DANTE-prepared three-dimensional FLASH: A fast isotropic-resolution MR approach to morphological evaluation of the peripheral arterial wall at 3 tesla

Background To develop and assess a sequence using DANTE dark-blood preparation combined with FLASH readout (DANTE-FLASH) for rapid isotropic-resolution three-dimensional (3D) peripheral vessel wall imaging at 3 Tesla (T). Methods Numerical simulations were first conducted to optimize imaging parameters for maximizing the wall-lumen contrast. The sequence, implemented at 3T, was then assessed in the bilateral superficial femoral arteries of eight healthy volunteers and three patients who were undergoing non-contrast-enhanced MRA due to known peripheral artery disease. Conventional 2D dark-blood turbo spin echo (DB-TSE) was performed as a reference in all subjects. Image quality on a 5-point scale, apparent wall signal-to-noise ratio, apparent wall-lumen contrast-to-noise ratio, wall thickness, wall area and lumen area were assessed or measured in all healthy subjects. Additionally, the agreement in the depiction of wall thickening or luminal stenosis between DANTE-FLASH and DB-TSE, or MRA was assessed using a 4-point scale in the patient study. Results DANTE-FLASH allowed for a 30-cm-long coverage within 4 min, whereas DB-TSE took approximately 7 min for a 9-cm-long coverage. Good image quality was obtained by DANTE-FLASH (score > 3). The wall thickness, wall area, and lumen area were all comparable (t-test; P = 0.334, 0.224 and 0.136) and showed excellent agreement between DANTE-FLASH and DB-TSE (intra-class correlation = 0.81, 0.85, and 0.98). The atherosclerotic plaques and luminal stenosis identified by DANTE-FLASH were in accordance with the findings by 2D DB-TSE or MRA. Conclusion DANTE-FLASH is a 3D dark-blood MR sequence allowing for rapid isotropic-resolution imaging of the peripheral vessel wall at 3T. J. Magn. Reson. Imaging 2016;43:343-351.