Gesine Knobloch1,2, Timothy Colgan1, Mark L Schiebler1, Kevin M Johnson1,3, Geng Li4, Tilman Schubert1,5, Scott B Reeder1,3,6,7,8, Scott K Nagle1,3,9. 1. Department of Radiology, University of Wisconsin-School of Medicine and Public Health, Madison, Wisconsin. 2. Department of Radiology, Charité University Hospital, Berlin, Germany. 3. Department of Medical Physics, University of Wisconsin-School of Medicine and Public Health, Madison, Wisconsin. 4. Department of Biostatistics and Medical Informatics, University of Wisconsin-School of Medicine and Public Health, Madison, Wisconsin. 5. Department of Neuroradiology, Zurich University Hospital, Zurich, Switzerland. 6. Department of Biomedical Engineering, University of Wisconsin-School of Medicine and Public Health, Madison, Wisconsin. 7. Department of Medicine, University of Wisconsin-School of Medicine and Public Health, Madison, Wisconsin. 8. Department of Emergency Medicine, University of Wisconsin-School of Medicine and Public Health, Madison, Wisconsin. 9. Department of Pediatrics, University of Wisconsin-School of Medicine and Public Health, Madison, Wisconsin.
Abstract
PURPOSE: To evaluate the feasibility of ferumoxytol (FE)-enhanced UTE-MRA for depiction of the pulmonary vascular and nonvascular structures. METHODS: Twenty healthy volunteers underwent contrast-enhanced pulmonary MRA at 3 T during 2 visits, separated by at least 4 weeks. Visit 1: The MRA started with a conventional multiphase 3D T1 -weighted breath-held spoiled gradient-echo MRA before and after the injection of 0.1 mmol/kg gadobenate dimeglumine (GD). Subsequently, free-breathing GD-UTE-MRA was acquired as a series of 3 flip angles (FAs) (6°, 12°, 18°) to optimize T1 weighting. Visit 2: After the injection of 4 mg/kg FE, MRA was performed during the steady state, starting with a conventional 3D T1 -weighted breath-held spoiled gradient-echo MRA and followed by free-breathing FE-UTE-MRA, both at 4 different FAs (6°, 12°, 18°, 24°). The optimal FA for best T1 contrast was evaluated. Image quality at the optimal FA was compared between methods on a 4-point ordinal scale, using multiphase GD conventional pulmonary MRA (cMRA) as standard of reference. RESULTS: Flip angle in the range of 18°-24° resulted in best T1 contrast for FE cMRA and both UTE-MRA techniques (p > .05). At optimized FA, image quality of the vasculature was good/excellent with both FE-UTE-MRA and GD cMRA (98% versus 97%; p = .51). Both UTE techniques provided superior depiction of nonvascular structures compared with either GD-enhanced or FE-enhanced cMRA (p < .001). However, GD-UTE-MRA showed the lowest image quality of the angiogram due to low image contrast. CONCLUSION: Free-breathing UTE-MRA using FE is feasible for simultaneous assessment of the pulmonary vasculature and nonvascular structures. Patient studies should investigate the clinical utility of free-breathing UTE-MRA for assessment of pulmonary emboli.
PURPOSE: To evaluate the feasibility of ferumoxytol (FE)-enhanced UTE-MRA for depiction of the pulmonary vascular and nonvascular structures. METHODS: Twenty healthy volunteers underwent contrast-enhanced pulmonary MRA at 3 T during 2 visits, separated by at least 4 weeks. Visit 1: The MRA started with a conventional multiphase 3D T1 -weighted breath-held spoiled gradient-echo MRA before and after the injection of 0.1 mmol/kg gadobenate dimeglumine (GD). Subsequently, free-breathing GD-UTE-MRA was acquired as a series of 3 flip angles (FAs) (6°, 12°, 18°) to optimize T1 weighting. Visit 2: After the injection of 4 mg/kg FE, MRA was performed during the steady state, starting with a conventional 3D T1 -weighted breath-held spoiled gradient-echo MRA and followed by free-breathing FE-UTE-MRA, both at 4 different FAs (6°, 12°, 18°, 24°). The optimal FA for best T1 contrast was evaluated. Image quality at the optimal FA was compared between methods on a 4-point ordinal scale, using multiphase GD conventional pulmonary MRA (cMRA) as standard of reference. RESULTS: Flip angle in the range of 18°-24° resulted in best T1 contrast for FE cMRA and both UTE-MRA techniques (p > .05). At optimized FA, image quality of the vasculature was good/excellent with both FE-UTE-MRA and GD cMRA (98% versus 97%; p = .51). Both UTE techniques provided superior depiction of nonvascular structures compared with either GD-enhanced or FE-enhanced cMRA (p < .001). However, GD-UTE-MRA showed the lowest image quality of the angiogram due to low image contrast. CONCLUSION: Free-breathing UTE-MRA using FE is feasible for simultaneous assessment of the pulmonary vasculature and nonvascular structures. Patient studies should investigate the clinical utility of free-breathing UTE-MRA for assessment of pulmonary emboli.
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