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1.5T MobiFlex angiography - ULB Erasme, Brussels

ExamCard
Metens, Thierry, Ph.D. Brussels, Erasme Hospital

1.5T MobiFlex peripheral angiography - ULB Erasme hospital, Brussels, Belgium

ExamCard purpose

Two release 2.5 Achieva 1.5T ExamCards have been created to perform MobiFlex angiography of the peripheral vessels. The first ExamCard includes protocols for a 3 station MobiFlex study with the SENSE XL Torso coil positioned on the most distal station. As an alternative, a second ExamCard is provided where both the 3D 3-station MobiFlex scans and a 4D-TRAK scan are acquired.

ExamCard overviews

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Rep FF supine: survey scan using the SENSE XL Torso coil

 

Ref_SXLT_ALL: SENSE reference scan for the SENSE XL Torso coil

 

2DBT Supine: is planned on the lower abdomen with the F-H off-centers adjusted accordingly.

 

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Rep FF Supine: survey using the SENSE XL Torso coil.

 

Ref_SXLT_ALL : SENSE reference scan for the SENSE XL Torso coil on the most distal station.

 

2D_TIMING: should be planned as a transversal section through the femoral artey.

 

4D_trak_L-Leg feet 4D: includes 1 mask and 8 dynamic acquisitions.

ExamCard description

When using the Quadrature Body coil the acquired voxel size of the first and second stations are 1.08 x 1.99 x 4.00 mm, which are reconstructed with a voxel size of 0.84 x 0.84 x 2.00 mm. Using the SENSE XL Torso coil the acquired voxel size of the third station is 1.08 x 1.00 x 2.00 mm, which is reconstructed with a voxel size of 1.00 x 1.00 x 1.00 mm.

 

The SENSE XL Torso coil used with a SENSE factor of 2-3 makes it possible to acquire a higher spatial resolution on the distal vascularization without increasing scan time.

 

The first station is acquired with a linear k-space filling, while stations two and three are acquired with a CENTRA k-space filling.

 

The second ExamCard provides a 4D-TRAK scan which combines the SENSE and CENTRA keyhole methods to deliver high spatial and temporal resolutions. This is acquired after a preliminary test bolus has been injected to determine the scan delay time of the 4D-TRAK. The timing scan has to be planned at the level of the femoral artery.

 

The best results are obtained using the 16-channel SENSE XL Torso coil, however the 4-channel SENSE Body coil can also be used.

Patient preparation

The SENSE XL Torso coil has to be put around the distal extremities, on the angiography feet holder.

 

When using the SENSE Body coil, it has to be positioned vertically to allow table movement towards the pelvis without stretching the coil cable.

Contrast agent / injection protocol

MRAMinfXL-QBC ExamCard

12mL gadolinium-based contrast agent 1 mmol/ml at 0.8 ml/s, followed by 3 ml gadolinium-based contrast agent 1 mmol/ml at 0.4 ml/s and then 22 ml saline injected at a rate of 0.4 ml/s.

 

MRA 4D-TRAK xl-qbc 2inj ExamCard

The test bolus at the level of the femoral artery is to be performed first:

injection of 1 ml gadolinium-based contrast agent 1 mmol/ml at 1 ml/s, followed by 15-20 ml saline injected at a rate of 1 ml/s.

 

Delay 2 minutes

3D acquisition three stations mask and contrast enhanced images after injection of 8-10 ml gadolinium-based contrast agent 1 mmol/ml at 0.8 ml/s followed by 20 ml of saline injected at a rate of 0.4 ml/s.

 

Delay 6-8 minutes

4D-TRAK acquisition of the distal station only:

injection of 6 ml gadolinium-based contrast agent 1 mmol/ml at 1 ml/s, followed by 20 ml saline injected at a rate of 1 ml/s. The image has to be acquired after the timing has been obtained by the femoral test bolus.

ExamCard images

Example 1:MobiView image
Example 1:MobiView image

The two top stations have a reconstructed resolution of 0.84 x 0.84 x 2.00 mm and were acquired with the Quadrature Body coil.

The distal station has a higher spatial resolution, reconstructed resolution of 1.00 x1.00 x1.00 mm, and was acquired with the SENSE XL Torso coil.

The image depicts various vascular abnormalities, for example stenosis, calcifications and obliteration.

 

Note: Click on the image to enlarge.

Example 2: image 1 Example 2: image 2
Example 2: image 1
Example 2: image 2

Image 1 demonstartes a patient with a very early venous enhancement in the distal station.

Image 2 demonstrates the same patient where the distal station has been replaced by a choosen acquisition from the 4D-TRAK time series corresponding to the arterial enhancement.

 

Note: Click on the images to enlarge.

Example 3: image 1 Example 3: image 2
Example 3: image 1
Example 3: image 2

Image 1 demonstrates a MobiFlex 3D study with the most distal station obtained using the SENSE Body coil and showing early venous enhancement.

Image 2 is from the same patient demonstrating a MobiFlex 3D and 4D-TRAK study with the most distal station obtained using the SENSE Body coil and a 4D-TRAK scan technique. It shows a reduction in the venous enhancement.

 

Note: Click on the images to enlarge.

Post-processing / analysis

Maximum Intensity Projection MIP demonstrating the high spatial resolution attainable with the SENSE XL Torso coil.
Maximum Intensity Projection
MIP demonstrating the high spatial resolution attainable with the SENSE XL Torso coil.
Maximum Intensity Projection 1 High spatial resolution MIP of the distal station in a patient with early venous enhancement on the left side.Maximum Intensity Projection 2 An arterial image extracted from the 4D time series obtained from the same patient.
Maximum Intensity Projection 1
Maximum Intensity Projection 2
High spatial resolution MIP of the distal station in a patient with early venous enhancement on the left side.
An arterial image extracted from the 4D time series obtained from the same patient.


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ExamCard
Achieva 1.5T
Release 2
Abdominal MRA, Body, mobitrak, Peripheral MRA, Vascular
 

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