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1ISMRM 2006
Cardiac MRI: 3.0TCardiac MRI: 3.0T
Paul Finn, MD
David Geffen School of Medicine at UCLA
AcknowledgementsAcknowledgements
Stefan Ruehm, MD
Kambiz Nael, MD
Roya Saleh, MD
Anthony Ton, MD
Mayil Krishnam, MD
Sergio Godines, RT
Glen Nyborg, RT
Howard Dinh,MD
Carissa Fonseca, Ph
Gerhard Laub, PhD
Vibhas Deshpande, PhD
Hanns Weinmann, PhD
3 Tesla: Advantages3 Tesla: Advantages
SNR
[ T ]1.5 3.0
T1
Field Strength
SNR x 2SNR x 2SNR x 2
2ISMRM 2006
3 Tesla: Disadvantages3 Tesla: Disadvantages
SAR
1.5 3.0
SAR x 4SAR x 4SAR x 4
[ T ]
Field Strength
Cardiac MRI at 3.0TCardiac MRI at 3.0T
Why?
Needs to compete favorably with cardiac MRI at 1.5T
Tim Trio Tim AvantoTim Trio Tim Avanto
3T 1.5T45 mT/SR200 45 mT/SR20050 cm 50 cmTim Tim
3T 1.5T45 mT/SR200 45 mT/SR20050 cm 50 cmTim Tim
3ISMRM 2006
Cardiac Cine MRI at 1.5T*Breath-hold Segmented SSFP Cine
Cardiac Cine MRI at 1.5T*Breath-hold Segmented SSFP Cine
* Carr JC, et al. Radiology 2001;219:828-834.
Segmented TrueFISP Cine: 1.5T
General Trends at 3.0T vs 1.5TGeneral Trends at 3.0T vs 1.5T
4ISMRM 2006
Increased SARIncreased SAR
Limits flip angles and minimum TR for high-performance sequences
SSFP cine
Spin echo train imaging
CEMRA
Increased SNRIncreased SNR
Potential benefits for techniques which have borderline SNR
Perfusion imaging
Viability imaging with delayed enhancement
Coronary imaging
B1 InhomogeneityB1 Inhomogeneity
Shading in some regions
Inhomogeneous contrast in some regions
May make calibration of RF transmitter voltages difficult –varying flip angles within body regions
5ISMRM 2006
B1-InhomogeneityB1-Inhomogeneity
Increased sensitivity to flow-induced noise on ECG trace can make gating more problematic
Magneto-hydrodynamic effectMagneto-hydrodynamic effect
Cine MRI at 3.0T vs 1.5TCine MRI at 3.0T vs 1.5T
SSFP now the standard at 1.5T
TrueFISP
FIESTA
Balanced FFE
At 3.0T, SSFP cine is challenging
6ISMRM 2006
Cine MRI at 3.0T vs 1.5TCine MRI at 3.0T vs 1.5T
Ideal conditions for TrueFISP cine
TR as short as possible
Flip angle high and uniform
Very homogeneous magnetic field
At 3.0T, all of these conditions are violated due to a combination of SAR, patient-induced susceptibility gradients and dielectric resonance effects
3T Functional Cardiac ImagingSSFP cine: off-resonance artifact
α = 30 degα = 50 deg
SAR-Limitations:Effects on TrueFISP cine
SAR-Limitations:Effects on TrueFISP cine
lower CNR
7ISMRM 2006
Dark-blood Imaging @ 3T: long „TR“Dark-blood Imaging @ 3T: long „TR“
db-HASTE db - TSE
Cardiac Function @ 3TCardiac Function @ 3T
FLASH, 20°TrueFISP, 40°
• Use longer RF pulses than at 1.5T• flip angle around 30° - 40° (less signal and contrast)
Cardiac TrueFISP imaging at 3TCardiac TrueFISP imaging at 3T
8-channel cardiac array coil
with PAT x2 TA 8 sec
8ISMRM 2006
Parallel Imaging @ 3TParallel Imaging @ 3T
15 sec 8 secwith iPAT x2without iPAT
TrueFISP short axis
Temporal resolution 25 msecMatrix: 256x256
Cine TrueFISP iPAT x24 slices in 12 sec 3.5 x 2.8 x 8 mm
Temporal resolution = 25 ms
Cardiac Function @ 3TCardiac Function @ 3T
TaggingTagging
Longer T1 @ 3T keeps tags visible longer
9ISMRM 2006
Functional MRI @ 3T(LVH)
Functional MRI @ 3T(LVH)
TrueFISP cine grid tagging
But: With TrueFISP Cardiac Tagging at 1.5TBut: With TrueFISP Cardiac Tagging at 1.5T
1.0mm x 1.5mm x 6 mm voxels30 msec temporal resolution
7 second acquisition
Better persistance of tags than with SGRE
Cardiac Function @ 3TCardiac Function @ 3T
Cine TrueFISP
courtesy of Dr. Miller, University of Tuebingen
10ISMRM 2006
Cardiac Function @ 3TCardiac Function @ 3T
Cine TrueFISP
courtesy of Dr. Miller, University of Tuebingen
Current status of Cine MRI at 3.0T vs 1.5TCurrent status of Cine MRI at 3.0T vs 1.5T
SSFP cine at 3.0T is more sensitive to off-resonance effects than at 1.5T
Can be ‘managed’ by attention to shim status and by adjusting frequency offsets on a slice-orientation basis
In an individual case, may work; or may not
Contrast Enhancement in InfarctionContrast Enhancement in Infarction
Ex-vivo comparison of TTC and Gd-enhanced MRI in infarcted myocardium
TTC MRI
courtesy of Dr. R. Judd, Northwestern University, Chicago
11ISMRM 2006
Evaluation of Viability and Myocardial Perfusionwith IV contrast
Note: Gd is not FDA approved for cardiac imaging
Evaluation of Viability and Myocardial Perfusionwith IV contrast
Note: Gd is not FDA approved for cardiac imaging
time
Normal MyocardiumInfarcted Myocardium
Ischemic butViable Myocardium
First-Pass Delayed Enhancement
Gadoliniumcontrastinjection
Left Circumflex distribution infarction: 1.5TLeft Circumflex distribution infarction: 1.5T
Segmented TrueFISP: Cine and Viability @ 1.5TNon-Ischemic Cardiomyopathy
Segmented TrueFISP: Cine and Viability @ 1.5TNon-Ischemic Cardiomyopathy
IR TrueFISP: 64 lines / heart beat
12ISMRM 2006
Viability @ 3T
IR single shot TrueFISPCourtesy of Dr Regenfuss, University of Erlangen
Viability & Function @ 3TViability & Function @ 3T
IR single shotTrueFISP
Cine TrueFISP
Viability & Function @ 3TViability & Function @ 3T
IR TurboFLASH
Cine TrueFISP
courtesy of Dr. Miller, University of Tuebingen
13ISMRM 2006
Lt Cx Infarction: 1.5TLt Cx Infarction: 1.5T
Lt Cx Infarction cine: 3.0T vs 1.5TLt Cx Infarction cine: 3.0T vs 1.5T
Lt Cx Infarction: ViabilityLt Cx Infarction: Viability
3.0TVS
1.5T
14ISMRM 2006
Perfusion @ 3TPerfusion @ 3T
SR single shot TurboflashFirst passiPAT x24 slices/heartbeat
Courtesy of Dr Regenfuss, University of Erlangen
First-Pass Imaging at 3.0TTurboFLASH + iPAT
First-Pass Imaging at 3.0TTurboFLASH + iPAT
Optimized Saturation Recovery Pulse forReduced B1 Sensitivity
Northwestern University, Chicago
Adenocarcinoma RVOT: 3.0TAdenocarcinoma RVOT: 3.0T
15ISMRM 2006
32 channel Tim Trio: 32 channel Tim Avanto32 channel Tim Trio: 32 channel Tim Avanto
3T 1.5T45 mT/SR200 45 mT/SR20050 cm 50 cmTim Tim
3T 1.5T45 mT/SR200 45 mT/SR20050 cm 50 cmTim Tim
Cardiac MRI at 3.0T: Pre-RF AblationCardiac MRI at 3.0T: Pre-RF Ablation
SSFP CINE
Delayed Contrast enhancement Viability Imaging
Cardiac MRI at 3.0T: Pre-RF AblationCardiac MRI at 3.0T: Pre-RF Ablation
16ISMRM 2006
Pulmonary Vein Anatomy
500 mm FOV 576 matrix
Cardiac MRI at 3.0T: Pre-RF AblationCardiac MRI at 3.0T: Pre-RF Ablation
Pulmonary Vein Anatomy
500 mm FOV 576 matrix Volume rendering
Cardiac MRI at 3.0T: Pre-RF AblationCardiac MRI at 3.0T: Pre-RF Ablation
Coronary MRA @ 3TCoronary MRA @ 3T
LADRCA
Breath-held 3T TrueFISP Coronary MRA
Courtesy Vibhas Deshpande, PhD, UCLA
17ISMRM 2006
Coronary MRA @ 3TCoronary MRA @ 3T
3T TrueFISP Coronary MR Angiography(breath-hold, 28 heart beats)
UCLA
LADLAD
Coronary MRA @ 3T Coronary MRA @ 3T
TA: 6:27 minPixelsize: 0.9 x 0.9 x 1.2 mm
8-channel cardiac array
Active electrode ECG triggering
1D PACE for motion correction
3.0T1.5T
Coronary MRAContrast-enhanced FLASH
X. Bi, D. Li. Northwestern UniversityCourtesy of Drs X Bi, D Li , Northwestern University, Chicago.
18ISMRM 2006
LMLM
AOAO
LADLAD
0.6 x 0.6 x 3mm voxel size
3T Coronary MRA in-vivo & in humans
3T Coronary MRA: ResultsCourtesy Matthias Stuber, PhD. Johns Hopkins University
RCARCA
LVLVRVRV
AOAO
PAPA LCXLCX
But: Coronary CT Angiography!But: Coronary CT Angiography!
R.F. 3532862
Right Heart FailureRight Heart Failure
19ISMRM 2006
TIM Trio: Thorax - dissection
TIM Trio: Thorax - dissection
6ml Gd, 12 measurements each 1.7 s apart21 s breath hold: iPAT x 3
Rest (R)Stress +
Stenosis (SS) SS - R
Myocardial BOLD Imaging at 3TMyocardial BOLD Imaging at 3T
Shea, D Li. Northwestern University, Chicago, Illinois.
Dog with LCx stenosis
20ISMRM 2006
Promising results for cardiac MR @ 3T.Limitations for SSFP cineThe increased SNR is advantageous for viability imaging, dynamic angiography and perfusion imaging.
Areas to be addressedprotocols and sequence design with reduced SAR, reduced B1 sensitivityContrast agents?
SummarySummary
3T Functional Cardiac Imaging
Gadomer, pig study. Schering AG, Inc.
3T Functional Cardiac Imaging
Gadomer, pig study. Schering AG, Inc.
21ISMRM 2006
3T Functional Cardiac Imaging
3T Functional Cardiac Imaging
3T Functional Cardiac Imaging
22ISMRM 2006
Thank you