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Purpose To achieve rapid, low specific absorption rate (SAR) super-resolution imaging by exploiting the characteristic magnetization off-resonance profile in SSFP. Theory and methods In the presented technique, low flip angle unbalanced SSFP imaging is used to acquire a series of images at a low nominal resolution that are then combined in a super-resolution strategy analogous to non-linear structured illumination microscopy. This is demonstrated in principle via Bloch simulations and synthetic phantoms, and the performance is quantified in terms of point-spread function (PSF) and SNR for gray and white matter from field strengths of 0.35T to 9.4T. A k-space reconstruction approach is proposed to account for B0 effects. This was applied to reconstruct super-resolution images from a test object at 9.4T. Results Artifact-free super-resolution images were produced after incorporating sufficient preparation time for the magnetization to approach the steady state. High-resolution images of a test object were obtained at 9.4T, in the presence of considerable B0 inhomogeneity. For gray matter, the highest achievable resolution ranges from 3% of the acquired voxel dimension at 0.35T, to 9% at 9.4T. For white matter, this corresponds to 3% and 10%, respectively. Compared to an equivalent segmented gradient echo acquisition at the optimal flip angle, with a fixed TR of 8 ms, gray matter has up to 34% of the SNR at 9.4T while using a ×10 smaller flip angle. For white matter, this corresponds to 29% with a ×11 smaller flip angle. Conclusion This approach achieves high degrees of super-resolution enhancement with minimal RF power requirements.

Background High tibial osteotomy (HTO) re-aligns the weight-bearing axis (WBA) of the lower limb. The surgery reduces medial load (reducing pain and slowing progression of cartilage damage) while avoiding overloading the lateral compartment. The optimal correction has not been established. This study investigated how different WBA re-alignments affected load distribution in the knee, to consider the optimal post-surgery re-alignment. Methods We collected motion analysis and seven Tesla MRI data from three healthy subjects, and combined this data to create sets of subject-specific finite element models (total = 45 models). Each set of models simulated a range of potential post-HTO knee re-alignments. We shifted the WBA from its native alignment to between 40% and 80% medial–lateral tibial width (corresponding to 2.8°–3.1° varus and 8.5°–9.3° valgus), in three percent increments. We then compared stress/pressure distributions in the models. Results Correcting the WBA to 50% tibial width (0° varus–valgus) approximately halved medial compartment stresses, with minimal changes to lateral stress levels, but provided little margin for error in undercorrection. Correcting the WBA to a more commonly-used 62%–65% tibial width (3.4°–4.6° valgus) further reduced medial stresses but introduced the danger of damaging lateral compartment tissues. To balance optimal loading environment with that of the historical risk of under-correction, we propose a new target: WBA correction to 55% tibial width (1.7°–1.9° valgus), which anatomically represented the apex of the lateral tibial spine. Conclusions Finite element models can successfully simulate a variety of HTO re-alignments. Correcting the WBA to 55% tibial width (1.7°–1.9° valgus) optimally distributes medial and lateral stresses/pressures.

Sodium magnetic resonance imaging (MRI), or imaging of the 23Na nucleus, has been under exploration for several decades, and holds promise for potentially revealing additional biochemical information about the health of tissues that cannot currently be obtained from conventional hydrogen (or proton) MRI. This additional information could serve as an important complement to conventional MRI for many applications. However, despite these exciting possibilities, sodium MRI is not yet used routinely in clinical practice, and will likely remain strictly in the domain of exploratory research for the coming decade. This paper begins with a technical overview of sodium MRI, including the nuclear magnetic resonance (NMR) signal characteristics of the sodium nucleus, the challenges associated with sodium MRI, and the specialized pulse sequences, hardware, and reconstruction techniques required. Various applications of sodium MRI for quantitative analysis of the musculoskeletal system are then reviewed, including the non-invasive assessment of cartilage degeneration in vivo, imaging of tendinopathy, applications in the assessment of various muscular pathologies, and assessment of muscle response to exercise.

In cardiac perfusion imaging, choice of flip angle is an important factor for steady state acquisition. This work focuses on presenting an analytical framework for understanding how non-ideal slice excitation profiles affect contrast in ungated 2D steady state cardiac perfusion studies, and to study a technique for estimating flip angle that maximizes enhanced/unenhanced myocardial contrast-to-noise ratio (CNR) in single slice and multi-slice acquisitions. A numerical simulation of ungated 2D golden ratio radial spoiled gradient echo (SPGR) was created that takes into consideration the actual (Bloch simulated) slice excitation profile. The effect of slice excitation profile on myocardial CNR as a function of flip angle was assessed in phantoms and in vivo. For fast RF pulses, the flip angle that yields maximum CNR (considering the actual slice excitation profile) was considerably higher than expected, assuming an ideal excitation. The simulation framework presented accurately predicts the flip angle yielding maximum CNR when the actual slice excitation profile is taken into consideration. The prescribed flip angle for optimal contrast in ungated 2D steady-state SPGR cardiac perfusion studies can vary significantly from that calculated when an ideal slice excitation profile is assumed. Consideration of the actual slice excitation can yield a more optimal flip angle estimate in both the single slice and multi-slice cases.

Background\ud \ud Delayed Gadolinium Enhanced Magnetic Resonance Imaging of Cartilage (dGEMRIC) can detect glycosaminoglycan loss in the acetabular cartilage of asymptomatic individuals with cam morphology. The aims of this study were to explore the relationship between cam morphology and dGEMRIC values, and to explore whether baseline dGEMRIC can predict the development of radiographic hip osteoarthritis.\ud \ud \ud \ud Methods\ud \ud Prospective cohort (SibKids) study with clinical, radiographic, and MRI assessment at baseline and five-year follow-up (n = 34). The dGEMRIC values of cartilage regions were correlated with measures of cam morphology. Receiver operating characteristic (ROC) analysis was applied to baseline variables to predict radiographic loss of joint space width.\ud \ud \ud \ud Results\ud \ud Superolateral acetabular cartilage dGEMRIC values were significantly lower in participants with cam morphology (P < 0.001), defined as an alpha angle greater than 60°. There was a negative correlation between alpha angle and the dGEMRIC value of adjacent acetabular cartilage. This relationship was strongest superoanteriorly (r = −0.697 P < 0.001). There was a positive correlation between baseline dGEMRIC and the magnitude of joint space width narrowing (r = 0.398 P = 0.030). ROC analysis of combined baseline variables (positive impingement test, alpha angle, dGEMRIC ratio) gave an Area Under the Curve (AUC) of 0.75 for predicting joint space width narrowing greater than 0.5 mm within 5 years.\ud \ud \ud \ud Conclusions\ud \ud The size and position of cam morphology determines the severity and location of progressive cartilage damage, supporting the biomechanical aetiology of femoroacetabular impingement. Baseline dGEMRIC is able to predict the development of radiographic osteoarthritis. Compositional MRI offers the potential to identify patients who may benefit from early intervention to prevent the development of osteoarthritis.

Purpose Highly undersampled three-dimensional (3D) saturation-recovery sequences are affected by k-space trajectory since the magnetization does not reach steady state during the acquisition and the slab excitation profile yields different flip angles in different slices. This study compares centric and reverse-centric 3D cardiac perfusion imaging. Methods An undersampled (98 phase encodes) 3D ECG-gated saturation-recovery sequence that alternates centric and reverse-centric acquisitions each time frame was used to image phantoms and in vivo subjects. Flip angle variation across the slices was measured, and contrast with each trajectory was analyzed via Bloch simulation. Results Significant variations in flip angle were observed across slices, leading to larger signal variation across slices for the centric acquisition. In simulation, severe transient artifacts were observed when using the centric trajectory with higher flip angles, placing practical limits on the maximum flip angle used. The reverse-centric trajectory provided less contrast, but was more robust to flip angle variations. Conclusion Both of the k-space trajectories can provide reasonable image quality. The centric trajectory can have higher CNR, but is more sensitive to flip angle variation. The reverse-centric trajectory is more robust to flip angle variation. Magn Reson Med 74:1070–1076, 2015. © 2014 Wiley Periodicals, Inc.

Purpose The objective of this study was to determine whether a sodium phased array would improve sodium breast MRI at 3 T. The secondary objective was to create acceptable proton images with the sodium phased array in place. Methods A novel composite array for combined proton/sodium 3 T breast MRI is compared with a coil with a single proton and sodium channel. The composite array consists of a 7-channel sodium receive array, a larger sodium transmit coil, and a 4-channel proton transceive array. The new composite array design utilizes smaller sodium receive loops than typically used in sodium imaging, uses novel decoupling methods between the receive loops and transmit loops, and uses a novel multichannel proton transceive coil. The proton transceive coil reduces coupling between proton and sodium elements by intersecting the constituent loops to reduce their mutual inductance. The coil used for comparison consists of a concentric sodium and proton loop with passive decoupling traps. Results The composite array coil demonstrates a 2–5× improvement in signal-to-noise ratio for sodium imaging and similar signal-to-noise ratio for proton imaging when compared with a simple single-loop dual resonant design. Conclusion The improved signal-to-noise ratio of the composite array gives breast sodium images of unprecedented quality in reasonable scan times. Magn Reson Med 71:2231–2242, 2014. © 2013 Wiley Periodicals, Inc.

Dedicated and specialized radiofrequency coils are critical for high quality musculoskeletal magnetic resonance imaging (MRI). Dedicated coils improve the signal to noise ratio, allowing for faster or higher resolution examinations. Transmit-receive coils can reduce heating at high field str

OBJECTIVE. MRI is the most accurate noninvasive method available to diagnose disorders of articular cartilage. Conventional 2D and 3D approaches show changes in cartilage morphology. Faster 3D imaging methods with isotropic resolution can be reformatted into arbitrary planes for improved detection and visualization of pathology. Unique contrast mechanisms allow us to probe cartilage physiology and detect changes in cartilage macromolecules.CONCLUSION. MRI has great promise as a noninvasive comprehensive tool for cartilage evaluation.

Flow-independent angiography is a non-contrast-enhanced technique that can generate vessel contrast even with reduced blood flow in the lower extremities. A method is presented for producing these angiograms with magnetization-prepared balanced steady-state free precession (bSSFP). Because bSSFP yields bright fat signal, robust fat suppression is essential for detailed depiction of the vasculature. Therefore, several strategies have been investigated to improve the reliability of fat suppression within short scan times. Phase-sensitive (PS) SSFP can efficiently suppress fat; however, partial volume effects due to fat and water occupying the same voxel can lead to the loss of blood signal. In contrast, alternating repetition time (ATR) SSFP minimizes this loss; however, the level of suppression is compromised by field inhomogeneity. Finally, a new double-acquisition ATR-SSFP technique reduces this sensitivity to off-resonance. In vivo results indicate that the two ATR-based techniques provide more reliable contrast when partial volume effects are significant.

Summary Objective To measure the variability of T 1ρ relaxation times using CubeQuant, T 2 relaxation times using quantitative double echo in steady state (DESS), and normalized sodium signals using 3D cones sodium magnetic resonance imaging (MRI) of knee cartilage in vivo at 3 T. Design Eight healthy subjects were scanned at 3 T at baseline, 1 day, 5 months, and 1 year. Ten regions of interest (ROIs) of knee cartilage were segmented in the medial and lateral compartments of each subject's knee. T 1ρ and T 2 relaxation times and normalized sodium signals were measured and the root-mean-square coefficient of variation (CV RMS ) was calculated. Intra-subject variability was measured over short, moderate and long-term, as well as intra-observer and inter-observer variability. Results The average intra-subject CV RMS measurements over short, moderate, and long-term time periods were 4.6%, 6.1%, and 6.0% for the T 1ρ measurements, 6.4%, 9.3%, and 10.7% for the T 2 measurements and 11.3%, 11.6%, and 12.9% for the sodium measurements, respectively. The average CV RMS measurements for intra-observer and inter-observer segmentation were 3.8% and 5.7% for the T 1ρ measurements, 4.7% and 6.7% for the T 2 measurements, and 8.1% and 11.4% for the sodium measurements, respectively. Conclusions These CV RMS measurements are substantially lower than previously measured changes expected in patients with advanced osteoarthritis compared to healthy volunteers, suggesting that CubeQuant T 1ρ , quantitative DESS T 2 and 3D cones sodium measurements are sufficiently sensitive for in vivo cartilage studies.

The purpose of this work was to synchronously acquire proton (1H) and sodium (23Na) image data on a 3T clinical MRI system within the same sequence, without internal modification of the clinical hardware, and to demonstrate synchronous acquisition with 1H/23Na-GRE imaging with Cartesian and radial k-space sampling. Synchronous dual-nuclear imaging was implemented by: mixing down the 1H signal so that both the 23Na and 1H signal were acquired at 23Na frequency by the conventional MRI system; interleaving 1H/23Na transmit pulses in both Cartesian and radial sequences; and using phase stabilization on the 1H signal to remove mixing effects. The synchronous 1H/23Na setup obtained images in half the time necessary to sequentially acquire the same 1H and 23Na images with the given setup and parameters. Dual-nuclear hardware and sequence modifications were used to acquire 23Na images within the same sequence as 1H images, without increases to the 1H acquisition time. This work demonstrates a viable technique to acquire 23Na image data without increasing 1H acquisition time using minor additional custom hardware, without requiring modification of a commercial scanner with multinuclear capability.

Objective The purpose of this study was to measure and compare the relaxation times of musculoskeletal tissues at 3.0 T and 7.0 T, and to use these measurements to select appropriate parameters for musculoskeletal protocols at 7.0 T. Materials and methods We measured the T1 and T2 relaxation times of cartilage, muscle, synovial fluid, bone marrow and subcutaneous fat at both 3.0 T and 7.0 T in the knees of five healthy volunteers. The T1 relaxation times were measured using a spin-echo inversion recovery sequence with six inversion times. The T2 relaxation times were measured using a spin-echo sequence with seven echo times. The accuracy of both the T1 and T2 measurement techniques was verified in phantoms at both magnetic field strengths. We used the measured relaxation times to help design 7.0 T musculoskeletal protocols that preserve the favorable contrast characteristics of our 3.0 T protocols, while achieving significantly higher resolution at higher SNR efficiency. Results The T1 relaxation times in all tissues at 7.0 T were consistently higher than those measured at 3.0 T, while the T2 relaxation times at 7.0 T were consistently lower than those measured at 3.0 T. The measured relaxation times were used to help develop high resolution 7.0 T protocols that had similar fluid-to-cartilage contrast to that of the standard clinical 3.0 T protocols for the following sequences: proton-density-weighted fast spin-echo (FSE), T2-weighted FSE, and 3D-FSE-Cube. Conclusion The T1 and T2 changes were within the expected ranges. Parameters for musculoskeletal protocols at 7.0 T can be optimized based on these values, yielding improved resolution in musculoskeletal imaging with similar contrast to that of standard 3.0 T clinical protocols.

Purpose To describe and evaluate a fast, fluid-suppressed 2D multislice steady-state free precession (SSFP) neuroimaging sequence. Materials and Methods We developed a fast fluid-attenuated inversion-recovery SSFP sequence for use in neuroimaging. The inversion time (TI) was optimized to yield good cerebrospinal fluid (CSF) suppression while conserving white matter (WM)/lesion contrast across a broad range of flip angles. Multiple SSFP acquisitions were combined using the sum-of-squares (SOS) method to maximize SNR efficiency while minimizing SSFP banding artifacts. We compared our fluid-attenuated inversion-recovery (FLAIR) SSFP sequence with FLAIR fast spin-echo (FSE) in both normal subjects and a volunteer with multiple sclerosis. SNR measurements were performed to ascertain the SNR efficiency of each sequence. Results Our FLAIR SSFP sequence demonstrated excellent CSF suppression and good gray matter (GM)/WM contrast. Coverage of the entire brain (5-mm slices, 24-cm FOV, 256 × 192 matrix) was achieved with FLAIR SSFP in less than half the scan time of a corresponding FLAIR FSE sequence with similar SNR, yielding improvements of more than 50% in SNR efficiency. Axial scans of a volunteer with multiple sclerosis show clearly visible plaques and very good visualization of brain parenchyma. Conclusion We have demonstrated the feasibility of a very fast fluid-suppressed neuroimaging technique using SSFP. J. Magn. Reson. Imaging 2006. © 2006 Wiley-Liss, Inc.

Balanced steady-state free precession (SSFP) sequences use fully refocused gradient waveforms to achieve a high signal and useful image contrast in short scan times. Despite these strengths, the clinical feasibility of balanced SSFP is still limited both by bright fat signal and by the signal voids that result from off-resonance effects such as field or susceptibility variations. A new method, dual-acquisition phase-sensitive SSFP, combines the signals from two standard balanced SSFP acquisitions to separate fat and water while simultaneously reducing the signal voids. The acquisitions are added in quadrature and then phase corrected using a simple algorithm before fat and water can be identified simply by the sign of the signal. This method is especially useful for applications at high field, where the RF power deposition, spatial resolution requirements and gradient strength limit the minimum repetition times. Finally, dual-acquisition phase-sensitive SSFP can be combined with other magnetization preparation schemes to produce specific image contrast in addition to separating fat and water signals.