Whole-brain vessel wall MRI: A parameter tune-up solution to improve the scan efficiency of three-dimensional variable flip-angle turbo spin-echo

Qi Yang; Zixin Deng; Xiaoming Bi; Shlee S Song; Konrad H Schlick; Nestor R Gonzalez; Debiao Li; Zhaoyang Fan

doi:10.1002/jmri.25611

Whole-brain vessel wall MRI: A parameter tune-up solution to improve the scan efficiency of three-dimensional variable flip-angle turbo spin-echo

J Magn Reson Imaging. 2017 Sep;46(3):751-757. doi: 10.1002/jmri.25611. Epub 2017 Jan 20.

Authors

Qi Yang^{1

2}, Zixin Deng^{2

3}, Xiaoming Bi⁴, Shlee S Song⁵, Konrad H Schlick⁵, Nestor R Gonzalez⁶, Debiao Li^{2

3}, Zhaoyang Fan²

Affiliations

¹ Department of Radiology, Xuanwu Hospital, Beijing, China.
² Biomedical Imaging Research Institute, Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, California, USA.
³ Department of Bioengineering, University of California, Los Angeles, California, USA.
⁴ MR R&D, Siemens Healthcare, Los Angeles, California, USA.
⁵ Department of Neurology, Cedars-Sinai Medical Center, Los Angeles, California, USA.
⁶ Department of Neurosurgery, Cedars-Sinai Medical Center, Los Angeles, California, USA.

Abstract

Purpose: To propose and evaluate a parameter tune-up solution to expedite a three-dimensional (3D) variable-flip-angle turbo spin-echo (TSE) sequence for whole-brain intracranial vessel wall (IVW) imaging.

Materials and methods: Elliptical k-space sampling and prolonged echo train length (ETL), were used to expedite a 3D variable-flip-angle TSE-based sequence. To compensate for the potential loss in vessel wall signal, optimal combination of prescribed T₂ and ETL was experimentally investigated on 22 healthy volunteers at 3 Tesla. The optimized protocol (7-8 min) was then compared with a previous protocol (reference protocol, 11-12 min) in terms of signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), vessel wall sharpness, and wall delineation quality on a 4-point scale (0:poor; 3:excellent) in 10 healthy volunteers. A pilot study of five patients was performed and lesion delineation score was used to demonstrate the diagnostic quality.

Results: A protocol with ETL = 52 and prescribed T₂ = 170 ms was deemed an optimized one, which, compared with the reference protocol, provided significantly improved wall SNR (12.0 ± 1.3 versus 10.0 ± 1.1; P = 0.002), wall-lumen CNR (9.7 ± 1.2 versus 8.0 ± 0.9; P = 0.002), wall-CSF CNR (2.8 ± 1.0 versus 1.7 ± 1.0; P = 0.026), similar vessel wall sharpness at both inner (1.59 ± 0.18 versus 1.58 ± 0.14, P = 0.87) and outer (1.71 ± 0.25 versus 1.83 ± 0.30; P = 0.18) boundaries, and comparable vessel wall delineation score for individual segments (1.95-3; P > 0.06). In all patients, atherosclerotic plaques (10) or wall dissection (5) were identified with a delineation score of 3 or 2.

Conclusion: A parameter tune-up solution can accelerate 3D variable-flip-angle TSE acquisitions, particularly allowed for expedited whole-brain IVW imaging with preserved wall delineation quality.

Level of evidence: 2. Technical Efficacy: Stage 1 J. MAGN. RESON. IMAGING 2017;46:751-757.

Keywords: 3D TSE; intracranial vessel wall; magnetic resonance imaging; vessel wall imaging; whole brain.

Publication types

Research Support, Non-U.S. Gov't
Research Support, N.I.H., Extramural

MeSH terms

Adult
Brain / blood supply*
Brain / diagnostic imaging*
Female
Humans
Imaging, Three-Dimensional / methods*
Magnetic Resonance Angiography / methods*
Male
Reproducibility of Results
Signal-To-Noise Ratio

Grants and funding

R01 HL096119/HL/NHLBI NIH HHS/United States