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Flow QuantificationInfoSheet: - Sequences - 
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Quantification relies on inflow effects or on spin phase effects and therefore on quantifying the phase shifts of moving tissues relative to stationary tissues.
With properly designed pulse sequences (see phase contrast sequence) the pixel by pixel phase represents a map of the velocities measured in the imaging plane. Spin phase effect-based flow quantification schemes use pulse sequences specifically designed so that the phase angle in a pixel obtained upon measuring the signal is proportional to the velocity. As the relation of the phase angle to the velocity is defined by the gradient amplitudes and the gradient switch-on times, which are known, velocity can be determined quantitatively on a pixel-by-pixel basis. Once, this velocity is known, the flow in a vessel can be determined by multiplying the pixel area with the pixel velocity. Summing this quantity for all pixels inside a vessel results in a flow volume, which is measured, e.g. in ml/sec.
Flow related enhancement-based flow quantification techniques (entry phenomena) work because spins in a section perpendicular to the vessel of interest are labeled with some radio frequency RF pulse. Positional readout of the tagged spins some time T later will show the distance D they have traveled.
For constant flow, the velocity v is obtained by dividing the distance D by the time T : v = D/T. Variations of this basic principle have been proposed to measure flow, but the standard methods to measure velocity and flow use the spin phase effect.
Cardiac MRI sequences are used to encode images with velocity information. These pulse sequences permit quantification of flow-related physiologic data, such as blood flow in the aorta or pulmonary arteries and the peak velocity across stenotic valves.
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Field Even Echo Rephasing
 
The FEER method was the first clinically useful flow quantification method using phase effects, from which all spin phase related flow quantification techniques currently in use are derived.
In this sequence a gradient echo is measured after a gradient with flow compensation. The measured signal phase should be zero for all pixels. A deviation from gradient symmetry by shifting the gradient ramp slightly away from the symmetry condition will impart a defined phase shift to the magnetization vectors associated with spins from pixels with flow.
Slight stable variations in the magnetic field across the imaging volume will prevent the phase angle from being uniformly zero throughout the volume in the flow-compensated image. The first image (acquired without gradient shift) serves as reference, defining the values of all pixel phase angles in the flow (motion) compensated sequence. Ensuing images with gradient phase shifts imparted in each of the 3 spatial axes will then permit measurement of the 3 components of the velocity vector v = (vx, vy, vz) by calculating the respective phases px, py and pz by simply subtracting the pixel phases measured in the compensated image from the 3 images with a well defined velocity sensitization.
The determination of all 3 components of the velocity vector requires the measurement of 4 images.
The phase quantification requires an imaging time four times longer than the simple measurement of a phase image and associated magnitude image. If only one arbitrary flow direction is of interest, it suffices to acquire the reference image plus one image velocity sensitized in the arbitrary direction of interest.

See also Flow Quantification.
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In the last years, cardiac MRI techniques have progressively improved. No other noninvasive imaging modality provides the same degree of contrast and temporal resolution for the assessment of cardiovascular anatomy and pathology. Contraindications MRI are the same as for other magnetic resonance techniques.
The primary advantage of MRI is extremely high contrast resolution between different tissue types, including blood. Moreover, MRI is a true 3 dimensional imaging modality and images can be obtained in any oblique plane along the true cardiac axes while preserving high temporal and spatial resolution with precise demonstration of cardiac anatomy without the administration of contrast media.
Due to these properties, MRI can precisely characterize cardiac function and quantify cavity volumes, ejection fraction, and left ventricular mass. In addition, cardiac MRI has the ability to quantify flow (see flow quantification), including bulk flow in vessels, pressure gradients across stenosis, regurgitant fractions and shunt fractions. Valve morphology and area can be determined and the severity of stenosis quantified. In certain disease states, such as myocardial infarction, the contrast resolution of MRI is further improved by the addition of extrinsic contrast agents (see myocardial late enhancement).
A dedicated cardiac coil, and a field strength higher than 1 Tesla is recommended to have sufficient signal. Cardiac MRI acquires ECG gating. Cardiac gating (ECGs) obtained within the MRI scanner, can be degraded by the superimposed electrical potential of flowing blood in the magnetic field. Therefore, excellent contact between the skin and ECG leads is necessary. For male patients, the skin at the lead sites can be shaved. A good cooperation of the patient is necessary because breath holding at the end of expiration is practiced during the most sequences.

See also Displacement Encoding with Stimulated Echoes.
For Ultrasound Imaging (USI) see Cardiac Ultrasound at Medical-Ultrasound-Imaging.com.

See also the related poll results: 'In 2010 your scanner will probably work with a field strength of' and 'MRI will have replaced 50% of x-ray exams by'
 
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Further Reading:
  Basics:
Cardiac MRI - Technical Aspects Primer
Wednesday, 7 August 2002
Prediction of Myocardial Viability by MRI
1999   by circ.ahajournals.org    
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MRI technology visualizes heart metabolism in real time
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Tuesday, 15 February 2022   by www.sciencedaily.com    
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Wednesday, 19 February 2020   by www.dicardiology.com    
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Friday, 13 May 2016   by www.upi.com    
Precise visualization of myocardial injury: World's first patient-based cardiac MRI study using 7T MRI
Wednesday, 10 February 2016   by medicalxpress.com    
New technique could allow for safer, more accurate heart scans
Thursday, 10 December 2015   by www.gizmag.com    
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Flow phenomena are intrinsic processes in the human body. Organs like the heart, the brain or the kidneys need large amounts of blood and the blood flow varies depending on their degree of activity. Magnetic resonance imaging has a high sensitivity to flow and offers accurate, reproducible, and noninvasive methods for the quantification of flow. MRI flow measurements yield information of blood supply of of various vessels and tissues as well as cerebro spinal fluid movement.
Flow can be measured and visualized with different pulse sequences (e.g. phase contrast sequence, cine sequence, time of flight angiography) or contrast enhanced MRI methods (e.g. perfusion imaging, arterial spin labeling).
The blood volume per time (flow) is measured in: cm3/s or ml/min. The blood flow-velocity decreases gradually dependent on the vessel diameter, from approximately 50 cm per second in arteries with a diameter of around 6 mm like the carotids, to 0.3 cm per second in the small arterioles.

Different flow types in human body:
Behaves like stationary tissue, the signal intensity depends on T1, T2 and PD = Stagnant flow
Flow with consistent velocities across a vessel = Laminar flow
Laminar flow passes through a stricture or stenosis (in the center fast flow, near the walls the flow spirals) = Vortex flow
Flow at different velocities that fluctuates = Turbulent flow

See also Flow Effects, Flow Artifact, Flow Quantification, Flow Related Enhancement, Flow Encoding, Flow Void, Cerebro Spinal Fluid Pulsation Artifact, Cardiovascular Imaging and Cardiac MRI.
 
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Further Reading:
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The super-fast MRI scan that could revolutionise heart failure diagnosis
Wednesday, 21 September 2022   by www.eurekalert.org    
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Phase Contrast AngiographyMRI Resource Directory:
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(PCA) With this method images of the blood flow-velocity (or any other movement of tissue) are produced. The MRI signal contains both amplitude and phase information. The phase information can be used with subtraction of images with and without a velocity encoding gradient. The signal will be directly proportional to the velocity because of the relation between blood flow-velocity and signal intensity.
This is the strength of PCA, complete suppression of stationary tissue (no velocity - no signal), the direct velocity of flow is being imaged, while in TOF (Inflow) angiography, tissue with short T1 (fat or methaemoglobin) might be visualized.
The strength of the gradient determines the sensitivity to flow. It is set by setting the aliasing or encoding velocity (VENC). Unfortunately, phase sensitization can only be acquired along one axis at a time. Therefore, phase contrast angiographic techniques tend to be 4 times slower than TOF techniques with the same matrix.

See also Phase Contrast Sequence, Magnetic Resonance Angiography, Contrast Enhanced Magnetic Resonance Angiography, Flow Effects and Flow Quantification.
 
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Further Reading:
  Basics:
Magnetic resonance angiography: current status and future directions
Wednesday, 9 March 2011   by www.jcmr-online.com    
  News & More:
MR–ANGIOGRAPHY(.pdf)
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