Optimization of 3D phase contrast venography for the assessment of the cranio-cervical venous system at 1.5 T
The aim of this work was to optimize a three-dimensional (3D) phase-contrast venography (PCV) product MR pulse sequence in order to obtain clinically reliable images with less artifacts for an improved depiction of the cranio-cervical venous vessels.
Starting from the product sequence, the 3D PCV protocol was optimized in eight steps with respect to the velocity encoding (Venc) direction and value, slice thickness, reduction of susceptibility artifacts and arterial contamination, gradient mode and radio-frequency (RF)-spoiling, B0-Shimming, asymmetric echo technique and RF-pulse type, and flip angle. The product and optimized protocol was used to perform 3D PCV in 12 healthy male volunteers with a median age of 50 years using a state-of-the-art 1.5-T MR system. For evaluation, the cranio-cervical venous system was divided into 15 segments. These segments were evaluated by three radiologists with experience in neuroradiology. An ordinal scoring system was used to access the overall diagnostic quality, arterial contamination, and the quality of visualization.
Image quality in the optimized 3D PCV was graded as “excellent” by all readers in 65.3% of the cases (p < 0.0001). The visualization of venous segments was strongly improved: it was considered diagnostic in 81.8% of all cases using the optimized sequence and in 47.6% for the product 3D PCV (p < 0.0001), respectively. The optimized protocol improved the imaging of all venous segments (p < 0.0001).
The optimized 3D PCV pulse sequence showed superior results compared to the product 3D PCV for the visualization and evaluation of the venous system in all healthy volunteers.
KeywordsMagnetic resonance imaging (MRI) Non-contrast-enhanced venography 3D phase contrast magnetic resonance imaging (PCV-MRI) Pseudotumor cerebri Cerebral venous thrombosis
The authors thank the MRI technicians in the Department of Radiology and Neuroradiology for their assistance in MR imaging. We quite warmly thank Dr. Klaus Moldenhauer for his patience, his interest in the science and especially for the fact that he made available himself over the course of several weeks as a volunteer for the optimization of this product 3D PCV.
Compliance with Ethical Standards
JBH was funded by the Deutsche Forschungsgemeinschaft (DFG; HO 4604/1-1 and HO 4604/2-1), the Cluster of Excellence EXC306 at Kiel University and the Medical Faculty for the Molecular Imaging North Competence Center (MOIN CC) as core facility for imaging. MOIN CC was funded by a grant of the European Regional Development Fund (ERDF) and the Zukunftsprogramm Wirtschaft of Schleswig-Holstein (Project No. 122-09-053).
Conflict of interest
The authors declare that they have no conflict of interest.
All procedures performed in the studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
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