Quantification of Steady- State Perfusion Rates Using Flow- Sensitive Alternating Inversion Recovery with an Extra Radiofrequency Pulse

(FAIRER)
V.M. Mai,"2 J. Knight-Scott,l D.F. Kallmes,l W. Marx,' W.S. Cail," J.S. Christopher,l, and S.S. Berr 2

University of Virginia Health Sciences Center, Departments of Radiology' and Biomedical Engineering2, Charlottesville, VA 22903

Introduction Tissue perfusion is an important physiological parameter for the assessment of pathological processes where perfusion is disturbed, such as in brain ischemia or central nervous system (CNS) tumors. MR offers a powerful method to noninvasively measure qualitative and quantitative perfusion using endogenous arterial water as a freely diffusible tracer. One of the most widely used perfusion imaging methods is Flow-sensitive Alternating Inversion 1,2 Recovery (FAIR)'2 Two inherent problems associated with FAIR's are: 1) the order of the magnitude image subtraction is inconsistent,' and 2) the image quality of FAIR perfusion-weighted image at TI's between the null points of different tissues is poor. We present here a new method that resolves the aforementioned problems associated with FAIR. FAIRER uses an additional slice selective saturation pulse immediately after the preparatory inversion pulse.
Theory The modified Bloch equation for perfusion imaging is:3

Results Average measured perfusionrates for white and gray matter in normal volunteers are 39.6 + 10.8 ml 100 g'min' and 94. 5 + 6. 3 ml'100 g'lmin1, respectively. 1 L 1

0.
0

Time

0.
0o

Time

(a) (b) Figure 1. Simulation of inconsistent and consistent order of image subtraction of FAIR (a) and FAIRER (b), respectively. Open triangle is representative of selective IR (SI) and SISS, and solid triangle of
nonselective IR (NI) and NISS for FAIR and FAIRER. (a) At TI < tnul, MSI <MNI, and vice versa at TI > tnull. (b) MNISS < MsIss for all t.

dM(t) dt dt

Mo - M(t)
-

T1

+fMa(t)fMv(t),

[1]

where M(t) is the longitudinal magnetization of the tissue, t is the

time delay TI, Mo is the fully relaxed longitudinal magnetization of tissue water protons, T1 is the longitudinal relaxation time of tissue in
the absence of flow,f is the blood flow (ml'100g'lmin1), Ma is the

magnetization of arterial blood water, and Mv is the magnetization of venous blood water. A well-mixed compartment model has been assumed in that inverted arterial water exchanges instantaneously with
the tissue water, which allows the assumption that Mv(t) = M(t)/X,

where X (ml/g) is the tissue:blood partition coefficient. The time dependent solution of the saturation recovery (SR) of the tissue magnetization for the selective inversion, selective saturation (SISS) and the nonselective inversion, selective saturation (NISS) are

Figure 2. (a,b) FAIR difference images at TI=700 ms. (a) SI image is subtracted from NI image, where white matter has negative values, and vice versa in (b) NI subtracted from SI image. (c) FAIRER difference image at the same TI has none of the observed problems as in FAIR's.

Msi (t) = Mo
Mni (t) =

(1-

et/lTs,i ),

[2] [3]

Mo

(1-e- tIT,i ),

respectively, where Msi(t) is the longitudinal magnetization of the tissue in SISS, Mni(t) is the longitudinal magnetization of the tissue in
NISS, Tsii is the T1 of the tissue weighted by the inflowing of relaxed blood (1/Tlisi= 1/Ti +flk), and Tlni is the T1 of the tissue T1 weighted by the inflowing of inverted blood, (1/Tlni = 1/Tl -fiX). Tsii < Tlni for all time t, and as a result, Msi(t) > Mni(t), which allows for a consistent

order of image subtraction. AR1 and AT, are then

ARg1 = Rlsi Rlni

=2

f
A

[4]

t'
[5]

i AT1 - Tini-Tlsi
whereas AR1FAIR =fl,.

A=l

2 ~( ,. Tini) ,

When the difference between Tlblood and Titissue is taken into account, the solution to the Bloch equation for Mni(t) is then Mni (t)

= Msi (t)2- Mo

etlTlsi _ e- t/Tub
1 1

[6]

Tlb

Tlhi

where Tlb is Ti of blood. Equation [6] is the same equation derived by Kwong et al4 and Calamante et al. 5

Materials and Methods All experiments were performed on a VISION 1.5 T Magnetom system (Siemens Medical Systems, Iselin, NJ) with maximum gradient strengths and slew rates of 25 mT/m and 83 T/m/s, respectively. FAIR and FAIRER images were acquired from five normal volunteers and FAIRER images from a patient volunteer with pathologically confirmed recurrent meningioma.

Figure 3. (a) T2-weighted image with hyperyascular meningioma (arrows), (b) AT1 map, (c) ARI map, and (d) calculated perfusion map from Eq. [6], which shows better gray-white contrast and conspicuity than AT, and ARi. Conclusion We have shown that FAIRER resolves two problems associated with FAIR and its AR1 has better dynamic range than that of FAIR. We have demonstrated that quantification of steady-state perfusion rates is possible using FAIRER. Also, we show preliminary evidence that FAIRER may be able to detect hypervascularity in tumors. References 1. Kwong et al. Proc. Natl. Acad. Sci. U.S.A. 89: 5675- 5679, 1992. 2. Kim et al. MRM 34:293-301, 1995. 3. Detre et al. MRM 23: 37- 45, 1992. 4. Kwong et al. MRM 34: 878-887, 1995. 5. Calamante et al. NMR in Biomedicine 8: 79-83, 1996.