A black-blood ultra-short echo time (UTE) sequence for 3D isotropic resolution imaging of the lungs

Ultra-short echo time MRI is a promising alternative to chest CT for cystic fibrosis patients. Black-blood imaging in particular could help discern small-sized anomalies, such as mucoid plugging, which may otherwise be confused with neighboring blood vessels, particularly when contrast agent is not used. We, therefore, implemented and tested an ultra-short echo time sequence with black-blood preparation. Additionally, this sequence may also be used to generate bright-blood angiograms.

Using this sequence, data was acquired during free breathing in 10 healthy volunteers to obtain respiratory-motion-resolved 3D volumes covering the entire thorax with an isotropic resolution of (1 mm)³ . The magnitude of signal suppression relative to a bright-blood reference acquisition was quantified and compared with that obtained with a turbo-spin echo (TSE) acquisition. Bright-blood angiograms were also generated by subtraction. Finally, an initial feasibility assessment was performed in 2 cystic fibrosis patients, and images were visually compared with contrast-enhanced images and with CT data.

Black-blood preparation significantly decreased the average normalized signal intensity in the vessel lumen (-66%; P < 0.001). Similarly, blood signal was significantly lowered (-60%; P = 0.001) compared with the TSE acquisition. In patients, mucoid plugging could be emphasized in the black-blood datasets. An intercostal artery could also be visualized in the subtraction angiograms.

Black-blood free-breathing ultra-short echo time imaging was successfully implemented and motion-resolved full volumetric coverage of the lungs with high spatial resolution was achieved, while obtaining an angiogram without contrast agent injection. Encouraging initial results in patients prompt further investigations in a larger cohort.