Radial sliding-window magnetic resonance angiography (MRA) with highly-constrained projection reconstruction (HYPR)

Sufficient temporal resolution is required to image the dynamics of blood flow, which may be critical for accurate diagnosis and treatment of various intracranial vascular diseases, such as arteriovenous malformations (AVMs) and aneurysms. Highly-constrained projection reconstruction (HYPR) has recently become a technique of interest for high-speed contrast-enhanced magnetic resonance angiography (CE-MRA). HYPR provides high frame rates by preferential weighting of radial projections while maintaining signal-to-noise ratio (SNR) by using a high SNR composite. An analysis was done to quantify the effects of HYPR on SNR, contrast-to-noise ratio (CNR), and temporal blur compared to the previously developed radial sliding-window technique using standard filtered backprojection or regridding methods. Computer simulations were performed to study the effects of HYPR processing on image error and the temporal information. Additionally, in vivo imaging was done on patients with angiographically confirmed AVMs to measure the effects of alteration of various HYPR parameters on SNR as well as the fidelity of the temporal information. The images were scored by an interventional radiologist in a blinded read and were compared with X-ray digital subtraction angiography (DSA). It was found that with the right choice of parameters, modest improvements in both SNR and dynamic information can be achieved as compared to radial sliding-window MRA.