Phenomena associated with flow in MRI

Ari Supriyono, Photo here

MR Applications Specialist,
GE Healthcare Indonesia
Date 06-Jan-2015
Phenomena associated with flow in MRI

Content
1. Fundamental and Principle: TOF
2. Fundamental and Principle: PC
3. Characteristics of Contrast-enhancement MRA
4. Contrast detection techniques
5. Centric k-space filling technique
6. Elliptic-centric k-space filling technique
7. Artifacts of ceMRA
8. TRICKS
Phenomena associated with flow in MRI
• The inflow effect: flow of
nonsaturated blood into the
explored zone (vascular
hypersignal)
• The outflow effect: the excited Photo here
blood flows out of the explored
zone (loss of vascular signal)
• Dephasing of moving spins in a
gradient
Phenomena associated with flow in MRI
• Time of Flight
• Phase Contrast
• FBI (Fresh Blood Imaging)
• Contrast-enhanced MRA
Photo here
Fundamental and Principle: Time Of Flight MRA (TOF-MRA)

Inflowing, previously unsaturated spins

(e.g. blood) produce a stronger signal
than stationary spins
Fundamental and Principle: Time Of Flight MRA (TOF-MRA)

Saturation Pulse used to reduce

signal from flowing blood by
saturating regions upstream from
region being imaged.
Time Of Flight MRA (TOF-MRA)
Saturation pules

Imaging Volume
MOTSA: Multiple Overlapping Thin Slap Acquisition.
Time Of Flight MRA (TOF-MRA)
Time Of Flight MRA (TOF-MRA)
Time Of Flight MRA (TOF-MRA)

General TOF advantages:

• Sensitive to T1 effects (short T1 tissues are bright. Contrast may be given for
additional enhancement).
• Reasonable imaging times (approximately 5min depending on parameters).
• Sensitive to slow flow.
• Reduced sensitivity to intra-voxel dephasing.

General TOF disadvantages:

• Sensitive to T1 effects (short T1 tissues are bright so that hemorrhagic lesions may
mimic vessels ).
• Saturation of in-plane flow (any flow within the FoV or volume of tissues can be
saturated along with background tissue).
• Enhancement is limited to either flow entering the FoV or very high velocity flow.
Time Of Flight MRA (TOF-MRA)
2D TOF advantages
Large area of coverage
Sensitive to slow flow
Sensitive to T1 effects
3D TOF advantages
High resolution for small vessels
Sensitive to T1 effects
2D TOF disadvantages
Lower resolution
Saturation of in-plane flow
Venetian blind artifact
3D TOF disadvantages
Saturation of in-plane flow
Small area of coverage
Fundamental and Principle: Phase Contrast MRA (PC-MRA)

Phase contrast angiography relies on

dephasing the moving spins
submitted to a bipolar gradient.
Fundamental and Principle: Phase Contrast MRA (PC-MRA)

For a complete measurement of the flow

velocity more measurements are
necessary with orthogonal (X,Y and Z) flow
sensitization.
Fundamental and Principle: Phase Contrast MRA (PC-MRA)

Phase contrast (PC) MRA it is important to

correctly set the VENC of the sequence to
the maximum flow velocity which is
expected to see.
Phase Contrast MRA (PC-MRA)
Phase Contrast MRA (PC-MRA)

PC-MRA advantages PC-MRA disadvantages

Sensitivity to a variety of vascular Long imaging times with 3D
velocities
Sensitive to flow within the FoV More sensitive to turbulence flow
Reduce intra-voxel dephasing
Increased background suppression 3D TOF disadvantages
Magnitude and phase images
Characteristics of Contrast-enhanced MRA (ceMRA)

• High contrast due to contrast media application

• Fast acquisition techniques
• High isotropic spatial resolution
• Acquisition of 3D data sets
• Minimum artifacts
• Flow-independent base on CM imaging of slow flow
• State-of-the art in clinical routine for most applications
Contrast-enhanced MRA (ceMRA)

Contrast detection K-space filling

SmartPrep Fluoro Trigger Centric Eliptic-centric TRICKS

Contrast detection techniques:
Auto Gd detection
SmartPrep: a tracking pulse sequence to
continuously monitor the MR signal coming
from a user prescribed volume of interest in
the patient. When the measured signal
exceeds the system threshold, the preselected
Protocol is automatically initiated.

Tracker Volume: a three-dimensional object to

monitor the selected region of interest for the
arrival of a contrast bolus.

Imaging Volume: The area which is scanned.

Threshold: a level at which the system start acquisition.

Contrast detection techniques:
Auto Gd detection

TD Scan

Signal intensity
Threshold

Threshold Trigger Point

Trigger Point

16 sec*.
Time (sec) Baseline Monitor Time Scan Time
Contrast detection techniques:
Human Visualize Gd detection

Fluoro Trigger: technique that uses a thick slab, 2D real time acquisition and reconstruction to
monitor the region of interest. FT MRA is used to detect the arrival of a contrast bolus.
Contrast detection techniques:
Human Visualize Gd detection
Draw Line: a cut plane by drawing a
line on the image that becomes that
plane.

Go 3D: initiates the prescribed acquisition.

Delay text box: system delay value

annotated in seconds, can be
changed. The delay period is the time after
Go 3D is clicked and the scan actually
Starts.
Centric k-space filling technique:

ky Fills the center lines of k-space for all slices

during the first 1/3 of the total scan time.

Suits well for capturing the arterial phase.

kx
Most of aorta and renal MRA acquisition use
Centric k-space filling technique by default

-1st station of femoral runoff MRA

Elliptic-centric k-space filling technique:

Fills the center lines portion of k-space first, and

ky
also fill the center lines in the z-slice direction.
During the first 1/9 of the total scan
time
kx Suits well for carotid and femoral runoff MRA
application.
-Peak of the arterial phase is very fast
and very important.
-Prevent venous contaminate.
kz -2nd and 3rd station.
K-space filling schemes use for ceMRA:
Artifacts of ceMRA:

Maki or Ringing artifact Optimal contrast Venous contaminate

TRICKS:
TRICKS, Time Resolved Imaging Contrast KineticS

Advantages of TRICKS

•Eliminates timing and triggering

•Isolates a pure arterial phase even with asymmetric flow

•Eliminates venous contamination

Captures flow dynamics, characterizing filling like conventional angiography

•Enables multiple injections through automated complex subtraction

TRICKS:
TRICKS, Time Resolved Imaging Contrast KineticS
•K-space is divided in 4 regions from the center to the periphery
•The data are acquired using a elliptic-centric view ordering.
•The central region “region A” is sampled more frequently compare to the outer regions

= Mask
A B C D

A B A C A D A B A C A D

………………….
A B C D
- k-space segmentation in 4 regions
- elliptic-centric view ordering
- Central region sampled more frequently
TRICKS:
Temporal Resolution VS Spatial Resolution

Temporal resolution refers to the precision of a measurement with respect to time.

Often there is a tradeoff between temporal resolution of a measurement and its spatial
resolution.

Signal Intensity

1 2 3 4 5 6 7 time
TRICKS:
Image Samples
TRICKS:
Image Samples

Courtesy of Norman HealthPlex Hospital, St. Anne Hospital, France

Thank You