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This work demonstrates that the principles underlying phase-contrast MRI may be used to encode spatial rather than flow information along a perpendicular dimension, if this dimension contains an MRI-visible object at only one spatial location. In particular, the situation applies to 3D mapping of curved 2D structures which requires only two projection images with different spatial phase-encoding gradients. These phase-contrast gradients define the field of view and mean spin-density positions of the object in the perpendicular dimension by respective phase differences. When combined with highly undersampled radial fast low angle shot (FLASH) and image reconstruction by regularized nonlinear inversion, spatial phase-contrast MRI allows for dynamic 3D mapping of 2D structures in real time. First examples include 3D MRI movies of the acting human hand at a temporal resolution of 50 ms. With an even simpler technique, 3D maps of curved 1D structures may be obtained from only three acquisitions of a frequency-encoded MRI signal with two perpendicular phase encodings. Here, 3D MRI movies of a rapidly rotating banana were obtained at 5 ms resolution or 200 frames per second. In conclusion, spatial phase-contrast 3D MRI of 2D or 1D structures is respective two or four orders of magnitude faster than conventional 3D MRI.

Background Functional assessments of the heart by dynamic cardiovascular magnetic resonance (CMR) commonly rely on (i) electrocardiographic (ECG) gating yielding pseudo real-time cine representations, (ii) balanced gradient-echo sequences referred to as steady-state free precession (SSFP), and (iii) breath holding or respiratory gating. Problems may therefore be due to the need for a robust ECG signal, the occurrence of arrhythmia and beat to beat variations, technical instabilities (e.g., SSFP "banding" artefacts), and limited patient compliance and comfort. Here we describe a new approach providing true real-time CMR with image acquisition times as short as 20 to 30 ms or rates of 30 to 50 frames per second. Methods The approach relies on a previously developed real-time MR method, which combines a strongly undersampled radial FLASH CMR sequence with image reconstruction by regularized nonlinear inversion. While iterative reconstructions are currently performed offline due to limited computer speed, online monitoring during scanning is accomplished using gridding reconstructions with a sliding window at the same frame rate but with lower image quality. Results Scans of healthy young subjects were performed at 3 T without ECG gating and during free breathing. The resulting images yield T1 contrast (depending on flip angle) with an opposed-phase or in-phase condition for water and fat signals (depending on echo time). They completely avoid (i) susceptibility-induced artefacts due to the very short echo times, (ii) radiofrequency power limitations due to excitations with flip angles of 10° or less, and (iii) the risk of peripheral nerve stimulation due to the use of normal gradient switching modes. For a section thickness of 8 mm, real-time images offer a spatial resolution and total acquisition time of 1.5 mm at 30 ms and 2.0 mm at 22 ms, respectively. Conclusions Though awaiting thorough clinical evaluation, this work describes a robust and flexible acquisition and reconstruction technique for real-time CMR at the ultimate limit of this technology.

Objective: Real-time phase-contrast flow MRI at high spatiotemporal resolution was applied to simultaneously evaluate haemodynamic functions in the ascending aorta (AA) and superior vena cava (SVC) during elevated intrathoracic pressure (Valsalva manoeuvre). Methods: Real-time phase-contrast flow MRI at 3 T was based on highly undersampled radial gradient-echo acquisitions and phase-sensitive image reconstructions by regularized non-linear inversion. Dynamic alterations of flow parameters were obtained for 19 subjects at 40-ms temporal resolution, 1.33-mm in-plane resolution and 6-mm section thickness. Real-time measurements were performed during normal breathing (10 s), increased intrathoracic pressure (10 s) and recovery (20 s). Results: Real-time measurements were technically successful in all volunteers. During the Valsalva manoeuvre (late strain) and relative to values during normal breathing, the mean peak flow velocity and flow volume decreased significantly in both vessels (p < 0.001) followed by a return to normal parameters within the first 10 s of recovery in the AA. By contrast, flow in the SVC presented with a brief (1-2 heartbeats) but strong overshoot of both the peak velocity and blood volume immediately after pressure release followed by rapid normalization. Conclusion: Real-time phase-contrast flow MRI may assess cardiac haemodynamics non-invasively, in multiple vessels, across the entire luminal area and at high temporal and spatial resolution. Advances in knowledge: Future clinical applications of this technique promise new insights into haemodynamic alterations associated with pre-clinical congestive heart failure or diastolic dysfunction, especially in cases where echocardiography is technically compromised.

Background Analysis of cardiac function in patients with arrhythmias is very limited or nearly impossible in ECG synchronized cine acquisitions with balanced SSFP. A real-time method at 1.5 T with SSFP contrast was used to show that this method is superior for image quality and analysis of ventricular function in a subset of patients with atrial fibrillation and AV-Block. Methods Radial gradient-echo sequences with fully balanced SSFP gradients and at least 15-fold undersampling (real-time SSFP, RT) and conventional ECG-synchronized cine SSFP CMR (Cine) was used on a 1.5 T scanner system. Patients who had permanent arrhythmias (most often atrial fibrillation, AA; n = 8) or wall motion abnormalities (WMA; n = 3) were scanned in the standard views and compared to patients in sinus rhythm (SR;n = 21) without wall motion abnormalities. Image reconstruction of RT was performed offline by regularized nonlinear inversion. Quality (IQ) of scan was detected using an image quality score (ranging from 0 = no diagnostic quality to 1 = reduced diagnostic quality, 2 = many artifacts, 3 = some artifacts, and 4 = optimal diagnostic quality). Cardiac function was analyzed using a semiautomatic contour detection (Q mass, Medis, NL) applied to 5 consecutive baets in RT and Cine avering data of 10-12 beats. All analysis was done by two blinded observers (3 and 8 years experience of CMR evaluation). Results IQ was comparable for Cine and RT SSFP in patients with WMA or patients in sinus rhythm without WMA given in Table 1. However, IQ was significantly better

Purpose: To develop a method for T1 mapping at high spatial resolution and for multiple slices. Methods: The proposed method emerges as a single-shot inversion-recovery experiment which covers the entire spin-lattice relaxation process by serial acquisitions of highly undersampled radial FLASH images, either in single-slice or multi-slice mode. Serial image reconstructions are performed in time-reversed order and first involve regularized nonlinear inversion (NLINV) to estimate optimum coil sensitivity profiles. Subsequently, the coil profiles are fixed for the calculation of differently T1-weighted frames and the resulting linear inverse problem is solved by a conjugate gradient (CG) technique. T1 values are obtained by pixelwise fitting with a Deichmann correction modified for multi-slice applications. Results: T1 accuracy was validated for a reference phantom. For human brain, T1 maps were obtained at 0.5 mm resolution for single-slice acquisitions and at 0.75 mm resolution for up to 5 simultaneous slices (5 mm thickness). Corresponding T1 maps of the liver were acquired at 1 mm and 1.5 mm resolution, respectively. All T1 values were in agreement with literature data. Conclusion: Inversion-recovery sequences with highly undersampled radial FLASH images and NLINV/CG reconstruction allow for fast, robust and accurate T1 mapping at high spatial resolution and for multiple slices.

Background A high resolution real-time phase-contrast MRI flow technique was used to measure flow dynamics in the ascending aorta as well as superior vena cava. MRI technique based on undersampled radial fast low-angle shot acquisitions with phase-sensitive image reconstructions by regularized nonlinear inversion. Normal flow values as well as flow measurements during physiologic stress tests like Valsalva (increased intrathoracic pressure) and Mueller (decreased intrathoracic pressure, reverse of Valsalva maneuver) were obtained in healthy volunteers.

Simultaneous flow dynamics in small and great thoracic vessels during physiological stress tests and normal breathing using real-time cardiac magnetic-resonance Jan M Sohns, Martin Fasshauer, Johannes T Kowallick, Andreas Schuster, Wieland Staab, Arun Joseph, Shoun Zhang, Dirk Voit, Sebastian Schaetz, Klaus-Dietmar Merboldt, Michael Steinmetz, Christina Unterberg-Buchwald, Jens Frahm, Joachim Lotz