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1.

Objectives

The goal of this study was to quantify CEST related parameters such as chemical exchange rate and fractional concentration of exchanging protons at a clinical 3T scanner. For this purpose, two CEST quantification approaches—the AREX metric (for ‘apparent exchange dependent relaxation’), and the AREX-based Ω-plot method were used. In addition, two different pulsed RF irradiation schemes, using Gaussian-shaped and spin-lock pulses, were compared.

Materials and methods

Numerical simulations as well as MRI measurements in phantoms were performed. For simulations, the Bloch–McConnell equations were solved using a two-pool exchange model. MR experiments were performed on a clinical 3T MRI scanner using a cylindrical phantom filled with creatine solution at different pH values and different concentrations.

Results

The validity of the Ω-plot method and the AREX approach using spin-lock preparation for determination of the quantitative CEST parameters was demonstrated. Especially promising results were achieved for the Ω-plot method when the spin-lock preparation was employed.

Conclusion

Pulsed CEST at 3T could be used to quantify parameters such as exchange rate constants and concentrations of protons exchanging with free water. In the future this technique might be used to estimate the exchange rates and concentrations of biochemical substances in human tissues in vivo.
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2.

Objective

To develop a novel framework for evaluating the accuracy of quantitative analysis on dynamic contrast-enhanced (DCE) MRI with a specific combination of imaging technique, scanning parameters, and scanner and software performance and to test this framework with breast DCE MRI with Time-resolved angiography WIth Stochastic Trajectories (TWIST).

Materials and methods

Realistic breast tumor phantoms were 3D printed as cavities and filled with solutions of MR contrast agent. Full k-space raw data of individual tumor phantoms and a uniform background phantom were acquired. DCE raw data were simulated by sorting the raw data according to TWIST view order and scaling the raw data according to the enhancement based on pharmaco-kinetic (PK) models. The measured spatial and temporal characteristics from the images reconstructed using the scanner software were compared with the original PK model (ground truth).

Results

Images could be reconstructed using the manufacturer’s platform with the modified ‘raw data.’ Compared with the ‘ground truth,’ the RMS error in all images was <10% in most cases. With increasing view-sharing acceleration, the error of the initial uptake slope decreased while the error of peak enhancement increased. Deviations of PK parameters varied with the type of enhancement.

Conclusion

A new framework has been developed and tested to more realistically evaluate the quantitative measurement errors caused by a combination of the imaging technique, parameters and scanner and software performance in DCE-MRI.
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3.

Objectives

A postprocessing technique termed 3D true-phase polarity recovery with independent phase estimation using three-tier stacks based region growing (3D-TRIPS) was developed, which directly reconstructs phase-sensitive inversion-recovery images without acquisition of phase-reference images. The utility of this technique is demonstrated in myocardial late gadolinium enhancement (LGE) imaging.

Materials and methods

A data structure with three tiers of stacks was used for 3D-TRIPS to directly achieve reliable region growing for successful background-phase estimation. Fifteen patients undergoing postgadolinium 3D phase-sensitive inversion recovery (PSIR) cardiac LGE magnetic resonance imaging (MRI) were recruited, and 3D-TRIPS LGE reconstructions were compared with standard PSIR. Objective voxel-by-voxel comparison was performed. Additionally, blinded review by two radiologists compared scar visibility, clinical acceptability, voxel polarity error, or groups and blurring.

Results

3D-TRIPS efficiently reconstructed postcontrast phase-sensitive myocardial LGE images. Objective analysis showed an average 95% voxel-by-voxel agreement between 3D-TRIPS and PSIR images. Blinded radiologist review demonstrated similar image quality between 3D-TRIPS and PSIR reconstruction.

Conclusion

3D-TRIPS provided similar image quality to PSIR for phase-sensitive myocardial LGE MRI reconstruction. 3D-TRIPS does not require acquisition of a reference image and can therefore be used to accelerate phase-sensitive LGE imaging.
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4.

Objective

Ultrahigh field MRI provides great opportunities for medical diagnostics and research. However, ultrahigh field MRI also brings challenges, such as larger magnetic susceptibility induced field changes. Parallel-transmit radio-frequency pulses can ameliorate these complications while performing advanced tasks in routine applications. To address one class of such pulses, we propose an optimal-control algorithm as a tool for designing advanced multi-dimensional, large flip-angle, radio-frequency pulses. We contrast initial conditions, constraints, and field correction abilities against increasing pulse trajectory acceleration factors.

Materials and methods

On an 8-channel 7T system, we demonstrate the quasi-Newton algorithm with pulse designs for reduced field-of-view imaging with an oil phantom and in vivo with scans of the human brain stem. We used echo-planar imaging with 2D spatial-selective pulses. Pulses are computed sufficiently rapid for routine applications.

Results

Our dataset was quantitatively analyzed with the conventional mean-square-error metric and the structural-similarity index from image processing. Analysis of both full and reduced field-of-view scans benefit from utilizing both complementary measures.

Conclusion

We obtained excellent outer-volume suppression with our proposed method, thus enabling reduced field-of-view imaging using pulse trajectory acceleration factors up to 4.
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5.

Objective

Our aim was to map the in vivo human functional connectivity of several brainstem nuclei with the rest of the brain by using seed-based correlation of ultra-high magnetic field functional magnetic resonance imaging (fMRI) data.

Materials and methods

We used the recently developed template of 11 brainstem nuclei derived from multi-contrast structural MRI at 7 Tesla as seed regions to determine their connectivity to the rest of the brain. To achieve this, we used the increased contrast-to-noise ratio of 7-Tesla fMRI compared with 3 Tesla and time-efficient simultaneous multi-slice imaging to cover the brain with high spatial resolution (1.1-mm isotropic nominal resolution) while maintaining a short repetition time (2.5 s).

Results

The delineated Pearson’s correlation-based functional connectivity diagrams (connectomes) of 11 brainstem nuclei of the ascending arousal, motor, and autonomic systems from 12 controls are presented and discussed in the context of existing histology and animal work.

Conclusion

Considering that the investigated brainstem nuclei play a crucial role in several vital functions, the delineated preliminary connectomes might prove useful for future in vivo research and clinical studies of human brainstem function and pathology, including disorders of consciousness, sleep disorders, autonomic disorders, Parkinson’s disease, and other motor disorders.
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6.

Objective

Our objective was to compare available techniques reducing artifacts in echo planar imaging (EPI)-based diffusion-weighed magnetic resonance imaging MRI (DWI) of the neck at 3 Tesla caused by B0-field inhomogeneities.

Materials and methods

A cylindrical fat–water phantom was equipped with a Maxwell coil allowing for additional linear B0-field variations in z-direction. The effect of increasing strength of this superimposed gradient on image quality was observed using a standard single-shot EPI-based DWI sequence (sEPI), a zoomed single-shot EPI sequence (zEPI), a readout-segmented EPI sequence (rsEPI), and an sEPI sequence with integrated dynamic shimming (intEPI) on a 3-Tesla system. Additionally, ten volunteers were examined over the neck region using these techniques. Image quality was assessed by two radiologists. Scan durations were recorded.

Results

With increasing strength of the external gradient, marked distortions, signal loss, and failure of fat suppression were observed using sEPI, zEPI, and rsEPI. These artifacts were markedly reduced using intEPI. Significantly better in vivo image quality was also observed using intEPI compared with the other techniques. Scan time of intEPI was similar to sEPI and zEPI and shorter than rsEPI.

Conclusion

The use of integrated 2D shim and frequency adjustment for EPI-based DWI results in a significant improvement in image quality of the head/neck region at 3 Tesla. Combining integrated shimming with rsEPI or zEPI can be expected to provide additional improvements.
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7.

Objective

Here we develop a three-dimensional analytic model for MR image contrast of collagen lamellae in the annulus fibrosus of the intervertebral disc of the spine, based on the dependence of the MRI signal on collagen fiber orientation.

Materials and methods

High-resolution MRI scans were performed at 1.5 and 7 T on intact whole disc specimens from ovine, bovine, and human spines. An analytic model that approximates the three-dimensional curvature of the disc lamellae was developed to explain inter-lamellar contrast and intensity variations in the annulus. The model is based on the known anisotropic dipolar relaxation of water in tissues with ordered collagen.

Results

Simulated MRI data were generated that reproduced many features of the actual MRI data. The calculated inter-lamellar image contrast demonstrated a strong dependence on the collagen fiber angle and on the circumferential location within the annulus.

Conclusion

This analytic model may be useful for interpreting MR images of the disc and for predicting experimental conditions that will optimize MR image contrast in the annulus fibrosus.
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8.

Objective

In this work, a prototype of an effective electromagnet with a field-of-view (FoV) of 140 mm for neonatal head imaging is presented. The efficient implementation succeeded by exploiting the use of steel plates as a housing system. We achieved a compromise between large sample volumes, high homogeneity, high B0 field, low power consumption, light weight, simple fabrication, and conserved mobility without the necessity of a dedicated water cooling system.

Materials and methods

The entire magnetic resonance imaging (MRI) system (electromagnet, gradient system, transmit/receive coil, control system) is introduced and its unique features discussed. Furthermore, simulations using a numerical optimization algorithm for magnet and gradient system are presented.

Results

Functionality and quality of this low-field scanner operating at 23 mT (generated with 500 W) is illustrated using spin-echo imaging (in-plane resolution 1.6 mm × 1.6 mm, slice thickness 5 mm, and signal-to-noise ratio (SNR) of 23 with a acquisition time of 29 min). B0 field-mapping measurements are presented to characterize the homogeneity of the magnet, and the B0 field limitations of 80 mT of the system are fully discussed.

Conclusion

The cryogen-free system presented here demonstrates that this electromagnet with a ferromagnetic housing can be optimized for MRI with an enhanced and homogeneous magnetic field. It offers an alternative to prepolarized MRI designs in both readout field strength and power use. There are multiple indications for the clinical medical application of such low-field devices.
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9.

Objectives

The need for affordable and appropriate medical technologies for developing countries continues to rise as challenges such as inadequate energy supply, limited technical expertise, and poor infrastructure persist. Low-field magnetic resonance imaging (LF MRI) is a technology that can be tailored to meet specific imaging needs within such countries. Its low power requirements and the possibility of operating in minimally shielded or unshielded environments make it especially attractive. Although the technology has been widely demonstrated over several decades, it is yet to be shown that it can be diagnostic and improve patient outcomes in clinical applications. We here demonstrate the robustness of prepolarizing MRI (PMRI) technology for assembly and deployment in developing countries for the specific application to infant hydrocephalus. Hydrocephalus treatment planning and management requires only modest spatial resolution, such that the brain can be distinguished from fluid—tissue contrast detail within the brain parenchyma is not essential.

Materials and Methods

We constructed an internally shielded PMRI system based on the Lee-Whiting coil system with a 22-cm diameter of spherical volume.

Results

In an unshielded room, projection phantom images were acquired at 113 kHz with in-plane resolution of 3 mm?×?3 mm, by introducing gradient fields of sufficient magnitude to dominate the 5000 ppm inhomogeneity of the readout field.

Discussion

The low cost, straightforward assembly, deployment potential, and maintenance requirements demonstrate the suitability of our PMRI system for developing countries. Further improvement in image spatial resolution and contrast of LF MRI will broaden its potential clinical utility beyond hydrocephalus.
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10.

Objective

Magnetic resonance elastography (MRE) requires substantial data processing based on phase image reconstruction, wave enhancement, and inverse problem solving. The objective of this study is to propose a new, fast MRE method based on MR raw data processing, particularly adapted to applications requiring fast MRE measurement or high elastogram update rate.

Materials and methods

The proposed method allows measuring tissue elasticity directly from raw data without prior phase image reconstruction and without phase unwrapping. Experimental feasibility is assessed both in a gelatin phantom and in the liver of a porcine model in vivo. Elastograms are reconstructed with the raw MRE method and compared to those obtained using conventional MRE. In a third experiment, changes in elasticity are monitored in real-time in a gelatin phantom during its solidification by using both conventional MRE and raw MRE.

Results

The raw MRE method shows promising results by providing similar elasticity values to the ones obtained with conventional MRE methods while decreasing the number of processing steps and circumventing the delicate step of phase unwrapping. Limitations of the proposed method are the influence of the magnitude on the elastogram and the requirement for a minimum number of phase offsets.

Conclusion

This study demonstrates the feasibility of directly reconstructing elastograms from raw data.
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11.

Objective

This study assesses and quantifies impairment of postoperative magnetic resonance imaging (MRI) at 7 Tesla (T) after implantation of titanium cranial fixation plates (CFPs) for neurosurgical bone flap fixation.

Materials and methods

The study group comprised five patients who were intra-individually examined with 3 and 7 T MRI preoperatively and postoperatively (within 72 h/3 months) after implantation of CFPs. Acquired sequences included T1-weighted magnetization-prepared rapid-acquisition gradient-echo (MPRAGE), T2-weighted turbo-spin-echo (TSE) imaging, and susceptibility-weighted imaging (SWI). Two experienced neurosurgeons and a neuroradiologist rated image quality and the presence of artifacts in consensus reading.

Results

Minor artifacts occurred around the CFPs in MPRAGE and T2 TSE at both field strengths, with no significant differences between 3 and 7 T. In SWI, artifacts were accentuated in the early postoperative scans at both field strengths due to intracranial air and hemorrhagic remnants. After resorption, the brain tissue directly adjacent to skull bone could still be assessed. Image quality after 3 months was equal to the preoperative examinations at 3 and 7 T.

Conclusion

Image quality after CFP implantation was not significantly impaired in 7 T MRI, and artifacts were comparable to those in 3 T MRI.
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12.

Purpose

To evaluate the function of an active implantable medical device (AIMD) during magnetic resonance imaging (MRI) scans. The induced voltages caused by the switching of magnetic field gradients and rectified radio frequency (RF) pulse were measured, along with the AIMD stimulations.

Materials and methods

An MRI-compatible voltage probe with a bandwidth of 0–40 kHz was designed. Measurements were carried out both on the bench with an overvoltage protection circuit commonly used for AIMD and with a pacemaker during MRI scans on a 1.5 T (64 MHz) MR scanner.

Results

The sensor exhibits a measurement range of?±?15 V with an amplitude resolution of 7 mV and a temporal resolution of 10 µs. Rectification was measured on the bench with the overvoltage protection circuit. Linear proportionality was confirmed between the induced voltage and the magnetic field gradient slew rate. The pacemaker pacing was recorded successfully during MRI scans.

Conclusion

The characteristics of this low-frequency voltage probe allow its use with extreme RF transmission power and magnetic field gradient positioning for MR safety test of AIMD during MRI scans.
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13.

Objectives

Our objective was to test a data-exclusion strategy for respiratory motion suppression by retrospectively eliminating data acquired at extreme respiratory positions for improved coronary vessel sharpness (VS) of 1-D self-navigated 3-D radial whole-heart coronary angiography acquisitions.

Materials and methods

3-D radial self-navigated acquisitions were performed on a 1.5T scanner in volunteers during free-breathing (n = 8), in coached volunteers (n = 13) who were asked to breathe in a controlled manner to mimic cardiovascular patients presenting with Cheyne-Stokes breathing, and in free-breathing patients (n = 20). Data collected during large respiratory excursions were gradually excluded retrospectively from the reconstruction yielding 14 data sets per subject on average. The impact on VS, blood and myocardium signal-to-noise and contrast-to-noise was measured. From these results, two retrospective gating strategies were defined for the k-line elimination procedure and tested in all groups.

Results

Maximum right coronary artery VS improvement was +7.4 and +2.7% in coached volunteers and patients (P < 0.0001 for both), respectively, and 1.6% for the free-breathing volunteers (P = 0.13). The first gating strategy was defined as a fixed undersampling factor of 5 compared to a fully sampled 3-D radial acquisition, yielding significant VS improvement in coached volunteers and patients while myocardial signal-to-noise decreased in these. The second strategy was defined as a fixed gating window of 5.7 mm, leading to similar improvements.

Conclusion

The presented strategies improve image quality of self-navigated acquisitions by retrospectively excluding data collected during end-inspiration.
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14.

Objectives

In order to introduce 4D flow magnetic resonance imaging (MRI) as a standard clinical instrument for studying the cerebrovascular system, new and faster postprocessing tools are necessary. The objective of this study was to construct and evaluate a method for automatic identification of individual cerebral arteries in a 4D flow MRI angiogram.

Materials and methods

Forty-six elderly individuals were investigated with 4D flow MRI. Fourteen main cerebral arteries were manually labeled and used to create a probabilistic atlas. An automatic atlas-based artery identification method (AAIM) was developed based on vascular-branch extraction and the atlas was used for identification. The method was evaluated by comparing automatic with manual identification in 4D flow MRI angiograms from 67 additional elderly individuals.

Results

Overall accuracy was 93 %, and internal carotid artery and middle cerebral artery labeling was 100 % accurate. Smaller and more distal arteries had lower accuracy; for posterior communicating arteries and vertebral arteries, accuracy was 70 and 89 %, respectively.

Conclusion

The AAIM enabled fast and fully automatic labeling of the main cerebral arteries. AAIM functionality provides the basis for creating an automatic and powerful method to analyze arterial cerebral blood flow in clinical routine.
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15.

Objectives

Reproducibility of myocardial contour determination in cardiac magnetic resonance imaging is important, especially when determining T2* values per myocardial segment as a prognostic factor of heart failure or thalassemia. A method creating a composite image with contrasts optimized for drawing myocardial contours is introduced and compared with the standard method on a single image.

Materials and methods

A total of 36 short-axis slices from bright-blood multigradient echo (MGE) T2* scans of 21 patients were acquired at eight echo times. Four observers drew free-hand myocardial contours on one manually selected T2* image (method 1) and on one image composed by blending three images acquired at TEs providing optimum contrast-to-noise ratio between the myocardium and its surrounding regions (method 2).

Results

Myocardial contouring by method 2 met higher interobserver reproducibility than method 1 (P < 0.001) with smaller Coefficient of variance (CoV) of T2* values in the presence of myocardial iron accumulation (9.79 vs. 15.91 %) and in both global myocardial and mid-ventricular septum regions (12.29 vs. 16.88 and 5.76 vs. 8.16 %, respectively).

Conclusion

The use of contrast-optimized composite images in MGE data analysis improves reproducibility of myocardial contour determination, leading to increased consistency in the calculated T2* values enhancing the diagnostic impact of this measure of iron overload.
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16.

Objective

To retrospectively assess perception of safety of healthy individuals working with human 7 Tesla (T) magnetic resonance imaging (MRI) scanners.

Materials and methods

A total of 66 healthy individuals with a mean age of 31 ± 7 years participated in this retrospective multicentre survey study. Nonparametric correlation analysis was conducted to evaluate the relation between self-reported perception of safety and prevalence of sensory effects while working with 7 T MRI scanners for an average 47 months.

Results

The results indicated that 98.5 % of the study participants had a neutral or positive feeling about safety aspects at 7 T MRI scanners. 45.5 % reported that they feel very safe and none of the participants stated that they feel moderately or very unsafe while working with 7 T MRI scanners. Perception of safety was not affected by the number of hours per week spent in the vicinity of the 7 T MRI scanner or the duration of experience with 7 T MRI. More than 50 % of individuals experienced vertigo and metallic taste while working with 7 T MRI scanners. However, participants’ perceptions of safety were not affected by the prevalence of MR-related symptoms.

Conclusions

The overall data indicated an average perception of a moderately safe work environment. To our knowledge, this study delineates the first attempt to assess the subjective safety perception among 7 T MRI workers and suggests further investigations are indicated.
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17.

Objective

Zero echo time (ZTE) and ultrashort echo time (UTE) pulse sequences for MRI offer unique advantages of being able to detect signal from rapidly decaying short-T2 tissue components. In this paper, we applied 3D ZTE and UTE pulse sequences at 7T to assess differences between these methods.

Materials and methods

We matched the ZTE and UTE pulse sequences closely in terms of readout trajectories and image contrast. Our ZTE used the water- and fat-suppressed solid-state proton projection imaging method to fill the center of k-space. Images from healthy volunteers obtained at 7T were compared qualitatively, as well as with SNR and CNR measurements for various ultrashort, short, and long-T2 tissues.

Results

We measured nearly identical contrast-to-noise and signal-to-noise ratios (CNR/SNR) in similar scan times between the two approaches for ultrashort, short, and long-T2 components in the brain, knee and ankle. In our protocol, we observed gradient fidelity artifacts in UTE, and our chosen flip angle and readout also resulted in shading artifacts in ZTE due to inadvertent spatial selectivity. These can be corrected by advanced reconstruction methods or with different chosen protocol parameters.

Conclusion

The applied ZTE and UTE pulse sequences achieved similar contrast and SNR efficiency for volumetric imaging of ultrashort-T2 components. Key differences include that ZTE is limited to volumetric imaging, but has substantially reduced acoustic noise levels during the scan. Meanwhile, UTE has higher acoustic noise levels and greater sensitivity to gradient fidelity, but offers more flexibility in image contrast and volume selection.
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18.

Objective

We demonstrate the potential clinical utility of a 4D non-gadolinium dynamic angiography technique based on arterial spin-labeling called contrast inherent inflow enhanced multi-phase angiography (CINEMA) in pediatric patients.

Materials and Methods

CINEMA was qualitatively compared to conventional time-of-flight (TOF) angiography in a cohort of 31 pediatric patients at 3 Tesla.

Results

CINEMA data were successfully acquired and reconstructed in all patients with no image artifacts. There were no cases where CINEMA was rated inferior to TOF in depicting intracranial vessel conspicuity. In 19 cases, CINEMA was rated equivalent to TOF and in the 12 remaining cases CINEMA was rated superior to TOF.

Conclusion

There is a steadily rising concern in adults and children over the potential effects of intracranial deposition of gadolinium. CINEMA is therefore a viable alternative in dynamic neurovascular imaging.
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19.

Objectives

The objective of the current work was to evaluate flow and turbulent kinetic energy in different transcatheter aortic valve implants using highly undersampled time-resolved multi-point 3-directional phase-contrast measurements (4D Flow MRI) in an in vitro setup.

Materials and methods

A pulsatile flow setup was used with a compliant tubing mimicking a stiff left ventricular outflow tract and ascending aorta. Five different implants were measured using a highly undersampled multi-point 4D Flow MRI sequence. Velocities and turbulent kinetic energy values were analysed and compared.

Results

Strong variations of turbulent kinetic energy distributions between the valves were observed. Maximum turbulent kinetic energy values ranged from 100 to over 500 J/m3 while through-plane velocities were similar between all valves.

Conclusion

Highly accelerated 4D Flow MRI for the measurement of velocities and turbulent kinetic energy values allowed for the assessment of hemodynamic parameters in five different implant models. The presented setup, measurement protocol and analysis methods provides an efficient approach to compare different valve implants and could aid future novel valve designs.
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20.

Objective

To accelerate super-selective arterial spin labeling (ASL) angiography by using a single control condition denoted as cycled super-selective arterial spin labeling.

Materials and methods

A single non-selective control image is acquired that is shared by selective label images. Artery-selective imaging is possible by geometrically changing the position of the labeling focus to more than one artery of interest during measurement. The presented approach is compared to conventional super-selective imaging in terms of its labeling efficiency inside and outside the labeling focus using numerical simulations and in vivo measurements. Additionally, the signal-to-noise ratios of the images are compared to non-selective ASL angiography and analyzed using a two-way ANOVA test and calculating the Pearson’s correlation coefficients.

Results

The results indicate that the labeling efficiency is not reduced within the labeled artery, but can increase as a function of distance to the artery of interest when compared to conventional super-selective ASL. In the final images, no statistically significant difference of image quality can be observed while the acquisition duration could be reduced when the major brain feeding arteries are being tagged.

Conclusion

Using super-selective arterial spin labeling, a single non-selective control acquisition suffices for reconstructing selective angiograms of the cerebral vasculature, thereby accelerating image acquisition of the major intracranial arteries without notable loss of information.
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