An MR angiographic technique, referred to as 3D TRICKS (3D time-resolved imaging of contrast kinetics) has been developed. This technique combines and extends to 3D imaging several previously published elements. These elements include an increased sampling rate for lower spatial frequencies, temporal interpolation of k-space views, and zero-filling in the slice-encoding dimension. When appropriately combined, these elements permit reconstruction of a series of 3D image sets having an effective temporal frame rate of one volume every 2-6 s. Acquiring a temporal series of images offers advantages over the current contrast-enhanced 3D MRA techniques in that it I) increases the likelihood that an arterial-only 3D image set will be obtained. II) permits the passage of the contrast agent to be observed, and III) allows temporal-processing techniques to be applied to yield additional information, or improve image quality.
Undersampled projection reconstruction (PR) is investigated as an alternative method for MRA (MR angiography). In conventional 3D Fourier transform (FT) MRA, resolution in the phase‐encoding direction is proportional to acquisition time. Since the PR resolution in all directions is determined by the readout resolution, independent of the number of projections (Np), high resolution can be generated rapidly. However, artifacts increase for reduced Np. In X‐ray CT, undersampling artifacts from bright objects like bone can dominate other tissue. In MRA, where bright, contrast‐filled vessels dominate, artifacts are often acceptable and the greater resolution per unit time provided by undersampled PR can be realized. The resolution increase is limited by SNR reduction associated with reduced voxel size. The hybrid 3D sequence acquires fractional echo projections in the kx–ky plane and phase encodings in kz. PR resolution and artifact characteristics are demonstrated in a phantom and in contrast‐enhanced volunteer studies. Magn Reson Med 43:91–101, 2000. © 2000 Wiley‐Liss, Inc.
Time-resolved contrast-enhanced 3D MR angiography (MRA) methods have gained in popularity but are still limited by the tradeoff between spatial and temporal resolution. A method is presented that greatly reduces this tradeoff by employing undersampled 3D projection reconstruction trajectories. The variable density k-space sampling intrinsic to this sequence is combined with temporal k-space interpolation to provide time frames as short as 4 s. This time resolution reduces the need for exact contrast timing while also providing dynamic information. Spatial resolution is determined primarily by the projection readout resolution and is thus isotropic across the FOV, which is also isotropic. Although undersampling the outer regions of k-space introduces aliased energy into the image, which may compromise resolution, this is not a limiting factor in highcontrast applications such as MRA. Results from phantom and volunteer studies are presented demonstrating isotropic resolution, broad coverage with an isotropic field of view (FOV), minimal projection reconstruction artifacts, and temporal information. In one application, a single breath-hold exam covering the entire pulmonary vasculature generates high-resolution, isotropic imaging volumes depicting the bolus passage. Contrast-enhanced magnetic resonance angiography (MRA) of the chest or abdomen is typically accomplished by completing the scan in a single breath-hold to limit respiratory artifacts, and during the first pass of a contrast agent for maximum arterial enhancement (1,2). As the arterial-to-venous delay decreases, timing the bolus arrival and rapid scanning become more important. Time-resolved methods have become of increasing interest as they can mitigate the need for precise bolus timing, in addition to providing important dynamic information (3,4). Repetitive 3D Cartesian acquisitions of k-space acquired at high speed have recently generated dynamic MRA exams of the pulmonary vasculature (5,6), and when combined with correlation postprocessing, they can be used to calculate arterial and venous image volumes (7). Time-resolved methods generally require further compromises between temporal resolution, spatial resolution, and field of view (FOV) (8). Speed is generated by acquiring less throughplane resolution or by a partial acquisition of k-space in all three dimensions.Sparse sampling of k-space, analyzed generally in Ref. 9, has increased resolution per unit time in cases wherein the artifacts from aliased energy are acceptable due to high signal contrast. Peters et al. (10) increased in-plane resolution by a factor of 4 relative to Cartesian techniques by sampling the in-plane k-space dimensions with projections, and the slice dimension with Cartesian encoding. As is well known in computed tomography (CT), the readout resolution of the projections determines the resolution of the image, and the total number of acquired projections determines the level of artifact (11). Imaging time with these hybrid project reconstruction (PR) methods, termed PRojecti...
The utility of cardiac magnetic resonance imaging (MRI) as a screening tool for myocarditis in competitive student athletes returning to training after recovering from coronavirus disease 2019 (COVID-19) infection is unknown.OBJECTIVE To describe the prevalence and severity of cardiac MRI findings of myocarditis in a population of competitive student athletes recovering from COVID-19. DESIGN, SETTING, AND PARTICIPANTSIn this case series, an electronic health record search was performed at our institution (University of Wisconsin) to identify all competitive athletes (a consecutive sample) recovering from COVID-19, who underwent gadolinium-enhanced cardiac MRI between January 1, 2020, and November 29, 2020. The MRI findings were reviewed by 2 radiologists experienced in cardiac imaging, using the updated Lake Louise criteria. Serum markers of myocardial injury and inflammation (troponin-I, B-type natriuretic peptide, C-reactive protein, and erythrocyte sedimentation rate), an electrocardiogram, transthoracic echocardiography, and relevant clinical data were obtained.EXPOSURES COVID-19 infection, confirmed using reverse transcription-polymerase chain reaction testing. MAIN OUTCOMES AND MEASURESPrevalence and severity of MRI findings consistent with myocarditis among young competitive athletes recovering from COVID-19.RESULTS A total of 145 competitive student athletes (108 male and 37 female individuals; mean age, 20 years; range, 17-23 years) recovering from COVID-19 were included. Most patients had mild (71 [49.0%]) or moderate (40 [27.6%]) symptoms during the acute infection or were asymptomatic (24 [16.6%]). Symptoms were not specified or documented in 10 patients (6.9%). No patients required hospitalization. Cardiac MRIs were performed a median of 15 days (range, 11-194 days) after patients tested positive for COVID-19. Two patients had MRI findings consistent with myocarditis (1.4% [95% CI, 0.4%-4.9%]). Of these, 1 patient had marked nonischemic late gadolinium enhancement and T2-weighted signal abnormalities over multiple segments, along with an abnormal serum troponin-I level; the second patient had 1-cm nonischemic mild late gadolinium enhancement and mild T2-weighted signal abnormalities, with normal laboratory values. CONCLUSIONS AND RELEVANCEIn this case series study, based on MRI findings, there was a low prevalence of myocarditis (1.4%) among student athletes recovering from COVID-19 with no or mild to moderate symptoms. Thus, the utility of cardiac MRI as a screening tool for myocarditis in this patient population is questionable.
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