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.

Electroanatomic mapping and radiofrequency ablation of porcine left atria and atrioventricular nodes using magnetic resonance catheter tracking.

BACKGROUND: The MRI-compatible electrophysiology system previously used for MR-guided left ventricular electroanatomic mapping was enhanced with improved MR tracking, an MR-compatible radiofrequency ablation system and higher-resolution imaging sequences to enable mapping, ablation, and ablation monitoring in smaller cardiac structures. MR-tracked navigation was performed to the left atrium (LA) and atrioventricular (AV) node, followed by LA electroanatomic mapping and radiofrequency ablation of the pulmonary veins (PVs) and AV node. METHODS AND RESULTS: One ventricular ablation, 7 PV ablations, 3 LA mappings, and 3 AV node ablations were conducted. Three MRI-compatible devices (ablation/mapping catheter, torqueable sheath, stimulation/pacing catheter) were used, each with 4 to 5 tracking microcoils. Transseptal puncture was performed under x-ray, with all other procedural steps performed in the MRI. Preacquired MRI roadmaps served for real-time catheter navigation. Simultaneous tracking of 3 devices was performed at 13 frames per second. LA mapping and PV radiofrequency ablation were performed using tracked ablation catheters and sheaths. Ablation points were registered and verified after ablation using 3D myocardial delayed enhancement and postmortem gross tissue examination. Complete LA electroanatomic mapping was achieved in 3 of 3 pigs, Right inferior PV circumferential ablation was achieved in 3 of 7 pigs, with incomplete isolation caused by limited catheter deflection. During AV node ablation, ventricular pacing was performed, 3 devices were simultaneously tracked, and intracardiac ECGs were displayed. 3D myocardial delayed enhancement visualized node injury 2 minutes after ablation. AV node block succeeded in 2 of 3 pigs, with 1 temporary block. CONCLUSIONS: LA mapping, PV radiofrequency ablation, and AV node ablation were demonstrated under MRI guidance. Intraprocedural 3D myocardial delayed enhancement assessed lesion positional accuracy and dimensions.

Accurate flip-angle calibration for 13C MRI.

(13)C imaging and spectroscopy in the presence of injected labeled compounds can vastly extend the capability of MRI to perform metabolic imaging. The details of imaging in the presence of injected compounds, however, pose new technological challenges. Pulse sequences, in general, rely on precise flip-angle (FA) calibration to create high signal-to-noise ratio (SNR), artifact-free images. Signal quantification also requires precise knowledge of the excitation FA. In MRI scans that rely on signal acquisitions from injected compounds, however, such FA calibration is challenged by low natural-abundance (13)C signal levels before injection, and by time-varying signal following injection. A method to precisely set the FA at the (13)C frequency based on FA calibration at the (23)Na frequency is presented here. A practical implementation of a coil (a dual-tuned, (23)Na/(13)C low-pass birdcage coil) suitable for this calibration in vivo is also documented. Accurate FA calibration is demonstrated at the (13)C frequency for in vivo rat experiments using this approach.

Making MRI quieter.

We have mitigated acoustic noise in a 1.5 T cylindrical MRI scanner equipped with epoxy-potted, shielded gradients. It has been widely assumed that MRI acoustic noise comes overwhelmingly from vibrations of the gradient assembly. However, with vibration-isolated gradients contained in an airtight enclosure, we found the primary sources of acoustic noise to be eddy-current-induced vibrations of metal structures such as the cryostat inner bore and the rf body coil. We have elucidated the relative strengths of source-pathways of acoustic noise and assembled a reduced-acoustic-noise demonstration MRI system. This scanner employed a number of acoustic noise reduction measures including a vacuum enclosure of a vibrationally isolated gradient assembly, a low-eddy-current rf coil and a non-conducting inner bore cryostat. The demonstration scanner reduced, by about 20 dBA, the acoustic noise levels in the patient bore to 85 dBA and below for several typical noisy pulse sequences. The noise level standing near the patient bore is 71 dBA and below. We have applied Statistical Energy Analysis to develop a vibroacoustic model of the MR system. Our model includes vibrational sources and acoustic pathways to predict acoustic noise and provides a good spectral match above 400 Hz to experimentally measured sound levels. This tool enables us to factor acoustics into the design parameters of new MRI systems.