Joint blood and cerebrospinal fluid suppression for intracranial vessel wall MRI

PURPOSE: To develop and evaluate a joint blood and cerebrospinal fluid (CSF) suppression technique for improved intracranial vessel wall MR imaging. METHODS: The Delay Alternating with Nutation for Tailored Excitation (DANTE) prepulse was specifically optimized for CSF suppression to improve vessel wall and CSF contrast. It was evaluated on six patients and three healthy volunteers. CSF suppression efficiency, lumen signal to noise ratio, and wall-lumen contrast to noise ratio were compared between images with and without DANTE in major intercranial artery segments. Contrast changes in tissues were also compared with evaluate the technique's compatibility with multicontrast imaging techniques. RESULTS: The optimized DANTE images significantly improved intracranial vessel wall characterization on all images. Quantitatively, CSF to wall contrast improved by 28% (DANTE-VISTA 1.354 ± 0.216 versus VISTA 1.057 ± 0.13; P < 0.001). DANTE also significantly improved wall-lumen (10.55 ± 3.79 versus 9.34 ± 3.54; P < 0.001) and wall-CSF (4.62 ± 3.19 versus 0.78 ± 2.30; P < 0.001) contrast-to-noise ratios. DANTE prepared images were also found to make only minimal impact on static tissue contrast. CONCLUSION: DANTE prepared MR imaging can significantly improve contrast between the vessel wall and cerebral spinal fluid in major intracranial arteries, holding a good potential to be combined with multicontrast protocol for intracranial wall imaging.