Optimizing scan efficiency of T1-weighted imaging for whole-brain intracranial vessel wall imaging

Clinical intracranial vessel wall imaging (VWI) requires high spatial resolution leading to long scan times and artifacts.

To accelerate standard-of-care (SOC) 3D T1-weighted variable-flip-angle turbo-spin-echo (VFA-TSE) sequence with parallel imaging (Generalized Autocalibrating Partially Parallel Acquisitions, GRAPPA) using compressed sensing (CS) or Controlled Aliasing in Parallel Imaging Results in Higher Acceleration (CAIPIRINHA, CAIPI) with either standard or large field-of-view (FOV) configurations to reduce scan time, artifacts and accommodate head sizes.

Prospective study.

Ten healthy volunteers.

3 Telsa, 20-channel head coil, T1-weighted VFA-TSE.

Accelerated sequences were compared to SOC GRAPPA (R=2), including standard FOV CAIPI (SFCAIPI, R=4), CS (SFCS7, R=7), and large FOV CS (LFCS7, R=7; LFCS10, R=10). Four neuroradiologists rated image quality (IQ) and signal-to-noise ratio (SNR) using a 4-point Likert scale. Scores of 3-4 were categorized as clinically interpretable. Lumen and wall diameters were measured.

Descriptive statistics are reported. McNemar's test compared proportions of IQ- and SNR-based clinically interpretable scans between relevant sequences of interest. Inter- and intra-rater reliabilities were calculated with Fleiss Kappa and weighted Cohen's Kappa, respectively. Lumen and wall diameters of the CS- and CAIPI-accelerated sequences were compared to SOC using paired t-tests.

SFCAIPI showed the lowest mean IQ and SNR scores. SFCS7 showed no significant difference in the proportion of IQ-based clinically interpretable scans compared to SFGRAPPA. When testing FOV, LFCS7 (35/40 scans; time of acquisition (TA)=3:45) showed a significantly higher proportion of IQ-based clinically interpretable scans compared to SFCS7 (27/40, p=0.03; TA=6:37). Upon increasing acceleration (R=10), there was no difference in the proportion of IQ-based clinically interpretable scans between LFCS7 and LFCS10 (36/40, p=0.65). Large FOV eliminated aliasing artifacts compared standard FOV (aliasing in 7 of 10 subjects). LFCS10 (TA=4:55) achieved a 50.6% reduction in TA relative to SFGRAPPA (TA=9:57).

Large FOV CS VWI sequence with 10x acceleration achieved a 50.6% reduction in scan time while delivering image quality comparable to SOC standard FOV GRAPPA.