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Clinical Application of Balanced Steady-State Free Precession Technique in Neuroradiology

Clinical Application of Balanced Steady-State Free Precession Technique in Neuroradiology. Yueh-hsun Lu Hsiu-mei Wu Jiing-feng Limg Wan-yuo Guo Cheng-yen Chang Taipei Veterans General Hospital, Taiwan National Yang-Ming University, Taiwan. Properties of b-SSFP.

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Clinical Application of Balanced Steady-State Free Precession Technique in Neuroradiology

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  1. Clinical Application of Balanced Steady-State Free Precession Technique in Neuroradiology Yueh-hsun Lu Hsiu-mei Wu Jiing-feng Limg Wan-yuo Guo Cheng-yen Chang Taipei Veterans General Hospital, Taiwan National Yang-Ming University, Taiwan

  2. Properties of b-SSFP • Total coherent steady-state magnetization • Image contrast is given by T2/T1 ratio high signal of fluid and fat, and low signal of soft tissues • Within a certain range, field inhomogeneity induced dephasing will be nearly completely refocused at TE=TR/2 (~SE)

  3. Balanced Steady-State Free Precession Scheffler Eur Radiol 2003 13:2409–2418

  4. Clinical Application in Neuroradiology • Ventriculocisternography • MR myelography with brachial plexus injury • CSF leakage • Delineation of intracranial cystic lesion

  5. Ventriculocisternography

  6. Ventriculocisternography ↖ Obstructive hydrocephalus

  7. Presurgical Evaluation for Hydrocephalus

  8. MR myelogram and brachial plexus image

  9. Brachial Plexus Imaging T2WI Axi FIESTA

  10. Brachial Plexus Injury 31y/o M, Post Motorcycle Accident

  11. CSF Leakage • Traumatic cause • Iatrogenic cause

  12. Post Traumatic CSF Leakage CT with bone window T2WI

  13. Post Traumatic CSF Leakage Axi 3D FIESTA COR 3D FIESTA

  14. Post TSA CSF Rhinorrhea • 2D FSE T2WI 2mm 3D FIESTA 1mm TR/TR/FA: 4.88/1.38/65

  15. ↖ 3D FIESTA 1mm TR/TR/FA: 4.88/1.38/65

  16. Delineation of cystic lesion • Demonstration of normal structure

  17. Diagnosis and Delineation of Arachnoid Cyst 3-month-boy, Arachnoid cyst with hydronephrosis

  18. 3D b-SSFP DWI FLAIR Delineation of Epidermoid Cyst 61/M, right trigeminal neuralgia for 3 years

  19. Delineation of Cranial Nerves: CN 7th and 8th 77/M vertigo attacks in recent weeks

  20. Detection and Delineation of Small Intracannalicular Acoustic Neuroma

  21. Discussion • The quality of image is somehow machine and parameter dependent. Magnetic inhomogeneity will cause artifacts, such as banding artifact. • Flip angle effect and section aliasing effect. • Proper selection of TR/TE/Flip angle would improve the quality of image.

  22. α=70 ° α=50 ° α=30 ° Section Aliasing Artifacts flip angle effect alone is an important factor that presents an obvious tradeoff between image contrast and aliasing artifacts in 3D SSFP MR ventriculocisternography. AJNR 26:1170–1173, May 2005

  23. Conclusion • b-SSFP offers the highest SNR per unit time of all other imaging sequences. • The dynamic equilibrium of b-SSFP is insensitive to flow or motion. • It can provide the high resolution of ventriculocystography for delineation of CSF space lesion, cranial nerve, intradural cervical nerve roots and detection of CSF leakage.

  24. Thank You For Your Attention The 101 Building, Taipei, Taiwan

  25. Imaging of Membranous Labyrinth 26

  26. Imaging of 3D Membranous Labyrinth 75y/o m, TR/TE 6.9x1.7, 0.4mm, 14x14cm 488x256

  27. Artifacts of b-SSFP • Banding artifact • Section aliasing artifact • Acquisition artifact • Susceptibility artifact

  28. Banding Artifact

  29. FIESTA C

  30. FOV 20x20 cm 182 slicesTR/TE/a: 5.49/1.47/65NEX:2Matrix 448x256Slice thickness: 1.4 0.7 cm FOV 24x24 cm 232 slicesTR/TE/a: 5.63/1.37/65NEX:2Matrix 448x256Slice thickness: 1.4 0.7 mm

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