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Biomedical subjects

Debiao Li

Publications and source records attributed to Debiao Li.

At least 37 records · Page 2Linked to original sources

Contrast-enhanced 4D radial coronary artery imaging at 3.0 T within a single breath-hold.

Coronary magnetic resonance angiography data are usually acquired during mid-diastole of each heartbeat to minimize cardiac motion related artifacts. The proper trigger delay time, which may vary widely among subjects, must be determined individually for each subject before data acquisition to achieve optimal image quality. These complications could be resolved by acquiring contiguous cardiac phase images through the cardiac cycle. In this study, we used a radial sampling technique to acquire 3D cine coronary artery images at 3 T within a single breath-hold. An extravascular, paramagnetic contrast agent was i.v. administered to improve the blood signal intensity. Relatively high temporal resolution and spatial resolution were achieved simultaneously with radial sampling, parallel data acquisition, and interleaved sliding window image reconstruction. Volunteer studies demonstrate the feasibility of this technique in acquiring 4D coronary artery images and the flexibility in postprocessing of 3D image sets.

Contrast Media↗

4D radial coronary artery imaging within a single breath-hold: cine angiography with phase-sensitive fat suppression (CAPS).

Coronary artery data acquisition with steady-state free precession (SSFP) is typically performed in a single frame in mid-diastole with a spectrally selective pulse to suppress epicardial fat signal. Data are acquired while the signal approaches steady state, which may lead to artifacts from the SSFP transient response. To avoid sensitivity to cardiac motion, an accurate trigger delay and data acquisition window must be determined. Cine data acquisition is an alternative approach for resolving these limitations. However, it is challenging to use conventional fat saturation with cine imaging because it interrupts the steady-state condition. The purpose of this study was to develop a 4D coronary artery imaging technique, termed "cine angiography with phase-sensitive fat suppression" (CAPS), that would result in high temporal and spatial resolution simultaneously. A 3D radial stacked k-space was acquired over the entire cardiac cycle and then interleaved with a sliding window. Sensitivity-encoded (SENSE) reconstruction with rescaling was developed to reduce streak artifact and noise. Phase-sensitive SSFP was employed for fat suppression using phase detection. Experimental studies were performed on volunteers. The proposed technique provides high-resolution coronary artery imaging for all cardiac phases, and allows multiple images at mid-diastole to be averaged, thus enhancing the signal-to-noise ratio (SNR) and vessel delineation.

Adipose Tissue↗

High-resolution steady-state free precession coronary magnetic resonance angiography within a breath-hold: parallel imaging with extended cardiac data acquisition.

Coronary artery imaging data are conventionally acquired in a single imaging frame during mid-diastole. The data acquisition window must be sufficiently short to avoid cardiac motion artifacts. A short data acquisition window results in decreased imaging efficiency and limited spatial resolution. Parallel imaging may lessen these limitations, but requires highly accurate coil sensitivity. The purpose of this work was to increase the imaging efficiency and spatial resolution in coronary artery imaging using parallel imaging with an extended acquisition window. External coil calibration data were acquired before and after a short mid-diastolic period of accelerated imaging data acquisition. It was assumed that residual cardiac motion in the extended acquisition window would not impede accurate estimation of coil sensitivity since only low spatial frequency signals were acquired for coil calibration. Experimental studies were performed in five healthy volunteers at 3 T using steady-state free precession sequence. Statistical comparison was made between the proposed method and conventional data acquisition for visual quality of image and vessel sharpness. The proposed technique demonstrated higher visual grading and improved vessel sharpness. The proposed method is a new approach to enhance the imaging efficiency and spatial resolution in coronary artery imaging.

Artifacts↗

Comparison of X-ray fluoroscopy and interventional magnetic resonance imaging for the assessment of coronary artery stenoses in swine.

The accuracy of a two-step interventional MRI protocol to quantify coronary artery disease was compared to the clinical gold standard, X-ray angiography. Studies were conducted in nine swine with a surgically induced stenosis in the proximal left circumflex coronary artery. The two-step protocol consisted of catheter-directed magnetic resonance angiography (MRA), which was first used to localize the stenosis, followed by MRI cross-sectional images to quantify the degree of stenosis without the use of contrast agent. Line signal intensity profiles were drawn across the vessel diameter at the stenosis site and proximal to the stenosis for each data set to measure percentage stenosis for each animal. Catheter-directed MRA successfully detected eight of nine stenoses. Cross-sectional MRI accurately quantified each stenosis, with strong agreement to the measurements made using X-ray fluoroscopy (intraclass correlation coefficient = 0.955; P < 0.05). This study demonstrates that in the future interventional MRI may be an alternative to X-ray angiography for the detection and quantification of coronary artery disease.

Angiography↗

Determination of optimal gadolinium concentration using SSFP for catheter-directed contrast-enhanced coronary MR angiography.

RATIONALE AND OBJECTIVES: To determine the optimal gadolinium concentration for catheter-directed coronary magnetic resonance angiography (MRA) using magnetization-prepared steady-state free-precession (SSFP) in swine. MATERIALS AND METHODS: In six pigs, we performed real-time MR imaging-guided coronary artery catheterization using a 1.5 T MR scanner. For catheter-directed coronary MRA, we injected 3-4 mL of dilute Gd at 1 mL/second for each tested concentration (4%, 8%, 10%, and 12% Gd). Eleven images per concentration were acquired using electrocardiographic-triggered, magnetization-prepared two-dimensional (2D) projection SSFP. We compared mean relative signal-to-noise ratio (SNR) values for each concentration using two-way analysis of variance. RESULTS: The targeted coronary artery was catheterized under real-time MR guidance in all pigs. Magnetization-prepared 2D projection SSFP successfully depicted the coronary arteries in all 44 injections. Mean relative SNR (+/- standard error) was 7.2 +/- 0.49 for 4%, 8.8 +/- 0.47 for 8%, 9.5 +/- 0.38 for 10%, and 8.8 +/- 0.41 for 12%. Injections of 4% dilute gadolinium yielded significantly less relative SNR than the other tested concentrations (P < .05). There were no statistically significant differences between the remaining concentrations. CONCLUSION: For catheter-directed contrast-enhanced coronary MRA, the ideal gadolinium concentration should maximize relative SNR and limit the total gadolinium dose. Using these criteria, of those concentrations we tested in the swine model, 8% injected gadolinium was superior for catheter-directed SSFP coronary MRA.

Analysis of Variance↗

Magnetic resonance angiography of coronary arteries with a 3-dimensional magnetization-prepared true fast imaging with steady-state precession sequence compared with conventional coronary angiography.

BACKGROUND: The aim of the study was to compare the detection of clinically significant coronary artery stenosis using a magnetic resonance 3-dimensional (3D) breath-hold true fast imaging with steady-state precession (trueFISP) sequence with conventional coronary angiography. METHODS: Twenty-nine patients who were scheduled to undergo or had recently undergone diagnostic conventional coronary angiogram participated in this study. The left main, left anterior descending, left circumflex, and right coronary arteries were studied using the 3D breath-hold trueFISP technique. Each artery was imaged with 1 acquisition in 16 to 32 heartbeats. The image quality, vessel length, and presence or absence of stenosis were evaluated. A score of 1 to 3 (1 = noninterpretable, 2 = good, 3 = excellent) was used to assess image quality. The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of magnetic resonance angiography in detecting significant coronary artery stenosis (> 50% luminal narrowing) on conventional coronary angiogram were calculated. RESULTS: Of 116 vessels, 108 were assessed in 29 patients. Twenty vessels that had image quality score of 1 were excluded from further evaluation. The mean lengths of vessels visualized were the following: left anterior descending 3.6 cm, left circumflex 3.4 cm, and right coronary 6.6 cm. The entire length of the left main coronary artery was visualized. For the visualized arterial segments, the sensitivity, specificity, accuracy, positive predictive value, and negative predictive value for detecting significant coronary artery stenosis were 92.8%, 95.3%, 95.0%, 68.4%, and 99.2%, respectively. CONCLUSIONS: The 3D breath-hold trueFISP technique, which uses the endogenous contrast of blood, is potentially useful in ruling out significant coronary artery stenosis but not yet sensitive enough as a screening tool.

Adult↗

Single-session magnetic resonance coronary angiography and myocardial perfusion imaging using the new blood pool compound B-22956 (gadocoletic acid): initial experience in a porcine model of coronary artery disease.

OBJECTIVE: The objective of this study was to evaluate a new blood pool contrast agent, B-22956, for detecting myocardial perfusion abnormality and coronary artery stenosis by magnetic resonance imaging (MRI) in 1 setting. MATERIALS AND METHODS: Coronary artery atherosclerotic stenoses were created in 6 miniswine. Myocardial first-pass perfusion imaging was performed with a bolus injection of 0.015 mmol/kg B-22956 during pharmacologic stress followed by postcontrast coronary artery imaging after another injection of B-22956/1. The total doses for the 6 pigs were 0.1 mmol/kg (n=3) and 0.15 mmol/kg (n=3). Perfusion upslope maps were analyzed and MR coronary artery images were reviewed by 2 readers. RESULTS: For all 6 pigs, the normalized upslopes of the perfusion curves were 0.83+/-0.12, 0.74+/-0.15, and 0.52+/-0.05 (P<0.01 vs. normal) with normal or mild (<50% area stenosis), moderate (<50% and <75%), and severe stenosis (>75%), respectively. Mean signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) in right coronary artery images improved 90% and 200%, respectively, with a total dose of 0.1 mmol/kg of B-22956. Excellent agreements (kappa=0.82) were achieved for evaluating the grade of stenosis between MR postcontrast coronary artery images and histopathology by 2 reviewers. CONCLUSION: The MR blood pool contrast agent B-22956 demonstrated the ability for detecting myocardial perfusion abnormalities and coronary artery stenosis in 1 setting.

Animals↗

Catheter-directed MR angiography and cross-sectional imaging for the assessment of renal artery stenosis.

PURPOSE: Catheter-directed intraarterial (IA) gadolinium (Gd)-enhanced gradient-echo (GRE) imaging has been used in the setting of magnetic resonance (MR) imaging-guided endovascular procedures for two-dimensional (2D) or three-dimensional (3D) depiction of blood vessels. In a swine model, the hypothesis was tested that the combination of 2D IA GRE and 2D cross-sectional steady-state free precession (SSFP) imaging improves assessment of renal artery stenosis (RAS) compared with 3D IA GRE imaging alone. MATERIALS AND METHODS: Bilateral RAS was surgically induced in seven pigs. Detection of stenoses was then compared between the combination of 2D projection IA GRE and cross-sectional 2D SSFP imaging without contrast agent and 3D IA GRE alone. Radiographic digital subtraction angiography (DSA) was employed as the reference standard. Linear regression was used to compare stenosis measurements, with an alpha of 0.05. RESULTS: Radiographic DSA and MR imaging were successful in the seven animals (14 stenoses). With use of linear regression analysis, the combination of 2D IA GRE and 2D SSFP imaging had a higher r(2) (0.87 vs 0.72) and a slope closer to unity (1.02 vs 0.77) compared with 3D IA GRE imaging alone. When comparing intercepts, the regression line for SSFP significantly differed from that of 3D IA GRE imaging (P < .05). CONCLUSION: The combination of 2D IA GRE and cross-sectional 2D SSFP imaging improves the accuracy of RAS detection compared with IA 3D IA-GRE alone.

Anatomy, Cross-Sectional↗

Feasibility of blood oxygenation level-dependent MR imaging to monitor hepatic transcatheter arterial embolization in rabbits.

Blood oxygenation level-dependent (BOLD) magnetic resonance (MR) imaging is a noninvasive method to assess changes in oxygen delivery to tissues. It was hypothesized that BOLD MR imaging can detect changes in rabbit VX2 liver tumor oxygenation after hepatic artery embolization with polyvinyl alcohol particles. In four discrete VX2 liver tumors, a statistically significant mean reduction in apparent transverse relaxation time was shown, from 55 milliseconds before embolization to 41 milliseconds after embolization (P < .01). This reduction corresponded to a decrease in hepatic tumor oxygenation. The use of BOLD MR imaging to monitor changes in hepatic tumor oxygenation after embolization is feasible. These functional MR imaging measurements of hypoxia may be targeted as an endpoint for therapy in future studies.

Angiography, Digital Subtraction↗

T2-prepared steady-state free precession blood oxygen level-dependent MR imaging of myocardial perfusion in a dog stenosis model.

PURPOSE: To assess the ability of a T2-prepared steady-state free precession blood oxygen level-dependent (BOLD) magnetic resonance (MR) imaging sequence to depict changes in myocardial perfusion during stress testing in a dog stenosis model. MATERIALS AND METHODS: Study was approved by the institutional Animal Care and Use Committee. A hydraulic occluder was placed in the left circumflex coronary artery (LCX) in 10 dogs. Adenosine was administered intravenously to increase coronary blood flow, and stenosis was achieved in the LCX with the occluder. A T2-prepared two-dimensional steady-state free precession sequence was used for BOLD imaging at a spatial resolution of 1.5 x 1.2 x 5.0 mm3, and first-pass perfusion images were acquired for visual comparison. Microspheres were injected to provide regional perfusion information. Mixed-effect regression analysis was performed to assess normalized MR signal intensity ratios and microsphere-measured perfusion differences. For the same data, 95% prediction intervals were calculated to determine the smallest perfusion change detectable. Means +/- standard deviations were calculated for myocardial regional comparison data. A two-tailed Student t test was used to determine if significant differences (P < .01) existed between different myocardial regions. RESULTS: Under maximal adenosine stress, MR clearly depicted stenotic regions and showed regional signal differences between the left anterior descending coronary artery (LAD)-fed myocardium and the stenosed LCX-fed myocardium. Visual comparisons with first-pass images were also excellent. Regional MR signal intensity differences between LAD and LCX-fed myocardium (1.24 +/- 0.08) were significantly different (P < .01) from differences between LAD and septal-fed myocardium (1.02 +/- 0.07), which was in agreement with microsphere-measured flow differences (LAD/LCX, 3.38 +/- 0.83; LAD/septal, 1.26 +/- 0.49). The linear mixed-effect regression model showed good correlation (R = 0.79) between MR differences and microsphere-measured flow differences. CONCLUSION: On T2-prepared steady-state free precession BOLD MR images in dogs, signal intensity differences were linearly related to flow differences in myocardium, with a high degree of correlation. SUPPLEMENTAL MATERIAL: radiology.rsnajnls.org/cgi/content/full/236/2/503/DC1

Animals↗

Myocardial perfusion imaging based on the blood oxygen level-dependent effect using T2-prepared steady-state free-precession magnetic resonance imaging.

BACKGROUND: The decision to perform coronary revascularization procedures may hinge on assessment of myocardial perfusion reserve. Blood oxygen level-dependent (BOLD) MRI is a potential method to detect the effects of regional variations in myocardial blood flow during vasodilation. METHODS AND RESULTS: We imaged dogs (n=13) on a 1.5-T whole-body MRI scanner using a new T(2)-prepared steady-state free-precession (SSFP) MRI pulse sequence sensitive to BOLD contrast. Images (in-plane resolution approximately 1 mm(2)) of 5 short-axis and 2 long-axis slices of the heart were acquired during graded levels of adenosine infusion via a surgically placed left circumflex (LCx) catheter (n=11) or via a right atrial catheter in animals with an LCx occluder (n=2). Relative myocardial perfusion was measured with the use of fluorescent microspheres. Signal intensity changes in myocardium subtended by the left anterior descending coronary artery were compared with those in the LCx region. Unprocessed T(2)-weighted images revealed changes in signal intensity corresponding to areas of regional vasodilation or reduced myocardial perfusion reserve during systemic vasodilation. At maximal vasodilation, the signal intensity ratio in the LCx versus left anterior descending territories increased by 33+/-4% compared with baseline, corresponding to a 3.8+/-0.3-fold increase in relative perfusion (P<0.01). MR intensity at progressive levels of vasodilation demonstrated good agreement with microsphere flow (R=0.80, P<0.01). CONCLUSIONS: T(2)-prepared SSFP BOLD imaging is a promising method to determine an index of myocardial perfusion reserve in this animal model.

Adenosine↗

Coronary artery imaging using three-dimensional breath-hold steady-state free precession with two-dimensional iterative partial fourier reconstruction.

PURPOSE: To assess the feasibility of using a two-dimensional partial Fourier (PF) reconstruction scheme to reduce the acquisition time of magnetic resonance imaging (MRI) of coronary arteries. MATERIALS AND METHODS: Symmetric k-space data sets of coronary arteries were collected in seven volunteers using a three-dimensional breath-hold steady-state free precession (SSFP) sequence. Partial, asymmetric k-space data sets were generated by removing 25% of the data in the readout direction and 25% of the data in the phase encoding direction. The missing data were then estimated using a two-dimensional projection-onto-convex-sets (POCS) algorithm or filled with zeroes. Images were reconstructed from the full data set, the PF data set, and the zero-filled (ZF) data set, respectively. Coronary artery sharpness was evaluated quantitatively and qualitatively. RESULTS: Coronary artery sharpness in PF images was comparable to that in full k-space images and significantly better than that in ZF images. CONCLUSION: Two-dimensional POCS PF reconstruction is a potentially useful technique for reducing acquisition time or improving spatial resolution for breath-hold coronary MR angiography.

Adult↗

Magnetic resonance imaging-guided coronary interventions.

Magnetic resonance imaging (MRI) guidance for coronary interventions offers potential advantages over conventional x-ray angiography. Advantages include the use of nonionizing radiation, combined assessment of anatomy and function, and three-dimensional assessment of the coronary arteries leading to the myocardium. These advantages have prompted a series of recent studies in this field. Real-time coronary MR angiography, with low-dose catheter-directed intraarterial (IA) infusion of contrast media, has achieved in-plane spatial resolution as low as 0.8 x 0.8 mm2 and temporal resolution as short as 130 msec per image. Catheter-based IA injection of contrast agent has proven useful in the collection of multislice and three-dimensional images, not only for coronary intervention guidance, but also in the assessment of regional myocardial perfusion fed by the affected vessel. Actively visible guidewires and guiding catheters, based on the loopless antenna concept, have been effectively used to negotiate tortuous coronary vessels during catheterization, permitting placement of coronary angioplasty balloon catheters. Passive tracking approaches have been used to image contrast agent-filled coronary catheters and to place susceptibility-based endovascular stents. Although the field is in its infancy, these early results demonstrate the feasibility for performing MRI-guided coronary interventions. Although further methodological and technical developments are required before these methods become clinically applicable, we anticipate that MRI someday will be included in the armamentarium of techniques used to diagnose and treat coronary artery disease.

Contrast Media↗

Self-gated cardiac cine MRI.

The need for ECG gating presents many difficulties in cardiac magnetic resonance imaging (CMRI). Real-time imaging techniques eliminate the need for ECG gating in cine CMRI, but they cannot offer the spatial and temporal resolution provided by segmented acquisition techniques. Previous MR signal-based techniques have demonstrated an ability to provide cardiac gating information; however, these techniques result in decreased imaging efficiency. The purpose of this work was to develop a new "self-gated" (SG) acquisition technique that eliminates these efficiency deficits by extracting the motion synchronization signal directly from the same MR signals used for image reconstruction. Three separate strategies are proposed for deriving the SG signal from data acquired using radial k-space sampling: echo peak magnitude, kymogram, and 2D correlation. The SG techniques were performed on seven normal volunteers. A comparison of the results showed that they provided cine image series with no significant differences in image quality compared to that obtained with conventional ECG gating techniques. SG techniques represent an important practical advance in clinical MRI because they enable the acquisition of high temporal and spatial resolution cardiac cine images without the need for ECG gating and with no loss in imaging efficiency.

Algorithms↗

Dynamic estimation of the myocardial oxygen extraction ratio during dipyridamole stress by MRI: a preliminary study in canines.

The myocardial oxygen extraction fraction (OEF) reflects the balance between myocardial oxygen supply and demand. The feasibility of quantifying myocardial OEF was demonstrated with MRI during pharmacologic vasodilation in dogs. Dipyridamole was infused intravenously to increase blood flow and change in myocardial oxygen content. Arterial and coronary sinus blood sampling was performed during dipyridamole-induced vasodilation to measure the myocardial blood oxygen content. Myocardial T(2) was measured dynamically during the vasodilation, and quantified with a simplified diffusion model as a function of myocardial OEF and blood volume. The results showed a strong correlation (R(2) = 0.89) between myocardial OEF values measured by MRI and those measured by blood sampling. Regional differences in the OEF were demonstrated by direct infusion of dipyridamole into coronary arteries in dogs. Combined with vasodilator stress, dynamic assessments of the OEF may provide a putative measurement of myocardial flow reserve and allow consecutive monitoring of myocardial dose and response.

Animals↗

Feasibility and performance of breath-hold 3D true-FISP coronary MRA using self-calibrating parallel acquisition.

Spatial resolution in 3D breath-hold coronary MR angiography (MRA) is limited by imaging time. The purpose of this work was to investigate the feasibility of improving the spatial resolution of coronary MRA using generalized autocalibrating partially parallel acquisition (GRAPPA) and fast imaging with steady state precession (True-FISP) data acquisition. Coronary data were acquired in 10 healthy volunteers. In five volunteers, the data were fully acquired in k-space and decimated for GRAPPA with an outer reduction factor (ORF) of 2. The coil calibration in GRAPPA was improved by segmented least-squares fitting along the frequency-encoding direction. More than 5% of the total k-space lines were required for the calibration to achieve acceptable artifact suppression despite slightly lower signal-to-noise ratio (SNR). In another five volunteers, coronary data were obtained with both conventional and accelerated data acquisitions in the same imaging time. GRAPPA allowed a submillimeter in-plane resolution, and improved coronary artery definition with an acceptable loss of SNR. In conclusion, 3D breath-hold coronary MRA by GRAPPA and True-FISP is highly feasible.

Artifacts↗

Automated rectilinear self-gated cardiac cine imaging.

ECG-based gating in cardiac MR imaging requires additional patient preparation time, is susceptible to RF and magnetic interference, and is ineffective in a significant percentage of patients. "Wireless" or "self-gating" techniques have been described using either interleaved central k-space lines or projection reconstruction to obtain MR signals synchronous with the cardiac cycle. However, the interleaved, central line method results in a doubling of the acquisition time, while radial streak artifacts are encountered with the projection reconstruction method. In this work, a new self-gating technique is presented to overcome these limitations. A retrospectively gated TrueFISP cine sequence was modified to acquire a short second echo after the readout and phase gradients are rewound. The information obtained from this second echo was used to derive a gating signal. This technique was compared to ECG-based gating in 10 healthy volunteers and shown to have no significant difference in image quality. The results indicate that this method could serve as an alternative gating strategy without the need for external physiological signal detection.

Electrocardiography↗

Projection imaging of the right coronary artery with an intravenous injection of contrast agent.

Contrast-enhanced (CE) MR angiography of the right coronary artery (RCA) was performed using 2D thick-slice projection imaging with a small (8 mL) intravenous injection of contrast agent in six volunteers. With a tight contrast bolus injection, the RCA was enhanced for a few seconds after the contrast bolus was washed out of the right ventricle. This allowed data to be acquired when only the RCA was enhanced. Using 2D thick-slice magnetization prepared steady-state free precession (SSFP) imaging, background signal was suppressed and a complete data set was acquired in three heartbeats. A mean vessel length of 7.1 +/- 0.9 cm was depicted with a signal-to-noise ratio of 11.8 +/- 0.7 and contrast-to-noise ratio of 6.1 +/- 0.6. Thick-slice 2D projection CE SSFP is a promising method to depict the RCA.

Adult↗