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    MR Angiography: Divya Ninan

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    Benjamin Barsouma Mathew
    MR angiography is a non-invasive imaging technique used to visualize blood vessels. It does not require iodinated contrast media or radiation exposure. There are two main types of MR angiography - black blood imaging which depicts slow or stagnant blood as bright, and bright blood imaging which uses gradient echo sequences to depict flowing blood as bright. Time-of-flight MRA is a common bright blood technique that uses inflow enhancement to produce vascular contrast. It can image straight vessels but has limitations for complex or tortuous vessels due to saturation effects. Phase contrast MRA uses velocity encoding gradients to measure blood flow velocities and direction which allows creation of magnitude and directional velocity maps, though it has longer scan times.

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    MR Angiography: Divya Ninan

    Uploaded by

    Benjamin Barsouma Mathew
    50 views52 pages
    MR angiography is a non-invasive imaging technique used to visualize blood vessels. It does not require iodinated contrast media or radiation exposure. There are two main types of MR angiography - black blood imaging which depicts slow or stagnant blood as bright, and bright blood imaging which uses gradient echo sequences to depict flowing blood as bright. Time-of-flight MRA is a common bright blood technique that uses inflow enhancement to produce vascular contrast. It can image straight vessels but has limitations for complex or tortuous vessels due to saturation effects. Phase contrast MRA uses velocity encoding gradients to measure blood flow velocities and direction which allows creation of magnitude and directional velocity maps, though it has longer scan times.

    Original Description:

    Technique of MR angiograms

    Original Title

    MR Angiography

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    MR angiography is a non-invasive imaging technique used to visualize blood vessels. It does not require iodinated contrast media or radiation exposure. There are two main types of MR angiography - black blood imaging which depicts slow or stagnant blood as bright, and bright blood imaging which uses gradient echo sequences to depict flowing blood as bright. Time-of-flight MRA is a common bright blood technique that uses inflow enhancement to produce vascular contrast. It can image straight vessels but has limitations for complex or tortuous vessels due to saturation effects. Phase contrast MRA uses velocity encoding gradients to measure blood flow velocities and direction which allows creation of magnitude and directional velocity maps, though it has longer scan times.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    50 views52 pages

    MR Angiography: Divya Ninan

    Uploaded by

    Benjamin Barsouma Mathew
    MR angiography is a non-invasive imaging technique used to visualize blood vessels. It does not require iodinated contrast media or radiation exposure. There are two main types of MR angiography - black blood imaging which depicts slow or stagnant blood as bright, and bright blood imaging which uses gradient echo sequences to depict flowing blood as bright. Time-of-flight MRA is a common bright blood technique that uses inflow enhancement to produce vascular contrast. It can image straight vessels but has limitations for complex or tortuous vessels due to saturation effects. Phase contrast MRA uses velocity encoding gradients to measure blood flow velocities and direction which allows creation of magnitude and directional velocity maps, though it has longer scan times.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    of 52

    MR Angiography

    Divya Ninan
    MR Angiography
    • Angiography – imaging technique for the
    visualization of blood vessels

    • Non invasive, does not involve iodinated contrast


    media / radiation
    MRA techniques

    www.radiologycafe.com
    Black / bright blood imaging
    Black blood imaging Bright blood imaging
    • Spin echo sequences • Gradient echo based
    • Flowing blood appears techniques
    dark • Multiple short TR
    • Slow flow, clot - brighter • Blood appears bright
    Black blood imaging

    Spin Echo
    Black blood imaging / Flow voids

    Signal void of
    flowing
    blood

    High signal
    of stationary
    tissue
    Time of Flight MRA (ToF MRA)
    Time of flight MRA

    Gradient echo sequence

    Inflow enhancement

    Produces vascular contrast by manipulating
    longitudinal relaxation of stationary tissue

    Basic mechanism

    Background
    tissue Bright inflow
    suppression signal
    2D ToF MRA
    • Straight vessels running perpendicular to the
    plane of imaging – aorta, carotids, peripheral
    arteries
    • Thin (1-2 mm) slices are obtained as a stack
    • Good sensitivity to slow flow - veins
    2D ToF image

    www.mriquestions.com
    3D ToF MRA
    • Compact anatomic regions - circle of Willis
    • Image is obtained by isotropic (square) voxels,
    allowing reformation in any direction
    • High spatial resolution
    • High signal-to-noise ratio
    • Not sensitive to slow flow
    • Longer acquisition times
    3D ToF Image

    www.mriquestions.com
    ToF MRA Artifacts
    1. Stair step artifact
    Subtle pixelated appearance to obliquely
    oriented vessels
    Slices in 2D are relatively thick (1-3 mm)
    compared to the in-plane spatial resolution of
    0.5-1.0 mm
    Minimized by overlapping slices by 25-30% -
    more slices are needed, increased scan time
    http://mriquestions.com/tof-mra-artifacts.html
    ToF MRA Artifacts
    2. Shine through artifacts
    2D and 3D TOF MR angiographic images are
    displayed using a maximum intensity projection
    (MIP) algorithm
    Underlying TOF MRA pulse sequences are T1-
    weighted
    Short T1 materials (hematoma, gadolinium, fat) will
    "shine through" and "contaminate" the MIP
    image
    http://mriquestions.com/tof-mra-artifacts.html
    ToF MRA Artifacts
    4. Flow reversal artifact
    Employ travelling saturation pulses to eliminate
    signal from veins flowing in the opposite
    direction
    If an artery has retrograde flow it will be
    suppressed on ToF MRA
    http://mriquestions.com/tof-mra-artifacts.html
    ToF MRA Artifacts
    3. In Plane Saturation Artifact
    Image plane is kept perpendicular to the flow
    direction
    When vessels travel within plane, their blood
    may become saturated like stationary tissues,
    resulting in decreased signal
    http://mriquestions.com/tof-mra-artifacts.html
    Saturation effects in 3D ToF
    • Gradual loss of longitudinal magnetization
    caused by repeated excitation radio-frequency
    (RF) pulses
    • Distal portion of the vessel may not be
    included in the image
    • MOTSA – multiple overlapping thin slice
    accquisition
    Multiple overlapping thin slice acquisition
    (MOTSA)
    • Sequential acquisition of several overlapping
    3D volumes (or "slabs")
    • Each slab is typically less than 5 cm in
    thickness
    • Central portions for each of the overlapping
    acquisitions to make up the final data set for
    processing into the MRA projections.
    Multiple overlapping thin slice acquisition
    (MOTSA)
    Venetian Blind Artifact in MOTSA

    Exact registration of position and signal intensity of


    adjacent slabs may not be possible
    2D vs 3D Time of Flight (ToF MRA)
    Phase contrast (PC) MRA
    Phase contrast (PC) MRA
    • Uses change in the phase of transverse
    magnetization (TM) of the flowing blood to produce
    image
    • Phase gain of flowing blood through a gradient is
    proportional to its velocity
    • Bipolar gradients are applied sequentially along the
    cardinal directions (x-, y-, and z-)
    • Measuring phase shifts, velocity measurements can
    be computed
    Principle of PC MRA
    All protons are brought in phase
    by initial RF PULSE

    Gradient is applied – phase shift in


    both stationary and flowing protons
    at different rates
    Second gradient pulse applied of
    opposite polarity

    Stationary tissue – equal reversal


    of phase shift occurs ( no net
    Flowing protons have changed
    phase shift)
    their position – phase shift is not
    corrected – used to create
    angiographic images

    Magnitude map Phase image


    PC used for measuring flow
    • Calculation of three velocity vector
    components: vx, vy, and vz

    • Directional velocity map or a magnitude


    (speed) image
    Directional velocity map vs Magnitude image

    Directional velocity map Magnitude Image


    Velocity encoding (VENC)
    • Parameter selected by the MR operator when
    using PC MRA
    • VENC represents the maximum velocity
    present in the imaging volume
    • Any velocity greater than the VENC will be
    aliased according to the formula
    • Aliased velocity = VENC – actual velocity
    Aliasing in PC MRA
    Advantages
    • Magnitude and directional velocity map
    images
    • Superior background suppression
    Limitations
    • Takes 4x as long as TOF
    • More sensitivity to turbulence
    • Optimum VENC to be selected

    • 2D techniques are faster


    • 3D techniques have better signal to noise ratio
    Phase contrast MRA

    http://mriquestions.com/phase-contrast-mra.html
    Summary

    www.radiologycafe.com
    Bibliography
    • Morita S, Masukawa A, Suzuki K, Hirata M, Kojima S, Ueno E. Unenhanced
    MR Angiography: Techniques and Clinical Applications in Patients with
    Chronic Kidney Disease. RadioGraphics. 2011 Mar;31(2):E13–33.
    • MRI made easy – Govind B Chavhan
    • www.radiologyassistant.nl
    • www.radiologycafe.com
    • www.mriquestions.com
    Acknowledgements
    • Dr Prateek
    Thank you

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