Phase-field dithering for active catheter tracking.

A strategy to increase the robustness of active MR tracking of microcoils in low signal-to-noise ratio conditions was developed and tested. The method employs dephasing magnetic field gradient pulses that are applied orthogonal to the frequency-encoding gradient pulse used in conventional point-source MR tracking. In subsequent acquisitions, the orthogonal dephasing gradient pulse is rotated while maintaining a perpendicular orientation with respect to the frequency-encoding gradient. The effect of the dephasing gradient is to apply a spatially dependent phase shift in directions perpendicular to the frequency-encoding gradient. Since the desired MR signal for robust MR tracking comes from the small volume of nuclear spins near the small detection coil, the desired signal is not dramatically altered by the dephasing gradient. Undesired MR signals arising from larger volumes (e.g., due to coupling with the body coil or surface coils), on the other hand, are dephased and reduced in signal intensity. Since the approach requires no a priori knowledge of the microcoil orientation with respect to the main magnetic field, data from several orthogonal dephasing gradients are acquired and analyzed in real time. One of several selection algorithms is employed to identify the "best" data for use in the coil localization algorithm. This approach was tested in flow phantoms and animal models, with several multiplexing schemes, including the Hadamard and zero-phase reference approaches. It was found to provide improved MR tracking of untuned microcoils. It also dramatically improved MR tracking robustness in low signal-to-noise-ratio conditions and permitted tracking of microcoils that were inductively coupled to the body coil.

3D coronary motion tracking in swine models with MR tracking catheters.

PURPOSE: To develop MR-tracked catheters to delineate the three-dimensional motion of coronary arteries at high spatial and temporal resolution. MATERIALS AND METHODS: Catheters with three tracking microcoils were placed into nine swine. During breath-holds, electrocardiographic (ECG)-synchronized 3D motion was measured at varying vessel depths. 3D motion was measured in American Heart Association left anterior descending (LAD) segments 6-7, left circumflex (LCX) segments 11-15, and right coronary artery (RCA) segments 2-3, at 60-115 beats/min heart rates. Similar-length cardiac cycles were averaged. Intercoil cross-correlation identified early systolic phase (ES) and determined segment motion delay. RESULTS: Translational and rotational motion, as a function of cardiac phase, is shown, with directionality and amplitude varying along the vessel length. Rotation (peak-to-peak solid-angle RCA approximately 0.10, LAD approximately 0.06, LCX approximately 0.18 radian) occurs primarily during fast translational motion and increases distally. LCX displacement increases with heart rate by 18%. Phantom simulations of motion effects on high-resolution images, using RCA results, show artifacts due to translation and rotation. CONCLUSION: Magnetic resonance imaging (MRI) tracking catheters quantify motion at 20 fps and 1 mm(3) resolution at multiple vessel depths, exceeding that available with other techniques. Imaging artifacts due to rotation are demonstrated. Motion-tracking catheters may provide physiological information during interventions and improve imaging spatial resolution.

128-channel body MRI with a flexible high-density receiver-coil array.

PURPOSE: To determine whether the promise of high-density many-coil MRI receiver arrays for enabling highly accelerated parallel imaging can be realized in practice. MATERIALS AND METHODS: A 128-channel body receiver-coil array and custom MRI system were developed. The array comprises two clamshells containing 64 coils each, with the posterior array built to maximize signal-to-noise ratio (SNR) and the anterior array design incorporating considerations of weight and flexibility as well. Phantom imaging and human body imaging were performed using a variety of reduction factors and 2D and 3D pulse sequences. RESULTS: The ratio of SNR relative to a 32-element array of similar footprint was 1.03 in the center of an elliptical loading phantom and 1.7 on average in the outer regions. Maximum g-factors dropped from 5.5 (for 32 channels) to 2.0 (for 128 channels) for 4x4 acceleration and from 25 to 3.3 for 5x5 acceleration. Residual aliasing artifacts for a right/left (R/L) reduction factor of 8 in human body imaging were significantly reduced relative to the 32-channel array. CONCLUSION: MRI with a large number of receiver channels enables significantly higher acceleration factors for parallel imaging and improved SNR, provided losses from the coils and electronics are kept negligible.

Electroanatomic mapping of the left ventricle in a porcine model of chronic myocardial infarction with magnetic resonance-based catheter tracking.

BACKGROUND: X-ray fluoroscopy constitutes the fundamental imaging modality for catheter visualization during interventional electrophysiology procedures. The minimal tissue discriminative capability of fluoroscopy is mitigated in part by the use of electroanatomic mapping systems and enhanced by the integration of preacquired 3-dimensional imaging of the heart with computed tomographic or magnetic resonance (MR) imaging. A more ideal paradigm might be to use intraprocedural MR imaging to directly image and guide catheter mapping procedures. METHODS AND RESULTS: An MR imaging-based electroanatomic mapping system was designed to assess the feasibility of navigating catheters to the left ventricle in vivo using MR tracking of microcoils incorporated into the catheters, measuring intracardiac ventricular electrograms, and integrating this information with 3-dimensional MR angiography and myocardial delayed enhancement images to allow ventricular substrate mapping. In all animals (4 normal, and 10 chronically infarcted swine), after transseptal puncture under fluoroscopic guidance, catheters were successfully navigated to the left ventricle with MR tracking (13 to 15 frames per second) by both transseptal and retrograde aortic approaches. Electrogram artifacts related to the MR imaging gradient pulses were successfully removed with analog and digital signal processing. In all animals, it was possible to map the entire left ventricle and to project electrogram voltage amplitude maps to identify the scarred myocardium. CONCLUSIONS: It is possible to use MR tracking to navigate catheters to the left ventricle, to measure electrogram activity, and to render accurate 3-dimensional voltage maps in a porcine model of chronic myocardial infarction, completely in the MR imaging environment. Myocardial delayed enhancement guidance provided dense sampling of the proximity of the infarct and accurate localization of complex infarcts.

Feasibility of stent placement in carotid arteries with real-time MR imaging guidance in pigs.

All examinations were performed with approval from the institutional animal care and use committee of Columbia University. To assess the feasibility of real-time magnetic resonance (MR) imaging-guided neurovascular intervention in a swine model, the authors placed stents in the carotid arteries of five domestic pigs. Seven-French vascular sheaths were placed in the target carotid arteries via femoral access by using active MR tracking. Ten nitinol stents (8-10 x 20-40 mm) were successfully deployed in the target segments of carotid arteries bilaterally. MR imaging and necropsy findings confirmed stent position. Necropsy revealed no gross vascular injury. Study results demonstrated the feasibility of performing real-time MR imaging-guided neurovascular intervention by using an active-tracking technique in an animal model.

Transfemoral catheterization of carotid arteries with real-time MR imaging guidance in pigs.

All procedures and protocols were approved by the institutional animal care and use committee of Columbia University. To determine whether transfemoral catheterization of the carotid arteries can be performed entirely with real-time magnetic resonance (MR) imaging guidance, the authors catheterized the carotid arteries in six domestic pigs by using active-tracking catheters and guidewires and MR tracking software created for neurovascular procedures. The carotid arteries were successfully catheterized 24 times, on average within 5 minutes after insertion of the catheter into the femoral artery. Results demonstrated the feasibility of performing transfemoral catheterization of the carotid arteries with active MR tracking devices in a conventional MR imaging unit.

Large field-of-view real-time MRI with a 32-channel system.

The emergence of parallel MRI techniques and new applications for real-time interactive MRI underscores the need to evaluate performance gained by increasing the capability of MRI phased-array systems beyond the standard four to eight high-bandwidth channels. Therefore, to explore the advantages of highly parallel MRI a 32-channel 1.5 T MRI system and 32-element torso phased arrays were designed and constructed for real-time interactive MRI. The system was assembled from multiple synchronized scanner-receiver subsystems. Software was developed to coordinate across subsystems the real-time acquisition, reconstruction, and display of 32-channel images. Real-time, large field-of-view (FOV) body-survey imaging was performed using interleaved echo-planar and single-shot fast-spin-echo pulse sequences. A new method is demonstrated for augmenting parallel image acquisition by independently offsetting the frequency of different array elements (FASSET) to variably shift their FOV. When combined with conventional parallel imaging techniques, image acceleration factors of up to 4 were investigated. The use of a large number of coils allowed the FOV to be doubled in two dimensions during rapid imaging, with no degradation of imaging time or spatial resolution. The system provides a platform for evaluating the applications of many-channel real-time MRI, and for understanding the factors that optimize the choice of array size.