Optimization of single shot 3D breath-hold non-enhanced MR angiography of the renal arteries
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Optimization of single shot 3D breath-hold non-enhanced MR angiography of the renal arteries Huan Tan1*, Ioannis Koktzoglou1,2, Christopher Glielmi3, Mauricio Galizia4 and Robert R Edelman1,4
Abstract Background: Cardiac and navigator-gated, inversion-prepared non-enhanced magnetic resonance angiography techniques can accurately depict the renal arteries without the need for contrast administration. However, the scan time and effectiveness of navigator-gated techniques depend on the subject respiratory pattern, which at times results in excessively prolonged scan times or suboptimal image quality. A single-shot 3D magnetization-prepared steady-state free precession technique was implemented to allow the full extent of the renal arteries to be depicted within a single breath-hold. Methods: Technical optimization of the breath-hold technique was performed with fourteen healthy volunteers. An alternative magnetization preparation scheme was tested to maximize inflow signal. Quantitative and qualitative comparisons were made between the breath-hold technique and the clinically accepted navigator-gated technique in both volunteers and patients on a 1.5 T scanner. Results: The breath-hold technique provided an average of seven fold reduction in imaging time, without significant loss of image quality. Comparable single-to-noise and contrast-to-noise ratios of intra- and extra-renal arteries were found between the breath-hold and the navigator-gated techniques in volunteers. Furthermore, the breath-hold technique demonstrated good image quality for diagnostic purposes in a small number of patients in a pilot study. Conclusions: The single-shot, breath-hold technique offers an alternative to navigator-gated methods for nonenhanced renal magnetic resonance angiography. The initial results suggest a potential supplementary clinical role for the breath-hold technique in the evaluation of suspected renal artery diseases. Keywords: Non-enhanced Renal MRA, 3D Steady-State Precession Acquisition, Breath-hold
Background Renal artery stenosis (RAS) is an important cause of secondary hypertension and chronic renal failure [1]. Several imaging options are available, including CT angiography, MR angiography (MRA), radionuclide renography, and duplex sonography [2-5]. Contrastenhanced (CE) MRA is commonly used for renal artery evaluation. However, recent studies [6,7] have found a strong association between nephrogenic systemic fibrosis and the use of gadolinium-based contrast material in * Correspondence: [email protected] 1 Department of Radiology, NorthShore University HealthSystem, 2650 Ridge Avenue, Evanston, IL 60201, USA Full list of author information is available at the end of the article
patients with impaired renal function. Consequently, there is growing interest to use non-enhanced MRA techniques. A cardiac and navigator-gated, magnetization-prepared 3D balanced steady-state free precession (Nav MP-SSFP) sequence is frequently used for non-enhanced MRA of the renal arteries [8-14]. The magne
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