Guoxi Xie¹, Hanwei Chen², Chen Huang³, Xueping He², Yueyuan Xie⁴, Xiaoyong Zhang⁵, Tianjing Zhang⁶, Yi Sun⁵, Debiao Li⁷, and Zhaoyang Fan^8
1Department of Biomedical Engineering, Guangzhou Medical University, Guangzhou, China, ²Department of Radiology, Guangzhou Panyu Central Hospital, Guangzhou, China, ³Department of Minimally Invasive Interventional Radiology, Guangzhou Panyu Central Hospital, Guangzhou, China, ⁴Department of Anesthesiology, Mindong Hospital, Ningde, China, ⁵MR Collaborations, Siemens Healthcare Ltd, Shenzhen, China, ⁶Philips Healthcare, Guangzhou, China, ⁷Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, United States, ⁸Department of Radiology, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States

Patients with acute deep vein thrombosis (DVT) can be characterized as iso- or hyper-intense thrombus signals using a T1-weighted black-blood magnetic resonance imaging (BTI) technique. Patients with hyper-intense thrombus signals demonstrated a significant higher incidence of post-thrombotic syndrome (PTS) than those with iso-intense thrombus signals, regardless of the patient’s age, gender, the severity of DVT, and the treatment strategy of catheter-directed thrombolysis or conventional anticoagulant therapy. The results suggest that the thrombus signal characteristics obtained on BTI imaging are valuable for assessing the prognosis of acute DVT and may aid in guiding the clinical treatment plan.

Jitka Starekova¹, Scott K Nagle¹, Mark L Schiebler¹, Scott B Reeder^1,2,3,4,5, and Venkata N Meduri^1
1Radiology, University of Wisconsin-Madison, Madison, WI, United States, ²Medicine, University of Wisconsin-Madison, Madison, WI, United States, ³Medical Physics, University of Wisconsin-Madison, Madison, WI, United States, ⁴Biomedical Engineering, University of Wisconsin-Madison, Madison, WI, United States, ⁵Emergency Medicine, University of Wisconsin-Madison, Madison, WI, United States

Ferumoxytol (Feraheme®, AMAG Pharmaceuticals, Waltham) is an injectable iron micro particle-solution approved by the FDA for treatment of iron-deficiency anemia. This medication also has favorable properties as intravascular blood pool agent (off-label) for contrast-enhanced MRA (Fe-MRA). Fe-MRA is an alternative modality for the assessment of pulmonary embolism without the need for ionizing radiation or gadolinium in pregnant patients. The purpose of this study was to summarize our clinical experience with 70 Fe-MRA exams in 66 pregnant patients. We aimed to demonstrate the safety and efficacy of Fe-MRA and provide guidance in establishing a clinical service. 

John Heerfordt^1,2, Aurélien Bustin^2,3,4, Ludovica Romanin^1,2, Estelle Tenisch², Milan Prsa⁵, Tobias Rutz⁶, Christopher W. Roy², Jérôme Yerly^2,7, Juerg Schwitter^6,8, Matthias Stuber^2,7, and Davide Piccini^1,2
1Advanced Clinical Imaging Technology, Siemens Healthcare AG, Lausanne, Switzerland, ²Department of Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland, ³IHU LIRYC, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, Pessac-Bordeaux, France, ⁴Department of Cardiovascular Imaging, Hôpital Cardiologique du Haut-Lévêque, CHU de Bordeaux, Pessac, France, ⁵Division of Pediatric Cardiology, Department Woman-Mother-Child, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland, ⁶Division of Cardiology, Cardiovascular Department, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland, ⁷CIBM Center for Biomedical Imaging, Lausanne, Switzerland, ⁸Cardiac MR Center, Lausanne University Hospital, Lausanne, Switzerland

A SImilarity-driven Multi-dimensional Binning Algorithm (SIMBA) was recently proposed for fast reconstruction of motion-consistent clusters for free-running whole-heart MRA acquisitions. Originally, only the most populated cluster was used for the reconstruction of a motion-suppressed image. In this work we investigated whether the redundancy of information among the clusters can be exploited to improve image quality. Specifically, an adapted XD-GRASP reconstruction and a multidimensional patch-based low-rank denoising algorithm were compared. Four different reconstructions were quantitatively evaluated and compared using ferumoxytol-enhanced free-running datasets from 10 pediatric and adult CHD patients. Information sharing resulted in significantly sharper anatomical features and increased image quality.

Giulia MC Rossi¹, Nemanja Masala¹, Jessica AM Bastiaansen¹, Aurelien Bustin^1,2, Jérôme Yerly^1,3, John Heerfordt^1,4, Davide Piccini^1,4, Matthias Stuber^1,3, and Christopher W Roy^1
1Department of Radiology, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland, ²LIRYC (Electrophysiology and Heart Modeling Institute), Bordeaux, France, ³CIBM Center for Biomedical Imaging, Lausanne, Switzerland, ⁴Advanced Clinical Imaging Technology (ACIT), Siemens Healthcare AG, Lausanne, Switzerland

A novel method for reconstructing motion-compensated 3D CMRA images from free-running data is proposed. We extend the use of a recent method for non-rigid respiratory motion correction called focused navigation (fNAV) to also encompass cardiac motion compensation that accounts for beat-to-beat heart-rate variability. Our combined fNAV approach is compared to the previously established cardiac and respiratory motion-resolved 5D imaging in vivo and is shown to provide overall similar image quality and comparable right coronary artery visualizations to 5D imaging in significantly shorter reconstruction times.  

Xin Li¹, Di Tian¹, Qingwei Song¹, Ailian Liu¹, and Zhiyong Li^1
1The First Affiliated Hospital of Dalian Medical University, Dalian, China, Dalian, China

In comparison with the traditional whole-heart coronary magnetic resonance angiography (WH-CMRA) based on the spectral pre-saturation with inversion recovery (SPIR), the advanced WH-CMRA based on Dixon with non-contrast-enhanced free respiratory navigation is associated with advantages of improved image quality, increased blood signal-to-noise ratio, and the extra fat image. This study proved that it is feasible to visualize the coronary artery (image quality scores met the requirement of clinical diagnosis) using the Dixon based WH-CMRA without increasing scan time.

Anastasia Fotaki^1,2, Karl Kunze¹, Harith Alam², Yasodhara Emmanuel², Alessandra Frigiola², Kuberan Pushparajah^1,2, René Botnar¹, and Claudia Prieto^1
1School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom, ²Adult Congenital Heart Disease Department, Guy’s and St Thomas’s Hospital, London, United Kingdom

Bright- and black-blood MRI sequences provide complementary information on anatomical assessment for patients with Congenital Heart Disease(CHD).A free-breathing 3D whole-heart sequence (MTC-BOOST) has been recently proposed for simultaneous bright and black-blood high quality depiction of cardiac and vascular structures waiving the need for contrast agent injection. In this study, we clinically validated this sequence in a cohort of 35 patients with CHD against the conventional T2-prep bSSFP sequence. Quantitative and qualitative image quality assessment demonstrates that MTC-BOOST enhances pulmonary venous depiction, mitigates flow-related artefacts and has comparable image quality for intracardiac and vascular structures, promising potential integration into clinical workflow.

Zhehao Hu^1,2, Jiayu Xiao¹, Xianglun Mao¹, Yibin Xie¹, Alan Kwan^1,3, Xiaoming Bi⁴, Shlee Song⁵, Alison Wilcox⁶, Debiao Li^1,2, Anthony Christodoulou^1,2, and Zhaoyang Fan^1,6,7
1Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, United States, ²Department of Bioengineering, University of California, Los Angeles, Los Angeles, CA, United States, ³Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, United States, ⁴Siemens Medical Solutions USA, Inc., Los Angeles, CA, United States, ⁵Department of Neurology, Cedars-Sinai Medical Center, Los Angeles, CA, United States, ⁶Department of Radiology, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States, ⁷Department of Radiation Oncology, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States

Non-invasive imaging of cardiac anatomy plays an important role in diagnosis, risk stratification, and planning of procedures in patients with cardiovascular disease. MR imaging has the potential to provide a comprehensive evaluation of cardiac chambers and thoracic vessels. However, the clinical workflow for the acquisition of conventional cardiac MR imaging is complex and time-consuming. MR MultiTasking based 3D Multi-dimensional Assessment of Cardiovascular System (MT-MACS) technique has recently been demonstrated in thoracic aortic diseases without need for ECG- and navigator-gating. In this work, we further extend the application of MT-MACS to the assessment of the whole heart and great thoracic vessels.

Ioannis Koktzoglou^1,2, Rong Huang¹, Nondas Leloudas¹, and Robert R Edelman^1,3
1Radiology, NorthShore University HealthSystem, Evanston, IL, United States, ²University of Chicago Pritzker School of Medicine, Chicago, IL, United States, ³Northwestern University Feinberg School of Medicine, Chicago, IL, United States

Time of flight (TOF) and quiescent interval slice selective (QISS) magnetic resonance angiography (MRA) provide accurate anatomic evaluation blood vessels but do not readily quantify blood velocity or flow. Addressing this deficiency, we report two multi-echo stack-of-stars variants of TOF and QISS MRA (which we refer to as “quantitative TOF” (qTOF) and “quantitative QISS” (qQISS) MRA) that provide for simultaneous high-resolution anatomic and hemodynamic evaluation of the intracranial arteries.

Yuehong Liu¹, Fang Wu², Xiuqin Jia³, Haibin Li⁴, Xunming Ji⁵, and Qi Yang^1
1Radiology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China, ²Radiology, Xuanwu Hospital, Capital Medical University, Beijing, China, ³Department of Radiology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China, ⁴Epidemiology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China, ⁵Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China

This study investigates the relation between the heterogeneity of intramural hematoma (IMH) on three-dimensional vessel wall MRI (3D-VWMRI) images and acute ischemic stroke in patients with proven cervical artery dissection (CAD). We found the high heterogenous IMH on 3D-VWMRI was associated with acute ischemic stroke in proven and non-occluded CAD. The heterogeneous signal of an IMH on 3D-VWMRI may indicate the asynchronous progress of CAD, possibly leading to thrombosis or hemodynamic instability, therefore results in ischemic stroke. The current finding may hold promise to better elucidate the pathophysiological mechanisms and occurrence risk of ischemic stroke for patients with CAD.

Yoshihiko Tachikawa¹, Hiroshi Hamano², Hikaru Yoshikai¹, Kento Ikeda¹, Yasunori Maki¹, Yukihiko Takahashi¹, and Kunishige Matake^1
1Karatsu Red Cross Hospital, Saga, Japan, ²Philips Japan, Tokyo, Japan

Assessment of vessel lumen and wall and plaques lesions is important in management of patients with atherosclerosis. Conventional MR imaging typically requires long scan times to acquire MRA and vessel wall imaging (VWI), respectively. In this work, we present a new multi-contrast blood imaging method named BRIDGE (bright and dark blood images with multi-shot gradient-echo-planar imaging), which simultaneously acquires MRA and VWI in a single acquisition. Initial results with volunteers and patients showed that comparable image quality to conventional methods could be acquired in a short time, allowed simultaneous assessment of luminal changes and vulnerable plaques in a single acquisition.