Dynamic Bright Blood Imaging What is it?
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1 Dynamic Bright Blood Imaging What is it? Amol Pednekar, Ph.D. Philips Healthcare, Houston, TX, USA. 1
2 Disclosure I have following disclosures related to my presentation Employee: Philips Healthcare I will not disclose off label use and/or investigational use in my presentation 2
3 What is Dynamic Bright Blood Imaging Bright blood imaging principle (Gradient Echo) Time of Flight Effect (TOF) MR image - Multiple acquisitions with different phase encoding gradients Scan parameters affecting signal Dynamic imaging Prospective synchronization Retrospective synchronization Free Breathing Optimization Trade off between spatial resolution, temporal resolution, and acquisition time (breath hold time) 3
4 Sources of MR Signal and Contrast Intrinsic characteristics Proton density, Relaxation times (T1,T2,T2*,T1rho), Flow Programmable pulse sequence parameters Type of echo, TR, TE, flip angle Physiologic constraints Periodic motion and deformation in synchronization with cardiac and respiratory cycle Motion induced artifacts Short TR gradient echo sequences are commonly employed in dynamic cardiac imaging 4
5 Time of Flight Effects MR signal intensity are determined by: Stationary spins T1,TR, flip angle Moving spins T1,TR, flip angle, velocity, relative slice orientation, slice thickness These additional effects are called time of flight effects. They influence the relative MR signal amplitudes between stationary and moving spins 5
6 Time of Flight Effects (Spin Echo) When RF pulses are slice selective then moving spins will not be affected by all RF pulses Spin Echo - signal reduction (flow void) TE/2 TE (echo time) TE/2 RF Acq G s G p G m 6
7 Time of Flight Effects (Gradient Echo) Gradient which forms the echo is not slice selective. Even if excited blood flows out of the slice, wherever the blood ends up, it will generate a signal appropriate to the location of the blood when it received the excitation pulse TE (echo time) RF Acq G s G p G m 7
8 Bright Blood Effect However, RF pulses are slice selective Moving spins will not be affected by all RF pulses Static spins are saturated with each excitation pulse Gradient Echo - Signal enhancement (bright blood) TR (repetition time) RF TE (echo time) Acq Acq Acq G s G p G m 8
9 Mz [au] Cine Imaging: Bright Blood Effect Saturation of static spins approaches steady state Unsaturated Blood Saturated Tissue Myocardium 0.7 Blood (static) 0.6 Blood (flowing) Time [ms] 23 ms 167 ms 382 ms 9
10 relative Mz Bright Blood: Effect of Excitation Angle Saturation effect on stationary tissue is to FA and 1/TR z-magnetization alpha = 18 alpha = 45 alpha = 90 time [ms] 10
11 Bright Blood: Effect of Velocity and Slice Thickness MR signal SL/TR velocity Signal will increase with velocity until V = SL/TR (SL=slice thickness) 11
12 Cine Imaging Flow Sensitivity Turbo GRE The signal of blood in TFE sequences depends on the flow. When flow appears in-plane, such as in a 4 chamber view, saturation of the blood may happen. To avoid this select lower flip angle (<25 ) for 4 chamber and long axis views and decrease slice thickness Select slightly higher flip angles (>25 ) for short axis views 12
13 Motion Compensation Periodic motion and deformation in synchronization with cardiac and respiratory cycle Multiple acquisition with different phase encoding gradients Motion induced artifacts Motion compensation Rapid acquisition to freeze the motion Synchronization of acquisition to physiologic signal k k Unaliased FOV Spatial resolution Scan Time TR y k Ky_max N y xtr (2D slice) 13
14 Fast Imaging: Cardiac Cycle Dimension T d # shots = Ny/PE_per_shot Good Image Quality Long Scan time Linear profile order 14
15 Cine Imaging: Multiple Cardiac Phases n 15
16 Cine Imaging Triggering v/s Gating Multi phase Turbo GRE Intermittent excitations Multi phase Steady state 16
17 Cine Imaging Contrast Manipulation Steady State Free Precession Vs SPGRE SPGRE Transverse magnetiztaion spoiled after each RF pulse. They do not contribute any signal in subsequent excitations Balanced SSFP 1. Reduced flow sensitivity 2. High SNR/Time 3. High Temporal Resolution Balanced SSFP Transverse magnetiztion coherence is carefully preserved after each RF pulse - unwinding the phase encoding gradient, balancing the read and slice-select gradients, and with short TR 17
18 Cine Imaging: Spoiled GRE v/s balanced SSFP 18
19 bssfp Flow Effects: Relative Slice Orientation 19
20 Cine Imaging: Physiology Synchronization Cardiac Triggering Prospective Gating Retrospective Gating Respiratory Gating Breath-hold scans Averaging No synchronization Real-time dynamic scan 20
21 Cine Imaging : Retrospective Gating Acquisition (17 phases, 7 heart-beats) Stretching Rescaling to average RR interval k y 0 Reconstruction t=0 t=rr (24 Phases; Phase%=75%) 21
22 Cine Imaging: Respiratory Synch / Compensation Respiration Gating Window Scan 22
23 Decrease Spatial Resolution Cine Imaging: Strategies to reduce scan time SNR Decrease # of sampling steps Spatial Resolution Temporal Res Contrast Res Resolution Scan Time Motion Artifact BH ability Scan efficiency SNR Spatial Resolution Temporal Resolution Scan Time Pixel Size HS Factor Acc. Factor TFE Factor 23
24 Free Breathing Cine: Multiple Averages 24
25 Real Time Imaging: Ungated Acquisitions 25
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