SUMMARY:This second article of the 2-part review builds on the theoretic background provided by the first article to cover the major technical factors that affect image quality in diffusion imaging, including the acquisition sequence, magnet field strength, gradient amplitude, and slew rate as well as multichannel radio-frequency coils and parallel imaging. The sources of many common diffusion image artifacts are also explored in detail. The emphasis is on optimizing these technical factors for stateof-the-art diffusion-weighted imaging and diffusion tensor imaging (DTI) based on the best available evidence in the literature. An overview of current methods for quantitative analysis of DTI data and fiber tractography in clinical research is also provided.
In this article, the major technical factors that affect image quality in diffusion MR imaging are evaluated in detail. The first half focuses on diffusion-weighted imaging (DWI). The strengths and weaknesses of single-shot echo-planar imaging, by far the most popular sequence for brain DWI, are considered, and alternative sequences are presented for special purpose applications. The effect of hardware and software variables such as magnetic field strengths, gradient amplitudes and slew rates, radio-frequency coils, and parallel imaging reconstruction methods is reviewed. The causes of common DWI artifacts are explained, and strategies are provided for minimizing artifacts and optimizing image quality.The second half of the article focuses on technical considerations specific to diffusion tensor imaging (DTI) and fiber tractography, including optimizing the b-values, the number and orientations of diffusion-weighted acquisitions, as well as the fiber tracking parameters. The undesirable effects of common problems such as low signal intensity-to-noise ratio (SNR) and pulsation artifact are reviewed. An overview is provided of current methods for analyzing quantitative DTI data for clinical research, including the reproducibility of DTI measurements. Throughout this review, the emphasis is on optimizing the many technical factors needed for state-of-the-art DWI and DTI based on the best available evidence in the literature.
Technical Considerations for State-of-the-Art DWI
Echo-Planar DWIAdvantages of Single-Shot Echo-Planar DWI. Because even minimal bulk patient motion during acquisition of DWIs can obscure the effects of the much smaller microscopic water motion due to diffusion, ultrafast imaging sequences are necessary for successful clinical DWI. Most commonly, diffusion imaging is performed by using spin-echo single-shot echoplanar imaging (SS-EPI) techniques. The term "single shot" means that an entire 2D image is formed from a single radiofrequency excitation pulse. Images can be acquired in a fraction of a second; therefore, artifact from physiologic cardiac and respiratory pulsatility and from patient motion is greatly reduced, including motion between acquisitions with different orientations of the diffusion-sensitizing gradients. Another advantage of S...