Maoxue Wang1, Yiming Ma1, Fei Chen2, Fei Zhou1, Jilei Zhang3, Bing Zhang1,4. 1. Department of Radiology, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China. 2. Department of Radiology, The Yancheng School of Clinical Medicine of Nanjing Medical University, Yancheng, China. 3. Philips Healthcare, Shanghai, China. 4. Institute of Brain Science, Nanjing University, Nanjing, China.
Abstract
Objectives: The objectives of this study were to accelerate the non-contrast-enhanced four-dimensional magnetic resonance angiography (4D MRA) based on pseudocontinuous arterial spin labeling combined with the Keyhole and View-sharing (4D-PACK) procedure using the Compressed SENSE (C-SENSE) and to improve intracranial vasculopathy evaluations for clinical purposes. Methods: 4D-PACK acquisition with different C-SENSE and SENSE acceleration factors was performed on 29 healthy volunteers and six patients by means of a 3.0 T MR system. Two radiologists used a 4-grade scale to qualitatively assess the vessel visualization of the middle cerebral artery (MCA) and used a 5-grade scale to qualitatively examine the image quality of 4D-PACK axial source images. Interobserver agreement was assessed by determining the weighted kappa statistic. The contrast-to-noise ratio (CNR) and arterial transmit time (ATT) were calculated in four segments of the MCA. The repeated measures one-way ANOVA for CNR and the Friedman test for source images and vessel visualization were used to analyse the differences in five sequences. Results: (1) At the M4 segment, C-SENSE5 acquisition (scores, 2.72 ± 0.53) and C-SENSE6.5 (scores, 2.55 ± 0.57) provided similar vessel visualization compared with SENSE4.5 (scores, 2.72 ± 0.46); however, C-SENSE8 (scores, 1.79 ± 0.49) and C-SENSE10 (scores, 1.52 ± 0.51) had lower scores (P < 0.050). (2) The source image quality of C-SENSE5 (scores, 4.55 ± 0.51), C-SENSE6.5 (scores, 4.03 ± 0.33), and C-SENSE8 (scores, 3.48 ± 0.51) acquisition was higher than that of SENSE4.5 (scores, 3.07 ± 0.26) (P < 0.001). (3) CNRs of different MCA segments for C-SENSE5 and C-SENSE6.5 acquisitions were not significantly different compared with that of SENSE4.5 acquisition. However, the CNRs were significantly lower for C-SENSE8 (M1: 45.85 ± 13.91, M2: 27.08 ± 9.92, M4: 7.93 ± 4.49) and C-SENSE10 (M1: 37.94 ± 9.92, M2: 23.51 ± 9.0, M4: 6.78 ± 4.12) than for SENSE4.5 (M1: 55.49 ± 13.39, M2: 36.94 ± 11.02, M4: 10.18 ± 5.15) in each corresponding segment (P < 0.050). ATTs in all MCA segments within different accelerating C-SENSE factors were obviously correlated with SENSE4.5. Conclusion: C-SENSE6.5 acquisition could be used to evaluate both the intracranial macrovascular and distal arteries, which could reduce the acquisition time by 18% (5 min 5 s) compared with SENSE4.5. Moreover, C-SENSE8 acquisition (37% acceleration, 3 min 54 s) could be used for routine screening and clinical diagnosis of intracranial macrovascular disease with balanced image quality.
Objectives: The objectives of this study were to accelerate the non-contrast-enhanced four-dimensional magnetic resonance angiography (4D MRA) based on pseudocontinuous arterial spin labeling combined with the Keyhole and View-sharing (4D-PACK) procedure using the Compressed SENSE (C-SENSE) and to improve intracranial vasculopathy evaluations for clinical purposes. Methods: 4D-PACK acquisition with different C-SENSE and SENSE acceleration factors was performed on 29 healthy volunteers and six patients by means of a 3.0 T MR system. Two radiologists used a 4-grade scale to qualitatively assess the vessel visualization of the middle cerebral artery (MCA) and used a 5-grade scale to qualitatively examine the image quality of 4D-PACK axial source images. Interobserver agreement was assessed by determining the weighted kappa statistic. The contrast-to-noise ratio (CNR) and arterial transmit time (ATT) were calculated in four segments of the MCA. The repeated measures one-way ANOVA for CNR and the Friedman test for source images and vessel visualization were used to analyse the differences in five sequences. Results: (1) At the M4 segment, C-SENSE5 acquisition (scores, 2.72 ± 0.53) and C-SENSE6.5 (scores, 2.55 ± 0.57) provided similar vessel visualization compared with SENSE4.5 (scores, 2.72 ± 0.46); however, C-SENSE8 (scores, 1.79 ± 0.49) and C-SENSE10 (scores, 1.52 ± 0.51) had lower scores (P < 0.050). (2) The source image quality of C-SENSE5 (scores, 4.55 ± 0.51), C-SENSE6.5 (scores, 4.03 ± 0.33), and C-SENSE8 (scores, 3.48 ± 0.51) acquisition was higher than that of SENSE4.5 (scores, 3.07 ± 0.26) (P < 0.001). (3) CNRs of different MCA segments for C-SENSE5 and C-SENSE6.5 acquisitions were not significantly different compared with that of SENSE4.5 acquisition. However, the CNRs were significantly lower for C-SENSE8 (M1: 45.85 ± 13.91, M2: 27.08 ± 9.92, M4: 7.93 ± 4.49) and C-SENSE10 (M1: 37.94 ± 9.92, M2: 23.51 ± 9.0, M4: 6.78 ± 4.12) than for SENSE4.5 (M1: 55.49 ± 13.39, M2: 36.94 ± 11.02, M4: 10.18 ± 5.15) in each corresponding segment (P < 0.050). ATTs in all MCA segments within different accelerating C-SENSE factors were obviously correlated with SENSE4.5. Conclusion: C-SENSE6.5 acquisition could be used to evaluate both the intracranial macrovascular and distal arteries, which could reduce the acquisition time by 18% (5 min 5 s) compared with SENSE4.5. Moreover, C-SENSE8 acquisition (37% acceleration, 3 min 54 s) could be used for routine screening and clinical diagnosis of intracranial macrovascular disease with balanced image quality.
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