High temporal and high spatial resolution MR angiography (4D-MRA)

Abstract

In the first decade of the twenty-first century, whole-body magnetic resonance scanners with high field strengths (and thus potentially better signal-to-noise ratios) were developed. At the same time, parallel imaging and “echo-sharing” techniques were refined to allow for increasingly high spatial and temporal resolution in dynamic magnetic resonance angiography (“time-resolved” = TR-MRA). This technological progress facilitated tracking the passage of intra-venously administered contrast agent boluses as well as the acquisition of volume data sets at high image refresh rates (“4D-MRA”). This opened doors for many new applications in non-invasive vascular imaging, including simultaneous anatomic and functional analysis of many vascular pathologies including arterio-venous malformations. Different methods were established to acquire 4D-MRA using various strategies to acquire k-space trajectories over time in order to optimize imaging according to clinical needs. These include “keyhole”-based techniques (e. g. 4D-TRAK), TRICKS – both with and without projection – and HYPR-reconstruction, TREAT, and TWIST. Some of these techniques were first introduced in the 1980 s and 1990 s, were later enhanced and modified, and finally implemented in the products of major vendors. In the last decade, a large number of studies on the clinical applications of TR-MRA was published. This manuscript provides an overview of the development of TR-MRA methods and the 4D-MRA techniques as they are currently used in the diagnosis, treatment and follow-up of vascular diseases in various parts of the body.

Key statements

• 4D-MRA, which differs according to manufacturer, generates high temporal and spatial resolution MRA volume data sets.

Key differences in 4D-MRA techniques concern the sequence of the acquisition of k-space portions.

• Central k-space portions define image contrast and are thus repetitively scanned with 4D-MRA.

• Numerous clinical applications of 4D-MRA are already documented in the literature.

Citation Format:

• Hadizadeh DR., Marx C, Gieseke J et al. High temporal and high spatial resolution MR angiography (4D-MRA). Fortschr Röntgenstr 2014; 186: 847 – 859

Zusammenfassung

Im ersten Jahrzehnt des 21. Jahrhunderts wurden Ganzkörper-Magnetresonanztomografen mit höheren Feldstärken (und damit potenziell besserem Signal-zu-Rausch-Verhältnis) entwickelt. Dies und die nahezu zeitgleiche Entwicklung bzw. Verfeinerung von Techniken wie der parallelen Bildgebung und „Echo-sharing“ erlaubten ein zunehmend höheres räumliches und zeitliches Auflösungsvermögen in der dynamischen Magnetresonanzangiografie („Time-resolved“ = TR-MRA). Somit konnten erstmals sowohl die Passage eines Kontrastmittelbolus mit einer angemessenen räumlichen Auflösung verfolgt als auch Volumendatensätze mit hohen Bildauffrischungsraten erzeugt werden („4D-MRA“). Damit eröffneten sich neue Optionen der nicht invasiven Gefäßdiagnostik, wie beispielsweise die gleichzeitige anatomische und funktionelle Analyse von Gefäßmalformationen. Es wurden zahlreiche unterschiedliche Methoden eingeführt, bei denen die Akquisitionen der k-Raum-Trajektorien strategisch unterschiedlich über den Akquisitionszeitraum verteilt wurden, um optimale klinische Ergebnisse zu erlangen. Dazu zählten beispielsweise Verfahren wie „Keyhole“-basierte Techniken (z. B. 4D-TRAK), TRICKS mit und ohne Projektions- und HYPR-Rekonstruktion, TREAT und TWIST. Einige dieser Techniken wurden bereits in den 80er- und 90er-Jahren vorgestellt, in der Folge weiterentwickelt und modifiziert und schließlich in handelsübliche MR-Tomografen der verschiedenen Hersteller implementiert. In der letzten Dekade wurden schließlich zahlreiche Studien zu klinischen Anwendungen der TR-MRA vorgestellt. Dieses Manuskript bietet eine Übersicht über die Entwicklung der TR-MRA-Verfahren und die gegenwärtig eingesetzten 4D-MRA-Techniken wie sie derzeit Ihren klinischen Einsatz bei der Diagnose, Behandlung und bei Verlaufsuntersuchungen von Gefäßerkrankungen in unterschiedlichen Körperregionen finden.

Es wurden zahlreiche unterschiedliche Methoden eingeführt, bei denen die Akquisitionen der k-Raum-Trajektorien strategisch unterschiedlich über den Akquisitionszeitraum verteilt wurden, um optimale klinische Ergebnisse zu erlangen. Dazu zählten beispielsweise Verfahren wie „Keyhole“-basierte Techniken (z. B. 4D-TRAK), TRICKS mit und ohne Projektions- und HYPR-Rekonstruktion, TREAT und TWIST. Einige dieser Techniken wurden bereits in den 80er und 90er Jahren vorgestellt, in der Folge weiterentwickelt und modifiziert und schließlich in handelsübliche MR-Tomografen der verschiedenen Hersteller implementiert. In der letzten Dekade wurden schließlich zahlreiche Studien zu klinischen Anwendungen der TR-MRA vorgestellt. Dieses Manuskript bietet eine Übersicht über die Entwicklung der TR-MRA-Verfahren und die gegenwärtig eingesetzten 4D-MRA Techniken wie sie derzeit Ihren klinischen Einsatz bei der Diagnose, Behandlung und bei Verlaufsuntersuchungen von Gefäßerkrankungen in unterschiedlichen Körperregionen finden.

Key words

vascular - MR-angiography - imaging sequences - AVM - arteries

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