(MOTSA) This technique combines the best features of 2D time of flight angiography (2D TOF) and 3D TOFMRA. The MOTSA technique consists of multiple 2 cm thick 3D TOFslabs (which minimize saturation effects for
through plane flow) combine to provide unlimited coverage similar to multiple 2D TOF slices. High resolution imaging of the carotid arteries is possible when image quality is of greater concern than acquisition time.
Images with 1 mm (or less) spatial resolution in all three planes are required. The slabs typically overlap 25-40 to
minimize the venetian blind artifactvenetian blind artifact due to minimal saturation effects.
MOTSA is an useful technique for the evaluation of vertebrobasilar ischemia and aneurysm scanning from the foramen
magnum through the circle of Willis.
(TOF) The time of flight angiography is used for the imaging of vessels. Usually the sequence type is a gradient echosequences with short TR, acquired with slices perpendicular to the direction of blood flow.
The source of diverse flow effects is the difference between the unsaturated and presaturated spins and creates a bright vascular image without the invasive use of contrast media. Flowing blood moves unsaturated spins from outside the slice into the imaging plane. These completely relaxed spins have full equilibriummagnetization and produce (when entering the imaging plane) a much higher signal than stationary spins if a gradient echo sequence is generated. This flow related enhancement is also referred to as entry slice phenomenon, or inflow enhancement.
Performing a presaturationslab on one side parallel to the slice can selectively destroy the MR signal from the in-flowing blood from this side of the slice. This allows the technique to be flow direction sensitive and to separate arteriograms or venograms. When the local magnetization of moving blood is selectively altered in a region, e.g. by selective excitation, it carries the altered magnetization with it when it moves, thus tagging the selected region for times on the order of the relaxation times.
For maximum flow signal, a complete new part of blood has to enter the slice every repetition (TR) period, which makes time of flight angiography sensitive to flow-velocity. The choice of TR and slice thickness should be appropriate to the expected flow-velocities because even small changes in slice thickness influences the performance of the TOF sequence.
The use of sequential 2 dimensional Fourier transformation (2DFT) slices, 3DFTslabs, or multiple 3D slabs (chunks) are depending on the coverage required and the range of flow-velocities.
3D TOF MRA is routinely used for evaluating the Circle of Willis.