(CE
MRA)
Contrast enhanced
MR angiography is based
on the T1 values of blood, the surrounding tissue, and paramagnetic
contrast agent.
T1-shortening
contrast agents reduces the T1 value of the blood (approximately to 50 msec, shorter than that of the surrounding tissues) and allow the visualizati
on of blood vessels, as the images are no l
onger dependent primarily
on the inflow effect of the blood.
C
ontrast enhanced
MRA is performed with a short TR to have low signal (due to the l
onger T1) from the stati
onary tissue, short
scan time to facilitate
breath hold imaging, short TE to minimize
T2* effects and a
bolus injection of a sufficient dose of a
gadolinium chelate.
Images of the
region of interest are performed with 3D spoiled
gradient echo pulse
sequences. The enhancement is maximized by timing the
contrast agent injecti
on such that the period of maximum arterial c
oncentrati
on corresp
onds to the
k-space acquisiti
on. Different techniques are used to ensure optimal
contrast of the arteries e.g.,
bolus timing,
automatic bolus detection,
bolus tracking,
care bolus.
A high
resolution with near
isotropic voxels and minimal pulsatility and misregistrati
on artifacts should be striven for. The
postprocessing with the
maximum intensity projection (
MIP) enables different views of the 3D data set.
Unlike c
onventi
onal
MRA techniques based
on velocity dependent inflow or
phase shift techniques,
contrast enhanced
MRA exploits the
gadolinium induced T1-shortening effects. CE
MRA reduces or eliminates most of the artifacts of
time of flight angiography or
phase contrast angiography. Advantages are the possibility of in plane imaging of the blood vessels, which allows to examine large parts in a short time and high
resolution scans in
one breath hold.
CE
MRA has found a wide acceptance in the clinical routine, caused by the
advantages:
•
3D
MRA can be acquired in any plane, which means that
greater vessel coverage can be obtained at high
resoluti
on with fewer slices (aorta, peripheral vessels);
•
the possibility to perform a time resolved examinati
on
(similarly to c
onventi
onal
angiography);
•
no use of i
onizing radiati
on; paramagnetic agents have a beneficial
safety.