous FS and to tissue signal loss for most techniques. Here, 4 different FS techniques for single-shot fast spin echo were compared, whereby the recently proposed time-interleaved acquisition of modes (TIAMO) was used for the imaging portion of the sequence to reduce B1 artifacts. MATERIALS AND METHODS: Fat suppression techniques included a novel method using TIAMO (TIAMO FS: multiple fat-selective 90-degree radiofrequency pulses applied with alternating transmit radiofrequency modes), slice-selective gradient reversal (SSGR), slice-selective smaller bandwidth refocusing pulses (SSB), and the combination of SSGR and SSB with TIAMO FS. Ten volunteers were examined in 6 different ways in the following order: without any FS, with TIAMO FS, with SSGR, SSGR with preceding TIAMO FS, SSB, and SSB with preceding TIAMO FS. For evaluation of the techniques, regions of interests were placed identically for all 6 protocols per volunteer in subcutaneous fat, intra-abdominal fat, organs, and muscle. Overall image quality, artifacts, quality of subcutaneous/intra-abdominal/retroperitoneal FS, and homogeneity of FS were rated over the entire field of view by 2 experienced radiologists using a 5-point scale. RESULTS: Comparing the different FS techniques, only SSGR and SSGR combined with TIAMO FS led to a nearly homogeneous FS over the entire field of view and all slices. All other techniques showed severe FS inhomogeneities. Results of a radiologic evaluation confirmed the observations made by the quantitative analysis. CONCLUSIONS: Of the compared techniques, the most favorable was SSGR because, here, a homogeneous FS with moderate tissue signal loss of approximately 20% was achieved with no additional preparation pulses being necessary. Using this FS technique combined with TIAMO image acquisition, delineation between fat and bright liquids in single-shot fast spin echo images, which is essential for diagnosis, is possible at 7 T.

Improved cerebral time-of-flight magnetic resonance angiography at 7 Tesla--feasibility study and preliminary results using optimized venous saturation pulses.

PURPOSE: Conventional saturation pulses cannot be used for 7 Tesla ultra-high-resolution time-of-flight magnetic resonance angiography (TOF MRA) due to specific absorption rate (SAR) limitations. We overcome these limitations by utilizing low flip angle, variable rate selective excitation (VERSE) algorithm saturation pulses. MATERIAL AND METHODS: Twenty-five neurosurgical patients (male n = 8, female n = 17; average age 49.64 years; range 26-70 years) with different intracranial vascular pathologies were enrolled in this trial. All patients were examined with a 7 Tesla (Magnetom 7 T, Siemens) whole body scanner system utilizing a dedicated 32-channel head coil. For venous saturation pulses a 35° flip angle was applied. Two neuroradiologists evaluated the delineation of arterial vessels in the Circle of Willis, delineation of vascular pathologies, presence of artifacts, vessel-tissue contrast and overall image quality of TOF MRA scans in consensus on a five-point scale. Normalized signal intensities in the confluence of venous sinuses, M1 segment of left middle cerebral artery and adjacent gray matter were measured and vessel-tissue contrasts were calculated. RESULTS: Ratings for the majority of patients ranged between good and excellent for most of the evaluated features. Venous saturation was sufficient for all cases with minor artifacts in arteriovenous malformations and arteriovenous fistulas. Quantitative signal intensity measurements showed high vessel-tissue contrast for confluence of venous sinuses, M1 segment of left middle cerebral artery and adjacent gray matter. CONCLUSION: The use of novel low flip angle VERSE algorithm pulses for saturation of venous vessels can overcome SAR limitations in 7 Tesla ultra-high-resolution TOF MRA. Our protocol is suitable for clinical application with excellent image quality for delineation of various intracranial vascular pathologies.

Initial evaluation of non-contrast-enhanced magnetic resonance angiography in patients with peripheral arterial occlusive disease at 7 T.

OBJECTIVES: The aim of this study was to achieve initial experience with non-contrast-enhanced (ne) magnetic resonance angiography (MRA) of the lower leg arteries in patients with peripheral arterial occlusive disease (PAOD) at 7 T. MATERIALS AND METHODS: Seven patients with PAOD were examined on a 7-T whole-body magnetic resonance system. A custom-built 16-channel transmit/receive coil and a manually positionable AngioSURF table were used for multistation imaging. For ne-MRA, an axial T1-weighted Turbo-fast low angle shot sequence (repetition time, 700 milliseconds; echo time, 3.84 milliseconds; bandwidth, 930 Hz/pixel; voxel volume, 1 × 1 × 2 mm; matrix, 384 × 288) with phonocardiogram gating was acquired at 7 T. Acquisition time of an entire angiogram covering the vasculature from pelvis to feet amounted to approximately 30 minutes, depending on the patient's heart frequency. All patients underwent a contrast-enhanced MRA (ce-MRA) at 1.5 T as standard of reference. The presence of stenosis and occlusions was evaluated segment based and compared for both MRA techniques. The degree of stenosis was defined as low grade (<50%), high grade (50%-99%), and occlusion (100%). High-grade stenosis and occlusion were considered to be hemodynamically significant stenosis. RESULTS: The 7-T ne-MRA enabled a homogenous, hyperintense artery signal and nearly total venous suppression with accurate delineation of arterial anatomy both proximal and distal to stenotic disease. A total of 154 artery segments were depicted with ce-MRA at 1.5 T. At 7 T, only 124 segments (80.5%) were displayed and involved for analysis, as the iliacal region was displayed incompletely in 4 patients because of the fact that the fixed coil diameter was too small to contain the lower abdomen and pelvis of these patients. In comparison with ce-MRA at 1.5 T as the reference standard, there was total agreement regarding the characterization of an artery segment as being normal or having any kind of stenosis. Of the 124 included segments, 28 segments (23%) had hemodynamically significant stenosis evaluated with 7-T ne-MRA and 26 segments (21%) assessed with 1.5-T ce-MRA. The sensitivity and specificity values of 7-T ne-MRA for detecting segments with hemodynamically significant stenosis were 93% and 98%, respectively. CONCLUSIONS: Non-contrast-enhanced MRA by means of T1-weighted Turbo-fast low angle shot imaging at 7 T in patients with PAOD is feasible and allowed for good visualization of stenosis and occlusions in all analyzed artery segments in this small patient group. However, this study also shows the challenges of ultrahigh-field body imaging, and more experience is required to determine the impact of 7-T ne-MRA in clinical practice.

Sequence comparison for non-enhanced MRA of the lower extremity arteries at 7 Tesla.

In this study three sequences for non-contrast-enhanced MRA of the lower extremity arteries at 7T were compared. Cardiac triggering was used with the aim to reduce signal variations in the arteries. Two fast single-shot 2D sequences, a modified Ultrafast Spoiled Gradient Echo (UGRE) sequence and a variant of the Quiescent-Interval Single-Shot (QISS) sequence were triggered via phonocardiogram and compared in volunteer examinations to a non-triggered 2D gradient echo (GRE) sequence. For image acquisition, a 16-channel transmit/receive coil and a manually positionable AngioSURF table were used. To tackle B1 inhomogeneities at 7T, Time-Interleaved Acquisition of Modes (TIAMO) was integrated in GRE and UGRE. To compare the three sequences quantitatively, a vessel-to-background ratio (VBR) was measured in all volunteers and stations. In conclusion, cardiac triggering was able to suppress flow artifacts satisfactorily. The modified UGRE showed only moderate image artifacts. Averaged over all volunteers and stations, GRE reached a VBR of 4.18±0.05, UGRE 5.20±0.06, and QISS 2.72±0.03. Using cardiac triggering and TIAMO imaging technique was essential to perform non-enhanced MRA of the lower extremities vessels at 7T. The modified UGRE performed best, as observed artifacts were only moderate and the highest average VBR was reached.

Non-enhanced MR imaging of cerebral aneurysms: 7 Tesla versus 1.5 Tesla.

PURPOSE: To prospectively evaluate 7 Tesla time-of-flight (TOF) magnetic resonance angiography (MRA) in comparison to 1.5 Tesla TOF MRA and 7 Tesla non-contrast enhanced magnetization-prepared rapid acquisition gradient-echo (MPRAGE) for delineation of unruptured intracranial aneurysms (UIA). MATERIAL AND METHODS: Sixteen neurosurgical patients (male n = 5, female n = 11) with single or multiple UIA were enrolled in this trial. All patients were accordingly examined at 7 Tesla and 1.5 Tesla MRI utilizing dedicated head coils. The following sequences were obtained: 7 Tesla TOF MRA, 1.5 Tesla TOF MRA and 7 Tesla non-contrast enhanced MPRAGE. Image analysis was performed by two radiologists with regard to delineation of aneurysm features (dome, neck, parent vessel), presence of artifacts, vessel-tissue-contrast and overall image quality. Interobserver accordance and intermethod comparisons were calculated by kappa coefficient and Lin's concordance correlation coefficient. RESULTS: A total of 20 intracranial aneurysms were detected in 16 patients, with two patients showing multiple aneurysms (n = 2, n = 4). Out of 20 intracranial aneurysms, 14 aneurysms were located in the anterior circulation and 6 aneurysms in the posterior circulation. 7 Tesla MPRAGE imaging was superior over 1.5 and 7 Tesla TOF MRA in the assessment of all considered aneurysm and image quality features (e.g. image quality: mean MPRAGE7T: 5.0; mean TOF7T: 4.3; mean TOF1.5T: 4.3). Ratings for 7 Tesla TOF MRA were equal or higher over 1.5 Tesla TOF MRA for all assessed features except for artifact delineation (mean TOF7T: 4.3; mean TOF1.5T 4.4). Interobserver accordance was good to excellent for most ratings. CONCLUSION: 7 Tesla MPRAGE imaging demonstrated its superiority in the detection and assessment of UIA as well as overall imaging features, offering excellent interobserver accordance and highest scores for all ratings. Hence, it may bear the potential to serve as a high-quality diagnostic tool for pretherapeutic assessment and follow-up of untreated UIA.

Nonenhanced magnetic resonance angiography of the lower extremity vessels at 7 tesla: initial experience.

OBJECTIVES: The aim of this study was to investigate the feasibility of nonenhanced magnetic resonance angiography (MRA) of the lower extremities at 7 tesla (T). MATERIALS AND METHODS: Eight healthy volunteers were examined on a 7-T whole-body magnetic resonance system. For image acquisition, a custom-built 16-channel transmit/receive coil and a manually positionable AngioSURF table for multistation imaging were used. A nonenhanced T1-weighted 2-dimensional fast low-angle shot (2D FLASH) sequence was acquired with and without venous saturation radiofrequency pulses in axial orientation, covering the vasculature from the pelvis to the feet. Acquisition time of 1 table position amounted to 2 minutes and 19 seconds (with venous saturation pulse) and 1 minute and 9 seconds (without venous saturation pulse), covering a field of view of approximately 10 cm in the z-axis. Time-interleaved acquisition of modes was integrated to obtain homogeneous image quality of the vasculature. A qualitative image analysis was performed in the iliac, femoral, popliteal, and tibiofibular vessel segments regarding vessel delineation using a 5-point scale (5 to 1, excellent vessel delineation to nondiagnostic). For the quantitative image evaluation, the signal was measured in the specified segments and in the surrounding musculature of both legs to obtain contrast ratios (CR). RESULTS: T1-weighted 2D FLASH imaging enabled homogeneous, hyperintense delineation of the arteries with saturation of surrounding tissue in almost all analyzed vessel segments. The qualitative image evaluation demonstrated a moderate to good delineation and assessment of the vessel lumen (mean score: iliac, 3.17; femoral, 3.71; popliteal, 4.00; and tibiofibular, 3.31 for 2D FLASH). The quantitative analysis showed similar CRs in all vessel segments, with the best contrast to surrounding tissue achieved in the femoral segments (CRiliac, 0.59; CRfemoral, 0.69; CRpopliteal, 0.74; and CRtibiofibular, 0.57), although a medial signal drop-off in the thigh region could be found in some volunteers. Transformation of the axial images into coronal maximum intensity projection images revealed an artifact characterized by recurrent short declines of vessel signal, most probably because of an interference between the alternating pressure and flow effects during systole and diastole and the image acquisition frequency. Nevertheless, the use of time-interleaved acquisition of modes enabled a homogenous image quality with successful reduction of B1 field inhomogeneities. CONCLUSIONS: The results of our study demonstrate the feasibility of non-contrast-agent-enhanced MRA of the lower extremity vessels at 7 T. Nonenhanced MRA of the lower extremities at this very high magnetic field can be considered to be in an early but promising stage. Further sequence optimization and the examination of a larger number of participants as well as comparison with contrast-enhanced MRA and nonenhanced techniques at lower field strengths should be pursued in future trials.